Sample records for psychiatric day hospital

  1. Psychiatric treatment outcomes of preschool children in a family day hospital.

    PubMed

    Müller, Jörg Michael; Averbeck-Holocher, Marlies; Romer, Georg; Fürniss, Tilman; Achtergarde, Sandra; Postert, Christian

    2015-04-01

    This study describes the treatment outcomes of preschoolers with severe mental health problems who were treated at the child psychiatric family day hospital for preschool children in Münster, Germany. The eclectic multi-modal treatment combines behavioral and psychodynamic techniques for both parents and children in various settings within an intermittent attendance structure provided by a multi-disciplinary team. This study evaluated 185 children with the Caregiver-Teacher Report Form (C-TRF/1.5-5), which was completed by therapists, and the Child Behavior Checklist (CBCL/1.5-5), which was completed by mothers, at admission and discharge. The mothers' ratings of their children were statistically adjusted for the distortion caused by their own psychopathology. After treatment, the patients showed significant improvement on the C-TRF/CBCL Total Problem score with an average Cohen's d = -0.50 based on therapists' ratings, d = -0.97 for the non-adjusted maternal ratings, and d = -0.68 for the adjusted maternal ratings. We conclude that specialized family day hospitals may successfully treat preschool psychiatric patients. PMID:25716180

  2. A CBT Approach to Inpatient Psychiatric Hospitalization

    ERIC Educational Resources Information Center

    Masters, Kim J.

    2005-01-01

    During a psychiatric hospitalization of 5 to 10 days, cognitive-behavioral therapy (CBT) strategies can be used for the management of inpatients and to support the transition to outpatient treatment. This format was chosen after several years of frustration dealing with crisis inpatient care. The use of CBT is well known, and it seemed that an…

  3. Inpatient Suicide in a Chinese Psychiatric Hospital

    ERIC Educational Resources Information Center

    Li, Jie; Ran, Mao-Sheng; Hao, Yuantao; Zhao, Zhenhuan; Guo, Yangbo; Su, Jinghua; Lu, Huixian

    2008-01-01

    Little is known about the risk factors for suicide among psychiatric inpatients in China. In this study we identified the risk factors of suicide among psychiatric inpatients at Guangzhou Psychiatric Hospital. All psychiatric inpatients who died by suicide during the 1956-2005 period were included in this study. Using a case-control design, 64…

  4. [The function of the independent day clinic in psychiatric treatment].

    PubMed

    Engelke, W

    1989-11-01

    This report on the first ten years of the independent day hospital for psychiatric patients at Siegburg, West Germany, is based on the special nature and position of the hospital within the pattern of psychiatric hospital care as is being practised in W. Germany, where such hospitals are being run with provincial (Land)government supervision and management, and also in consideration of the fact that very little concrete experience has so far been collected on the independent hospitals. Geographical and social data are described and the changes that have taken place in the psychiatric patient care system in West Germany, as well as the changes in proportionate distribution of diagnoses of the patients, are considered. Differentiation of patient groups according to the development of their strategies for psychotic and borderline patients are worked out on this basis. Hence, this type of independent day hospital ceases to be a transitory affair and has evolved a therapeutic approach of its own. PMID:2608764

  5. Medication safety in a psychiatric hospital

    Microsoft Academic Search

    Jeffrey M. Rothschild; Klaus Mann; Carol A. Keohane; Deborah H. Williams; Cathy Foskett; Stanley L. Rosen; James A. Chu; David W. Bates

    2007-01-01

    Objective: We sought to assess the epidemiology of medication errors (MEs) and adverse drug events (ADEs) in a psychiatric hospital. Methods: We conducted a 6-month prospective observational study in a 172-bed academic psychiatric hospital. Errors and ADEs were found by way of chart review, staff reports and pharmacy intervention reports. Physicians rated incidents as to the presence of injury, preventability

  6. 42 CFR 409.63 - Reduction of inpatient psychiatric benefit days available in the initial benefit period.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...entitlement are not subtracted under paragraph (a) of this section even if the stay was for diagnosis or treatment of mental illness. (2) After entitlement, all psychiatric care days, whether in a general or a psychiatric hospital, are...

  7. A SOCIO-DEMOGRAPHIC, PSYCHIATRIC AND MEDICAL PROFILE OF INPATIENT SUICIDE ATTEMPTERS IN A PSYCHIATRIC HOSPITAL OF PUERTO RICO Gabriel L. Martínez, MD

    Microsoft Academic Search

    Raquel Herrero; Christine Fabelo; Diana Diaz; Vilma McCarty

    Objectives: Describe the socio-de- mographic, medical, and psychiatric profile of patients who attempted sui- cide in a psychiatric hospital of Puerto Rico during the period of March 2005 to March 2007. Identify the methods most frequently used; also days, time, and observation level of the patient at the time of the attempt. Method: Inpatient suicidal attempts in a state psychiatric

  8. [Inpatient management of adolescent psychiatric patients. A single day study].

    PubMed

    Braun-Scharm, H; Räder, K; Martinius, J

    1991-06-01

    The distribution of disorders in a one-day sample of 1806 adolescents receiving inpatient psychiatric care and classified with the diagnostic system ICD-9 is described. Of the inpatient psychiatric facilities for adolescents in the Federal Republic of Germany and West Berlin, 85% responded to our questionnaire. The main findings were: 1) More of the inpatients were male than female (1:0.8); 2) 80% of the patients were being treated at non-university facilities; 3) differences in diagnose between university and other hospitals were small and concerned only psychosis, eating disorders and oligophrenia; 4) the most frequent diagnoses were psychosis and neurosis (20% each), followed by special symptoms/syndromes and conduct disorders (between 10% and 15% each) and emotional disorders (10%); 5) other disorders were less common (under 10% each); 6) a comparison of the different Länder in the Federal Republic indicated that some regions do not have enough inpatient facilities. PMID:1887692

  9. 42 CFR 482.60 - Special provisions applying to psychiatric hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Requirements for Specialty Hospitals § 482.60 Special provisions applying to psychiatric hospitals. Psychiatric hospital must— (a) Be primarily...61; and (d) Meet the staffing requirements specified...

  10. 42 CFR 482.60 - Special provisions applying to psychiatric hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Requirements for Specialty Hospitals § 482.60 Special provisions applying to psychiatric hospitals. Psychiatric hospital must— (a) Be primarily...61; and (d) Meet the staffing requirements specified...

  11. 42 CFR 482.60 - Special provisions applying to psychiatric hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Requirements for Specialty Hospitals § 482.60 Special provisions applying to psychiatric hospitals. Psychiatric hospital must— (a) Be primarily...61; and (d) Meet the staffing requirements specified...

  12. 42 CFR 482.60 - Special provisions applying to psychiatric hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Requirements for Specialty Hospitals § 482.60 Special provisions applying to psychiatric hospitals. Psychiatric hospital must— (a) Be primarily...61; and (d) Meet the staffing requirements specified...

  13. The dynamics of psychiatric bed use in general hospitals.

    PubMed

    Slade, Eric P; Goldman, Howard H

    2015-03-01

    This study examines general hospitals' adjustments in psychiatric bed utilization practices in response to increases in psychiatric inpatient admissions. Using panel data from 439 hospitals, monthly observations (N = 7,831) between 2007 and 2010 on psychiatric admissions, psychiatric bed occupancy rates, and average length-of-stay were created for psychiatric inpatients. In fixed-effects regressions, an increase in psychiatric admissions was associated with an increase in the probability of psychiatric bed use exceeding 100 % occupancy and with a reduction of mean length-of-stay. These results were confirmed in instrumental variables models. General hospitals may dynamically adjust bed utilization practices in response to changing psychiatric bed needs. An implication of this dynamic adjustment model is that bed shortages are likely to be local, transitory events. PMID:24756929

  14. [Solitary confinement as risk factor for psychiatric hospitalization].

    PubMed

    Volkart, R; Rothenfluh, T; Kobelt, W; Dittrich, A; Ernst, K

    1983-01-01

    The subjects of this study are prisoners who were hospitalized from custody in a psychiatric clinic. All of such patients of one psychiatric clinic during the period from 1976 till 1978 were compared with a random sample of other psychiatric patients using case reports and other data. Differences were found concerning social, personal, psychiatric, and criminal history as well as psychopathological state and diagnosis. Compared to the complete population of prisoners of the area, prisoners from solitary confinement (mostly remanding custody) were overrepresented. Other risk factors for psychiatric hospitalization of prisoners are described. The results are discussed from prophylactic, therapeutic, and humanitarian points of view. PMID:6647886

  15. Elements of Successful School Reentry after Psychiatric Hospitalization

    ERIC Educational Resources Information Center

    Clemens, Elysia V.; Welfare, Laura E.; Williams, Amy M.

    2011-01-01

    Psychiatric hospitalization is an intensive intervention designed to stabilize adolescents who are experiencing an acute mental health crisis. Reintegrating to school after discharge from psychiatric hospitalization can be overwhelming for many adolescents (E. V. Clemens, L. E. Welfare, & A. M. Williams, 2010). The authors used a consensual…

  16. Worsening psychosis induced by varenicline in a hospitalized psychiatric patient.

    PubMed

    DiPaula, Bethany A; Thomas, Michele D

    2009-07-01

    Varenicline is a novel treatment for smoking cessation; however, the agent has not been well studied in a population with severe mental illness. Varenicline can reportedly cause neuropsychiatric adverse effects, some resulting in hospitalizations and/or suicides. We describe a case of clinician-observed, worsening psychotic symptoms in a patient with chronic mental illness who was receiving varenicline. A 45-year-old woman with bipolar disorder, mixed type with psychotic features, was admitted to a psychiatric hospital due to acute decompensation after she discontinued her drug therapy. Because of the facility's smoke-free policy, the patient was not permitted to smoke cigarettes during her hospitalization. Over the next several weeks, her condition was stabilized with psychotropic drugs. Her symptoms improved, and plans were made for her discharge. Varenicline was prescribed to manage her nicotine cravings. After 2 days of treatment, staff members noted worsening of the patient's psychotic symptoms and agitation. Varenicline was discontinued, the patient's mental status returned to baseline, and she was subsequently discharged. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 7) between the patient's worsening psychosis and her varenicline therapy. This case report provides valuable support of previously published cases that demonstrate the risk of exacerbation of psychotic symptoms with varenicline use in patients with severe mental illness. With proper assessment and management of varenicline-induced neuropsychiatric effects, health care professionals can provide an important role in helping to prevent and manage worsening psychiatric symptoms. PMID:19558259

  17. 28 CFR 549.45 - Involuntary hospitalization in a suitable facility for psychiatric care or treatment.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...suitable facility for psychiatric care or treatment. 549.45 Section 549.45 Judicial...SERVICES Psychiatric Evaluation and Treatment § 549.45 Involuntary hospitalization...suitable facility for psychiatric care or treatment. (a) Hospitalization of...

  18. 28 CFR 549.45 - Involuntary hospitalization in a suitable facility for psychiatric care or treatment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...suitable facility for psychiatric care or treatment. 549.45 Section 549.45 Judicial...SERVICES Psychiatric Evaluation and Treatment § 549.45 Involuntary hospitalization...suitable facility for psychiatric care or treatment. (a) Hospitalization of...

  19. 28 CFR 549.45 - Involuntary hospitalization in a suitable facility for psychiatric care or treatment.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...suitable facility for psychiatric care or treatment. 549.45 Section 549.45 Judicial...SERVICES Psychiatric Evaluation and Treatment § 549.45 Involuntary hospitalization...suitable facility for psychiatric care or treatment. (a) Hospitalization of...

  20. Psychiatric Hospitalization Among Children with Autism Spectrum Disorders

    Microsoft Academic Search

    David S. Mandell

    2008-01-01

    This study examined predictors of psychiatric hospitalization among children with autism spectrum disorders (ASD). Data were\\u000a collected from 760 caregivers of children with ASD. Cox regression was used to determine factors associated with hospitalization.\\u000a Almost 11% were hospitalized. Youth in single parent homes were more likely to be hospitalized (OR = 2.54), as were youth\\u000a diagnosed at a later age (OR = 1.10). Engaging

  1. Good days and bad days: the experiences of children of a parent with a psychiatric disability.

    PubMed

    Riebschleger, Joanne

    2004-01-01

    Twenty-two children, ages 5 to 17, described their experiences living within a family that included a parent with a psychiatric disability who was involved in community mental health agency services. The children's descriptions of parents' "good days" and "bad days" were captured in a secondary data analysis of a study that included face-to-face children's interviews. Children also discussed their perceptions of psychiatric disabilities and rehabilitation. Children reported more attention from parents on "good days." They expressed concerns about multiple family stressors and bias associated with psychiatric disability. They had little information about psychiatric disabilities and/or rehabilitation. Children recommended "Get help earlier." PMID:15468633

  2. Prevalence and Correlates of Autism in a State Psychiatric Hospital

    ERIC Educational Resources Information Center

    Mandell, David S.; Lawer, Lindsay J.; Branch, Kira; Brodkin, Edward S.; Healey, Kristin; Witalec, Robert; Johnson, Donielle N.; Gur, Raquel E.

    2012-01-01

    This study estimated the ASD prevalence in a psychiatric hospital and evaluated the Social Responsiveness Scale (SRS) combined with other information for differential diagnosis. Chart review, SRS and clinical interviews were collected for 141 patients at one hospital. Diagnosis was determined at case conference. Receiver operating characteristic…

  3. THE DEVELOPMENT AND ORGANIZATION OF A CHILDREN'S PSYCHIATRIC HOSPITAL.

    PubMed

    ATCHESON, J D; ALDERTON, H R

    1964-07-25

    Thistletown Hospital is a children's psychiatric hospital which was established by the Department of Health of the Province of Ontario. Special legislation permitting control of the admissions procedures was enacted. The administrative organization consists of a series of committees made up of the heads of hospital departments. An advisory board of distinguished psychiatrists and psychologists advises the Minister of Health directly on major policy changes or innovations envisaged for the hospital. Clinical organization is related to four functions: (1) service (treatment and assessment), (2) research, (3) training of staff, and (4) community education.The basic units of the hospital are related to the treatment or research design necessary in special diagnostic categories. A children's psychiatric hospital should not be restricted to in-patient facilities but should consist of a totally community-oriented service. PMID:14180525

  4. The Jewish psychiatric hospital, Zofiówka, in Otwock, Poland.

    PubMed

    Seeman, Mary V

    2015-03-01

    The T4 euthanasia programme within Nazi Germany has been well researched, but much less is known about the extermination of psychiatric patients in Nazi-occupied territories during the same period. In Poland 20,000 mentally ill patients were deliberately killed during the German occupation. This paper traces the history of one psychiatric hospital, Zofiówka, in Otwock, south-east of Warsaw. The hospital once served the Jewish population of Poland and was the largest, most prestigious neuropsychiatric centre in the country. It is now in ruins and said to be haunted by ghosts. PMID:25698689

  5. Problems of female patients in a secure psychiatric hospital

    Microsoft Academic Search

    Mary McMurran; Pauline Clerkin; Harold Rosenberg

    1997-01-01

    The problems experienced by a sample of 30 female offender-patients in a secure psychiatric hospital were surveyed using the Behavioral Coding System (BCS). Common problems are emotional difficulties, antisocial behaviors, auditory hallucinations, and self-injury. Problem profiles derived from medical records, key workers' reports, and patients' self reports differed. The survey revealed the necessity of revising the BCS better to identify

  6. Examining Outcomes of Acute Psychiatric Hospitalization among Children

    Microsoft Academic Search

    Priya R. Tharayil; Sigrid James; Ronald Morgan; Kimberly Freeman

    2011-01-01

    Within the past two decades, few studies have examined outcomes of acute psychiatric hospitalization among children, demonstrating change in emotional and behavioral functioning. A secondary analysis of pre-test\\/post-test data collected on 36 children was conducted, using the Target Symptom Rating (TSR). The TSR is a 13-item measure with two subscales – Emotional Problems and Behavioral Problems and was designed for

  7. READMIT: a clinical risk index to predict 30-day readmission after discharge from acute psychiatric units.

    PubMed

    Vigod, Simone N; Kurdyak, Paul A; Seitz, Dallas; Herrmann, Nathan; Fung, Kinwah; Lin, Elizabeth; Perlman, Christopher; Taylor, Valerie H; Rochon, Paula A; Gruneir, Andrea

    2015-02-01

    Our aim was to create a clinically useful risk index, administered prior to discharge, for determining the probability of psychiatric readmission within 30 days of hospital discharge for general psychiatric inpatients. We used population-level sociodemographic and health administrative data to develop a predictive model for 30-day readmission among adults discharged from an acute psychiatric unit in Ontario, Canada (2008-2011), and converted the final model into a risk index system. We derived the predictive model in one-half of the sample (n = 32,749) and validated it in the other half of the sample (n = 32,750). Variables independently associated with 30-day readmission (forming the mnemonic READMIT) were: (R) Repeat admissions; (E) Emergent admissions (i.e. harm to self/others); (D) Diagnoses (psychosis, bipolar and/or personality disorder), and unplanned Discharge; (M) Medical comorbidity; (I) prior service use Intensity; and (T) Time in hospital. Each 1-point increase in READMIT score (range 0-41) increased the odds of 30-day readmission by 11% (odds ratio 1.11, 95% CI 1.10-1.12). The index had moderate discriminative capacity in both derivation (C-statistic = 0.631) and validation (C-statistic = 0.630) datasets. Determining risk of psychiatric readmission for individual patients is a critical step in efforts to address the potentially avoidable high rate of this negative outcome. The READMIT index provides a framework for identifying patients at high risk of 30-day readmission prior to discharge, and for the development, evaluation and delivery of interventions that can assist with optimizing the transition to community care for patients following psychiatric discharge. PMID:25537450

  8. 28 CFR 549.44 - Voluntary hospitalization in a suitable facility for psychiatric care or treatment, and voluntary...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...suitable facility for psychiatric care or treatment, and voluntary administration of psychiatric...SERVICES Psychiatric Evaluation and Treatment § 549.44 Voluntary hospitalization...suitable facility for psychiatric care or treatment, and voluntary administration of...

  9. 28 CFR 549.44 - Voluntary hospitalization in a suitable facility for psychiatric care or treatment, and voluntary...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...suitable facility for psychiatric care or treatment, and voluntary administration of psychiatric...SERVICES Psychiatric Evaluation and Treatment § 549.44 Voluntary hospitalization...suitable facility for psychiatric care or treatment, and voluntary administration of...

  10. 28 CFR 549.44 - Voluntary hospitalization in a suitable facility for psychiatric care or treatment, and voluntary...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...suitable facility for psychiatric care or treatment, and voluntary administration of psychiatric...SERVICES Psychiatric Evaluation and Treatment § 549.44 Voluntary hospitalization...suitable facility for psychiatric care or treatment, and voluntary administration of...

  11. [Hospital legislation in the Federal Republic of Germany and its effects on psychiatric hospitals (author's transl)].

    PubMed

    Zumpe, V

    1978-02-01

    The article discusses the hospital laws of several land governments enacted subsequent to the hospital financing law of the Federal Government, in respect of the influence exercised by these laws on the internal structure of the hospital. The fact that the laws apply to all kinds of hospitals, and hence also to big psychiatric hospitals, is considered a disadvantage for psychiatric care. Such care is obviously hampered, on the one hand, by the legislative demand for departmentalization of the individual fields according to specialist subjects, representing a setup which is opposed to the realization of patient care in accordance with the requirements of the communities and citizens who expect to be cared for on an individual and not on a schematic basis, whereas, on the other hand, the new structures of management stipulated by the law do not provide for the inclusion of representatives of the new groups of professions now engaged in psychiatric activities. The model of regrouping the hospital structure into sectors instead of medical specialist departments, is presented and contrasted with the proposed model. It is recommended to arrange for representation of the non-medical and non-nursing professions in the managing boards, as well as to take into account the sociotherapeutico-rehabilitative interests as forming part of the conceptual approach to care in psychiatric hospitals, via special hospital committees. PMID:643974

  12. Examining Outcomes of Acute Psychiatric Hospitalization Among Children

    Microsoft Academic Search

    Priya R. Tharayil; Sigrid James; Ronald Morgan; Kimberly Freeman

    2012-01-01

    Within the past two decades, few studies have examined outcomes of acute psychiatric hospitalization among children, demonstrating change in emotional and behavioral functioning. A secondary analysis of pretest\\/posttest data collected on 36 children was conducted, using the Target Symptom Rating (TSR). The TSR is a 13-item measure with two subscales—Emotional Problems and Behavioral Problems and was designed for evaluation of

  13. Private psychiatric hospitals, United States: 1983-84 and 1986.

    PubMed

    Redick, R W; Stroup, A; Witkin, M J; Atay, J E; Manderscheid, R W

    1989-10-01

    In 1986, a total of 314 private psychiatric hospitals provided inpatient services in 47 States and the District of Columbia (D.C.); 114, outpatient care services in 35 States and D.C.; and 102, partial care services in 26 States and D.C. Between 1983 and 1986, the total number of inpatient, outpatient, and partial care episodes in these hospitals increased from 333,731 to 483,284. During the 1983-86 period, the number of private psychiatric hospitals increased from 220 to 314. Almost all of this increase occurred among hospitals operating on a for-profit basis. By 1986, these hospitals represented three-quarters of all private psychiatric hospitals. With the exception of small not-for-profit hospitals, all bed-size groups in private psychiatric hospitals increased between 1983 and 1986. The number of beds in private psychiatric hospitals increased 41 percent, from 21,474 in 1983 to 30,201 in 1986. Similarly, the number of inpatient additions increased from 164,732 to 234,663 in this period, and inpatients at end of year increased from 16,079 to 24,591. The number of outpatient additions increased by more than half, from 77,589 in 1983 to 123,355 in 1986, and the outpatients at the end of the year rose from 79,598 to 135,606 (70 percent). In the same period, the number of partial care additions increased from 5,642 to 8,820, and partial care patients at the end of the year rose from 3,218 to 3,856 (20 percent). In the 1986 year-end inpatient caseload, males slightly outnumbered females, and the patient population was predominantly white, non-Hispanic. About two-fifths of the patients were under age 18, slightly over half were age 18-64 years, and 8 percent were age 65 or older. Mental illness was the major disability, with alcohol and drug abuse a distant second. By comparison, a smaller proportion of patients were under age 18 in 1983 (31 percent), and a larger proportion were age 18-64 (61 percent). In outpatient and partial care services, a more even distribution of the sexes was generally observed. Proportionately fewer outpatients were under age 18, more were between 18 and 64, and fewer were diagnosed with alcohol and drug abuse, compared with inpatient services. Also, proportionately more outpatients were Hispanic. Concomitant increases occurred in the number of full-time equivalent (FTE) staff, as well as in the amount of money expended by private psychiatric hospitals. FTE staff increased from 42,202 in June 1984 to 58,912 in November 1986.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2586308

  14. Intriguing model significantly reduces boarding of psychiatric patients, need for inpatient hospitalization.

    PubMed

    2015-01-01

    As new approaches to the care of psychiatric emergencies emerge, one solution is gaining particular traction. Under the Alameda model, which has been put into practice in Alameda County, CA, patients who are brought to regional EDs with emergency psychiatric issues are quickly transferred to a designated emergency psychiatric facility as soon as they are medically stabilized. This alleviates boarding problems in area EDs while also quickly connecting patients with specialized care. With data in hand on the model's effectiveness, developers believe the approach could alleviate boarding problems in other communities as well. The model is funded by through a billing code established by California's Medicaid program for crisis stabilization services. Currently, only 22% of the patients brought to the emergency psychiatric facility ultimately need to be hospitalized; the other 78% are able to go home or to an alternative situation. In a 30-day study of the model, involving five community hospitals in Alameda County, CA, researchers found that ED boarding times were as much as 80% lower than comparable ED averages, and that patients were stabilized at least 75% of the time, significantly reducing the need for inpatient hospitalization. PMID:25564695

  15. 42 CFR 482.60 - Special provisions applying to psychiatric hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Special provisions applying to psychiatric hospitals. 482.60 Section 482.60 Public Health...CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Requirements for Specialty Hospitals § 482.60 Special provisions...

  16. Implementing psychiatric day treatment for infants, toddlers, preschoolers and their families: a study from a clinical and organizational perspective

    PubMed Central

    2013-01-01

    Background An increasing number of empirical studies indicate that infants, toddlers and preschoolers may suffer from non-transient mental illnesses featuring developmental psychopathology. A few innovative child psychiatric approaches have been developed to treat infants, toddlers and preschoolers and their families, but have not yet been conceptually presented and discussed in the framework of different healthcare systems. The organizational and clinical experience gained while developing specific approaches may be important across disciplines and guide future developments in psychiatric treatment of infants, toddlers, preschoolers and their families. Results This article introduces the Preschool Family Day Hospital for Infants, Toddlers and Preschoolers and their Families at Münster University Hospital, Germany. This hospital is unique in the German healthcare system with regard to its social-service institution division of labor. Specifically, it uses an intermittent treatment approach and an integrated interactional family psychiatric approach to treat children and their parents as separate patients. This multidisciplinary, developmentally and family-oriented approach includes components of group treatments with children and separate treatments with parents. Specific techniques include video-assisted treatments of the parent–child interaction, psychiatric and psychotherapeutic treatments for parents, and conjoint family therapies that include both parents and siblings. Conclusions The Family Day Hospital for infants, toddlers and preschoolers and their families offers innovative family-oriented treatments for those who suffer from a wide range of severe child psychiatric disorders that cannot be sufficiently treated in outpatient settings. Treatment is based on the need for family-oriented approaches to the early psychiatric treatment of infants, toddlers and preschoolers. Family day hospitals are an innovative approach to preschool child psychiatry that requires further evaluation. PMID:23601961

  17. Psychiatric disorders and clinical correlates of suicidal patients admitted to a psychiatric hospital in Tokyo

    PubMed Central

    2010-01-01

    Background Patients admitted to a psychiatric hospital with suicidal behavior (SB) are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan. Method 155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II) and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined. Results The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD). SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range) of the total number of SBs in the lifetime history was 7 (1-141). Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified. Conclusions Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission and frequent SB repetition in the lifetime history. Gender and age appeared to have an influence on SB method selection and SB-preceding processes. The findings have important implications for assessment and treatment of psychiatric suicidal patients. PMID:21144041

  18. Retrospective assessment of factors associated with readmission in a large psychiatric hospital in Guangzhou, China

    PubMed Central

    ZHOU, Yanling; ROSENHECK, Robert A.; MOHAMED, Somaia; FAN, Ni; NING, Yuping; HE, Hongbo

    2014-01-01

    Background Most psychiatric inpatients in China are involuntarily admitted by their families, resulting in relatively long admissions and relatively low readmission rates. However, this pattern may change after implementation of China’s new national mental health law (promulgated in 2013), which restricts involuntary psychiatric admissions to the small proportion of mentally ill individuals who are a danger to self or others. Aim Assess the factors associated with readmission rates of psychiatric inpatients in Guangzhou, China. Methods A retrospective analysis of data from the Guangzhou Psychiatric Hospital, one of the largest psychiatric hospitals in China, used Cox regression models to evaluate the relationship between age, gender, diagnosis, marital status, employment status, relationship with the primary caregiver, type of medical insurance, length of stay of the index admission, and the number of previous admissions to estimate the risk of readmission over the year following discharge. Multivariate regression is used to assess factors associated with the total time of readmission during the year of follow-up. Results Among 3455 patients admitted from 1 January 2011 to 31 December 2012 who had a mean (sd) length of stay of 65.7 (66.3) days, 476 (13.8%) were readmitted one or more times within one year of discharge. After considering all potential predictors of readmission in a multivariate survival analysis, the number of previous hospitalizations prior to the index admission was the only statistically significant predictor of readmission. The only factor that was significantly related to the total time of readmission was the duration of the index admission. Conclusion Shorter length of stay was not associated with increased readmission rates in patients admitted to a large public psychiatric hospital in southern China. This suggests that the expected decrease in the length of psychiatric inpatient admissions that is likely to occur when, based on China’s new regulations, most patients are admitted voluntarily may not lead to increased rates of readmission. Prospective studies with a more comprehensive set of outcome measures (including patient functioning, medication adherence, and family burden) are needed to monitor the effect of the law on patients and on the distribution of mental health services. PMID:25114488

  19. Transnational Disorders: Returned Migrants at Oaxaca's Psychiatric Hospital.

    PubMed

    Duncan, Whitney L

    2015-03-01

    This article examines experiences of returned migrants seeking mental health care at the public psychiatric hospital in Oaxaca, Mexico. Approximately one-third of the hospital's patients have migration experience, and many return to Oaxaca due to mental health crises precipitated by conditions of structural vulnerability and "illegality" in the United States. Once home, migrants, their families, and their doctors struggle to interpret and allay these "transnational disorders"-disorders structurally produced and personally experienced within the borders of more than one country. Considering how space and time shape illness and treatment among transnational migrants, I contend that a critical phenomenology of illegality must incorporate migrant experience and political economy on both sides of the border before, during, and after migration. PMID:25294096

  20. Robert Schumann in the psychiatric hospital at Endenich.

    PubMed

    Steinberg, Reinhard

    2015-01-01

    Robert Schumann (1810-1856) spent the last two-and-a-half years of his life in the private psychiatric hospital in Endenich. His medical records emerged in 1991 and were published by B. R. Appel in 2006. Daily entries document the treatment typical at that time for what was at first considered to be "melancholy with delusions": Shielding from stimuli, physical procedures, and a dietary regimen. The feared, actual diagnosis, a "general (incomplete) paralysis," becomes a certainty in the course of the paranoid-hallucinatory symptoms with cerebro-organic characteristics and agitated states, differences in pupil size, and increasing speech disturbances. In the medicine of the time, syphilis is just emerging as the suspected cause, and the term "progressive paralysis" is coined as typical for the course. Proof of the Treponema pallidum infection and the serologic reaction is not obtained until 1906. People close to Robert, in particular his wife Clara and the circle of friends around Brahms and Joachim, cared intensively for him and suffered under the therapeutic isolation. The medical records and illness-related letters contradict the theory that Schumann was disposed of by being put into the psychiatric hospital; they show the concern of all during the unfavorable illness course. PMID:25684293

  1. Tough Transitions: Mental Health Care Professionals' Perception of the Psychiatric Hospital to School Transition

    ERIC Educational Resources Information Center

    Clemens, Elysia V.; Welfare, Laura E.; Williams, Amy M.

    2010-01-01

    Psychiatric reasons are among the most common causes of hospitalization for adolescents. A Consensual Qualitative Research approach was used to explore mental health professionals' perceptions of the needs of adolescents as they transition from psychiatric hospital to school. Academic, social, and emotional domains emerged as important areas of…

  2. [Cytogenetic study of 257 mentally deficient patients in psychiatric hospitals].

    PubMed

    Bourgeois, M; Bénézech, M; Tournier-Zerbid, N; Constant-Boy, M; Benazet-Rissou, J

    1975-11-01

    Cytogenetic survey of 257 mentally retarded individuals. A cytogenetic inquiry was undertaken among 257 patients with mental retardation of two psychiatric hospitals. 25 patients show chromosomes anomalies (10%). We found: --18 trisomy 21 (Down's syndrome); --3 sexual chromosome anomalies: 47, XYY syndrome; 47, XYY/46, XY mosaïcism; 47, XXY, or Klinefelter syndrom; --1 partial delection of long arm of chromosome number 18 (46, XX, 18 q--); --3 translocations; 45, XX, t (1, 13) (p 36, q 11); 46, XX, t (5 p--, 18 p+) (p 12, p 11); 46, XY, t (9, 19) (q 21, p 18). We also found 9 large Y chromosomes (46, XY q+), 8 cases of variant chromosomes, 1 case with chromosomes associations..., we report a case of masculine Turner phenotype or Noonan syndrom. PMID:135524

  3. Ethics, patient rights and staff attitudes in Shanghai's psychiatric hospitals

    PubMed Central

    2012-01-01

    Background Adherence to ethical principles in clinical research and practice is becoming topical issue in China, where the prevalence of mental illness is rising, but treatment facilities remain underdeveloped. This paper reports on a study aiming to understand the ethical knowledge and attitudes of Chinese mental health professionals in relation to the process of diagnosis and treatment, informed consent, and privacy protection in clinical trials. Methods A self-administered survey was completed by 1110 medical staff recruited from Shanghai’s 22 psychiatric hospitals. Simple random selection methods were used to identify target individuals from the computerized registry of staff. Results The final sample for analysis consisted 1094 medical staff (including 523 doctors, 542 nurses, 8 pharmacologists and 21 other staff). The majority reported that their medical institutions had not established an Ethics Committee (87.8%) and agreed that Ethics Committees should be set up in their institutions (72.9%). Approximately half (52%) had not received systematic education in ethics, and almost all (89.1%) of the staff thought it was necessary. Nearly all participants (90.0%) knew the Shanghai Mental Health Regulations which was the first local regulations relating to mental health in China, but only 11% and 16.6% respectively knew of the Nuremberg Code and the Declaration of Helsinki. About half (51.8%) thought that the guardian should make the decision as to whether the patient participated in clinical trials or not. Conclusions The study indicates that most psychiatric hospitals in Shanghai have no Medical Ethics Committee. More than half the medical staff had not received systematic education and training in medical ethics and they have insufficient knowledge of the ethical issues related to clinical practice and trials. Training in ethics is recommended for medical staff during their training and as ongoing professional development. PMID:22595041

  4. Psychiatric hospitalization in Ontario: the revolving door in perspective.

    PubMed Central

    Woogh, C. M.; Meier, H. M.; Eastwood, M. R.

    1977-01-01

    Ontario government statistics have indicated that during the 1960s the proportion of readmissions to psychiatric hospitals doubled to form two thirds of all admissions. Since this pertained to events rather than to individuals, a cohort of patients first admitted in 1969 was followed for 4 years to trace the pattern of readmission and the characteristics of patients at risk of readmission. Routinely returned data were linked and a sample from the greater metropolitan Toronto area was randomly selected. Of the cohort, 31% were readmitted, 8% three or more times. Age and diagnosis distinguished those readmitted. Most with multiple readmissions were under 25 years of age. Although diagnoses were equally distributed on first admission among psychotic, neurotic and other nonpsychotic disorders, with no significant change on readmission or multiple readmission, there was a predictably greater proportion of functional psychoses among the high-risk group and also an equal representation of personality, addictive and the remaining nonpsychotic conditions. The vulnerable few are identifiable early in their intermittent hospital career. It can be concluded that statistics suggesting that two thirds of admissions are readmissions are misleading. PMID:856431

  5. Predictors of psychiatric hospitalization during 6 months of maintenance treatment with olanzapine long-acting injection: post hoc analysis of a randomized, double-blind study

    PubMed Central

    2013-01-01

    Background Hospitalization is a costly and distressing event associated with relapse during schizophrenia treatment. No information is available on the predictors of psychiatric hospitalization during maintenance treatment with olanzapine long-acting injection (olanzapine-LAI) or how the risk of hospitalization differs between olanzapine-LAI and oral olanzapine. This study aimed to identify the predictors of psychiatric hospitalization during maintenance treatment with olanzapine-LAI and assessed four parameters: hospitalization prevalence, incidence rate, duration, and the time to first hospitalization. Olanzapine-LAI was also compared with a sub-therapeutic dose of olanzapine-LAI and with oral olanzapine. Methods This was a post hoc exploratory analysis of data from a randomized, double-blind study comparing the safety and efficacy of olanzapine-LAI (pooled active depot groups: 405 mg/4 weeks, 300 mg/2 weeks, and 150 mg/2 weeks) with oral olanzapine and sub-therapeutic olanzapine-LAI (45 mg/4 weeks) during 6 months’ maintenance treatment of clinically stable schizophrenia outpatients (n=1064). The four psychiatric hospitalization parameters were analyzed for each treatment group. Within the olanzapine-LAI group, patients with and without hospitalization were compared on baseline characteristics. Logistic regression and Cox’s proportional hazards models were used to identify the best predictors of hospitalization. Comparisons between the treatment groups employed descriptive statistics, the Kaplan–Meier estimator and Cox’s proportional hazards models. Results Psychiatric hospitalization was best predicted by suicide threats in the 12 months before baseline and by prior hospitalization. Compared with sub-therapeutic olanzapine-LAI, olanzapine-LAI was associated with a significantly lower hospitalization rate (5.2% versus 11.1%, p < 0.01), a lower mean number of hospitalizations (0.1 versus 0.2, p = 0.01), a shorter mean duration of hospitalization (1.5 days versus 2.9 days, p < 0.01), and a similar median time to first hospitalization (35 versus 60 days, p = 0.48). Olanzapine-LAI did not differ significantly from oral olanzapine on the studied hospitalization parameters. Conclusions In clinically stable schizophrenia outpatients receiving olanzapine-LAI maintenance treatment, psychiatric hospitalization was best predicted by a history of suicide threats and prior psychiatric hospitalization. Olanzapine-LAI was associated with a significantly lower incidence of psychiatric hospitalization and shorter duration of hospitalization compared with sub-therapeutic olanzapine-LAI. Olanzapine-LAI did not differ significantly from oral olanzapine on hospitalization parameters. Trial registration ClinicalTrials.gov: NCT00088491 PMID:24041270

  6. Main clinical features in patients at their first psychiatric admission to Italian acute hospital psychiatric wards. The PERSEO study

    PubMed Central

    Ballerini, Andrea; Boccalon, Roberto M; Boncompagni, Giancarlo; Casacchia, Massimo; Margari, Francesco; Minervini, Lina; Righi, Roberto; Russo, Federico; Salteri, Andrea; Frediani, Sonia; Rossi, Andrea; Scatigna, Marco

    2007-01-01

    Background Few data are available on subjects presenting to acute wards for the first time with psychotic symptoms. The aims of this paper are (i) to describe the epidemiological and clinical characteristics of patients at their first psychiatric admission (FPA), including socio-demographic features, risk factors, life habits, modalities of onset, psychiatric diagnoses and treatments before admission; (ii) to assess the aggressive behavior and the clinical management of FPA patients in Italian acute hospital psychiatric wards, called SPDCs (Servizio Psichiatrico Diagnosi e Cura = psychiatric service for diagnosis and management). Method Cross-sectional observational multi-center study involving 62 Italian SPDCs (PERSEO – Psychiatric EmeRgency Study and EpidemiOlogy). Results 253 FPA aged <= 40 were identified among 2521 patients admitted to Italian SPDCs over the 5-month study period. About half of FPA patients showed an aggressive behavior as defined by a Modified Overt Aggression Scale (MOAS) score greater than 0 Vs 46% of non-FPA patients (p = 0.3651). The most common was verbal aggression, while about 20% of FPA patients actually engaged in physical aggression against other people. 74% of FPA patients had no diagnosis at admission, while 40% had received a previous psychopharmacological treatment, mainly benzodiazepines and antidepressants. During SPDC stay, diagnosis was established in 96% of FPA patients and a pharmacological therapy was prescribed to 95% of them, mainly benzodiazepines, antipsychotics and mood stabilizers. Conclusion Subjects presenting at their first psychiatric ward admission have often not undergone previous adequate psychiatric assessment and diagnostic procedures. The first hospital admission allows diagnosis and psychopharmacological treatment to be established. In our population, aggressive behaviors were rather frequent, although most commonly verbal. Psychiatric symptoms, as evaluated by psychiatrists and patients, improved significantly from admission to discharge both for FPA and non-FPA patients. PMID:17239235

  7. A senior citizens center and a geriatric transitional house at a state psychiatric hospital.

    PubMed

    Ettlinger, R; Binkowski, N; Zaiser, A

    1984-10-01

    Many older, severely dependent patients in large psychiatric hospitals, who are often inadequately treated with traditional psychiatric approaches, have no realistic chance of improving or of returning to the community. At Marlboro (N.J.) Psychiatric Hospital, two programs--a senior citizens center and a transitional house--were founded in 1979 and 1981, respectively, to maximize productive life roles for clients. After discussing the goals, admission criteria, and activities of each program, the authors present a profile of a patient who had shown little progress during 15 years of hospitalization but whose participation in the programs facilitated her return to the community. PMID:6489950

  8. Daily weather variables and affective disorder admissions to psychiatric hospitals

    NASA Astrophysics Data System (ADS)

    McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard

    2014-12-01

    Numerous studies have reported that admission rates in patients with affective disorders are subject to seasonal variation. Notwithstanding, there has been limited evaluation of the degree to which changeable daily meteorological patterns influence affective disorder admission rates. A handful of small studies have alluded to a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (heat waves in particular), wind direction and sunshine. We used the Kruskal-Wallis test, ARIMA and time-series regression analyses to examine whether daily meteorological variables—namely wind speed and direction, barometric pressure, rainfall, hours of sunshine, sunlight radiation and temperature—influence admission rates for mania and depression across 12 regions in Ireland over a 31-year period. Although we found some very weak but interesting trends for barometric pressure in relation to mania admissions, daily meteorological patterns did not appear to affect hospital admissions overall for mania or depression. Our results do not support the small number of papers to date that suggest a link between daily meteorological variables and affective disorder admissions. Further study is needed.

  9. Daily weather variables and affective disorder admissions to psychiatric hospitals.

    PubMed

    McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard

    2014-12-01

    Numerous studies have reported that admission rates in patients with affective disorders are subject to seasonal variation. Notwithstanding, there has been limited evaluation of the degree to which changeable daily meteorological patterns influence affective disorder admission rates. A handful of small studies have alluded to a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (heat waves in particular), wind direction and sunshine. We used the Kruskal-Wallis test, ARIMA and time-series regression analyses to examine whether daily meteorological variables--namely wind speed and direction, barometric pressure, rainfall, hours of sunshine, sunlight radiation and temperature--influence admission rates for mania and depression across 12 regions in Ireland over a 31-year period. Although we found some very weak but interesting trends for barometric pressure in relation to mania admissions, daily meteorological patterns did not appear to affect hospital admissions overall for mania or depression. Our results do not support the small number of papers to date that suggest a link between daily meteorological variables and affective disorder admissions. Further study is needed. PMID:24599495

  10. The State Hospital survey: A description of psychiatric patients in conditions of special security in Scotland

    Microsoft Academic Search

    Lindsay Thomson; John Bogue; Martin Humphreys; David Owens; Eve Johnstone

    1997-01-01

    The State Hospital, Carstairs, is the maximum security psychiatric facility for Scotland and Northern Ireland. This study describes the cohort of patients there (N = 241) between 1992 and 1994. Case-notes were examined to ascertain demographic details and information on psychiatric, medical, drug, forensic, family and personal histories. Diagnoses were made by application of the St Louis criteria (Feighner et

  11. Defining the Needs of Patients with Intellectual Disabilities in the High Security Psychiatric Hospitals in England

    ERIC Educational Resources Information Center

    Thomas, S. D.; Dolan, M.; Johnston, S.; Middleton, H.; Harty, M. A.; Carlisle, J.; Thornicroft, G.; Appleby, L.; Jones, P.

    2004-01-01

    Previous studies have suggested that a substantial proportion of the patients with intellectual disabilities (ID) in the high security psychiatric hospitals (HSPHs) should be transferred to more appropriate services to cater for their specific needs in the longer term. The individual and placement needs of high secure psychiatric patients detained…

  12. Transitioning Children from Psychiatric Hospitals to Schools: The Role of the Special Educator

    ERIC Educational Resources Information Center

    Simon, Joan B.; Savina, Elena A.

    2010-01-01

    Over a quarter of a million U.S. students each year reside for a period of time in a psychiatric inpatient hospital setting to receive mental health treatment. Following inpatient treatment, most children are transitioned from the hospital into a regular school setting. Little is known about how these transitions are managed by hospital or school…

  13. Detection, occurrence and fate of 22 psychiatric pharmaceuticals in psychiatric hospital and municipal wastewater treatment plants in Beijing, China.

    PubMed

    Yuan, Shengliu; Jiang, Xiaoman; Xia, Xinghui; Zhang, Haixia; Zheng, Shaokui

    2013-03-01

    The liquid chromatography-electrospray ionization-tandem mass spectrometer (LC-MS/MS) method coupled with an automated solid-phase extraction procedure has been developed to identify 22 psychiatric pharmaceuticals, including seven anxiolytic-sedative-hypnotics, six antidepressants, and nine anti-schizophrenia drugs, in wastewater samples from two psychiatric hospital wastewater treatment plants (P-WWTPs) and three municipal wastewater treatment plants (M-WWTPs) in Beijing, China. Analyte recoveries from spiking experiments in the WWTP influent and effluent at three concentrations ranged from 70% to 110%, excluding sulpiride, ziprasidone, and olanzapine. Method detection limits for five, eight, and nine analytes in the WWTP influent and effluent were 20-80, 1-16, and <1 ng L(-1), respectively. High psychiatric pharmaceutical concentrations (e.g., ?942 ng L(-1) oxazepam, 5552-12,782 ng L(-1) clozapine, 2762-9832 ng L(-1) sulpiride, and 2030-4967 ng L(-1) quetiapine) were frequently observed in P-WWTP influent compared to M-WWTPs. Although P-WWTPs typically had higher removal rates, significantly higher concentrations of the target compounds were observed in the P-WWTP secondary effluent than in the M-WWTP influent (e.g., ?752 ng L(-1) oxazepam, ?8183 ng L(-1) clozapine, ?10,833 ng L(-1) sulpiride, and ?1168 ng L(-1) quetiapine). Thus, the discharge control of psychiatric pharmaceuticals from psychiatric hospitals requires improvement. PMID:23228908

  14. An Analysis of Relationships Among Peer Support, Psychiatric Hospitalization, and Crisis Stabilization

    Microsoft Academic Search

    Glenn M. Landers; Mei Zhou

    2011-01-01

    This study’s objective was to investigate how peer support relates to psychiatric hospitalization and crisis stabilization\\u000a utilization outcomes. The likelihood of experiencing a psychiatric hospitalization or a crisis stabilization was modeled for\\u000a consumers using peer support services and a control group of consumers using community mental health services but not peer\\u000a support with 2003 and 2004 Georgia Medicaid claims data;

  15. Crisis Visits and Psychiatric Hospitalizations Among Patients Attending a Community Clinic in Rural Southern California

    Microsoft Academic Search

    Alvaro Camacho; Bernardo Ng; Anabel Bejarano; Alan Simmons; Denise Chavira

    Ethnic minorities from disadvantaged socioeconomic backgrounds report increased utilization of mental health emergency services;\\u000a however findings have been inconsistent across ethnic\\/racial groups. In this study we describe patients who present to a rural\\u000a crisis unit in Southern California, examine rates of psychiatric hospitalizations across ethnic\\/racial groups, and investigate\\u000a factors that are associated with increased psychiatric hospitalizations in this sample. This

  16. Prevalence of nurses' smoking habits in psychiatric and general hospitals in China.

    PubMed

    An, Feng-Rong; Xiang, Yu-Tao; Yu, Liuyang; Ding, Yan-Ming; Ungvari, Gabor S; Chan, Sally Wai-Chi; Yu, Doris S F; Lai, Kelly Y C; Qi, Yun-Ke; Zeng, Jiao-Ying; Wu, Ping-Ping; Hou, Zhi-Jiaolong; Correll, Christoph U; Newhouse, Robin; Chiu, Helen F K

    2014-04-01

    This study determined the prevalence of lifetime and current smoking and the correlates of current smoking in nurses working in psychiatric and general hospitals in China. Of 807 distributed questionnaires, 799 nurses who were working in two psychiatric hospitals (n=387, 48.4%), and one general hospital (n=412, 51.6%) had analyzable data. Socio-demographic, alcohol use and smoking data were collected with a self-reported questionnaire. Work-related stress was evaluated with the Nurse Stress Inventory. In the whole sample, the lifetime smoking prevalence was 7.6% (females=2.1% vs. males=48.9%, p<0.0001; psychiatric nurses=14.5% vs. non-psychiatric nurses=1.2%, p<0.0001). The prevalence of current smoking was 7.1% (females=2.1% vs. males=44.7%, p<0.0001; psychiatric nurses=13.4% vs. non-psychiatric nurses=1.2%, p<0.0001). In a multiple logistic regression analysis, age 30 years or older, male gender, having children, being a psychiatric nurse and alcohol consumption were positively associated with smoking, while being a nursing officer was negatively associated with smoking (r(2) = 0.513, p<0.0001). Considering the harmful effects of smoking as well as second-hand smoking in the presence of children, effective measures to promote smoking cessation for male, older and psychiatric nurses and those with children are warranted. PMID:24673786

  17. Best practices: environmental and therapeutic issues in psychiatric hospital design: toward best practices.

    PubMed

    Karlin, Bradley E; Zeiss, Robert A

    2006-10-01

    The psychiatric hospital environment plays a significant, though often underappreciated, role in patient and staff functioning. This column reviews the literature on important environmental and therapeutic issues in psychiatric hospital design. Research findings and clinical conjecture reported over the past 50 years indicate that intervening environmentally through clinically informed, patient-centered design can improve functioning both among and between patients and staff. This column identifies specific best practice considerations and recommendations for designing inpatient psychiatric facilities and may serve as a useful planning resource to those interested in adopting a patient-centered, inclusive approach to design and treatment. PMID:17035554

  18. The significance of services in a psychiatric hospital for family members of persons with mental illness.

    PubMed

    Shor, Ron; Shalev, Anat

    2015-03-01

    Hospitalization of persons with mental illness may cause their family members to experience multiple stressors that stem from the hospitalization as well as from the duties of helping him or her. However, providing support services in psychiatric hospitals for family members has received only limited attention. To change this situation, mental health professionals in a psychiatric hospital in Israel developed an innovative family-centered practice model, the Family Members' Support and Consultation (FMSC) service center. We examined the significance to family members of the services they received from the FMSC service center in a study that included 20 caregivers. Ten participated in 2 focus groups of 5 participants each; 10 were interviewed personally. We implemented a thematic analysis to analyze the data. According to the participants, the staff of the FMSC service center provided support services that helped them cope with the stressors and difficulties they experienced within the context of the psychiatric hospital. The participants emphasized the significance of the immediacy and accessibility of support provided, as well as the positive effects of systemic interventions aimed at changing the relationships between family members and systems in the psychiatric hospital. Our findings show the importance of integrating a service that focuses on the needs of family members of persons with mental illness within a psychiatric hospital. (PsycINFO Database Record (c) 2015 APA, all rights reserved). PMID:25485823

  19. The relationship between meteorological conditions and homicide, suicide, rage, and psychiatric hospitalization.

    PubMed

    Talaei, Ali; Hedjazi, Arya; Rezaei Ardani, Amir; Fayyazi Bordbar, Mohammad Reza; Talaei, Andisheh

    2014-09-01

    This study focuses on the relationship between the incidence of homicide, rage, suicide, and psychiatric hospitalization as violent behaviors with temperature, humidity, and air pressure as specific meteorological variables in the city of Mashhad, in the northeast of Iran. The data were obtained from Iran Meteorological Organization, official registry of Legal Medicine Organization and the local psychiatric hospital, March 2009 to Feb 2010 daily and were analyzed with SPSS-14 using Pearson correlation coefficient, ANOVA, and post hoc analysis tests. The rates of rage and psychiatric admission had a significant relationship with the daily mean air temperature, minimum relative humidity, maximum relative humidity, minimum daily pressure, and maximum daily air pressure (p < 0.0001). There was no significant correlation between homicide and suicide rates with any meteorological variables (p > 0.05). We concluded that, the possibility of nonfatal violence and psychiatric hospitalization would increase in hot and arid weather with low air pressure. PMID:24635192

  20. Undignified care: violation of patient dignity in involuntary psychiatric hospital care from a nurse's perspective.

    PubMed

    Gustafsson, Lena-Karin; Wigerblad, Ase; Lindwall, Lillemor

    2014-03-01

    Patient dignity in involuntary psychiatric hospital care is a complex yet central phenomenon. Research is needed on the concept of dignity's specific contextual attributes since nurses are responsible for providing dignified care in psychiatric care. The aim was to describe nurses' experiences of violation of patient dignity in clinical caring situations in involuntary psychiatric hospital care. A qualitative design with a hermeneutic approach was used to analyze and interpret data collected from group interviews. Findings reveal seven tentative themes of nurses' experiences of violations of patient dignity: patients not taken seriously, patients ignored, patients uncovered and exposed, patients physically violated, patients becoming the victims of others' superiority, patients being betrayed, and patients being predefined. Understanding the contextual experiences of nurses can shed light on the care of patients in involuntary psychiatric hospital care. PMID:23820018

  1. Treatment refusal in the involuntarily hospitalized psychiatric population: Canadian policy and practice.

    PubMed

    Gupta, M

    2001-01-01

    Policies governing coercive psychiatric interventions must be scrutinized to ensure they are not only beneficent but just. Within Canada, in seven of ten provinces, persons may be detained in hospital against their will for dangerousness due to mental disorder but, if capable of making treatment decisions, may refuse treatment for the very illness that led to detention. In examining this issue, the purpose of this paper is threefold. First, it will demonstrate that treatment refusal amongst involuntarily hospitalized psychiatric patients has arisen from a recent separation, in law, of hospitalization from treatment. Second, it will argue that legal provisions that allow the detention of psychiatric patients prior to assessment of their treatment decision-making capacity discriminate against the mentally ill and undermine health service delivery. Finally, this paper will propose that a more just policy would allow involuntary hospitalization of only those patients who are both incapable of making treatment decisions and harmful to themselves or others. PMID:11495208

  2. Hospital staff nurse perceptions of competency to care for patients with psychiatric or behavioral health concerns.

    PubMed

    Rutledge, Dana N; Wickman, Mary E; Cacciata, Marysol; Winokur, Elizabeth J; Loucks, Jeannine; Drake, Diane

    2013-01-01

    Disruptive behaviors are common among hospitalized patients with psychiatric and substance abuse behaviors. Nurses working on nonpsychiatric units, however, may lack competencies to care for patients with such behaviors. A survey was developed and administered to 844 nurses across three hospital settings that revealed a lack of nurse confidence to intervene in situations that require de-escalation techniques and crisis communication. This study provides direction for further research and interventions in hospital settings with similar professional development needs. PMID:24060662

  3. Validation of the Children's Interview for Psychiatric Syndromes (ChIPS) with Psychiatrically Hospitalized Adolescents

    ERIC Educational Resources Information Center

    Swenson, Lance P.; Esposito-Smythers, Christianne; Hunt, Jeffrey I.; Hollander, Beth L. G.; Dyl, Jennifer; Rizzo, Christie J.; Steinley, Douglas L.; Spirito, Anthony

    2007-01-01

    A study was conducted to examine the concurrent validity of the Children's Interview for Psychiatric Syndromes (ChIPS) for adolescent inpatients aged 12 to 18. The results reveal moderate agreement between ChIPS diagnoses and Schedule for Affective Disorder sand Schizophrenia for School-Age Children-Present and Lifetime version diagnoses.

  4. Crime and Violence among Psychiatric Patients in a Maximum Security Psychiatric Hospital

    Microsoft Academic Search

    KIRSTEN RASMUSSEN; STEN LEVANDER

    1996-01-01

    Data on crime and aggression, psychopathology, and early adjustment problems were examined for 94 consecutively admitted patients to a national maximum security psychiatric unit. A majority of the patients had a criminal record. Aggression inside and outside institutional settings was frequent, as were early adjustment problems. Factor analysis suggested five types of crime\\/aggression patterns: a nonviolent pattern, a pattern involving

  5. PSYCHIATRIC UNITS IN GENERAL HOSPITALS—Problems in Development and Efficient Operation

    PubMed Central

    Bennett, A. E.

    1960-01-01

    An adequate 25-bed psychiatric unit can be housed in a wing of a general hospital. Even more important than physical facilities are competent personnel, to be headed by a chief psychiatrist and a psychiatric nurse supervisor, for the unit. Incorporating teaching facilities into the unit helps to integrate psychiatry into the other disciplines of medicine in a continuing educational program. Having psychiatric units in general hospitals enables many voluntary patients to be treated in early stages of the disorder, with a high proportion of recoveries. Medicolegal aspects and the lack of adequate coverage of mental disorders by voluntary prepayment health plans are serious problems in the economy of a unit. Improved hospital administration, expanded training programs, educational work by local mental health societies and modification of laws on malpractice and commitment will go far to help solve these problems. PMID:18732338

  6. Incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients

    PubMed Central

    Ruengorn, Chidchanok; Sanichwankul, Kittipong; Niwatananun, Wirat; Mahatnirunkul, Suwat; Pumpaisalchai, Wanida; Patumanond, Jayanton

    2011-01-01

    Background The incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients remain uninvestigated in Thailand. Objective To determine incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients. Methods A retrospective cohort study was conducted by reviewing medical charts at Suanprung Psychiatric Hospital, Chiang Mai, Thailand. Mood disorder patients, diagnosed with the International Statistical Classification of Diseases and Related Health Problems 10th Revision codes F31.x, F32.x, and F33.x, who were admitted owing to suicide attempts between October 2006 and May 2009 were eligible. The influence of sociodemographic and clinical risk factors on suicide reattempts was investigated using Cox’s proportional-hazards regression analysis. Results Of 235 eligible mood disorder patients, 36 (15.3%) reattempted suicide (median 109.5 days, range 1–322), seven (3.0%) completed suicide (median 90 days, range 5–185), and 192 (84.2%) neither reattempted nor completed suicide during follow-up. Of all nonfatal suicide reattempts, 14 patients (38.9%) did so within 90 days. Among suicide completers, one (14.3%) did so 5 days after discharge, and four (57.1%) did so within 90 days. The following three risk factors explained 73.3% of the probability of suicide reattempts: over two previous suicide attempts before the index admission (adjusted hazard ratio [HR] 2.48; 95% confidence interval [CI] 1.07–5.76), being concomitantly prescribed typical and atypical antipsychotics (adjusted HR 4.79; 95% CI 1.39–16.52) and antidepressants, and taking a selective serotonin reuptake inhibitor alone (adjusted HR 5.08; 95% CI 1.14–22.75) or concomitantly with norepinephrine and/or serotonin reuptake inhibitors (adjusted HR 6.18; 95% CI 1.13–33.65). Conclusion Approximately 40% of suicide reattempts in mood disorder patients occurred within 90 days after psychiatric hospital discharge. For mood disorders and when there have been over two previous suicide attempts, prescribed antipsychotics or antidepressants may help predict suicide reattempts. PMID:22253548

  7. Substance use disorders in hospitalized psychiatric patients: the experience of one psychiatric emergency service in Turin.

    PubMed

    Tiziana, Frieri; Cristiana, Montemagni; Barbara, Crivelli; Mara, Scalese; Vincenzo, Villari; Paola, Rocca

    2014-07-01

    In the present study we sought: 1) to estimate the frequency of substance use disorders (SUD), and 2) to investigate whether there is a mere association between diagnosis and SUD in a large cohort of patients with severe psychiatric disorders representative of the usual setting and modality of care of a psychiatric emergency service in a geographically well-defined catchment area in Italy, independent of sociodemographic features, anamnestic data and clinical status. The study was conducted between January 2007 and December 2008. The following rating scales were performed: the Clinical Global Impression-Severity (CGI-S), the Global Assessment of Functioning scale (GAF) and the Brief Psychiatric Rating Scale (BPRS). Factors found to be associated (p<0.05) with SUD[+] in the univariate analyses were subjected to multilevel logistic regression model with a backward stepwise procedure. Among 848 inpatients of our sample 29.1% had a SUD codiagnosis. Eleven factors accounted for 30.6% of the variability in SUD[+]: [a] a Personality Disorder diagnosis, [b] a Depressive Disorder diagnosis, [c] male gender, [d] previous outpatient contacts, [e] single marital status, [f] no previous psychiatric treatments, [g] younger age, [h] lower scores for BPRS Anxiety-depression and [i] BPRS Thought Disturbance, [l] higher scores for BPRS Activation and [m] BPRS Hostile-suspiciousness. The findings are important in identifying (1) the complexity of the clinical presentation of SUD in a inpatients sample, (2) the need for collaboration among health care workers, and (3) the need to develop and apply treatment programs that are targeted at particular risk groups. PMID:24791682

  8. Suicidality related to first-time admissions to psychiatric hospital

    Microsoft Academic Search

    Terje ØiesvoldTony; Tony Bakkejord; Vidje Hansen; Mary Nivison; Knut W. Sørgaard

    Background  The epidemiology of suicidality shows considerable variation across sites. However, one of the strongest predictors of suicide\\u000a is a suicidal attempt. Knowledge of the epidemiology of suicidal ideas and attempts in the general population as well as in\\u000a the health care system is of importance for designing preventive strategies. In this study, we will explore the role of the\\u000a psychiatric

  9. Illness severity and psychiatric hospitalization rates among Asian Americans and Pacific Islanders.

    PubMed

    Sentell, Tetine; Unick, George Jay; Ahn, Hyeong Jun; Braun, Kathryn L; Miyamura, Jill; Shumway, Martha

    2013-11-01

    OBJECTIVE The study objective was to fill research gaps about inpatient psychiatric service utilization among Asian Americans and Pacific Islanders (AA/PIs). METHODS Rates of psychiatric hospitalization, illness severity, and length of stay were compared among AA/PI adults overall and across diagnoses (schizophrenia, depression, bipolar, anxiety, and other psychiatric disorders identified by All Patient Refined Diagnosis Related Groups) by using discharge data from all hospitalizations in Hawaii from December 2006 to 2010. Multivariable models adjusted for gender, age, payer, and residence. RESULTS In multivariable analyses of total psychiatric hospitalizations, Chinese (rate ratio [RR]=.22), Japanese (RR=.23), Filipinos (RR=.30), and Native Hawaiians (RR=.37) had significantly lower rates than whites. Native Hawaiians had significantly higher hospitalization rates compared with other AA/PI groups. Length of stay was significantly longer for Chinese (length of stay ratio [LOSR]=1.53), Filipinos (LOSR=1.20), and Japanese (LOSR=1.19) compared with whites, whereas severity of illness was significantly higher for Japanese (odds ratio [OR]=1.36) and Filipinos (OR=1.30). Within specific diagnoses, Native Hawaiians had higher hospitalization rates than other AA/PI groups for depression, bipolar disorder, and anxiety disorder. Chinese, Japanese, and Filipinos had significantly higher illness severity or longer stays than whites for at least one diagnostic category. CONCLUSIONS AA/PI subgroups had lower psychiatric hospitalization rates than whites, but rates varied across AA/PI subgroups. Native Hawaiians had higher hospitalization rates for many diagnoses. Chinese, Japanese, and Filipinos had greater illness severity or longer stays than whites overall and for some diagnoses, whereas Native Hawaiians did not. Disaggregating AA/PI groups provides important insight into mental health services utilization and need. PMID:23945849

  10. Time of the year and absconding from a psychiatric hospital in Trinidad.

    PubMed

    Ali, Akleema; Maharajh, Hari D

    2003-01-01

    Personal characteristics of patients and environmental factors at psychiatric hospitals have been identified as predictors of absconding. This study seeks to establish a relationship between time of the year and absconding. All characteristics of absconders were analysed over a two-year period using hospital records (N= 104). Public holidays and lunar phases were obtained through almanacs for each year; and school vacation period was determined by reference to a school academic calendar. Friday was the most popular day of the week for absconding, males tend to escape more on the weekends compared to females, females tend to escape more during the wet season, and Christmas was the most popular holiday season for absconding to take place. The full moon phase had the largest percentage of absconding when compared to other phases. Recommendations are that the system of patient care should be client driven at all times and greater supervision of patients is needed on weekends, vacation periods and during the full moon phase. PMID:21206811

  11. Low serum vitamin B12 levels among psychiatric patients admitted in Butabika mental hospital in Uganda

    PubMed Central

    2014-01-01

    Background Psychiatric manifestations have been noted in patients with low serum vitamin B12 levels even in the absence of other neurologic and/or haematologic abnormalities. There is no literature on low serum B12 prevalence among Ugandans with psychiatric illnesses. The aim of this study was to establish the prevalence, risk factors, and clinical manifestations of low serum vitamin B12 among psychiatric patients admitted in a Mental Health Hospital in Uganda. Method Using a cross sectional descriptive study design, 280 in-patients selected by systematic sampling were studied using a standardized protocol. Low serum vitamin B12 was defined as a level?psychiatric diagnosis of schizophrenia (AOR 1.74 (95% C.I. 1.00, 3.02); p-value?=?0.049), duration of psychiatric illness?>?or?=?3 years (AOR 2.27 (95% C.I. 1.29, 3.98); p-value?=?0.004), and hospitalization?hospitalized psychiatric patients with the majority having no haematological findings. Associated risk factors included having a psychiatric diagnosis of schizophrenia, a shorter duration of hospitalization and longer duration of psychiatric illness. Female participants were less likely to have low serum vitamin B12 levels. Routine screening for serum vitamin B12 levels should be adopted by all hospitals for admitted psychiatric patients. PMID:24533701

  12. Reassessing the High Proportion of Involuntary Psychiatric Hospital Admissions in South Korea

    Microsoft Academic Search

    John R. BolaEon-Ha; Eon-Ha Park; Seong-Yeon Kim

    The 2007 WHO-AIMS report on the mental health system of South Korea documented progress towards a national mental health plan,\\u000a protection of human rights, and growth of community based services. Yet concern was expressed that the high proportion of\\u000a involuntary to total psychiatric hospitalizations (92%) may indicate an excessively coercive system. Involuntary hospitalization\\u000a in Korea rose from 117 to 132

  13. Job Satisfaction of Psychiatric Hospital Employees: A New Measure of an Old Concern

    Microsoft Academic Search

    Keith R. Aronson; Nicholas Sieveking; Jean-Phillipe Laurenceau; William Bellet

    2003-01-01

    The authors report on the factor structure of an employee satisfaction questionnaire designed for use with psychiatric hospital employees. The actions and attitudes of management were, by far, the single most prominent factor. This factor captures the extent to which management respects workers, operates with honesty and integrity, promotes efficiency, and has open lines of communication with employees. By surveying

  14. A Functional Model of Quality Assurance for Psychiatric Hospitals and Corresponding Staffing Requirements.

    ERIC Educational Resources Information Center

    Kamis-Gould, Edna; And Others

    1991-01-01

    A model for quality assurance (QA) in psychiatric hospitals is described. Its functions (general QA, utilization review, clinical records, evaluation, management information systems, risk management, and infection control), subfunctions, and corresponding staffing requirements are reviewed. This model was designed to foster standardization in QA…

  15. White Matter Hyperintensities and Their Associations with Suicidality in Psychiatrically Hospitalized Children and Adolescents.

    ERIC Educational Resources Information Center

    Ehrlich, Stefan; Noam, Gil G.; Lyoo, In Kyoon; Kwon, Bae J.; Clark, Megan A.; Renshaw, Perry F.

    2004-01-01

    Objective: Increasingly, researchers and clinicians are recognizing that there may be biological markers associated with increased risk of suicide. The objective of this study was to compare white matter hyperintensities in psychiatrically hospitalized children and youth with and without a history of suicide attempt while controlling for other…

  16. Enquiry about the Needs of Children Whose Mothers Are Admitted to Psychiatric Hospitals

    ERIC Educational Resources Information Center

    Manderson, J.; McCune, N.

    2004-01-01

    The objective of this study is to assess whether children's needs are taken into consideration in female patients who are admitted to an adult psychiatric hospital. A retrospective case note audit of 100 female inpatients aged between 18 and 55 years over a 6-month period were randomly selected. The medical and nursing case notes of patients with…

  17. Enhancing Treatment Team Process through Mindfulness-Based Mentoring in an Inpatient Psychiatric Hospital

    ERIC Educational Resources Information Center

    Singh, Nirbhay N.; Singh, Subhashni D.; Sabaawi, Mohamed; Myers, Rachel E.; Wahler, Robert G.

    2006-01-01

    The authors investigated changes in treatment team functioning in an adult inpatient psychiatric hospital after the implementation of a mindfulness-based mentoring intervention. Using a multiple baseline across treatment teams design, the authors assessed levels of functioning of three treatment teams using a 50-item rating scale and then…

  18. Assaultive Behavior in State Psychiatric Hospitals: Differences Between Forensic and Nonforensic Patients

    ERIC Educational Resources Information Center

    Linhorst, Donald M.; Scott, Lisa Parker

    2004-01-01

    Forensic patients are occupying an increasingly large number of beds in state psychiatric hospitals. The presence of these mentally ill offenders has raised concerns about the risk they present to nonforensic patients. This study compared the rate of assaults and factors associated with assaultive behavior among 308 nonforensic patients and two…

  19. The security, clinical and social needs of patients in high security psychiatric hospitals in England

    Microsoft Academic Search

    Mari-Anne Harty; Jenny Shaw; Stuart Thomas; Mairead Dolan; Lisa Davies; Graham Thornicroft; Julie Carlisle; Mauricio Moreno; Morven Leese; Louis Appleby; Peter Jones

    2004-01-01

    Previous studies have indicated that between one and two thirds of patients in the high security psychiatric hospitals (HSPHs) could be transferred to lower security. The aim of this study was to measure the individual and placement needs of all patients in the three HSPHs in England. In total 1255 patients were assessed using staggered census dates. Five hundred (40%)

  20. The individual needs of patients in high secure psychiatric hospitals in England

    Microsoft Academic Search

    Stuart Thomas; Morven Leese; Maired Dolan; Mari-Anne Harty; Jenny Shaw; Hugh Middleton; Julie Carlisle; Lisa Davies; Graham Thornicroft; Louis Appleby

    2004-01-01

    A comprehensive assessment of the needs of all high security psychiatric hospital (HSPH) patients in England has not previously been conducted. All inpatients in the three HSPHs in England (Ashworth, Broadmoor and Rampton, n?=?1256) were assessed. Factors associated with placement need were modelled using logistic regression, then cluster analysis was used to identify patient subgroups on the basis of their

  1. Racial Disparities in Mental Health Outcomes after Psychiatric Hospital Discharge among Individuals with Severe Mental Illness

    ERIC Educational Resources Information Center

    Eack, Shaun M.; Newhill, Christina E.

    2012-01-01

    Racial disparities in mental health outcomes have been widely documented in noninstitutionalized community psychiatric samples, but few studies have specifically examined the effects of race among individuals with the most severe mental illnesses. A sample of 925 individuals hospitalized for severe mental illness was followed for a year after…

  2. Predictors of Treatment Response for Suicidal Youth Referred for Emergency Psychiatric Hospitalization

    ERIC Educational Resources Information Center

    Huey, Jr., Stanley J.; Henggeler, Scott W.; Rowland, Melisa D.; Halliday-Boykins, Colleen A.; Cunningham, Phillippe B.; Pickrel, Susan G.

    2005-01-01

    This study evaluated factors that predicted poor treatment response for 70 suicidal youth (ages 10 to 17 years; 67% African American) who received either multisystemic therapy (MST) or inpatient psychiatric hospitalization. Following treatment, suicidal youth were classified as either treatment responders or nonresponders based on caregiver or…

  3. Working Models of Attachment in Psychiatrically Hospitalized Adolescents: Relation to Psychopathology and Personality.

    ERIC Educational Resources Information Center

    Rosenstein, Diana S.; Horowitz, Harvey A.

    This study examined the role of attachment in adolescent psychopathology among psychiatrically hospitalized adolescents. Subjects consisted of 60 adolescents and 27 of their mothers. Measures included the Adult Attachment Interview classification for both the adolescents and their mothers, and a battery of diagnostic and personality assessment of…

  4. Mothers with Severe Psychiatric Illness and Their Newborns: A Hospital-Based Model of Perinatal Consultation

    ERIC Educational Resources Information Center

    Almeida, Ana; Merminod, Gaelle, Schechter, Daniel S.

    2009-01-01

    Women with severe psychiatric illness face numerous risks and challenges during pregnancy and as parents. Mental health professionals can help these mothers and their infants by supporting the attachment relationship and by providing the external supports that are necessary for successful parenting. The authors describe a hospital-based…

  5. The rehabilitation of the chronic psychiatric patient: Beyond the hospital-based token economy system

    Microsoft Academic Search

    R. Shedletsky; G. Voineskos

    1976-01-01

    Token economy programmes have offered a promise in the rehabilitation and community resettlement of the chronic psychiatric patient. However, most studies have concentrated on the behavioural gains while the patient is still in hospital with little or no follow-up on the subsequent community adjustment. This paper describes a comparative evaluative study between a token economy programme and a generic programme

  6. Retrospective analysis of absconding behaviour by acute care consumers in one psychiatric hospital campus in Australia.

    PubMed

    Mosel, Krista A; Gerace, Adam; Muir-Cochrane, Eimear

    2010-06-01

    Absconding is increasingly being recognized as a problem within mental health settings with significant risks for consumers. This study examines absconding behaviours across three acute care wards within an Australian psychiatric hospital campus over a 12-month period. A descriptive statistical analysis determined the rate of absconding from 49 consumers who absconded 64 times. The absconding rate was 13.33% (absconding events), with most absconding events arising from males diagnosed with schizophrenia (57.14%) aged between 20 and 29 years, and with 62.50% of absconding events occurring whilst consumers were on their first 21-day detention order. Nearly half of all absconding events were by consumers who had absconded previously, with the highest proportion of events occurring during nursing handover. A profile of people who abscond, time of day of absconding, legal status and repeated absconding behaviours are described. The emergent profile of consumers who absconded within this study bears some similarities to that described in overseas research, although in this study consumers were slightly older and 25% of absconders were female. Of particular interest are findings that identify the timings of absconding events in relation to a consumer's legal status. Implications for practice, including assessment of risk of absconding and management, are considered. PMID:20550641

  7. Reading and spelling deficits among children attending a psychiatric day treatment program

    Microsoft Academic Search

    S. Kotsopoulos; S. Walker; K. Beggs; B. Jones; A. Kotsopoulos; P. Patel

    1996-01-01

    To investigate the specific behavioural and cognitive characteristics which may account for academic deficits in children with psychiatric disorders, 50 children admitted to a day treatment and school program were assessed using behaviour questionnaires for parents and teachers, and tests assessing intelligence (WISC-R), language (CELF-R) and academic performance (Kaufman Test of Educational Achievement). The academic measures Reading Decoding, Reading Comprehension

  8. Gender and psychiatric diagnosis: a profile of admissions to mental hospitals in the Western Cape Province, South Africa

    Microsoft Academic Search

    A. Strebel; M. Stacey; N. Msomi

    1999-01-01

    Summary  \\u000a Objectives: This retrospective, epidemiological study aimed to identify gender patterns of admission to public mental hospitals, with\\u000a regard to psychiatric diagnosis and management.\\u000a \\u000a \\u000a Methods: The hospital records of a random, stratified sample of all 7938 patients admitted to the three psychiatric hospitals in\\u000a the Western Cape Province for a calendar year were studied for gender differences regarding demographic features,

  9. Predictors of Medical or Surgical and Psychiatric Hospitalizations Among a Population-Based Cohort of Homeless Adults

    PubMed Central

    Chambers, Catharine; Katic, Marko; Chiu, Shirley; Redelmeier, Donald A.; Levinson, Wendy; Kiss, Alex

    2013-01-01

    Objectives. We identified factors associated with inpatient hospitalizations among a population-based cohort of homeless adults in Toronto, Ontario. Methods. We recruited participants from shelters and meal programs. We then linked them to administrative databases to capture hospital admissions during the study (2005–2009). We used logistic regression to identify predictors of medical or surgical and psychiatric hospitalizations. Results. Among 1165 homeless adults, 20% had a medical or surgical hospitalization, and 12% had a psychiatric hospitalization during the study. These individuals had a total of 921 hospitalizations, of which 548 were medical or surgical and 373 were psychiatric. Independent predictors of medical or surgical hospitalization included birth in Canada, having a primary care provider, higher perceived external health locus of control, and lower health status. Independent predictors of psychiatric hospitalization included being a current smoker, having a recent mental health problem, and having a lower perceived internal health locus of control. Being accompanied by a partner or dependent children was protective for hospitalization. Conclusions. Health care need was a strong predictor of medical or surgical and psychiatric hospitalizations. Some hospitalizations among homeless adults were potentially avoidable, whereas others represented an unavoidable use of health services. PMID:24148040

  10. [Prevention of tuberculosis in patients in psychiatric hospitals].

    PubMed

    Fisher, Iu Ia; She?nman, V L; Gutorova, V A

    1991-01-01

    Mental hospital patients are at high risk of tuberculosis reactivation, especially those with posttuberculous changes in the lungs and progressive severe schizophrenia. Outbreaks of tuberculosis are 2.5 times more frequent in them than in alcohol abusers and other mental patients. In subjects with posttuberculous changes on the lungs preventive chemotherapy can cause a 6-fold decrease in the likelihood of process reactivation. PMID:2034610

  11. Patients' lived seclusion experience in acute psychiatric hospital in the United States: a qualitative study.

    PubMed

    Ezeobele, I E; Malecha, A T; Mock, A; Mackey-Godine, A; Hughes, M

    2014-05-01

    The findings revealed that the patients perceived seclusion as an intervention that is punitive and a means used by the staff to exert control. Patients perceived that staff incitements and lack of communication skills led to their being secluded. The findings provided recommendations and strategies for seclusion reduction that were based on the patients' first-hand seclusion experiences. This phenomenological study used Husserlian's philosophy to explore and describe the lived experiences of psychiatric patients who were secluded at a free-standing acute care hospital located in South-western United States (US). The study is crucial because very few studies have been conducted in this area in the US. The study examined a purposive sample of 20 patients, 3 days post-seclusion. Data were generated through face-to-face, semi-structured interviews incorporating open-ended questions and probes to facilitate discussion until saturation was reached. Interviews were transcribed verbatim and data analysed using Colaizzi's seven steps method. Results were described according to the themes and subthemes identified. Findings uncovered four themes: (1) alone in the world; (2) staff exert power and control; (3) resentment towards staff; and (4) time for meditation. The findings from this study illuminated the views surrounding patients' seclusion experience. It provided first-hand information on the patients' seclusion experience that might be helpful to the mental health professionals in the seclusion reduction process. PMID:23834325

  12. Psychiatric comorbidity and mortality among veterans hospitalized for congestive heart failure.

    PubMed

    Banta, Jim E; Andersen, Ronald M; Young, Alexander S; Kominski, Gerald; Cunningham, William E

    2010-10-01

    A Behavioral Model of Health Services Utilization approach was used to examine the impact of comorbid mental illness on mortality of veterans admitted to Veterans Affairs medical centers in fiscal year 2001 with a primary diagnosis of congestive heart failure (n = 15,497). Thirty percent had a psychiatric diagnosis, 4.7% died during the index hospitalization, and 11.5% died during the year following discharge. Among those with mental illness, 23.6% had multiple psychiatric disorders. Multivariable logistic regression models found dementia to be positively associated with inpatient mortality. Depression alone (excluding other psychiatric disorders) was positively associated with one-year mortality. Primary care visits were associated with a reduced likelihood of both inpatient and one-year mortality. Excepting dementia, VA patients with a mental illness had comparable or higher levels of primary care visits than those having no mental illness. Patients with multiple psychiatric disorders had more outpatient care than those with one psychiatric disorder. PMID:20968262

  13. Neuropsychological screening as a standard of care during discharge from psychiatric hospitalization: the preliminary psychometrics of the CNS Screen.

    PubMed

    Levy, Boaz; Celen-Demirtas, Selda; Surguladze, Tinatin; Eranio, Sara; Ellison, James

    2014-03-30

    Cost-prohibitive factors currently prevent a warranted integration of neuropsychological screenings into routine psychiatric evaluations, as a standard of care. To overcome this challenge, the current study examined the psychometric properties of a new computerized measure-the CNS Screen. One hundred and twenty six psychiatric inpatients completed the CNS Screen, the Montreal Cognitive Assessment (MoCA), and the Quick Inventory of Depressive Symptomatology-Self Rated (QIDS-SR??) on the day of hospital discharge. Statistical analysis established convergent validity with a moderate correlation between the self-administered CNS Screen and the clinician-administered MoCA (r=0.64). Discriminant validity was implicated by a non-significant correlation with the QIDS-SR??. Concurrent validity was supported by a moderate, negative correlation with patients' age (r=-0.62). In addition, consistent with previous findings, patients with psychotic disorders exhibited significantly poorer performance on the CNS Screen than patients with a mood disorder. Similarly, patients with a formal disability status scored significantly lower than other patients. The CNS Screen was well tolerated by all patients. With further development, this type of measure may provide a cost-effective approach to expanding neuropsychological screenings on inpatient psychiatric units. PMID:24503284

  14. Effectiveness of a Psychosocial Intervention Model for Persons with Chronic Psychiatric Disorders in Long-Term Hospitalization

    ERIC Educational Resources Information Center

    Elbaz-Haddad, Merav; Savaya, Riki

    2011-01-01

    The article describes a psychosocial model of intervention with psychiatric patients in long-term hospitalization in a psychiatric ward in Israel and reports the findings of the evaluation conducted of its effectiveness. The model was aimed at maintaining or improving the patients' functioning in four main areas: personal hygiene, environmental…

  15. Psychiatric disorders in gynaecological, surgical and medical departments of general hospitals in an urban and a rural area of Austria

    Microsoft Academic Search

    J. Wancata; N. Benda; M. Hajji; O. M. Lesch; C. Müller

    1996-01-01

    A total of 728 patients admitted to the medical, gynaecological and surgical departments of one urban and one rural general hospital in Austria were investigated for psychiatric morbidity. Using the Clinical Interview Schedule and its case criteria, the prevalence of psychiatric morbidity was found to be highest in medical departments (38.2%), followed by surgical departments (32.5%), and lowest in gynaecological

  16. PSYCHOMS®, An electronic nursing management system to facilitate interdisciplinary communication and improve patient outcomes in psychiatric hospitals

    Microsoft Academic Search

    Tetsuya Tanioka; Kyoko Osaka; Shinichi Chiba; Carlo Parker; Yuko Yasuhara; Rozzano Locsin; Chiemi Kawanishi

    2011-01-01

    The purpose of this article is to introduce PSYCHOMS® (Psychiatric Outcome Management System, registered trademark, Tanioka et al.), an electronic nursing management system to facilitate interdisciplinary communication and improve patient outcomes in psychiatric hospitals and report on the agenda for commercialization of the PSYCHOMS® system. Our team has been developing the PSYCHOMS® system since 2006. This system has four major

  17. Analysis of outcome variables of a token economy system in a state psychiatric hospital: a program evaluation

    Microsoft Academic Search

    Joseph E Comaty; Michael Stasio; Claire Advokat

    2001-01-01

    This study describes the outcome of a token economy treatment applied to 2 distinct patient populations on the same unit of a state psychiatric hospital: individuals with a dual diagnosis of mental retardation and a DSM-IV Axis I diagnosis of either (a) a severe behavior disorder (BD) or (b) a serious and persistent psychiatric disorder (PD). Results showed that patients

  18. Post-hospitalization adjustment of psychiatric patients following a time-limited psychoeducational treatment program

    E-print Network

    Velasquez, John Martin

    1992-01-01

    at intake, discharge, and at a three-month follow-up to measure sociodemographic status, psychiatric symptomatology, various family variables, psychosocial adjustment and knowledge of illness, medication, stress management and problem-solving skills... Involvement and Group Status Family Environment and Group Status Family Life Stressors and Group Status Psychosocial Adjustment and Group Status Psychoeducational Treatment Evaluation and Treatment Response Length of Hospitalization and Group Status...

  19. Treatment satisfaction and recovery in Saami and Norwegian patients following psychiatric hospital treatment: a comparative study.

    PubMed

    Sørlie, Tore; Nergård, Jens-Ivar

    2005-06-01

    Treatment, treatment satisfaction and recovery in Saami and Norwegian patients treated in a psychiatric hospital were compared. Although half of the Saami patients preferred to speak Saami with their therapists, only one patient did. The extensive use of traditional helpers was only partly recognized. Despite no differences in type and amount of treatment or symptom-change during the hospital stay, the Saami patients showed less satisfaction with all investigated treatment parameters including contact with staff, treatment alliance, information and global treatment satisfaction. There was less agreement between the ratings of the therapists and the Saami patients. Suggestions for improvements are made. PMID:16114587

  20. Effectiveness of an intervention to improve day centre services for people with psychiatric disabilities

    PubMed Central

    Eklund, Mona; Gunnarsson, A Birgitta; Sandlund, Mikael; Leufstadius, Christel

    2014-01-01

    Background/aim Day centres for people with psychiatric disabilities need to be evaluated for effectiveness in order to provide the best possible support. This study aimed at investigating the effectiveness of a tailor-made intervention to improve day centre services for people with psychiatric disabilities. Methods The intervention was devised to bridge identified gaps in the services and lasted for 14 months. Eight centres were allotted to the intervention (55 attendees) or comparison condition (51 attendees). Fidelity to the intervention and major events in the day centres were assessed. The outcomes were degree of meaningfulness found in the day centre occupations, satisfaction with the rehabilitation received, satisfaction with everyday occupations and quality of life. Results The fidelity to the intervention was good, but more positive events, such as new occupational opportunities, had taken place in the comparison units. No differences were identified between the intervention and the comparison group regarding changes from baseline to the 14-month follow-up in perceived meaningfulness among day centre occupations, satisfaction with everyday occupations or quality of life. Conclusions The intervention seemed ineffective, but the positive events in the comparison group resembled the measures included in the tailor-made interventions. This first intervention study in the day centre context has hopefully helped to generate hypotheses and methods for future research. PMID:24571494

  1. The effects of state psychiatric hospital waitlist policies on length of stay and time to readmission.

    PubMed

    La, Elizabeth Holdsworth; Zhu, Ruoqing; Lich, Kristen Hassmiller; Ellis, Alan R; Swartz, Marvin S; Kosorok, Michael R; Morrissey, Joseph P

    2015-05-01

    This study examined the effects of a waitlist policy for state psychiatric hospitals on length of stay and time to readmission using data from North Carolina for 2004-2010. Cox proportional hazards models tested the hypothesis that patients were discharged "quicker-but-sicker" post-waitlist, as hospitals struggled to manage admission delays and quickly admit waitlisted patients. Results refute this hypothesis, indicating that waitlists were associated with increased length of stay and time to readmission. Further research is needed to evaluate patients' clinical outcomes directly and to examine the impact of state hospital waitlists in other areas, such as state hospital case mix, local emergency departments, and outpatient mental health agencies. PMID:24965771

  2. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology) survey

    PubMed Central

    Ballerini, Andrea; Boccalon, Roberto M; Boncompagni, Giancarlo; Casacchia, Massimo; Margari, Francesco; Minervini, Lina; Righi, Roberto; Russo, Federico; Salteri, Andrea; Frediani, Sonia; Rossi, Andrea; Scatigna, Marco

    2007-01-01

    Background The PERSEO study (psychiatric emergency study and epidemiology) is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management). The aims of this paper are: (i) to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii) to assess the clinical management, subjective wellbeing and attitudes toward medications. Methods A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period. Results Almost half of patients (46%) showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%), than in aggression toward other people (20%). A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%), followed by depression (16%) and personality disorders (14%), and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge), while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge) and depression (41 vs 32% during stay and 44 vs 25% at discharge). Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%). Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self-reported compliance increased during hospital stay. Conclusion Results confirm the widespread use of antipsychotics and the increasing trend in atypical drugs prescription, in both psychiatric in- and outpatients. PMID:17983468

  3. Discharge Outcomes in Seniors Hospitalized for More than 30 Days

    Microsoft Academic Search

    Anita L. Kozyrskyj; Charlyn Black; Dan Chateau; Carmen Steinbach

    2005-01-01

    Hospitalization is a sentinel event that leads to loss of independence for many seniors. This study of long-stay hospitalizations (more than 30 days) in seniors was undertaken to identify risk factors for not going home, to characterize patients with risk factors who did go home and to describe one year outcomes following home discharge. Using Manitoba’s health care databases, the

  4. Medication adherence and its determinants among psychiatric patients in an Ethiopian referral hospital

    PubMed Central

    Demoz, Zaid; Legesse, Befikadu; Teklay, Gebrehiwot; Demeke, Birhanu; Eyob, Tewodros; Shewamene, Zewdneh; Abera, Mubarek

    2014-01-01

    Background The degree to which an individual follows medical advice is a major concern in every medical specialty. Non-adherence to psychiatric treatment regimens has a profound impact on the disease course, relapse, future recovery, cost of health care, and the outcome for the patient. The aim of this study was to assess medication adherence and its correlates among psychiatric patients at Ayder Referral Hospital, Northern Ethiopia. Methods A cross-sectional study was conducted from June to September 2013 at Ayder Referral Hospital, where 423 patients were selected by a systematic random sampling technique from all patients attending the psychiatric clinic at the hospital. Data were collected by trained data collectors through interview of the patients using a structured questionnaire. The collected data were entered into Epi Info version 7 and analyzed by Statistical Package for the Social Sciences version 16 software. Logistic regression was used to assess independent predictors of adherence. Results A total of 387 patients completed the interview. Two hundred and sixteen (55.8%) and 113 (29.2%) were patients with a diagnosis of schizophrenia and mood disorder, respectively, while 35 (9%) and 23 (5.9%) had a diagnosis of drug addiction and autistic disorder. Two hundred and seven (71.6%) patients were found to be adherent to their medication. When adherence rates were observed according to type of disorder, 60 (53.1%), 24 (68.6%), 149 (69%), and 18 (78.3%) of patients with mood disorder, drug addiction, schizophrenia, and autism, respectively, were adherent to their medications. Female gender (adjusted odds ratio [AOR] 2.34; 95% confidence interval [CI] 1.45–3.74), tertiary education (AOR 2.69; 95% CI 1.46–4.85), living with family (AOR 2.57; 95% CI 1.66–4.58), and shorter treatment duration (AOR 1.82; 95% CI 1.21–2.84) were among the variables associated with better adherence. Conclusion Suboptimal adherence was observed among psychiatric patients in this study. Health professionals in the psychiatric clinic and pharmacists need to focus on and counsel patients about adherence and its implications for their clinical outcome. PMID:25284991

  5. Utility of an integrated electronic suicide alert system in a psychiatric hospital.

    PubMed

    Madan, Alok; Mahoney, Jane; Allen, Jon G; Ellis, Thomas; Hardesty, Susan; Oldham, John M; Fowler, J Christopher

    2015-01-01

    Management of suicide-related behaviors in a hospital is challenging. This article (1) describes integration of an electronic suicide risk notification system to improve assessment of psychiatric inpatients, (2) details the manner in which these alerts complement standard of care, and (3) provides support of using aggregate data to inform administrative decision-making. Complementing routine clinical care and under the supervision of an assessment coordinator, adult inpatients at a specialty psychiatric hospital complete a computerized battery of outcome assessments throughout the course of their hospitalization. A critical-item response notification system for suicide-related behaviors was implemented within the larger, assessment architecture, sending an alert e-mail to unit staff if patients endorsed suicidal ideation on any 1 of 6 critical items. Analysis of aggregate data over a 19-month period reveal a linear trend of increasing rate of suicide alerts from October 2012 to April 2013 (Phase A) with a stabilization at the heightened level from July 2013 to April 2014 (Phase B), R = 0.697, P = .007. Findings suggest that more nuanced training in the management of suicide-related behavior may be necessary and that traditional approaches to staffing may need to accommodate patient acuity. The communication innovation of this system is in line with the Joint Commission's emphasis on designing and implementing patient-centered systems that enhance quality of care, including improved safety. PMID:25830616

  6. Alcohol and drug misuse, risk of re-admission to a general hospital and psychiatric contact.

    PubMed

    Goldbeck, R; Asif, M; Sanderson, M; Farquharson, C

    2012-02-01

    Patients with physical problems related to the use of alcohol or drugs often present to general hospitals in an unplanned, emergency fashion. In 2005, the Kerr report concluded that fundamental changes were needed in our approach, shifting the emphasis from a reactive to a more proactive, prevention-based model in the treatment of acute medical conditions. We studied patients who had at least one alcohol- or drug-related emergency admission, whose most recent admission was to Aberdeen Royal Infirmary and who, using the Scottish Patients at Risk of Re-admission and Admission (SPARRA) All Ages Tool, were thought to be at high risk of further emergency admission. We examined data sets derived from the National Health Service National Services Scotland Information Services Division, a Liaison Psychiatry database, data from the local psychiatric Patient Information Management System and data collected by the hospital alcohol liaison nurse to examine this group of patients further and consider the scope for any future intervention. Patients who have an alcohol- or drug-related emergency admission to the general hospital are at increased risk of re-admission. A substantial proportion of these patients has come into contact with the psychiatric services, often attracting a substance misuse and/or personality disorder diagnosis. A significant proportion also presents in the context of self-harm. In conclusion, this group of frequent hospital attenders may be difficult to engage but may benefit from more proactive intervention, a more joined-up management approach and the development of an enhanced general hospital alcohol liaison service. PMID:22408219

  7. Main clinical features in patients at their first psychiatric admission to Italian acute hospital psychiatric wards. The PERSEO study

    Microsoft Academic Search

    Andrea Ballerini; Roberto M Boccalon; Giancarlo Boncompagni; Massimo Casacchia; Francesco Margari; Lina Minervini; Roberto Righi; Federico Russo; Andrea Salteri; Sonia Frediani; Andrea Rossi; Marco Scatigna

    2007-01-01

    BACKGROUND: Few data are available on subjects presenting to acute wards for the first time with psychotic symptoms. The aims of this paper are (i) to describe the epidemiological and clinical characteristics of patients at their first psychiatric admission (FPA), including socio-demographic features, risk factors, life habits, modalities of onset, psychiatric diagnoses and treatments before admission; (ii) to assess the

  8. The association between depressive symptoms in the community, non-psychiatric hospital admission and hospital outcomes: A systematic review

    PubMed Central

    Prina, A. Matthew; Cosco, Theodore D.; Dening, Tom; Beekman, Aartjan; Brayne, Carol; Huisman, Martijn

    2015-01-01

    Objectives This paper aims to systematically review observational studies that have analysed whether depressive symptoms in the community are associated with higher general hospital admissions, longer hospital stays and increased risk of re-admission. Methods We identified prospective studies that looked at depressive symptoms in the community as a risk factor for non-psychiatric general hospital admissions, length of stay or risk of re-admission. The search was carried out on MEDLINE, PsycINFO, Cochrane Library Database, and followed up with contact with authors and scanning of reference lists. Results Eleven studies fulfilled our inclusion and exclusion criteria, and all were deemed to be of moderate to high quality. Meta-analysis of seven studies with relevant data suggested that depressive symptoms may be a predictor of subsequent admission to a general hospital in unadjusted analyses (RR = 1.36, 95% CI: 1.28–1.44), but findings after adjustment for confounding variables were inconsistent. The narrative synthesis also reported depressive symptoms to be independently associated with longer length of stay, and higher re-admission risk. Conclusions Depressive symptoms are associated with a higher risk of hospitalisation, longer length of stay and a higher re-admission risk. Some of these associations may be mediated by other factors, and should be explored in more details. PMID:25466985

  9. Psychiatric morbidity and emotional exhaustion among hospital physicians and nurses: association with perceived job-related factors.

    PubMed

    Renzi, Cristina; Di Pietro, Cristina; Tabolli, Stefano

    2012-01-01

    The objective of this study was to evaluate psychiatric morbidity and emotional exhaustion among physicians and nurses of a general hospital in central Italy, examining the association with perceived job-related factors. Anonymous questionnaires were distributed to all 323 hospital physicians and 609 nurses of a nonprofit health organization in Rome, Italy. Standardized instruments were used to evaluate psychiatric morbidity (General Health Questionnaire), burnout (Maslach Burnout Inventory), and perceived job-related factors. Logistic regression was used to examine the association between job-related factors, psychiatric morbidity, and burnout, controlling for demographic factors. Questionnaires were returned by 155 physicians and 216 nurses (overall response rate 40%). Estimated prevalence of psychiatric morbidity was 25% among physicians and 36.9% among nurses. Burnout on the emotional exhaustion scale affected 38.7% of physicians and 46.4% of nurses. Personnel with emotional exhaustion was at higher risk of psychiatric morbidity (p < .001). The likelihood of psychiatric morbidity among physicians was increased by perceived insufficient recognition of personal commitments by the unit's head (odds ratio [OR] = 4.21; 95% confidence interval [CI] 1.2-15.1; p = .027), insufficient managerial ability of the unit's head (OR = 3.45; 95% CI 1.2-10.1; p = .023), and unsatisfactory communication (OR = 5.30; 95% CI 1.6-17.6; p = .006). Among nurses, psychiatric morbidity was associated with insufficient ability of the unit's head to solve conflicts, insufficient decisional power in relation to responsibilities, insufficient economic rewards and career possibilities, and working in surgery. Similar job-related factors were associated also with emotional exhaustion. Psychiatric morbidity and emotional exhaustion were relatively high, particularly among nurses. Specific job-related factors were associated with psychiatric morbidity and burnout. Improving these aspects is important for the well-being of hospital staff and the quality of patient care. PMID:22524653

  10. Prevalence and Correlates of Missed First Appointments among Outpatients at a Psychiatric Hospital in Nigeria

    PubMed Central

    Akhigbe, SI; Morakinyo, O; Lawani, AO; James, BO; Omoaregba, JO

    2014-01-01

    Background: Missed appointments are common in psychiatric practice. It compromises quality of care, results in poor treatment outcomes and drains financial resources. In Nigeria, where mental health services are poorly organized, missed appointments and its resultant consequences may be burdensome. Aim: This study sought to determine the prevalence and factors (sociodemographic and clinical) associated with missed clinic appointments at a regional psychiatric hospital. Subjects and Methods: A study on a cohort of patients attending the Outpatient Clinics for the first time between June and September 2011 was conducted. We interviewed each participant at their first presentation then tracked through case records to determine adherence to scheduled first clinic appointments after 4 weeks. A questionnaire was used in eliciting sociodemographic characteristics, clinical variables, and patient/caregiver satisfaction with treatment. Descriptive statistics were used to summarize the data and inferential statistics to test associations using the SPSS 16. Results: Three hundred and ten patients were recruited over the study period. The prevalence of missed first appointment was 32.6% (101/310). Participants who were single (P = 0.04), living alone (P < 0.01) or aggressive (P < 0.01) were more likely to miss their first appointment. However, having received previous treatment for a psychiatric illness (P = 0.02) and having comorbidity (P = 0.05) was associated with less likelihood to miss a first appointment. A binary logistic regression analysis showed that having received previous treatment independently predicted a less likelihood to miss first appointment (P = 0.03). Conclusion: Quite a proportion (32.6%) of patients attending outpatient clinics miss scheduled clinic appointments. Receiving previous psychiatric care predicted adherence to scheduled appointment. PMID:25328790

  11. Police referrals to a psychiatric hospital: experiences of nurses caring for police-referred admissions.

    PubMed

    Maharaj, Reshin; O'Brien, Louise; Gillies, Donna; Andrew, Sharon

    2013-08-01

    Police are a major source of referral to psychiatric hospitals in industrialized countries with mental health legislation. However, little attention has been paid to nurses' experience of caring for police-referred patients to psychiatric hospitals. This study utilized a Heideggerian phenomenological framework to explore the experiences of nine nurses caring for patients referred by the police, through semistructured interviews. Two major themes emerged from the hermeneutic analyses of interviews conducted with nurse participants: (i) 'expecting "the worst"?'; and (ii) 'balancing therapeutic care and forced treatment'. Expecting 'the worst' related to the perceptions nurse participants had about patients referred by the police. This included two sub-themes: (i) 'we are here to care for whoever they bring in'; and (ii) 'but who deserves care?' The second theme balancing therapeutic care and forced treatment included the sub-themes: (i) 'taking control, taking care'; and (ii) 'managing power'. The study raises ethical and skill challenges for nursing including struggling with the notion of who deserves care, and balancing the imperatives of legislation with the need to work within a therapeutic framework. PMID:23009594

  12. Voluntary psychiatric hospitalization and patient-driven requests for discharge: a statutory review and analysis of implications for the capacity to consent to voluntary hospitalization.

    PubMed

    Garakani, Amir; Shalenberg, Eli; Burstin, Samantha C; Weintraub Brendel, Rebecca; Appel, Jacob M

    2014-01-01

    Along with the advances in civil rights protections for psychiatric patients since the 1970s, so-called voluntary inpatient psychiatric admissions have become common. In most U.S. states, however, these voluntary admissions abridge the rights of patients through legal provisions that limit the conditions under which patients can be discharged upon their request. This phenomenon, including variations in the state laws governing requests for discharge from voluntary psychiatric hospitalization, has received little attention in the psychiatry literature. Using Lexis-Nexis, PubMed, and Web of Science, we conducted a review of state laws regarding patients' legal rights to request discharge from voluntary hospitalization. Our hypothesis was that most states would have provisions limiting access to immediate discharge for patients whose psychiatric admission had been voluntary. Our findings from the review indicate that 49 of the 51 jurisdictions (50 states plus the District of Columbia) have provisions about patients requesting discharge from voluntary psychiatric admission. The majority of states employ a 72-hour period in which patients can be held following a request for discharge from hospitalization. As a general rule, after this evaluation period, either the patient must be discharged, or the facility must initiate involuntary commitment proceedings. Given these provisions, we explore the range of clinical admission procedures and whether voluntary admissions are truly voluntary. We also discuss the implications of our analysis for assessing the decisional capacity of patients seeking voluntary psychiatric admission. PMID:24983871

  13. Developing a Tool to Assess Competency to Consent to Psychiatric Hospitalization (KATOC): Reliability and Validity

    PubMed Central

    Seo, Mi Kyung; Kim, Seung Hyun

    2011-01-01

    Objective The justification of informed consent requires that a patient be provided with the information necessary for deciding treatment and able to use such information based on reasonable thinking. The clinical decision to consider anyone who has mental disorder as incompetence without objective assessment does not only encroach human rights of the persons with mental illness, but seriously prevent them from being recovered. Hence the objective assessment of competency is needed in mental health. Our study aimed to develop the Korean Tool of Competency to Consent to Psychiatric Hospitalization and to analyze the reliability and validity of this tool. Methods Totally 98 patients with mental illness who were hospitalized in mental hospital, participated in this study. For the subjects a questionnaire composing of 22 questions of understanding, appreciation, reasoning and expression of a choice was used. To investigate validity of this tool, MMSE-K, insight test, estimated IQ, BPRS were conducted. Its reliability and usefulness were examined with Cronbach's alpha, ICC and ROC analysis respectively and criterion related validation performed. Results As results, this tool shows that agreement between raters is relatively high and the confirmatory factor analysis for constructive validation shows that the tool is valid. Also, for criterion related validation, estimated IQ, insight and MMSE are significantly correlated to understanding, appreciation and reasoning. However competence to express a choice did not show any significant correlation with criterion variables, nor showed BPRS any significant correlation with sub-competences. Conclusion Our study developed the Korean Tool of Competency to Consent to Psychiatric Admission Treatment in the Mentally Ill, verified the reliability and validity of the tool and analyzed the optimum cutoff to distinguish between competence and incompetence in sub-competences. Korean Assessment Tool of Competency to Consent to Psychiatric Hospitalization (KATOC), analyzed the reliability and validity of this tool and presented the cutoff points by subarea. As a result, the reliability and validity of satisfactory levels were verified, the ROC analysis was implemented based on the clinical assessment and the cutoff points were found in understanding, appreciation, expression of a choice and reasoning. Such findings showed that the tool developed by researchers could be very favorably used in Korea. PMID:21519535

  14. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...Certification of need for hospitalization when a SNF bed is not available. (1) A physician may...the patient could receive proper treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for the...

  15. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...Certification of need for hospitalization when a SNF bed is not available. (1) A physician may...the patient could receive proper treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for the...

  16. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Certification of need for hospitalization when a SNF bed is not available. (1) A physician may...the patient could receive proper treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for the...

  17. Bernburg psychiatric hospital, Germany, still imageSite: DNA Interactive (www.dnai.org)

    NSDL National Science Digital Library

    2008-10-06

    DNAi location: Chronicle>In the Third Reich>"the final solution" In January, 1940 a shower room fitted with a carbon monoxide vent was first tested to kill patients at the psychiatric hospital in Brandenberg, outside Berlin. Gas chambers on the Brandenberg model were quickly set up at Bernberg and other sites around Germany to accept patients marked for death. In 1940-41, more than 70,000 patients were poisoned with carbon monoxide at these extermination centers. Other patients were starved; given sleeping pills, morphine or scopolamine; or slowly administered poisons to disguise the cause of death. No such ruse was thought necessary in Poland and East Prussia, where storm troopers simply shot thousands of mental patients.

  18. Assessment of Psychiatrically Hospitalized Suicidal Adolescents: Self-Report Instruments as Predictors of Suicidal Thoughts and Behavior

    ERIC Educational Resources Information Center

    Huth-Bocks, Alissa C.; Kerr, David C. R.; Ivey, Asha Z.; Kramer, Anne C.; King, Cheryl A.

    2007-01-01

    Objective: The validity and clinical utility of the Reynolds Adolescent Depression Scale, Beck Hopelessness Scale, Suicidal Ideation Questionnaire-Junior, and Suicide Probability Scale (SPS) were examined longitudinally among suicidal adolescents. Method: Between 1998 and 2000, 289 psychiatrically hospitalized, suicidal youth, ages 12 to 17 years,…

  19. Prevalence and impact of co-occurring psychiatric disorders on outcomes from a private hospital drug and alcohol treatment program

    Microsoft Academic Search

    Genevieve A. Dingle; Pauline King

    2009-01-01

    Aim: This naturalistic study was designed to assess the prevalence and impact of co-occurring mental disorders in 104 adults (52% male) admitted to a private hospital drug and alcohol treatment program in Brisbane, Australia.Method: Psychiatric diagnoses made by the participants' admitting psychiatrists were collected by chart audit. Measures of substance use, dependence and mood were obtained by a program psychologist

  20. Trends, Victims, and Injuries in Injurious Patient Assaults on Adult, Geriatric, and Child/Adolescent Psychiatric Units in US Hospitals, 2007-2013.

    PubMed

    Staggs, Vincent S

    2015-04-01

    While rates of other nurse-sensitive adverse outcomes have declined in recent years, little is known about trends in rates of assault by psychiatric inpatients. The primary purpose of this study was to examine recent trends in injurious assault rates against patients and staff on adult, geriatric, and child/adolescent psychiatric units, using data from a nationwide sample of hospitals. A secondary aim was to assess the frequency with which patients and various types of hospital staff were reported as the most severely injured victim. National Database of Nursing Quality Indicators® data from 2007 to 2013 were extracted. The sample comprised 345 hospitals (324 general, 5 pediatric, 16 psychiatric), 438 adult, 75 geriatric, and 105 child/adolescent units, each with assault rate data from at least three of the seven study years. All but four states in the United States were represented. Spearman's rank coefficients were used to test for time trends. In 16.3 million patient days, nearly three-quarters of the 14,877 injurious assaults by patients involved injury only to hospital staff, whereas one-fifth resulted in injury only to patients. A registered nurse was named most frequently as the most severely injured victim (32.1% of assaults), and nursing staff of all types accounted for 64.9% of the most severely injured. Assault rates did not change significantly over time. Unlike several other nursing-sensitive adverse outcomes that have been the focus of policymakers, assault rates have not declined in recent years and remain a problem in need of more focused attention. © 2015 Wiley Periodicals, Inc. PMID:25684103

  1. A critical black feminist ethnography of treatment for women with co-occurring disorders in the psychiatric hospital.

    PubMed

    Creswell, Laryssa M

    2014-04-01

    The purpose of this study was to explore the perspectives of women diagnosed with co-occurring disorders on the treatments provided by a state psychiatric hospital so that appropriate recommendations for changes in treatment may be made. Critical ethnography was used and the data was viewed through the lens of intersectionality from the black feminist perspective. Seven women hospitalized in one psychiatric hospital in the Mid-Atlantic region participated in the study. Data was collected via semistructured interviews, Consumer Perceptions of Care survey, researcher's observations, and archival data. Three major findings emerged: (1) Dialectical Behavioral Therapy (DBT) was identified as a beneficial treatment, (2) a lack of trust in the system and people in the system, and (3) housing or homelessness was perceived as a barrier. Based on the results of this study, it is recommended clinicians, administrators, and policy makers listen closely to individuals receiving treatment to make decisions regarding treatment accordingly. PMID:23686217

  2. Self-reported lifetime psychiatric hospitalization histories of jail detainees with mental disorders: Comparison with a non-incarcerated national sample

    Microsoft Academic Search

    William H. Fisher; Ira K. Packer; Steven M. Banks; David Smith; Lorna J. Simon; Kristen Roy-Bujnowski

    2002-01-01

    Lack of access to hospitalization is an often-cited risk factor for incarceration among persons with severe mental illness. This proposition is examined by comparing self-reports of lifetime psychiatric hospitalization histories of mentally ill jail inmates with data from a national sample of non-incarcerated mentally ill. Roughly 52% of mentally ill jail detainees reported at least one psychiatric hospitalization, a rate

  3. The effectiveness of an individualized form of day hospital treatment.

    PubMed

    McFarlane, Traci; MacDonald, Danielle E; Trottier, Kathryn; Olmsted, Marion P

    2015-01-01

    The traditional group format of day hospital treatment for eating disorders restricts individual tailoring of treatment, which is challenging when complex cases are referred. In 2007 we introduced a new program that included individual sessions. Patients referred to this program were older, had longer illness duration, and more pre-treatment symptoms than the original group program. These clients also had more psychopathology, and were more likely to have a diagnosis of anorexia nervosa binge/purge subtype. Weight gain and abstinence from symptoms were less likely for patients in this new program. However, premature discharge, rapid response, symptom frequencies, and relapse rates did not differ. PMID:25411716

  4. Excess non-psychiatric hospitalizations among employees with mental disorders: a 10-year prospective study of the GAZEL cohort

    PubMed Central

    Azevedo Da Silva, M; Lemogne, C; Melchior, M; Zins, M; Van Der Waerden, J; Consoli, S M; Goldberg, M; Elbaz, A; Singh-Manoux, A; Nabi, H

    2015-01-01

    Objective To examine whether non-psychiatric hospitalizations rates were higher in those with mental disorders. Method In a cohort of 15 811 employees, aged 35–50 years in 1989, mental disorder status was defined from 1989 to 2000. Hospitalizations for all-causes, myocardial infarction (MI), stroke, and cancer, were recorded yearly from 2001 to 2011. Negative binomial regression models were used to estimate hospitalization rates over the follow-up. Results After controlling for baseline sociodemographic factors, health-related behaviors, self-rated health, and self-reported medical conditions, participants with a mental disorder had significantly higher rates of all-cause hospitalization [incidence rate ratio, IRR = 1.20 (95%, 1.14–1.26)], as well as hospitalization due to MI [IRR = 1.44 (95%, 1.12–1.85)]. For stroke, the IRR did not reach statistical significance [IRR = 1.37 (95%, 0.95–1.99)] and there was no association with cancer [IRR = 1.01 (95%, 0.86–1.19)]. A similar trend was observed when mental disorders groups were considered (no mental disorder, depressive disorder, mental disorders due to psychoactive substance use, other mental disorders, mixed mental disorders, and severe mental disorder). Conclusion In this prospective cohort of employees with stable employment as well as universal access to healthcare, we found participants with mental disorders to have higher rates of non-psychiatric hospitalizations. PMID:25289581

  5. Liquid Risperidone in the treatment of rages in psychiatrically hospitalized children with possible bipolar disorder

    PubMed Central

    Carlson, Gabrielle A.; Potegal, Michael; Margulies, David; Basile, Joann; Gutkovich, Zinoviy

    2010-01-01

    Objective To examine the safety and efficacy of liquid risperidone to reduce duration of rages in children with severe mood dysregulation (SMD) or possible bipolar disorder (BP). Method There were 151 admissions of 5–12 year old children to a psychiatric inpatient unit. Diagnostic information and history of prior rages were obtained at admission. In hospital, a first rage outburst was treated with seclusion. If a 2nd rage occurred, the child was offered liquid risperidone to help him/her regain control. Risperidone dose was increased by 0.02 mg/kg for any successive rages. Duration of unmedicated and last medicated rage were compared. Rage frequency in children with SMD and several definitions of BP were compared. Results Although 82 of 151 admissions were prompted by rages, they occurred during only 49 hospitalizations, and occurred more than once in only 24. In 16 multiply-medicated children duration of rages dropped from a baseline of 44.4± 20.2 minutes to 25.6 ± 12.5 minutes at the child’s last dose. Neither SMD nor any definition of BP influenced rage response in this small sample. The average liquid risperidone dose was 0.02 mg/kg. All but 2 children also took atypical antipsychotics daily. No adverse events were observed. Conclusions Liquid risperidone may be a safe and effective way to shorten the duration of rage episodes regardless of diagnosis. However, definitive conclusions cannot be drawn in the absence of a placebo control as children were also receiving other behavioral and psychopharmacologic treatments. PMID:20402713

  6. Social-Cognitive Moderators of the Relationship between Peer Victimization and Suicidal Ideation among Psychiatrically Hospitalized Adolescents

    PubMed Central

    Wolff, Jennifer; Esposito-Smythers, Christianne; Becker, Sara; Seaboyer, Lourah; Rizzo, Christie; Lichtenstein, David; Spirito, Anthony

    2013-01-01

    Peer victimization among children and adolescents is a major public health concern, given its widespread individual and societal ramifications. Victims of peer aggression often face significant levels of psychological distress and social difficulties, such as depression, suicidal ideation, suicide attempts, and social rejection. The purpose of the present study was to examine whether cognitive distortions and perceptions of social support moderate the association between peer victimization and suicidal thoughts among psychiatrically hospitalized adolescents. Participants included 183 psychiatrically hospitalized adolescents (ages 13–18). In multiple regression analyses that controlled for gender, social and cognitive factors served as significant resources factors. Cognitive factors also moderated the relationship between peer victimization and suicidal ideation. PMID:25125940

  7. The ecological relationship between deprivation, social isolation and rates of hospital admission for acute psychiatric care: a comparison of London and New York City

    Microsoft Academic Search

    Sarah Curtis; Alison Copeland; James Fagg; Peter Congdon; Michael Almog; Justine Fitzpatrick

    2006-01-01

    We report on comparative analyses of small area variation in rates of acute hospital admissions for psychiatric conditions in Greater London around the year 1998 and in New York City (NYC) in 2000. Based on a theoretical model of the factors likely to influence psychiatric admission rates, and using data from the most recent population censuses and other sources, we

  8. Estimating genetic correlations among discontinuous phenotypes: An analysis of criminal convictions and psychiatric-hospital diagnoses in Danish adoptees

    Microsoft Academic Search

    Laura A. Baker

    1986-01-01

    A biometrical model-fitting approach was applied to data from a full adoption design to study phenotypic variation and covariation among multiple discontinuous traits. Using statistical methods available for factor analyses of dichotomous-item data, generalized least-squares estimates were obtained for parameters of additive polygenic and environmental influences on criminal convictions and psychiatric-hospital diagnoses in 2532 Danish male adoptees and their family

  9. Relation of Callous-Unemotional Traits to Length of Stay among Youth Hospitalized at a State Psychiatric Inpatient Facility

    ERIC Educational Resources Information Center

    Stellwagen, Kurt K.; Kerig, Patricia K.

    2010-01-01

    We examined the association of callous-unemotional (C/U) traits with length of psychiatric hospitalization among two samples each with 50 participants: a group of 7-11 year-olds (39 males and 11 females) receiving services on a children's unit, and a group of 12-17 year-olds (27 males and 23 females) receiving services on an adolescent unit. Our…

  10. Psychiatric morbidity of a long stay hospital population with chronic schizophrenia and implications for future community care.

    PubMed Central

    Curson, D. A.; Patel, M.; Liddle, P. F.; Barnes, T. R.

    1988-01-01

    In the United Kingdom there are plans to close most mental hospitals over the next 10 years. There is continuing uncertainty about the effectiveness of community psychiatric services that will be expected to cope with mental hospital inpatients after discharge, most of whom have schizophrenia. A survey was conducted to assess the severity of illness among such patients and implications for their future care. All 222 patients in non-psychogeriatric long stay wards of a mental hospital who met research diagnostic criteria for schizophrenia were interviewed by two psychiatrists with the comprehensive psychopathological rating scale to establish the prevalence of psychiatric symptomatology. A complete interview was not possible for 28 patients, mainly for reasons related to their schizophrenia. Despite energetic pharmacological and social treatments almost half of the 194 patients interviewed had enduring florid psychotic symptoms that presented as one or more delusions or auditory hallucinations, or both, and a sizable proportion showed behaviour that would set them apart in a community setting. The results illustrate a problem that is still imperfectly understood by policy makers and administrators in central and local government and in health authorities who are responsible for planning and implementing services for psychiatric care in the community. PMID:3140934

  11. Patient overcrowding in psychiatric hospital units: Effects on seclusion and restraint

    Microsoft Academic Search

    Kathryn L. Brooks; Jane S. Mulaik; Maggie P. Gilead; Betty S. Daniels

    1994-01-01

    The effects of environmental crowding on the behavior of persons in institutional and noninstitutional setting have been studied extensively, but much less frequently with psychiatric patients. The relationship of violent patient behavior, as measured by incidents of seclusion and\\/or restraint, and population density, as measured by the average census of patients in psychiatric units, was determined in this retrospective study.

  12. A worldwide assessment of the frequency of suicide, suicide attempts, or psychiatric hospitalization after predictive testing for Huntington disease.

    PubMed Central

    Almqvist, E W; Bloch, M; Brinkman, R; Craufurd, D; Hayden, M R

    1999-01-01

    Prior to the implementation of predictive-testing programs for Huntington disease (HD), significant concern was raised concerning the likelihood of catastrophic events (CEs), particularly in those persons receiving an increased-risk result. We have investigated the frequency of CEs-that is, suicide, suicide attempt, and psychiatric hospitalization-after an HD predictive-testing result, through questionnaires sent to predictive-testing centers worldwide. A total of 44 persons (0.97%) in a cohort of 4,527 test participants had a CE: 5 successful suicides, 21 suicide attempts, and 18 hospitalizations for psychiatric reasons. All persons committing suicide had signs of HD, whereas 11 (52.4%) of 21 persons attempting suicide and 8 (44.4%) of 18 who had a psychiatric hospitalization were symptomatic. A total of 11 (84.6%) of 13 asymptomatic persons who experienced a CE during the first year after HD predictive testing received an increased-risk result. Factors associated with an increased risk of a CE included (a) a psychiatric history

  13. Determinants of mental illness stigma for adolescents discharged from psychiatric hospitalization.

    PubMed

    Moses, Tally

    2014-05-01

    Little is known about the factors that increase the risk for enacted mental illness stigma (i.e. rejection, devaluation and exclusion) as perceived by the stigmatized person. This is particularly true for the population of adolescents diagnosed with a mental illness. The aim of this study was to address this question and examine select social and clinical factors that predict enacted stigma (self-reported) with research that follows eighty American adolescents for 6 months following a first psychiatric hospitalization. Drawing on social identity theory, and research on stigma-threatening environments, social group identification and social support, this study tested four hypotheses: affiliation or identification with higher status and lower status peers predicts more and less stigma respectively (H1); a greater and more supportive social network, and more perceived family support predict less stigma (H2); greater severity of internalizing and externalizing symptoms predicts more stigma (H3); and poorer school functioning predicts more stigma (H4). Results indicated that about 70% of adolescents reported experiencing enacted stigma (at 6 months); disrespect or devaluation was more common than outright social rejection. Using OLS regression analyses, the results provided partial support for H1, H3 and H4, while H2 was not supported. The baseline factors found to be most predictive of enacted stigma ratings at 6-months were: affiliating with more friends with mental health problems, identifying with the 'populars' peer group, higher internalizing symptom ratings, and self-reported disciplinary problems at school. These four factors remained significant when controlling for initial enacted stigma ratings, pointing to their importance in determining changes in social stigma experiences in the follow-up period. They also remained significant when controlling for perceived public stigma ratings at follow-up, indicating that the findings were not due to generalized perceptions of stigma of youth with mental illness. PMID:24695363

  14. Interactional aspects of care during hospitalization: perspectives of family caregivers of psychiatrically ill in a tertiary care setting in India.

    PubMed

    Dinakaran, P; Mehrotra, Seema; Bharath, Srikala

    2014-12-01

    There are very few studies on user-perspectives about mental health care services that explore perspectives of family caregivers in India. An exploratory study was undertaken to understand the perceived importance of various aspects of interactions with mental health service providers during hospitalization, from the perspectives of family caregivers. In addition, it also aimed at documenting their actual experience of interactional aspects of care during the hospitalization of their relatives. The study was conducted on fifty family caregivers of patients with varied psychiatric diagnoses hospitalized in a tertiary psychiatric care setting in South India. Measures of Interactional aspects of care were developed to assess perceived importance of six different interactional domains of care and the actual experience of care in these domains. Provision of informational inputs and addressing of concerns raised emerged as the domains of care given highest importance. The item pertaining to 'sharing with the caregiver about different alternatives for treatment' received negative ratings in terms of actual experience by maximum number of participants (18%). Significant differences on perceived importance of four domains of interactional aspects of care (dignity, confidentiality and fairness, addressing concerns raised, informational inputs and prompt attention and consistent care) emerged between caregiver subgroups based on educational level of the caregiver, socio-economic status, hospitalization history and broad diagnostic categories. In addition, the care givers of patients with psychoses assigned significantly more positive ratings on actual experience for all the domains of interactional aspects of care. The findings have implications for further research and practice. PMID:25440563

  15. Prevalence of Cannabis Residues in Psychiatric Patients: A Case Study of Two Mental Health Referral Hospitals in Uganda

    PubMed Central

    Awuzu, Epaenetus A.; Kaye, Emmanuel; Vudriko, Patrick

    2014-01-01

    Various studies have reported that abuse of cannabis is a risk factor for psychosis. The aims of this study were to determine the prevalence of delta 9-tetrahydrocanabinol (?9-THC), a major metabolite of cannabis, in psychiatric patients in Uganda, and to assess the diagnostic capacity of two referral mental health hospitals to screen patients for exposure to cannabis in Uganda. Socio-demographic characteristics of the patients were collected through questionnaires and review of medical records. Urine samples were collected from 100 patients and analyzed using ?9-THC immunochromatographic kit (Standard Diagnostics®, South Korea). Seventeen percent of the patients tested positive for ?9-THC residues in their urine. There was strong association (P < 0.05) between history of previous abuse of cannabis and presence of ?9-THC residues in the urine. Alcohol, cocaine, heroin, pethidine, tobacco, khat and kuber were the other substances abused in various combinations. Both referral hospitals lacked laboratory diagnostic kits for detection of cannabis in psychiatric patients. In conclusion, previous abuse of cannabis is associated with occurrence of the residues in psychiatric patients, yet referral mental health facilities in Uganda do not have the appropriate diagnostic kits for detection of cannabis residues as a basis for evidence-based psychotherapy. PMID:24453492

  16. A Geriatric Day Hospital: Who Improves the Most?

    ERIC Educational Resources Information Center

    Desrosiers, Johanne; Hebert, Rejean; Payette, Helene; Roy, Pierre-Michel; Tousignant, Michel; Cote, Sylvie; Trottier, Lise

    2004-01-01

    This study compared the changes in some bio-psychosocial variables (functional independence, nutritional risk, pain, balance and walking, grip strength, general well-being, psychiatric profile, perception of social support, leisure satisfaction, and caregivers' feeling of burden) in four categories of clients during their program at a geriatric…

  17. Predictors of valued everyday occupations, empowerment and satisfaction in day centres: implications for services for persons with psychiatric disabilities.

    PubMed

    Eklund, Mona; Sandlund, Mikael

    2014-09-01

    This study addresses predictors of occupational value, empowerment and satisfaction with the rehabilitation received in day centres for people with psychiatric disabilities. These outcomes represent varying aspects of relevance for the day centre context and together create a manifold outcome picture. This was a longitudinal study with approval from the regional research vetting board. Self-report instruments were used, and the investigated predictors motivation for going to the day centre, occupational engagement, socio-demographic factors and self-reported diagnosis. Attendees (N = 108) at 8 day centres participated and filled in self-report questionnaires regarding the predictor and outcome variables. A baseline measurement and a 14-month follow-up composed the data. Occupational engagement at baseline could predict all three outcomes at the follow-up. Motivation for the day centre activities and not preferring work before attending the day centre were positive for satisfaction with the day centre. A low participation rate, although comparable with previous studies on the target group, was a limitation of this study. To conclude, both occupational engagement and motivation are factors that can be stimulated by the staff in day centres. Actions for how to accomplish that, and thereby also more positive outcomes of the day centre services, are proposed, such as a system of freedom of choice among day centres, and between day centres and supported employment. PMID:25066326

  18. Dating violence victimization, dispositional aggression, and nonsuicidal self-injury among psychiatrically hospitalized male and female adolescents.

    PubMed

    Rizzo, Christie J; Esposito-Smythers, Christianne; Swenson, Lance; Hower, Heather M; Wolff, Jennifer; Spirito, Anthony

    2014-06-01

    The objective of the current study was to characterize the association between dating violence victimization and dispositional aggression in predicting nonsuicidal self-injury (NSSI) among psychiatrically hospitalized male and female adolescents. One hundred fifty-five adolescents (ages 13-17) and their parents completed the Schedule for Affective Disorders and Schizophrenia for School-Age Children clinical interview to assess NSSI and child abuse; adolescents completed self-report measures of aggression and dating violence victimization (verbal, physical, and sexual). Dating violence victimization and NSSI were found to be highly prevalent among both males and females in this psychiatric inpatient sample. Two moderational models were supported, wherein dating violence was associated with NSSI in the context of elevated trait anger in males and indirect aggression in females. Findings suggest that helping victims of dating violence acquire skills to address certain forms of dispositional aggression may attenuate NSSI. PMID:24612026

  19. The potential consequences of informal interpreting practices for assessment of patients in a South African psychiatric hospital.

    PubMed

    Kilian, Sanja; Swartz, Leslie; Dowling, Tessa; Dlali, Mawande; Chiliza, Bonginkosi

    2014-04-01

    In South Africa health care practitioners are commonly professionals who speak only one, or at most two, of the languages spoken by their patients. This provides for language provision challenges, since many patients are not proficient in English or Afrikaans and ad hoc and haphazard arrangements are made for interpreting by untrained personnel. As part of a larger study (conducted in 2010) in a public psychiatric hospital, we report here on the potential consequences for diagnostic assessments of 13 psychiatric evaluations mediated by ad hoc interpreters who were employed as health care workers and household aides. The psychiatric evaluations were recorded and transcribed verbatim. The first author checked for accuracy of transcription and translations, and the two members of the author team who are both senior African language academics rechecked transcription and translation. We used the typology developed by Vasquez and Javier (1991) to study interpreter errors (i.e. omissions, additions and substitutions). All errors were independently rated by a senior psychiatrist and a senior clinical psychologist to determine whether the errors were likely to have a bearing on clinical decisions concerning the patient and to rate whether errors deemed clinically significant contributed to making the patient appear more ill psychiatrically, or less ill. Of the 57 errors recorded, 46% were rated as likely to have an impact on the goal of the clinical session. Raters concurred that the clinically significant errors contributed towards potentially making the patient look more psychiatrically ill. Detailed analyses of evaluations demonstrate the complexity of informal interpreter positioning regarding issues of diagnosis and cultural factors in illness. Evaluations conducted where clinicians and interpreters are not trained in language and interpreting issues may create a distorted picture of the patients' mental health conditions. PMID:24576645

  20. Opinions about Treatment Modalities among Patients Involuntarily Committed to a Forensic Psychiatric Hospital in Finland

    ERIC Educational Resources Information Center

    Repo-Tiihonen, Eila; Vuorio, Osmo; Koivisto, Hanna; Paavola, Paula; Hakola, Panu

    2004-01-01

    Patient satisfaction studies concerning various treatment modalities are few among involuntary forensic psychiatric treatment. They indicate general satisfaction with medication, interactive treatment and occupational therapy but dissatisfaction with lack of privacy, insufficiently explained rules and inadequately explained reasons of seclusion.…

  1. Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates

    Microsoft Academic Search

    S. T. O’Sullivan; C. M. Reardon; G. T. McGreal; D. J. Hehir; W. O. Kirwan; M. P. Brady

    1996-01-01

    Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience\\u000a with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised\\u000a at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients\\u000a presented with few, if any, symptoms.

  2. [Shortage of doctors in psychiatric hospitals--providing for the future by reorganizing medical services].

    PubMed

    Jordan, Wolfgang; Adler, Lothar; Bleich, Stefan; von Einsiedel, Regina; Falkai, Peter; Grosskopf, Volker; Hauth, Iris; Steiner, Johann; Cohrs, Stefan

    2011-11-01

    Increasing psychiatric disorder treatment need, increased work load, changes in the working hour regulations, the nation-wide shortage of physicians, efficiency principle and economisation can necessitate a reorganisation of medical services. The essential steps and instruments of process optimisation in medical services for a psychiatric clinic are elucidated and discussed in the context of demographic changes, generation change, and a new concept of values. PMID:22006451

  3. Hospital campaign celebrates anniversary, effort to recruit 100 nurses in 100 days.

    PubMed

    2006-01-01

    In addition to celebrating its 75th anniversary, St Bernardine Hospital embarked on a nurse recruitment campaign in hopes of hiring 100 nurses in 100 days. The successful effort worked in tandem with the hospital's anniversary celebration. PMID:16922253

  4. Medical Student Research Fellowship The Zucker Hillside Hospital is a 208-bed psychiatric facility located adjacent to the Long Island Jewish Medical

    E-print Network

    Bushman, Frederic

    Medical Student Research Fellowship The Zucker Hillside Hospital is a 208-bed psychiatric facility. The goal of the Zucker Hillside Hospital Medical Student Research Fellowship is to help fill the gap in funding available to medical students interested in research. The Fellowship provides the opportunity

  5. [One year functioning of a psychiatric unit in a general hospital: analyses and reflections].

    PubMed

    2015-01-01

    At a time where the organization of mental health care in Belgium is profoundly modified by the development of an ambulatory option, following as such the proposals of the WHO, it seemed interesting to measure the present functioning of a psychiatry unit located in a general hospital. Data concerning the psychiatry unit of C.H.U. Tivoli, at La Louvière, were analyzed over a period of one year. The age pyramid followed a Gaussian curve, with a peak at age 45, a period of life considered as one of the most difficult in surveys over general life satisfaction. The main reasons for admission were: major depressive disorder, alcohol desintoxication, looked for isolation from the external world (either for physical or psychological reasons), diagnostic (morbidities and comorbidities) and therapeutic (complex treatment combinations) workups, anxious and psychotic decompensations, and systemic conflits (e.g. conflicts within the family). The number and duration of admissions showed peaks in september-october, january-february and june-july. The most current stay duration was 6 days. A subgroup completed an additional survey about the ideal localization for their care. 19 % would have opted for an ambulatory care if the choice would have been proposed. By contrast, it appears that hospitals, with their concentration of disciplines in the same location and relatively efficient organization, still has an important role to play in the future network in mental health care. PMID:25856967

  6. Post-hospitalization course and predictive signs of suicidal behavior of suicidal patients admitted to a psychiatric hospital: a 2-year prospective follow-up study

    PubMed Central

    2012-01-01

    Background Suicidal patients admitted to a psychiatric hospital are considered to be at risk of suicidal behavior (SB) and suicide. The present study aimed to seek predictors of SB recurrence of the high-risk patients by examining their post-hospitalization course. Method The design was 2-year prospective follow-up study of patients consecutively admitted with SB to a psychiatric center in Tokyo. The DSM-IV diagnoses and SB-related features of subjects were determined in structured interviews. Subsequently, the subjects underwent a series of follow-up assessments at 6-month intervals. The assessment included inquiries into SB recurrence, its accompanying suicidal intent (SI) and SF-8 health survey. Analyses of serial change over time in the follow-up data and Cox proportional hazards regression analyses of SB recurrence were performed. Results 106 patients participated in this study. The dropout rate during the follow-up was 9%. Within 2 years, incidences of SB as a whole, SB with certain SI (suicide attempt) and suicide were 67% (95% CI 58 - 75%), 38% (95% CI 29 - 47%) and 6% (95% CI 3 - 12%), respectively. Younger age, number of lifetime SBs and maltreatment in the developmental period were predictive of SB as a whole, and younger age and hopelessness prior to index admission were predictive of suicide attempt. Regarding diagnostic variables, anxiety disorders and personality disorders appeared to have predictive value for SB. Additionally, poor physical health assessed during the follow-up was indicated as a possible short-term predictor of SB recurrence. Conclusions This study demonstrated a high incidence of SB and suicide and possible predictors of SB recurrence in the post-hospitalization period of psychiatric suicidal patients. Specialized interventions should be developed to reduce the suicide risk of this patient population. PMID:23114285

  7. Sickle cell anemia day hospital: an approach for the management of uncomplicated painful crises

    Microsoft Academic Search

    Lennette J. Benjamin; Gwendolyn I. Swinson; Ronald L. Nagel

    2000-01-01

    Painful crisis episodes are poorly treated in sickle cell anemia, both in timeliness and appropriateness of care. Delayed treatment in Emergency Departments, unrelieved pain, frequent admissions, and prolonged hospitalizations are com- mon. We established a Day Hospital (DH) to determine if an alternative care deliv- ery system could improve pain relief and reduce unnecessary hospital admissions for patients with uncomplicated

  8. Individual Characteristics and Peer Relations of Psychiatrically Hospitalized Aggressive Youths: Implications for Treatment

    Microsoft Academic Search

    Javad H. Kashani; Michael R. Jones; Charles M. Borduin; Lisa Thomas; John C. Reid

    2000-01-01

    Objective: This study identified individual and peer-relations problems of inpatient youths who are aggressive, and whether youths who are aggressive in two settings have greater treatment needs than youths who are aggressive in one setting only. Method: 85 youths aged 10 to 16 years who were consecutively admitted to a psychiatric facility served as participants. Based on ratings by parents

  9. Emergency Psychiatric Services for Individuals with Intellectual Disabilities: Perspectives of Hospital Staff

    ERIC Educational Resources Information Center

    Lunsky, Yona; Gracey, Carolyn; Gelfand, Sara

    2008-01-01

    Strains on the mainstream mental health system can result in inaccessible services that force individuals with intellectual disabilities into the emergency room (ER) when in psychiatric crisis. The purpose of this study was to identify clinical and systemic issues surrounding emergency psychiatry services for people with intellectual disabilities,…

  10. PCL-R Psychopathy Predicts Disruptive Behavior Among Male Offenders in a Dutch Forensic Psychiatric Hospital

    ERIC Educational Resources Information Center

    Hildebrand, Martin; De Ruiter, Corine; Nijman, Henk

    2004-01-01

    In this study, the relationship between psychopathy, according to the Dutch language version of Hare's Psychopathy Checklist-Revised (PCL-R), and various types of disruptive behavior during inpatient forensic psychiatric treatment is investigated. Ninety-two male participants were administered the PCL-R following admission to an inpatient forensic…

  11. Adults with Autism Spectrum Disorders Using Psychiatric Hospitals in Ontario: Clinical Profile and Service Needs

    ERIC Educational Resources Information Center

    Lunsky, Yona; Gracey, Carolyn; Bradley, Elspeth

    2009-01-01

    Background: Adults with Autism Spectrum Disorders (ASD) represent a small, but challenging sub-group of patients within Ontario's mental health care system. However, few studies have documented the clinical characteristics of this population and examined how such individuals differ from other psychiatric patients, with or without intellectual…

  12. The influence of psychiatric comorbidity on perioperative outcomes following primary total hip and knee arthroplasty; a 17-year analysis of the National Hospital Discharge Survey database.

    PubMed

    Buller, Leonard T; Best, Matthew J; Klika, Alison K; Barsoum, Wael K

    2015-02-01

    Studies conflict regarding the impact of psychiatric illnesses including depression, anxiety, dementia and schizophrenia on perioperative outcomes following total hip (THA) and knee arthroplasty (TKA). Psychiatric comorbidity incidence, in-hospital adverse events, discharge disposition, and mortality were assessed for THA or TKA patients between 1990 and 2007 using the US National Hospital Discharge Survey. A cohort representative of 8,379,490 patients was identified and analyzed using multivariable regression analysis. Diagnoses of depression, dementia and schizophrenia were associated with increased odds of adverse events (P<0.001). Schizophrenia and depression were associated with higher odds of perioperative blood transfusion (P<0.001). All psychiatric comorbidities were associated with higher odds of non-routine discharge (P<0.001). Diagnosis of dementia was associated with higher in-hospital mortality (P<0.001). PMID:25267536

  13. Day Hospital and Residential Addiction Treatment: Randomized and Nonrandomized Managed Care Clients

    ERIC Educational Resources Information Center

    Witbrodt, Jane; Bond, Jason; Kaskutas, Lee Ann; Weisner, Constance; Jaeger, Gary; Pating, David; Moore, Charles

    2007-01-01

    Male and female managed care clients randomized to day hospital (n=154) or community residential treatment (n=139) were compared on substance use outcomes at 6 and 12 months. To address possible bias in naturalistic studies, outcomes were also examined for clients who self-selected day hospital (n=321) and for clients excluded from randomization…

  14. Effectiveness of Day Hospital Mentalization-Based Treatment for Patients with Severe Borderline Personality Disorder: A Matched Control Study.

    PubMed

    Bales, Dawn L; Timman, Reinier; Andrea, Helene; Busschbach, Jan J V; Verheul, Roel; Kamphuis, Jan H

    2014-07-24

    The present study extends the body of evidence regarding the effectiveness of day hospital Mentalization-Based Treatment (MBT) by documenting the treatment outcome of a highly inclusive group of severe borderline personality disorder (BPD) patients, benchmarked by a carefully matched group who received other specialized psychotherapeutic treatments (OPT). Structured diagnostic interviews were conducted to assess diagnostic status at baseline. Baseline, 18-month treatment outcome and 36-month treatment outcome (after the maintenance phase) on psychiatric symptoms (Brief Symptom Inventory) and personality functioning (118-item Severity Indices of Personality Problems) were available for 29 BPD patients assigned to MBT, and an initial set of 175 BPD patients assigned to OPT. Propensity scores were used to determine the best matches for the MBT patients within the larger OPT group, yielding 29 MBT and 29 OPT patients for direct comparison. Treatment outcome was analysed using multilevel modelling. Pre to post effect sizes were consistently (very) large for MBT, with a Cohen's d of -1.06 and -1.42 for 18 and 36?months, respectively, for the reduction in psychiatric symptoms, and ds ranging from 0.81 to 2.08 for improvement in domains of personality functioning. OPT also yielded improvement across domains but generally of moderate magnitude. In conclusion, the present matched control study, executed by an independent research institute outside the UK, demonstrated the effectiveness of day hospital MBT in a highly inclusive and severe group of BPD patients, beyond the benchmark provided by a mix of specialized psychotherapy programmes. Interpretation of the (large) between condition effects warrants cautionary caveats given the non-randomized design, as well as variation in treatment dosages. Copyright © 2014 John Wiley & Sons, Ltd. PMID:25060747

  15. Work engagement supports nurse workforce stability and quality of care: nursing team-level analysis in psychiatric hospitals.

    PubMed

    Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S

    2013-10-01

    Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n?=?357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care. PMID:22962847

  16. Clinical assessment and management of psychiatric patients' violent and aggressive behaviors in general hospital.

    PubMed

    Bernstein, Kunsook Song; Saladino, Joseph P

    2007-10-01

    Patients with co-morbid psychiatric disorders exhibiting violent and aggressive behaviors can be a challenge for nurses in medical-surgical units. They can deliver effective, safe care by assessing risk and building a rapport with the patient during the admission process; utilizing crisis prevention strategies, including appropriate medication administration, environmental, psychobiological, counseling, and health teaching interventions; and employing conflict resolution technique. Utilizing the nursing process, the nurse can provide effective therapeutic interventions to promote safety for both the patient and the nurse. PMID:18072668

  17. Effects of a Dedicated Regional Psychiatric Emergency Service on Boarding of Psychiatric Patients in Area Emergency Departments

    PubMed Central

    Zeller, Scott; Calma, Nicole; Stone, Ashley

    2014-01-01

    Introduction Mental health patients boarding for long hours, even days, in United States emergency departments (EDs) awaiting transfer for psychiatric services has become a considerable and widespread problem. Past studies have shown average boarding times ranging from 6.8 hours to 34 hours. Most proposed solutions to this issue have focused solely on increasing available inpatient psychiatric hospital beds, rather than considering alternative emergency care designs that could provide prompt access to treatment and might reduce the need for many hospitalizations. One suggested option has been the “regional dedicated emergency psychiatric facility,” which serves to evaluate and treat all mental health patients for a given area, and can accept direct transfers from other EDs. This study sought to assess the effects of a regional dedicated emergency psychiatric facility design known at the “Alameda Model” on boarding times and hospitalization rates for psychiatric patients in area EDs. Methods Over a 30-day period beginning in January 2013, 5 community hospitals in Alameda County, California, tracked all ED patients on involuntary mental health holds to determine boarding time, defined as the difference between when they were deemed stable for psychiatric disposition and the time they were discharged from the ED for transfer to the regional psychiatric emergency service. Patients were also followed to determine the percentage admitted to inpatient psychiatric units after evaluation and treatment in the psychiatric emergency service. Results In a total sample of 144 patients, the average boarding time was approximately 1 hour and 48 minutes. Only 24.8% were admitted for inpatient psychiatric hospitalization from the psychiatric emergency service. Conclusion The results of this study indicate that the Alameda Model of transferring patients from general hospital EDs to a regional psychiatric emergency service reduced the length of boarding times for patients awaiting psychiatric care by over 80% versus comparable state ED averages. Additionally, the psychiatric emergency service can provide assessment and treatment that may stabilize over 75% of the crisis mental health population at this level of care, thus dramatically alleviating the demand for inpatient psychiatric beds. The improved, timely access to care, along with the savings from reduced boarding times and hospitalization costs, may well justify the costs of a regional psychiatric emergency service in appropriate systems. PMID:24578760

  18. An extra day in the hospital may prevent readmissions, reduce mortality.

    PubMed

    2015-03-01

    When researchers at Columbia Business School reviewed Medicare records, they concluded that an extra day in the hospital decreases the readmission rate and mortality risk for some patients. They examined the charts of more than 6.6 million Medicare patients who were hospitalized for pneumonia, heart failure, or heart attack. They concluded that one more day in the hospital cuts the risk of readmission for heart failure patients by 7%. The extra day lowered the mortality rate for pneumonia and heart attack patients. PMID:25730960

  19. Physician visits and 30-day hospital readmissions in patients receiving hemodialysis.

    PubMed

    Erickson, Kevin F; Winkelmayer, Wolfgang C; Chertow, Glenn M; Bhattacharya, Jay

    2014-09-01

    A focus of health care reform has been on reducing 30-day hospital readmissions. Patients with ESRD are at high risk for hospital readmission. It is unknown whether more monitoring by outpatient providers can reduce hospital readmissions in patients receiving hemodialysis. In nationally representative cohorts of patients in the United States receiving in-center hemodialysis between 2004 and 2009, we used a quasi-experimental (instrumental variable) approach to assess the relationship between frequency of visits to patients receiving hemodialysis following hospital discharge and the probability of rehospitalization. We then used a multivariable regression model and published hospitalization data to estimate the cost savings and number of hospitalizations that could be prevented annually with additional provider visits to patients in the month following hospitalization. In the main cohort (n=26,613), one additional provider visit in the month following hospital discharge was estimated to reduce the absolute probability of 30-day hospital readmission by 3.5% (95% confidence interval, 1.6% to 5.3%). The reduction in 30-day hospital readmission ranged from 0.5% to 4.9% in an additional four cohorts tested, depending on population density around facilities, facility profit status, and patient Medicaid eligibility. At current Medicare reimbursement rates, the effort to visit patients one additional time in the month following hospital discharge could lead to 31,370 fewer hospitalizations per year, and $240 million per year saved. In conclusion, more frequent physician visits following hospital discharge are estimated to reduce rehospitalizations in patients undergoing hemodialysis. Incentives for closer outpatient monitoring following hospital discharge could lead to substantial cost savings. PMID:24812168

  20. The epidemiology of delays in a teaching hospital. The development and use of a tool that detects unnecessary hospital days.

    PubMed

    Selker, H P; Beshansky, J R; Pauker, S G; Kassirer, J P

    1989-02-01

    This study's purpose was to develop a tool that detects, quantifies, and assigns causes for medically unnecessary hospital delays and use it to describe the epidemiology of delays at a teaching tertiary care hospital. Based on observational data, a taxonomy of delays was constructed that included nine major categories and 166 subcategories. This formed the basis for an instrument for detecting inefficiency in hospital care: the Delay Tool. Initially designed for real-time concurrent assessment, in retrospective use it was also reliable, requiring about 6 minutes per medical record. In using the Delay Tool over a 6-month period on general internal medical and gastrointestinal services, it was discovered that 30% of 960 patients experienced delays, the average length of which was 2.9 days. This represented 17% of all hospital days. The most frequent causes of delays were scheduling of tests (31%), unavailability of post-discharge facilities (18%), physician decision-making (13%), discharge planning (12%), and scheduling of surgery (12%). Because of the longer lengths of the delays involved with awaiting postdischarge facilities (primarily nursing home beds), this was the most important cause of delays and represented 41% of all delay days. The general medicine and gastrointestinal services had significantly different distributions of delay types related to their different kinds of patients and care. The Delay Tool should be helpful in addressing hospital, and hospital-related, inefficiencies in health care delivery. PMID:2918764

  1. The effects of daily weather variables on psychosis admissions to psychiatric hospitals

    NASA Astrophysics Data System (ADS)

    McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard

    2013-07-01

    Several studies have noted seasonal variations in admission rates of patients with psychotic illnesses. However, the changeable daily meteorological patterns within seasons have never been examined in any great depth in the context of admission rates. A handful of small studies have posed interesting questions regarding a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (especially heat waves) and sunshine. In this study, we used simple non-parametric testing and more complex ARIMA and time-series regression analysis to examine whether daily meteorological patterns (wind speed and direction, barometric pressure, rainfall, sunshine, sunlight and temperature) exert an influence on admission rates for psychotic disorders across 12 regions in Ireland. Although there were some weak but interesting trends for temperature, barometric pressure and sunshine, the meteorological patterns ultimately did not exert a clinically significant influence over admissions for psychosis. Further analysis is needed.

  2. Integration of partial hospitalization and inpatient child/adolescent psychiatric units: "A question of continuity of care".

    PubMed

    Javorsky, J

    1992-06-01

    In an ever-changing health care field, an organization must be willing to change to meet the needs and demands of its patients. With continuity of care as the impetus for change, the Harold E. Fox Center at St. Joseph Mercy Hospital experienced a significant change in the delivery of child/adolescent psychiatric services. To improve patient outcomes and patient, family, staff, physician, and community satisfaction, the partial hospitalization program and the inpatient unit were integrated. A treatment team model was adopted for the integrated program. This program consisted of a teacher, social worker, nurse, and activity therapist. Physicians supervised the team in the delivery of treatment for their patients. These patients were placed on a treatment team upon admission and were maintained in the team until discharge. A survey was completed analyzing patient, parent, and staff satisfaction with the new model of service delivery. The results indicated favorable support for the concept of the integrated program; however, the operation of such a program still requires refinement. PMID:10120296

  3. [The hospital and semi-inpatient clinic in the structure of psychiatric care for adolescents].

    PubMed

    Gurovich, I Ia; Visnevskaia, L Ia; Pre?s, V B; Nemirovski?, G M; Bole?ko, I G

    1988-01-01

    Comparative investigation of hospitalized mentally ill adolescents in two cities and an adolescent cohort under treatment in a newly created semi-inpatient unit and a dispensary resulted in a conclusion that assistance provided by hospital, semi-inpatient and dispensary units does not fully embrace the adolescents in whom borderline disorders are detected. New institutional forms are necessary to introduce in order to improve the medical aid to these patients (sanatoria, health camps, boarding schools for patients with pathologic deviations of behavior). PMID:3195272

  4. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than inpatient psychiatric facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Certification of need for hospitalization when a SNF bed is not available. (1) The physician...the patient could receive proper treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for the...

  5. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than inpatient psychiatric facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...Certification of need for hospitalization when a SNF bed is not available. (1) The physician...the patient could receive proper treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for the...

  6. Efficacy of psychiatric inpatient hospitalization for adolescents as measured by pre- and post-MMPI profiles

    Microsoft Academic Search

    Valerie Klinge; James Culbert; Leonard R. Piggott

    1982-01-01

    The efficacy of inpatient hospitalization on emotionally impaired adolescents was investigated using present and past MMPI data. The results indicated that there is a “flattening of the profile toward normalcy” from time of admission to discharge time. Further statistical analysis revealed that of the 9 clinical MMPI scales, the “Depression” scale showed greatest change toward improvement.

  7. The INDDEP study: inpatient and day hospital treatment for depression – symptom course and predictors of change

    PubMed Central

    2013-01-01

    Background Depression can be treated in an outpatient, inpatient or day hospital setting. In the German health care system, episodes of inpatient or day hospital treatment are common, but there is a lack of studies evaluating effectiveness in routine care and subgroups of patients with a good or insufficient treatment response. Our study aims at identifying prognostic and prescriptive outcome predictors as well as comparative effectiveness in psychosomatic inpatient and day hospital treatment in depression. Methods/Design In a naturalistic study, 300 consecutive inpatient and 300 day hospital treatment episodes in seven psychosomatic hospitals in Germany will be included. Patients are assessed at four time points of measurement (admission, discharge, 3-months follow-up, 12-months follow-up) including a broad range of variables (self-report and expert ratings). First, the whole sample will be analysed to identify prognostic and prescriptive predictors of outcome (primary outcome criterion: Quick Inventory of Depressive Symptoms QIDS-total score, expert rating). Secondly, for a comparison of inpatient and day hospital treatment, samples will be matched according to known predictors of outcome. Discussion Naturalistic studies with good external validity are needed to assess treatment outcome in depression in routine care and to identify subgroups of patients with different therapeutic needs. Trial registration Current Controlled Trials ISRCTN20317064 PMID:23531019

  8. Daily time series for cardiovascular hospital admissions and previous day's air pollution in London, UK

    Microsoft Academic Search

    J D Poloniecki; R W Atkinson; A P de Leon; H R Anderson

    1997-01-01

    OBJECTIVE: To test for a significant association between air pollution and emergency hospital admissions for circulatory diseases (international classification of diseases-9 390-459) in London, England, that would be consistent with a causal effect of pollution on the previous day. METHODS: Long term concurrent trends, temperature, humidity, day of the week, influenza epidemic of 1989, and cyclical covariations with periodicity >

  9. Is a day hospital rehabilitation programme associated with reduction of handicap in stroke patients?

    Microsoft Academic Search

    Avital Hershkovitz; Yichayaou Beloosesky; Shai Brill; Daniel Gottlieb

    2004-01-01

    Objective: (1) To assess whether a rehabilitation day hospital programme is associated with a reduced handicap level of stroke patients. (2) To estimate the relationship between the London Handicap Scale (LHS) and other outcome measures. (3) To examine the effect of demographic parameters (age, gender, family status, education) on LHS scores.Design: A prospective longitudinal survey.Setting: An urban geriatric rehabilitation day

  10. Readmission within 30 days of Hospital Discharge among Children Receiving Chronic Dialysis

    PubMed Central

    Laskin, Benjamin; Furth, Susan

    2014-01-01

    Background and objectives The hospital admission rate for children receiving chronic dialysis has been increasing over the last decade. Approximately one third of patients with ESRD age 0–19 years are readmitted to the hospital within 30 days of discharge. The objective of this study was to examine hospital readmissions among a cohort of children receiving chronic dialysis to identify factors associated with higher rates of 30-day readmission. Design, settings, participants, & measurements A retrospective cohort of index admissions was developed among chronic dialysis patients age 3 months to 17 years at free-standing children’s hospitals reporting information to the Pediatric Hospital Information System between January 2006 and November 30, 2010, and followed until December 31, 2010. The primary outcome was any-cause 30-day readmission, and the secondary outcome was 30-day readmission for a cause similar to that of the index hospitalization. Results In this cohort, 25% of hospital admissions were followed by a readmission within 30 days. Children older than 2 years of age had a lower odds of readmission (odds ratio [OR], 0.6; 95% confidence interval [95% CI], 0.5 to 0.8). Those receiving hemodialysis had a higher risk of readmission (OR, 1.2; 95% CI, 1.0 to 1.4), and admissions >14 days were also more likely to be followed by a readmission (OR, 1.5; 95% CI, 1.1 to 2.0). Approximately 50% of the readmissions were for a similar diagnosis as the index admission; however, the specific admitting diagnosis was not associated with readmission. Conclusions A significant number of admissions among children receiving long-term dialysis are followed by readmission within 30 days. Further investigation is required to reduce the high rate of readmissions in these children. PMID:24509294

  11. Suicidality and hospitalization as cause and outcome of pediatric psychiatric emergency room visits.

    PubMed

    Grudnikoff, Eugene; Soto, Erin Callahan; Frederickson, Anne; Birnbaum, Michael L; Saito, Ema; Dicker, Robert; Kane, John M; Correll, Christoph U

    2014-10-21

    The aim of this study was to identify predictors of suicidality in youth presenting to a pediatric psychiatric emergency room service (PPERS). To this end, we conducted a retrospective cohort study of youth aged <18 years consecutively assessed by a PPERS 01.01.2002-12.31.2002, using a 12-page semi-structured institutional evaluation form and the Columbia Classification Algorithm for Suicide Assessment. Multivariate regression analyses were conducted to identify correlates of suicidal thoughts and attempts/preparation and their relationship to outpatient/inpatient disposition. Of 1,062 youth, 265 (25.0 %) presented with suicidal ideation (16.2 %) or attempt/preparation (8.8 %). Suicidal ideation was associated with female sex, depression, adjustment disorder, absent referral by family/friend/self, school referral, precipitant of peer conflict, and no antipsychotic treatment (p < 0.0001). Suicidal attempt/preparation was associated with female sex, depression, lower GAF score, past suicide attempt, precipitant of peer conflict, and no stimulant treatment (p < 0.0001). Compared to suicidal attempt/preparation, suicidal ideation was associated with school referral, and higher GAF score (p < 0.0001). Of the 265 patients with suicidality, 58.5 % were discharged home (ideation = 72.1 % vs. attempt/preparation = 33.7 %, p < 0.0001). In patients with suicidal ideation, outpatient disposition was associated with higher GAF score, school referral, and adjustment disorder (p < 0.0001). In patients with suicidal attempt/preparation, outpatient disposition was associated with higher GAF score, lower acuity rating, and school referral (p < 0.0001). Suicidality is common among PPERS evaluations. Higher GAF score and school referral distinguished suicidal ideation from suicidal attempt/preparation and was associated with outpatient disposition in both presentations. Increased education of referral sources and establishment of different non-PPERS evaluation systems may improve identification of non-emergent suicidal presentations and encourage more appropriate outpatient referrals. PMID:25331538

  12. Reducing unnecessary hospital days to improve quality of care through physician accountability: a cluster randomised trial

    PubMed Central

    2013-01-01

    Background Over 20% of hospital bed use is inappropriate, implying a waste of resources and the increase of patient iatrogenic risk. Methods This is a cluster, pragmatic, randomised controlled trial, carried out in a large University Hospital of Northern Italy, aiming to evaluate the effect of a strategy to reduce unnecessary hospital days. The primary outcome was the percentage of patient-days compatible with discharge. Among secondary objectives, to describe the strategy’s effect in the long-term, as well as on hospital readmissions, considered to be a marker of the quality of hospital care. The 12 medical wards with the longest length of stay participated. Effectiveness was measured at the individual level on 3498 eligible patients during monthly index days. Patients admitted or discharged on index days, or with stay >90 days, were excluded. All ward staff was blinded to the index days, while staff in the control arm and data analysts were blinded to the trial’s objectives and interventions. The strategy comprised the distribution to physicians of the list of their patients whose hospital stay was compatible with discharge according to a validated Delay Tool, and of physician length of stay profiles, followed by audits managed autonomously by the physicians of the ward. Results During the 12 months of data collection, over 50% of patient-days were judged to be compatible with discharge. Delays were mainly due to problems with activities under medical staff control. Multivariate analysis considering clustering showed that the strategy reduced patient-days compatible with discharge by 16% in the intervention vs control group, (OR=0.841; 95% CI, 0.735 to 0.963; P=0.012). Follow-up at 1 year did not yield a statistically significant difference between the percentages of patient-days judged to be compatible with discharge between the two arms (OR=0.818; 95% CI, 0.476 to 1.405; P=0.47). There was no significant difference in 30-day readmission and mortality rates for all eligible patients (N=3498) between the two arms. Conclusions Results indicate that a strategy, involving physician direct accountability, can reduce unnecessary hospital days. Relatively simple interventions, like the one assessed in this study, should be implemented in all hospitals with excessive lengths of stay, since unnecessary prolongation may be harmful to patients. Trial registration ClinicalTrials.gov, identifier NCT01422811. PMID:23305251

  13. Associations of medical comorbidity, psychosis, pain, and capacity with psychiatric hospital length of stay in geriatric inpatients with and without dementia.

    PubMed

    Ismail, Zahinoor; Arenovich, Tamara; Granger, Robert; Grieve, Charlotte; Willett, Peggie; Patten, Scott; Mulsant, Benoit H

    2014-10-21

    ABSTRACT Background: Geriatric psychiatry hospital beds are a limited resource. Our aim was to determine predictors of hospital length of stay (LOS) for geriatric patients with dementia admitted to inpatient psychiatric beds. Methods: Admission and discharge data from a large urban mental health center, from 2005 to 2010 inclusive, were retrospectively analyzed. Using the resident assessment instrument - mental health (RAI-MH), an assessment that is used to collect demographic and clinical information within 72 hours of hospital admission, 169 geriatric patients with dementia were compared with 308 geriatric patients without dementia. Predictors of hospital LOS were determined using a series of general linear models. Results: A diagnosis of dementia did not predict a longer LOS in this geriatric psychiatry inpatient population. The presence of multiple medical co-morbidities had an inverse relationship to length of hospital LOS - a greater number of co-morbidities predicted a shorter hospital LOS in the group of geriatric patients who had dementia compared to the without dementia study group. The presence of incapacity and positive psychotic symptoms predicted longer hospital LOS, irrespective of admission group (patients with dementia compared with those without). Conversely, pain on admission predicted shorter hospital LOS. Conclusions: Specific clinical characteristics generally determined at the time of admission are predictive of hospital LOS in geriatric psychiatry inpatients. Addressing these factors early on during admission and in the community may result in shorter hospital LOS and more optimal use of resources. PMID:25330847

  14. Cause-Specific Hospital Admissions on Hot Days in Sydney, Australia

    PubMed Central

    Vaneckova, Pavla; Bambrick, Hilary

    2013-01-01

    Background While morbidity outcomes for major disease categories during extreme heat have received increasing research attention, there has been very limited investigation at the level of specific disease subcategories. Methodology/Principal Findings We analyzed daily hospital admissions for cardiovascular (CVD), respiratory (RD), genitourinary (GU) and mental diseases (MD), diabetes (DIA), dehydration (DEH) and ‘the effects of heat and light’ (HEAT) in Sydney between 1991 and 2009. We further investigated the sensitivity to heat of subcategories within the major disease groups. We defined hot days as those with temperatures in the 95th and 99th percentiles within the study period. We applied time-stratified case-crossover analysis to compare the hospital admissions on hot days with those on non-hot days matched by day of the week. We calculated the odds ratios (OR) of admissions between the two types of days, accounting for other environmental variables (relative humidity, ozone and particulate matter) and non-environmental trends (public and school holidays). On hot days, hospital admissions increased for all major categories except GU. This increase was not shared homogeneously across all diseases within a major category: within RD, only ‘other diseases of the respiratory system’ (includes pleurisy or empyema) increased significantly, while admissions for asthma decreased. Within MD, hospital admissions increased only for psychoses. Admissions due to some major categories increased one to three days after a hot day (e.g., DIA, RD and CVD) and on two and three consecutive days (e.g., HEAT and RD). Conclusions/Significance High ambient temperatures were associated with increased hospital admissions for several disease categories, with some within-category variation. Future analyses should focus on subgroups within broad disease categories to pinpoint medical conditions most affected by ambient heat. PMID:23408986

  15. The impact of the Great East Japan earthquake on mandatory psychiatric emergency hospitalizations in Tokyo: a retrospective observational study

    PubMed Central

    Aoki, A; Aoki, Y; Harima, H

    2012-01-01

    On 11 March 2011, the eastern part of Japan was struck by a magnitude 9.0 quake. About 20?000 people were killed or weremissing, and a nuclear crisis followed. In Tokyo, people were indirectly exposed to the earthquake and nuclear crisis by TV broadcast. The aim of our study was to evaluate the potential effect of the series of catastrophes on psychiatric emergency hospitalizations in Tokyo. Clinical records of patients who were mandatorily admitted to Tokyo Metropolitan Matsuzawa Hospital by law because of urgent risk to self or others were reviewed. Records regarding the 2 years of investigation, which include the 6 months after the earthquake, were reviewed. The six months after the earthquake were compared with the eighteen months before the earthquake in clinical and demographic data using independent t-tests or ?2 tests. During the 6 months before and after the earthquake, 97 and 127 people were mandatorily admitted. ?2 Tests demonstrated a significant increase in the number of patients after the earthquake (P=0.045), attributable to the significant increase in the number of patients with schizophrenia after the earthquake (P=0.011, 32 vs 56), whereas there were no significant differences in the number of patients with other diagnoses between those two periods. Independent t-tests revealed that patients admitted after the earthquake had marginally significantly shorter periods of education compared with those admitted before the earthquake (13.78 vs 12.82 years, P=0.084). This work suggests that patients with schizophrenia were more sensitive to indirect exposure to the earthquake and that a shorter period of education was a potential risk factor. PMID:23032944

  16. An Approach to the Teaching of Psychiatric Nursing in Diploma and Associate Degree Programs: Workshop Report.

    ERIC Educational Resources Information Center

    National League for Nursing, New York, NY. Mental Health and Psychiatric Nursing Advisory Service.

    This workshop was the third and final phase of a project to determine what goals, methods, content, and learning experiences in psychiatric-mental health nursing should be included in diploma and associate degree education for nursing in light of present day trends in psychiatric care. The project indicates that the hospital is no longer the focal…

  17. Factors associated with successful completion in an adolescent-only day hospital program for eating disorders.

    PubMed

    Grewal, Seena; Jasper, Karin; Steinegger, Cathleen; Yu, Evelyn; Boachie, Ahmed

    2014-01-01

    The purpose of this study was to examine factors associated with completion of an adolescent-only eating disorder day hospital program. A total of 65 adolescents were included. Completers were compared to non-completers on multiple variables including diagnosis, weight, and medication use. Adolescents who completed the program were more likely to have been prescribed antidepressants and less likely to purge. The two groups did not differ significantly on other variables. Few factors differentiated completers from non-completers of the eating disorder day hospital program. Further research is needed to determine the role medications or purging may play in completing treatment. PMID:24320681

  18. Prevalence of psychiatric co-morbidity among patients attending dental OPD and the role of consultation-liaison psychiatry in dental practice in a tertiary care general hospital

    PubMed Central

    Ray, Pradip K; Ray (Bhattacharya), Sampa; Makhal, Manabendra; Majumder, Uttam; De, Shantanu; Ghosh, Subhankar

    2015-01-01

    Background: Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated. Aims: The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients. Settings and Design: This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India. Materials and Methods: One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1st November 2013 to 30th April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination. Statistical analysis used: The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P <0.05 was considered to be statistically significant. Results: The commonest dental illness was dental caries (22%). More than two-third of the patients had psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%). Conclusions: This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists.

  19. Individual and organizational predictors of pediatric psychiatric inpatient admission in connecticut hospitals: a 6 month secondary analysis.

    PubMed

    Hunter, Nicole C; Schaefer, Mark; Kurz, Brenda; Prates, Marcos O; Sinha, Arijit

    2015-03-01

    The objective of this study is to test the hypotheses that bipolar disorders or depressive disorders, minority status, and the presence of pediatric inpatient psychiatric unit will be individual predictors of pediatric psychiatric inpatient admission, and to provide a model that will evaluate which individual and organizational characteristics predict pediatric psychiatric inpatient. For this purpose, a secondary analysis of the medical records of 1,520 pediatric patient visits between January 1, 2008 and June 30, 2008, was conducted using univariate and multivariate logistic regression. Independent predictors of pediatric psychiatric inpatient admission were presence of bipolar and depressive disorders, greater average daily census, and increasing operating margin. Minority status was a significant predictor of not being admitted, as was presence of an anxiety disorder, greater total margin and older age. The results indicate that both individual and organizational factors impact disposition outcomes in particular subsets of pediatric patients who present to emergency departments for psychiatric reasons. PMID:24879633

  20. Afrocentric religious consultations as treatment for psychotic disorders among day hospital patients in Santiago de Cuba

    Microsoft Academic Search

    Roger Carl Gibson; Alain Jiménez Morgado; Alberto Cutie Brosyle; Elena Hamilton Mesa; Concepción Hechavarría Sanchéz

    2011-01-01

    We investigated the utilisation of Afro-centric religious treatments for psychotic disorders among a sample of Cuban day hospital patients. Most (55%) had used such treatments and this practice was more common among older persons, although unassociated with any particular religious background or racial heritage. Persons who preferred Afro-centric religious practices to medical ones were more likely to be of African

  1. Afrocentric religious consultations as treatment for psychotic disorders among day hospital patients in Santiago de Cuba

    Microsoft Academic Search

    Roger Carl Gibson; Alain Jiménez Morgado; Alberto Cutie Brosyle; Elena Hamilton Mesa; Concepción Hechavarría Sanchéz

    2010-01-01

    We investigated the utilisation of Afro-centric religious treatments for psychotic disorders among a sample of Cuban day hospital patients. Most (55%) had used such treatments and this practice was more common among older persons, although unassociated with any particular religious background or racial heritage. Persons who preferred Afro-centric religious practices to medical ones were more likely to be of African

  2. [Notes on the abandoned construction project for the provincial psychiatric hospital in Istria in the second half of the nineteenth century].

    PubMed

    Cergna, Sandro

    2013-01-01

    Records about the need for a psychiatric hospital in Istria date back to the early 19th century). This article presents the views on the issue expressed by advisors of the National Council of Istria more than half a century later. It starts with the session held on 15 March 1864 and follows the development of views the National Council held, from the motion to build a new mental hospital in at the feet of Monte Ghiro to the actual construction of the "Santorio Santorio" Provincial Hospital (still existing) at the hill of St Mihovil in Pula. The paper also investigates the reasons why the Council advisors abandoned the project of building the psychiatric hospital in Istria in favour of a home for the mentally ill in Trieste, where many Istrian patients were provided accommodation from as early as the end of the eighteenth century until the end of World War II. During the rule of the Habsburg Monarchy, many other cities of the Empire hospitalised mental patients from Istria, whose pitiful condition was reported by Matteo Campitelli at the session of the Istrian Provincial Parliament in 1886. PMID:24304106

  3. Making strides in women’s mental health care delivery in rural Ethiopia: demographics of a female outpatient psychiatric cohort at Jimma University Specialized Hospital (2006–2008)

    PubMed Central

    Chemali, Zeina N; Borba, Christina PC; Henderson, Tanya E; Tesfaye, Markos

    2013-01-01

    This paper presents the delivery of mental health care to a sample of women living in Jimma, rural Ethiopia, and their access to mental health services. A total of 226 psychiatric charts were reviewed for women seen at Jimma University Specialized Hospital. The mental health charts included documentation ranging from one paragraph to a full note. No psychiatric chart recorded medication status, detailed substance abuse history, or a history of violence. Rendering appropriate mental health care for women requires concerted efforts by multiple stake holders. Using our results, we advance concrete and practical suggestions for improving women’s mental health in rural Ethiopia. We point out that the health care system needs to be responsive, allowing for change starting with gender rights, so that rural women have access to basic mental health services. PMID:23901297

  4. Making strides in women's mental health care delivery in rural Ethiopia: demographics of a female outpatient psychiatric cohort at Jimma University Specialized Hospital (2006-2008).

    PubMed

    Chemali, Zeina N; Borba, Christina Pc; Henderson, Tanya E; Tesfaye, Markos

    2013-01-01

    This paper presents the delivery of mental health care to a sample of women living in Jimma, rural Ethiopia, and their access to mental health services. A total of 226 psychiatric charts were reviewed for women seen at Jimma University Specialized Hospital. The mental health charts included documentation ranging from one paragraph to a full note. No psychiatric chart recorded medication status, detailed substance abuse history, or a history of violence. Rendering appropriate mental health care for women requires concerted efforts by multiple stake holders. Using our results, we advance concrete and practical suggestions for improving women's mental health in rural Ethiopia. We point out that the health care system needs to be responsive, allowing for change starting with gender rights, so that rural women have access to basic mental health services. PMID:23901297

  5. Medicare Program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system changes and FY2011 rates; provider agreements and supplier approvals; and hospital conditions of participation for rehabilitation and respiratory care services; Medicaid program: accreditation for providers of inpatient psychiatric services. Final rules and interim final rule with comment period.

    PubMed

    2010-08-16

    : We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. We are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and setting forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS. In addition, we are finalizing the provisions of the August 27, 2009 interim final rule that implemented statutory provisions relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS. We are making changes affecting the: Medicare conditions of participation for hospitals relating to the types of practitioners who may provide rehabilitation services and respiratory care services; and determination of the effective date of provider agreements and supplier approvals under Medicare. We are also setting forth provisions that offer psychiatric hospitals and hospitals with inpatient psychiatric programs increased flexibility in obtaining accreditation to participate in the Medicaid program. Psychiatric hospitals and hospitals with inpatient psychiatric programs will have the choice of undergoing a State survey or of obtaining accreditation from a national accrediting organization whose hospital accreditation program has been approved by CMS. We are also issuing an interim final rule with comment period to implement a provision of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 relating to Medicare payments for outpatient services provided prior to a Medicare beneficiary's inpatient admission. PMID:20712087

  6. Applicability of the Chinese Version of the Hypomania Symptom Checklist (HCL-32) Scale for Outpatients of Psychiatric Departments in General Hospitals

    PubMed Central

    Feng, Bin; Tan, Qingrong; Ji, Jianlin

    2013-01-01

    Objectives This study aimed to determine the suitability of the Chinese version of the Hypomania Symptom Checklist (HCL-32) scale for psychiatric department outpatients with mood disorders in Chinese general hospitals, and provide a theoretical basis for the application of the HCL-32 scale. Methods Outpatients with mood disorders receiving continuous treatment in the psychiatric medicine department of three top-ranking general hospitals in three cities completed scoring the HCL-32 scale. Results A total of 1010 patients were recruited. 417 were diagnosed with bipolar disorder (236 for type I and 181 for type II) and 593 were depression. Four factors with eigenvalues >1 were considered. Factor 1 with an eigenvalue of 5.5 was labeled “active/cheerful”. Factor 2 with an eigenvalue of 2.7 was labeled “adventurous/irritable.” The coefficient of internal consistency reliability of the HCL-32 total scale was 0.84, and the coefficients for factors 1 and 2 were 0.84 and 0.88, respectively. With the total score of HCL-32?14 as positive standard, the sensitivity of HCL-32 was calculated at 69.30% and the specificity was 97.81%. Conclusions Results showed that HCL-32 had a preferable reliability and validity and was suitable as auxiliary means for bipolar disorder screening in general hospitals. PMID:24116062

  7. Day hospital and residential addiction treatment: randomized and nonrandomized managed care clients.

    PubMed

    Witbrodt, Jane; Bond, Jason; Kaskutas, Lee Ann; Weisner, Constance; Jaeger, Gary; Pating, David; Moore, Charles

    2007-12-01

    Male and female managed care clients randomized to day hospital (n=154) or community residential treatment (n=139) were compared on substance use outcomes at 6 and 12 months. To address possible bias in naturalistic studies, outcomes were also examined for clients who self-selected day hospital (n=321) and for clients excluded from randomization and directed to residential treatment because of high environmental risk (n=82). American Society of Addiction Medicine criteria defined study and randomization eligibility. More than 50% of followed clients reported past-30-day abstinence at follow-ups (unadjusted rates, not significant between groups). Despite differing baseline severities, randomized, self-selecting, and directed clients displayed similar abstinence outcomes in multivariate longitudinal models. Index treatment days and 12-step attendance were associated with abstinence (p<.001). Other prognostic effects (including gender and ethnicity) were not significant predictors of differences in outcomes for clients in the treatment modalities. Although 12-step attendance continued to be important for the full 12 months, treatment beyond the index stay was not, suggesting an advantage for engaging clients in treatment initially and promoting 12-step attendance for at least a year. PMID:18085911

  8. Pediatric Day Case Surgical Practice at a Tertiary Hospital in Lagos: How Have We Faired?

    PubMed Central

    Elebute, OA; Ademuyiwa, AO; Bode, CO; Idiodi-Thomas, HOI

    2014-01-01

    Background: There has been a gradual increase in the number of patients treated as a day case surgery in our center. This study has been conducted to audit pediatric day case surgery practice at the Lagos University Teaching Hospital. Aims: The aim of the following study is to determine the morbidity and mortality from day case surgery in our center. Subjects and Methods: The type of study was a prospective study over a 2½ year period at the Lagos University Teaching Hospital. The patients scheduled for surgeries were assessed in the pediatric outpatient clinic and information obtained for each of the patients included age, sex, diagnosis and operation planned. Additional information collected included the (1) type of anesthesia (2) post-operative complications and the cadre of the surgeon. The data was analyzed using SPSS version 19 (IBM Corp. Released 2010. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp, USA). Result: A total of 381 patients were operated during the study period. The age range of patients was 2 weeks to 15 years and the mean age was 2.9 years (3.0). There were 338 male patients (88.7%;338/381) and 43 females (11.3%;43/381). Inguinal hernias and hydroceles constituted almost half of the cases treated while 16.0% of cases were undescended testis. There were four morbidities and no mortality. Conclusion: Day case surgery is associated with a low morbidity and no mortality in our center. PMID:25221704

  9. Performance of stool cultures before and after a 3-day hospitalization: fewer cultures, better for patients and for money.

    PubMed

    Le Guern, Rémi; Loïez, Caroline; Grandbastien, Bruno; Courcol, René; Wallet, Frédéric

    2013-09-01

    We evaluated retrospectively the yield of stool culture (SC) depending on the length of hospitalization, and we characterized the patients missed by the 3-day rejection rule. SC detects bacterial enteric pathogens (Campylobacter spp., Salmonella enterica, Yersinia spp., Shigella spp.). During this 5-year study period, 13,039 SCs were requested, and 376 were positive (2.9%). The yield of SC dropped from 11.7% before 3 days of hospitalization to 0.7% after 3 days in children and 4.3% to 0.3% in adults. Finally, only 13 clinically relevant cases (0.2% of SC prescribed after 3 days) were undiagnosed by strict application of the 3-day rule. In conclusion, rejection of SC prescribed after 3 days of hospitalization allows to reduce workload by 37.8% for children and 65.7% for adults, representing a cost of €12,500 ($16,250) per year in our hospital. PMID:23867328

  10. Identifying reasons for delays in acute hospitals using the Day-of-Care Survey method.

    PubMed

    Reid, Erica; King, Andrew; Mathieson, Alex; Woodcock, Thomas; Watkin, Simon W

    2015-04-01

    This paper describes a new tool called 'Day-of-Care Survey', developed to assess inpatient delays in acute hospitals. Using literature review, iterative testing and feedback from professional groups, a national multidisciplinary team developed the survey criteria and methodology. Review teams working in pairs visited wards and used case records and bedside charts to assess the patient's status against severity of illness and service intensity criteria. Patients who did not meet the survey criteria for acute care were identified and delays were categorised. From March 2012 to December 2013, nine acute hospitals across Scotland, Australia and England were surveyed. A total of 3,846 adult general inpatient beds (excluding intensive care and maternity) were reviewed. There were 145 empty beds at the time of surveys across the nine sites, with 270 definite discharges planned on the day of the survey. The total number of patients not meeting criteria for acute care was 798/3,431 (23%, range 18-28%). Six factors accounted for 61% (490/798) of the reasons why patients not meeting acute care criteria remained in hospital. This survey gives important insights into the challenges of managing inpatient flow using system level information as a method to target interventions designed to address delay. PMID:25824060

  11. Psychiatric In-Patients Away from Home: Accounts by People with Intellectual Disabilities in Specialist Hospitals outside Their Home Localities

    ERIC Educational Resources Information Center

    Chinn, Deborah; Hall, Ian; Ali, Afia; Hassell, Holly; Patkas, Iannis

    2011-01-01

    Background: This study reflects a growing concern with the placement of people with intellectual disabilities and complex mental health problems in out of area placements at a distance from their families and communities. Materials and methods: We interviewed service users (n = 17) living in out of area in-patient psychiatric units using a…

  12. Plasma levels of cytokines and soluble cytokine receptors in psychiatric patients upon hospital admission: effects of confounding factors and diagnosis

    Microsoft Academic Search

    M. Haack; D. Hinze-Selch; T. Fenzel; T. Kraus; M. Kühn; A. Schuld; T. Pollmächer

    1999-01-01

    It has been hypothesized that the immune system plays a pathogenetic role in psychiatric disorders, in particular in major depression and schizophrenia. This hypothesis is supported by a number of reports on altered circulating levels and in vitro production of cytokines in these disorders. However, the respective evidence is not consistent. This may be in part due to an incomplete

  13. Stability of psychiatric patients' perceptions of their admission experience.

    PubMed

    Cascardi, M; Poythress, N G; Ritterband, L

    1997-12-01

    The primary aim of this study was to evaluate the stability (i.e., consistency of patients' responses over time) of newly developed scales to measure the admission experience of psychiatric hospitalization. Eighty-four psychiatric patients involuntarily committed to a crisis stabilization unit participated. All participants were admitted under an emergency petition or ex parte order for a psychiatric evaluation. Patients were interviewed soon after admission (M = 3.33 days, SD = 1.86 days). The test-retest interval was 24-48 hours with most (83.3%) re-evaluated at 24 hours. Overall, the measures showed acceptable levels of stability (r's range from .62 to .72). Factors associated with reliable responses were lower overall psychiatric symptom severity, less severe psychotic symptoms, and mentioning the same person as an influence of perceptions about the admission experience at each assessment point. PMID:9403385

  14. Impact of Frontloading of Skilled Nursing Visits on the Incidence of 30-day Hospital Readmission

    PubMed Central

    O'Connor, Melissa; Hanlon, Alexandra; Bowles, Kathryn H.

    2014-01-01

    Hospitalization among older adults receiving skilled home health services continues to be prevalent. Frontloading of skilled nursing visits, defined as providing 60% of the planned skilled nursing visits within the first two weeks of home health episode, is one way home health agencies have attempted to reduce the need for readmission among this chronically ill population. This was a retrospective observational study using data from five Medicare-owned, national assessment and claim databases from 2009. An independent randomized sample of 4,500 Medicare-reimbursed home health beneficiaries was included in the analyses. Propensity score analysis was used to reduce known confounding among covariates prior to the application of logistic analysis. Although whether skilled nursing visits were frontloaded or not was not a significant predictor of 30-day hospital readmission (p=0.977), additional research is needed to refine frontloading and determine the type of patients who are most likely to benefit from it. PMID:24702719

  15. Neopositivism and the DSM psychiatric classification. An epistemological history. Part 2: Historical pathways, epistemological developments and present-day needs.

    PubMed

    Aragona, Massimiliano

    2013-12-01

    Little is known about the concrete historical sources for the use of neopositivist operational criteria by the DSM-III. This paper suggests that distinct sources operated implicitly. The current usefulness of the operational approach is questioned. It is shown that: (a) in epistemology, neopositivism has been replaced by more adequate accounts; (b) psychologists rejected operational definitions because these were unable to define the majority of mental phenomena; (c) mental symptoms cannot be directly described as such, because they already make part of the psychiatric diagnosis to which they belong. In conclusion, diagnosing is based on the hermeneutical co-construction of mental symptoms. The failure of the neopositivist programme suggests that it is time to reconcile scientific formalization and semiotic activity. PMID:24573752

  16. Mental health care policy environment in Rivers State: experiences of mental health nurses providing mental health care services in neuro-psychiatric hospital, Port Harcourt, Nigeria

    PubMed Central

    2013-01-01

    Background Mental health services for Rivers State and surrounding States in the Niger Delta region of Nigeria are provided only at the neuropsychiatric Rumuigbo Hospital in Port Harcourt City, Rivers State, Nigeria. The study explored mental health nurses’ experiences of providing mental health services at the hospital in an attempt to understand policy implications, identify difficulties and challenges of delivering mental health care services. Methods A qualitative study using in-depth interview was conducted among 20 mental health nurses working at the neuropsychiatric Rumuigbo Hospital. This was reviewed within the Townsend mental health policy template of context and resources domains. Results A lack of political support and senior position in the Ministry of Health hinders service delivery, the prevalence of institutionalized stigma, a lack of training, and system failure to provide services at all levels of care is hampering service delivery. The inadequate allocation of resources for hospital renovations and equipment is preventing appropriate client care, as does the lack of funding for drugs, the cost of which makes them unaffordable, affecting clients staying on treatment. Conclusion Education and training of mental health care professionals should be given priority to remedy human resource shortage, provide incentives to motivate health professionals for psychiatric practice, and move toward decentralization of care into general health care services. Information should be provided at all levels to overcome the myths surrounding the causes of mental illnesses, to reduce stigma and discrimination of the affected and their families. PMID:23414640

  17. Understanding psychiatric institutionalization: a conceptual review

    PubMed Central

    2013-01-01

    Background Since Goffman’s seminal work on psychiatric institutions, deinstitutionalization has become a leading term in the psychiatric debate. It described the process of closure or downsizing of large psychiatric hospitals and the establishment of alternative services in the community. Yet, there is a lack of clarity on what exactly the concept of institutionalization means in present-day psychiatry. This review aims to identify the meaning of psychiatric institutionalization since the early 1960s to present-day. Method A conceptual review of institutionalization in psychiatry was conducted. Thematic analysis was used to synthesize the findings. Results Four main themes were identified in conceptualizing institutionalization: bricks and mortar of care institutions; policy and legal frameworks regulating care; clinical responsibility and paternalism in clinician-patient relationships; and patients’ adaptive behavior to institutionalized care. Conclusions The concept of institutionalization in psychiatry reflects four distinct themes. All themes have some relevance for the contemporary debate on how psychiatric care should develop and on the role of institutional care in psychiatry. PMID:23773398

  18. Duration of Hospitalization and Post Discharge Suicide

    ERIC Educational Resources Information Center

    Ho, Ting-Pong

    2006-01-01

    A retrospective cohort of discharged patients from all public psychiatric hospitals in Hong Kong (1997-1999) was linked to suicide data from Coroner's court. Patients hospitalized shorter than 15 days had significantly lower suicide rates than longer stay patients. The results were fairly consistent across immediate/late post discharge periods,…

  19. [The day-to-day routine in hospitals--standards and conflicts, based on the example of the Rothschild spital in Vienna around the year 1900].

    PubMed

    Malleier, Elisabeth

    2014-01-01

    The juxtaposition of official regulations and letters of complaint from Vienna's Rothschild Hospital shows, beyond the rhetoric and euphemisms of hospital reports, how lively and diverse day-to-day life was in a Jewish hospital around the year 1900. The letters of complaint query the official hospital rules and show that ideal and reality did not always coincide. Often, religious questions were at the root of the critique--such as doubts as to whether kosher dietary laws were adhered to--or conflicts between the agents involved, be they individuals or groups, patients, nurses, physicians or administrative staff. As part of this process, power structures, social hierarchies, patient rights and gender issues were called into question and renegotiated. PMID:25134251

  20. The Claybury Community Psychiatric Nurse Stress Study: is it more stressful to work in hospital or the community?

    PubMed

    Fagin, L; Brown, D; Bartlett, H; Leary, J; Carson, J

    1995-08-01

    The Claybury community psychiatric nurse (CPN) stress study collected data on stress levels in 250 CPNs and 323 ward-based psychiatric nurses (WBPN) in the North East Thames region. Four out of 10 CPNs were found to be experiencing high levels of psychological distress on GHQ scores. Whilst both CPNs and WBPNs scored highly on scores of occupational burnout, especially on emotional exhaustion scores, WBPNs scored worse on emotional detachment from their patients and were achieving less personal fulfilment from their work. Both groups of nurses were more satisfied with direct patient clinical work than with their employment conditions, particularly their working environments and, for CPNs, their relationships with their managers. The different patterns of coping skills are explored and discussed for both groups of nurses, especially the use of social support, time management and organization of tasks. The study concludes that whilst major changes are occurring in the psychiatric arena for both groups of nurses, stress is reaping its toll on mental health nurses, in terms of higher absence rates, lower self-esteem and personal unfulfilment. This could not only affect the quality of patient care but also future career prospects for nurses. The study invites serious consideration of introducing stress-reducing measures in the work-place as well as further research into specific stressors for different groups of nurses. PMID:7593957

  1. [Prospective assessment of children with pervasive developmental disorder after 2 years of day-hospital treatment].

    PubMed

    Poinso, F; Dubois, B; Chatel, C; Viellard, M; Bastard-Rosset, D; Girardot, A-M; Grandgeorge, P; De Martino, S; Sokolowsky, M; Salle-Collemiche, X; Da Fonseca, D

    2013-01-01

    The treatment of children with pervasive developmental disorders (PDD) has not been systematically assessed in French day-care units. In this prospective study, 11 children with a diagnosis of PDD were followed up for 2years in a day-care unit in the Marseille university hospital. The treatment they received is based on an initial assessment by the "Centre Ressources Autisme" (CRA PACA) and further included a continued observation of the child and an assessment of the child's abilities and needs. This treatment used various therapeutic approaches 10h weekly and also included parental counseling and coordinated work with schools. Treatment in our day-care unit can be categorized as eclectic, non-intensive therapy. It is based on methods such as TEACCH (Treatment and Education of Autistic and related Communication handicapped Children), Floor Time Play, speech and language therapy, developmental therapy, and psychotherapy. International studies on intensive behavioral therapies suggest that this treatment is superior to non-behavioral and/or non-intensive treatment. They suggest its efficiency is due both to the nature of the treatment (behavioral) and to its intensity (more than 25h a week). In this study, the CRA diagnosed children using the ADI and ADOS. The 11 children (mean age, 3years 5months) were tested twice, with the Vineland and CARS scales. The first assessment was on admission to the day hospital and the second was 2years later. The results showed developmental progress with a mean increase of 13.5 months at the Vineland Scale, and a decrease of the autism severity score on the CARS. The treatment presented here proves to be efficient; if compared to similar results in international studies, we obtained better results than their eclectic intensive or non-intensive treatment comparison group. PMID:23219270

  2. Disposition at Discharge and 60-Day Mortality among Elderly People Following Shorter Hospital Stays: A Population-Based Comparison.

    ERIC Educational Resources Information Center

    Leibson, Cynthia; And Others

    1990-01-01

    Examination of hospitalizations for 5,854 elderly adults for 1980, 1985, and 1987 revealed significant increases in 60-day mortality and nursing home transfers after Medicare's Prospective Payment System began and hospital stays were shortened. Increases were largely explained by differences in risk factors other than length of stay (age, gender,…

  3. Greater temperature variation within a day associated with increased emergency hospital admissions for asthma.

    PubMed

    Qiu, Hong; Yu, Ignatius Tak-Sun; Tse, Lap Ah; Chan, Emily Y Y; Wong, Tze Wai; Tian, Linwei

    2015-02-01

    Asthma is one of the most common chronic conditions affecting both children and adults. Examining the health effects of environmental triggers such as temperature variation may have implications for maintenance of asthma control and prevention. We hypothesized that large diurnal temperature range (DTR) might be a source of additional environmental stress and therefore a risk factor for asthma exacerbation. Daily meteorological data, air pollution concentrations and emergency hospital admissions for asthma from 2004 to 2011 in Hong Kong were collected. Poisson regression models were used to fit the relationship between daily DTR and asthma, after adjusting for the time trend, seasonality, mean temperature, humidity, and levels of outdoor air pollution. Acute adverse effect of DTR on asthma was observed. An increment of 1 °C in DTR over lag0 to lag4 days was associated with a 2.49% (95% CI: 1.86%, 3.14%) increase in daily emergency asthma hospitalizations. The association between DTR and asthma was robust on the adjustment for daily absolute temperature and air pollution. DTR exhibited significantly greater effect in cool season. Males and female children appeared to be more vulnerable to DTR. Results supported that greater temperature variation within a day was an environmental risk factor for asthma exacerbation. PMID:25461053

  4. Efficacy of treatment for hyperglycemic crisis in elderly diabetic patients in a day hospital

    PubMed Central

    Benaiges, D; Chillarón, JJ; Carrera, MJ; Cots, F; Puig de Dou, J; Corominas, E; Pedro-Botet, J; Flores-Le Roux, JA; Claret, C; Goday, A; Cano, JF

    2014-01-01

    Background The purpose of this prospective cohort study was to compare the costs of day hospital (DH) care for hyperglycemic crisis in elderly diabetic patients with those of conventional hospitalization (CH). Secondary objectives were to compare these two clinical scenarios in terms of glycemic control, number of emergency and outpatient visits, readmissions, hypoglycemic episodes, and nosocomial morbidity. Methods The study population comprised diabetic patients aged >74 years consecutively admitted to a tertiary teaching hospital in Spain for hyperglycemic crisis (sustained hyperglycemia [>300 mg/dL] for at least 3 days with or without ketosis). The patients were assigned to DH or CH care according to time of admission and were followed for 6 months after discharge. Exclusion criteria were ketoacidosis, hyperosmolar crisis, hemodynamic instability, severe intercurrent illness, social deprivation, or Katz index >D. Results Sixty-four diabetic patients on DH care and 36 on CH care were included, with no differences in baseline characteristics. The average cost per patient was 1,345.1±793.6 € in the DH group and 2,212.4±982.5 € in the CH group (P<0.001). There were no differences in number of subjects with mild hypoglycemia during follow-up (45.3% DH versus 33.3% CH, P=0.24), nor in the percentage of patients achieving a glycated hemoglobin (HbA1c) <8% (67.2% DH versus 58.3% CH, P=0.375). Readmissions for hyperglycemic crisis and pressure ulcer rates were significantly higher in the CH group. Conclusion DH care for hyperglycemic crises is more cost-effective than CH care, with a net saving of 1,418.4 € per case, lower number of readmissions and pressure ulcer rates, and similar short-term glycemic control and hypoglycemia rates. PMID:24868152

  5. Family influence and psychiatric care: Physical treatments in Devon mental hospitals, c. 1920 to the 1970s?

    PubMed Central

    Baur, Nicole

    2013-01-01

    ‘What is it that appears to make the mentally ill so vulnerable to therapeutic experimentation?’1 One commentator wrote in the 1990s, regarding mental hospitals as repressive, coercive and custodial institutions where medical staff subjected patients to orgies of experimentation. A careful study of surviving documents of the Devon County Lunatic Asylum (DCLA), however, paints a different picture. Rather than medical staff, patients’ relatives and the wider community exercised a considerable influence over a patient's hospital admission and discharge, rendering the therapeutic regime in the middle of the 20th century the result of intense negotiations between the hospital and third parties. PMID:23876990

  6. Occupational exposure to blood-borne pathogens in a tertiary hospital: benchmarking using patient days.

    PubMed

    Mazi, Waleed; Senok, Abiola C; Assiri, Abdullah M; Kazem, Najla; Abato, Avigail Tan

    2015-03-01

    Incidence and risk factors for occupational exposure to blood-borne pathogens (OEBBPs) in a tertiary hospital in Saudi Arabia was assessed. Reported sharps injuries from 2009 to 2010 were analyzed and benchmarked using patient days. OEBBPs caused by sharps injuries increased from 41 in 2009 to 65 in 2010, with an incidence rate of 4.09/10 000 patient days in 2009 and 5.9/10 000 patient days in 2010. Most episodes (41%) occurred during recapping of hollow bore needles after obtaining blood specimens. The highest incidence was among nursing staff(n/N = 87/106; 82%), and injuries also occurred in housekeeping staff (3.7%). A correlationbetween morning shift and OEBBPs was observed, and the highest number of episodes occurred in the emergency room (21.5%) and renal dialysis unit (16.9%). There was exposure to HCV (n = 13) and HBV (n = 4) but not to HIV (n = 0), and no seroconversions were documented. Education on adherence to universal precaution measures and use of safety engineered devices as well as the introduction of an OEBBP notification hotline are recommended. PMID:22743860

  7. Integrated Educational and Mental Health Services within a Day Treatment Setting.

    ERIC Educational Resources Information Center

    Francis, Greta; Radka, Dale F.

    This paper discusses the integration of educational and mental health services for children and adolescents within a psychiatric day treatment setting at the Bradley School housed in a private psychiatric hospital affiliated with Brown University in Rhode Island. A full range of mental health services are used, and therapies are delivered in the…

  8. Stability of etoposide solutions in disposable infusion devices for day hospital cancer practices.

    PubMed

    Klasen, Alison; Kessari, Romain; Mercier, Lionel; Valade, Cyril; Grill, Jacques; Desmaris, Romain; Paci, Angelo

    2014-03-01

    In a context of day hospital care of cancer patients, a protocol combining etoposide and carboplatin is used in paediatrics. Disposable infusion devices can be used to improve patient quality of life and to optimize nursing time. Stability data are available for carboplatin in these devices but not for etoposide. The aim of this study was to determine the stability of etoposide solutions in these devices by monitoring the changing etoposide concentration. To study the changing etoposide concentration, we investigated three different concentrations, each in two different solvents: sodium chloride (NaCl) 0.9 % and dextrose 5 %, in Intermate(®) disposable infusion devices. Quantitative analyses were performed by high-performance liquid chromatography coupled with ultraviolet (UV) detection on samples collected over a 24-h study period. The results showed that 100 mg/L etoposide solutions were stable for 24 h in NaCl 0.9 % and for 12 h in dextrose 5 %, whatever the temperature. The 400-mg/L solutions were stable for 24 h in both diluents, whatever the temperature, whereas the 600-mg/L solutions when diluted in NaCl 0.9 % and dextrose 5 % in water were stable for 8 and 6 h, respectively. We found that precipitation was the main phenomenon responsible for decreased etoposide concentrations. This study allowed us to conclude that etoposide solutions prepared in Intermate(®) infusion devices are stable for day hospital administration in paediatrics. It will also allow us to conduct a future clinical study that will focus on the medico-economic feasibility of this protocol and on the evaluation of patient and nurse satisfaction. PMID:24627337

  9. Geriatric conditions as predictors of increased number of hospital admissions and hospital bed days over one year: findings of a nationwide cohort of older adults from Taiwan.

    PubMed

    Wang, Hui-Hsuan; Sheu, Ji-Tian; Shyu, Yea-Ing Lotus; Chang, Hsing-Yi; Li, Chia-Lin

    2014-01-01

    The main aim of the present study was to determine whether geriatric conditions independently predict hospital utilizations after controlling for chronic diseases and disability among community dwelling older adults. We analyzed data from a nationally representative sample of older adults aged 65 years and above by linkage of 2005 Taiwan National Health Interview Survey data (including demographic characteristics, chronic diseases, disability, and geriatric conditions such as depressive symptoms, cognitive impairment, falls, and urinary incontinence), and 2006 National Health Insurance (NHI) claims data (including hospital admissions and hospital bed days). A total of 1598 participants who consented to data linkage, were successfully linked to NHI data, and had complete data for geriatric conditions were eligible for analysis. The prevalence of depressive symptoms, cognitive impairment, falls, and urinary incontinence were 20.6%, 26.1%, 21.3% and 23.9%, respectively. Overall, 18.2% (291/1598) of participants had at least one hospital admission during 2006. After adjustment for demographics, prior hospitalization, chronic diseases and functional disability, participants with geriatric conditions had significantly more hospital admissions (incidence rate ratio=1.34; 95% confidence interval=[1.02-1.75]) and more hospital bed days (incidence rate ratio=1.72; 95% confidence interval=[1.11-2.66]) than participants without geriatric conditions. Our results highlight the high prevalence (56.3%) of one or more geriatric conditions and their independent association with excess hospital utilizations. Thus, it is of critical importance to develop programs aimed at preventing or improving these conditions to reduce hospital use in this population. PMID:24588875

  10. Violent psychiatric patients: a study.

    PubMed

    Kermani, E J

    1981-04-01

    In a study of fifty-three violent psychiatric patients in a psychiatric hospital setting, it was found that there are two distinct major groups of violent patients--one of patients with a long history of antisocial behavior who are often chronically homicidal and suicidal, and another of patients who neither have a history of destructive behavior nor exhibit homicidal or suicidal tendencies. The latter become acutely assaultive only during the course of psychiatric illness. The personality traits and background associated with these two groups offer additional contrasts. Each group presents different problems and, of major importance to the psychiatric practioner, each group requires different management. PMID:7258418

  11. “Too Young to be Worried!” Psychiatric Assessment and Follow-up of Young People After Severe Physical Assault in an Inner City Hospital of South London

    PubMed Central

    Viswanathan, S; Datta, SS; Sheridan, PB; Lax-Pericall, T

    2014-01-01

    Background: Interpersonal violence amongst youth is on the rise world-wide and London is no exception. The resulting injuries can be very serious and even result in death. This is a difficult to engage subgroup of patients and there is likely to be significant unmet social and mental health needs. Aim: The current paper discusses the results of immediate psychiatric and social assessment of young people following a serious physical assault as assessed by a pediatric liaison Child and Adolescent Mental Health Service (CAMHS). CAMHS in Kings College Hospital, London in one calendar year and also the help seeking behavior of the young people following the assault. Subjects and Methods: The Department of Pediatric Liaison Psychiatry is based within the Kings College Hospital and has a multidisciplinary team comprising of nurses, consultant child and adolescent psychiatrists and social workers who reviewed all patients who were referred to them following an episode of assault. All young people who were referred to the department of pediatric liaison psychiatry based within Kings College Hospital over one calendar year were included in the analysis. Results: 83% (29/35) of the victims were male and 83% (29/35) were from minority ethnic backgrounds. Although 70% (25/35) of the young people included in this study had significant safe guarding concerns, only 17% (6/35) turned up for their follow-up appointments with child mental health teams. Conclusions: Innovative models of service delivery are required to cater to the unique needs of this group of extremely vulnerable young people. PMID:24669337

  12. Antidepressants: Relationship to the Time to Psychiatric Readmission and Probability of Being in Hospital in Depressive Patients

    PubMed Central

    Warnke, Ingeborg; Nordt, Carlos; Moock, Jörn; Kawohl, Wolfram; Rössler, Wulf

    2014-01-01

    Introduction: Although antidepressants play a major role in the treatment of patients with depression, it is unclear which specific antidepressants are more efficacious than others. This study aims to analyze the relationship between several antidepressant substances and the time to readmission as well as the probability of being in hospital in a given week by using prescription data. Methods: The database was health-insurance claim data from the new Federal States in Germany. The analysis consisted of all patients with unipolar depression at their index admission in 2007 (N?=?1803). Patients were followed up for 2?years after discharge from index hospitalization. Statistical analyses were conducted by discrete-time hazards models and general estimation equation models, accounting for various predictors. Results: Of all prescribed antidepressant substances, sertraline was related to an increased time to readmission by 37% and to a reduction in the probability of being in hospital in a given week by 40%. However, it was prescribed to only about 5% of the patients. Conclusion: In this study, only sertraline appeared to have clinical and economic advantages. It is remarkable that just a minority of patients received sertraline in our study, thus differing from the prescription pattern in the US. PMID:24847477

  13. Day hospital programmes for eating disorders: a review of the similarities, differences and goals.

    PubMed

    Abbate-Daga, G; Gramaglia, C; Preda, S; Comba, E; Brustolin, A; Fassino, S

    2009-01-01

    Day hospital (DH) treatments for eating disorders (EDs) provide intensive daily care and allow patients to maintain and test their social relations and coping skills at home and outside. Although widespread, their description is lacking. This review compares the different types of DH described in the literature and presents our DH experience in Turin, Italy. We searched Psychinfo and Pubmed with the following keywords: anorexia nervosa, bulimia nervosa, EDs, DH, day treatment and partial hospitalisation. We found and reviewed the DH programmes of eleven specialised centres, which have some shared features but also many differences, suggesting that DH treatments are still largely experimental. Briefly, the shared elements are: biopsychosocial model as reference frame; cognitive-behavioural model or techniques; behavioural contract; patients' selection; body image therapy; involvement of family; weight normalisation/weight gain and modification/normalisation of eating behaviour as objectives. Nonetheless, shared opinions concerning inclusion criteria are lacking; the duration of DH treatment is surprisingly different among centres (from 3 to 39 weeks); the approach to eating and compensation behaviours ranges from control to autonomy; followup and psychometric assessment can be either performed or not; psychological and behavioural objectives can be different. This review suggests the existence of two different DH models: the first has a shorter duration and is mainly symptom-focused; the second is more individual-focused, has a longer duration and is focused on patients' relational skills, psychodynamic understanding of symptoms and more gradual changes in body weight. Further investigation is required to make DH treatment programmes measurable and comparable. PMID:19934635

  14. Changing patterns of psychiatric inpatient care in the United States, 1988-1994.

    PubMed

    Mechanic, D; McAlpine, D D; Olfson, M

    1998-09-01

    Using data from the National Hospital Discharge Survey and the Inventory of Mental Health Organizations, this article examines national trends in psychiatric inpatient care from 1988 to 1994 in general hospitals and mental hospitals. We find that discharges with a primary diagnosis of mental illness in general hospitals increased from 1.4 to 1.9 million during this period. The total increase of 1.2 million days of care in general hospitals was small relative to the reduction of 12.5 million inpatient days in mental hospitals. General hospital discharges increased most in private nonprofit hospitals and declined substantially in public hospitals. Length of stay has fallen most substantially in private nonprofit hospitals. Public programs have increasingly replaced private insurance as the major source of payment. These observations suggest that psychiatric inpatient care in general hospitals can be characterized as a process in which patients who would have been clients of public mental hospitals in a prior period replace privately insured patients who, under managed care, are largely treated in community settings. Private nonprofit general hospitals increasingly treat publicly financed patients with more severe illnesses. PMID:9736004

  15. Psychiatric hospital in Wiesloch, Germany, about 1925, still imageSite: DNA Interactive (www.dnai.org)

    NSDL National Science Digital Library

    2008-10-06

    DNAi location: Chronicle>In the Third Reich>"the final solution" In September 1939, Hitler attacked Poland. Sterilizations slowed nearly to a halt, likely because most people who fit the legal crtieria had already been sterilized. Acting on Hitler's suggestion that incurable mental patients "be granted mercy killing," a panel of psychiatrists and medical doctors completed a one-page questionnaire on each of 283,000 patients in mental hospitals throughout Germany. More than one-fourth of cases, those who were incurable or could not work, were marked with a "Â?" for death.

  16. A zero-inflated Poisson mixed model to analyze diagnosis related groups with majority of same-day hospital stays

    Microsoft Academic Search

    Kui Wang; Kelvin K. W. Yau; Andy H. Lee

    2002-01-01

    With increasing trend of same-day procedures and operations performed for hospital admissions, it is important to analyze those Diagnosis Related Groups (DRGs) consisting of mainly same-day separations. A zero-inflated Poisson (ZIP) mixed model is presented to identify health- and patient-related characteristics associated with length of stay (LOS) and to model variations in LOS within such DRGs. Random effects are introduced

  17. Psychiatric response to the Clapham rail crash.

    PubMed Central

    Burns, T P; Hollins, S C

    1991-01-01

    The psychiatric response to the Clapham rail crash is described. The psychiatric input was short term, dealing with the 38 inpatients and over 200 hospital staff involved in the response. The need to evolve a compact, responsive team structure is noted. The value of a proactive approach and provision of psychological debriefing is defended. Incorporation of components of the psychiatric response into the Hospital's major incident plan is reported. PMID:1994007

  18. Outbreak of scarlet fever at a hospital day care centre: analysis of strain relatedness with phenotypic and genotypic characteristics

    Microsoft Academic Search

    Po-Ren Hsueh; Lee-Jene Teng; Ping-Ing Lee; Pan-Chyr Yang; Li-Min Huang; Shan-Chwen Chang; Chin-Yun Lee; Kwen-Tay Luh

    1997-01-01

    An outbreak of scarlet fever involving 12 children occurred at a hospital day care centre from February to March 1996. Twenty-five throat isolates of Streptococcus pyogenes (GAS, group A streptococcus) available from 24 children, including 10 children with scarlet fever and 14 asymptomatic carriers, and one asymptomatic staff member were studied for the presence of genes encoding streptococcal pyrogenic exotoxin

  19. Factors Affecting Non-Adherence among Patients Diagnosed with Unipolar Depression in a Psychiatric Department of a Tertiary Hospital in Kolkata, India

    PubMed Central

    Banerjee, Sohini

    2013-01-01

    Non-adherence to depression treatment is a common clinical problem globally. However, limited research is available from India. This cross-sectional study aimed to assess non-adherence to prescribed treatment among patients with unipolar depression at a psychiatric out-patient department (OPD) of a tertiary hospital in Kolkata, India. The Morisky Medication Adherence Scale (MMAS) was used and a questionnaire designed by the Principal Investigator (PI) was administered. A total of 239 patients with unipolar depression were interviewed of whom 66.9% (160) were non-adherent and 33.1% (79) were adherent to treatment. The difference was significant (Fisher's Exact <0.000). Women were nearly three times at a higher risk of being non-adherent compared to men (OR 2.7; 95% CI 1.0–7.1). The non-adherent group compared to the adherent group was significantly more likely to consume extra medicines than the recommended amount (OR 2.8; 95% CI 1.1–7.3) and had lower internal locus of control (LOC) (OR 4.5; 95% CI 2.4–8.3). Adherence to prescribed treatment in an out-patient clinical setting was a problem among patients with unipolar depression. Suitable interventions on individuals with the above mentioned attributes are required in India and in similar settings where non-adherence to depression therapy is an important public health problem. PMID:24381752

  20. College Student Utilization of a Comprehensive Psychiatric Emergency Program

    ERIC Educational Resources Information Center

    Mitchell, Sharon L.; Kader, Mahrin; Haggerty, Melinda Z.; Bakhai, Yogesh D.; Warren, Calvert G.

    2013-01-01

    The authors sought to identify college students at risk for experiencing a mental health crisis that warranted a psychiatric evaluation at a hospital and/or a psychiatric hospitalization. A retrospective chart review of college students evaluated at a comprehensive psychiatric emergency program during a 1-year period was conducted. Demographic…

  1. The influence of maternal psychopathology on ratings of child psychiatric symptoms: an SEM analysis on cross-informant agreement

    Microsoft Academic Search

    Jörg M. Müller; Sandra Achtergarde; Tilman Furniss

    2011-01-01

    The distorting influence of maternal depression on the ratings of child behaviour is known as the depression-distortion hypothesis.\\u000a This study investigated the depression-distortion hypothesis in a clinical sample of child psychiatric preschool children\\u000a and extended the depression-distortion hypothesis to maternal psychopathology-distortion hypothesis in general. Subjects were 124 children, who were referred for treatment in a Child Psychiatric Family Day Hospital

  2. Psychiatric Emergencies

    PubMed Central

    Bayrakal, Sadi

    1972-01-01

    Dr. Bayrakal believes that the time has come for the family physician to deal with minor psychiatric disturbances in his office as well as psychiatric emergencies in the emergency department. The newly emerging medico-social philosophy of both the federal and provincial governments, he says, is giving greater responsibility and authority to the family physician in every area of medicine, including psychiatry. The author discusses major psychiatric emergencies (suicide, suicidal attempt, homicide, social scandal, as well as other psychiatric emergencies) on the ward including adolescent psychiatry. (The descriptions and treatment procedures are given on a concrete clinical level without theoretical overload.) In the family physician's work, psychological understanding is of profound importance. Giving him the added scope of psychiatric consideration to see the patient in bio-psycho-social totality will enable him to practice a more humanized form of medicine. PMID:20468779

  3. MENTAL HEALTH AND PSYCHIATRIC NURSING IN PRACTICAL NURSE EDUCATION. FINAL REPORT.

    ERIC Educational Resources Information Center

    CRAWFORD, ANNIE L.

    THIRTY-ONE PROFESSIONAL NURSE EDUCATORS IN SCHOOLS OF PRACTICAL NURSING IN THE SOUTHEAST ATTENDED A TWO-WEEK CLINICAL WORKSHOP ON PSYCHIATRIC NURSING AT WESTERN STATE HOSPITAL, STAUNTON, VIRGINIA, IN AUGUST 1966. THEY RECONVENED FOR A THREE-DAY FOLLOW-UP CONFERENCE AT ATLANTA, GEORGIA, IN JANUARY 1967. THE PROJECT WAS UNDERTAKEN TO UPDATE THE…

  4. Implementing a Music Therapy Program at a New 72-Hour Acute Psychiatric Admissions Unit: A Case Study of a Patient Who Was Malingering

    ERIC Educational Resources Information Center

    Silverman, Michael J.

    2009-01-01

    Because of the relatively poor treatment available, the high financial costs of hospitalization, multiple and complex issues of persons with severe mental illnesses, and advancements in pharmacotherapy, psychiatric patients are often only hospitalized for a few days before they are discharged. Thus, brief psychosocial interventions for persons who…

  5. Broader Indications for Psychiatric Consultation

    PubMed Central

    Steinberg, Paul

    1987-01-01

    A liaison approach to psychiatric consultation increases the patient population who can benefit from psychiatric assessment during hospitalization for medical or surgical conditions. It also broadens the scope of the psychiatric investigation of the individual patient. The meaning of the illness to the patient, and the patient's present methods of adapting to his or her illness are important considerations. Unconscious concerns, which interfere with the patient's compliance to medical treatment, may be sufficiently clarified and resolved so that medical progress is expedited. Psychiatric consultation can be used to prevent an untoward psychological reaction to illness, if this is foreseen. This preventive consultation, which is often possible only because of the family physician's awareness of the psychological vulnerability of some of her or his patients, can result in reduced medical and psychiatric morbidity. PMID:21263836

  6. High levels of bed occupancy associated with increased inpatient and thirty-day hospital mortality in Denmark.

    PubMed

    Madsen, Flemming; Ladelund, Steen; Linneberg, Allan

    2014-07-01

    High bed occupancy rates have been considered a matter of reduced patient comfort and privacy and an indicator of high productivity for hospitals. Hospitals with bed occupancy rates of above 85 percent are generally considered to have bed shortages. Little attention has been paid to the impact of these shortages on patients' outcomes. We analyzed all 2.65 million admissions to Danish hospitals' departments of medicine in the period 1995-2012. We found that high bed occupancy rates were associated with a significant 9 percent increase in rates of in-hospital mortality and thirty-day mortality, compared to low bed occupancy rates. Being admitted to a hospital outside of normal working hours or on a weekend or holiday was also significantly associated with increased mortality. The health risks of bed shortages, including mortality, could be better documented as a priority health issue. Resources should be allocated to researching the causes and effects of bed shortages, with the aim of creating greater interest in exploring new methods to avoid or reduce bed shortages. PMID:25006151

  7. DAY-CARE REHABILITATION CENTER FOR EMOTIONALLY DISTURBED ADOLESCENTS. FINAL REPORT.

    ERIC Educational Resources Information Center

    CRAWFORD, HUGH A.; VAN DUYNE, WILLIAM V.

    IN THIS FIVE YEAR DEMONSTRATION PROJECT, EMOTIONALLY DISTURBED ADULTS AND ADOLESCENTS RECEIVED TREATMENT AT A DAY CARE REHABILITATION CENTER SPONSORED BY THE RHODE ISLAND DIVISION OF VOCATIONAL REHABILITATION (DVR) LOCATED IN A PRIVATE PSYCHIATRIC HOSPITAL (BUTLER HOSPITAL). THE MAJOR TREATMENT GOALS WERE PRESERVATION AND RESTORATION OF…

  8. Lunar phase and psychiatric illness in goa.

    PubMed

    Parmeshwaran, R; Patel, V; Fernandes, J M

    1999-01-01

    There has been considerable research on the influence of the lunar cycle on mental illness with conflicting findings. The objective of this study was to determine the relationship between full moon (FM), new moon (NM), and other moon (OM) days and the frequency of specific psychiatric disorders in patients seen at a tertiary psychiatric hospital in Goa and to examine relationships with eclipses. Analysis of all new patients in two calendar years (1997 & 1993) was carried out. Diagnoses of interest were : Non affective psychoses; depression; and mania. The numbers of new patients seen at the OPD of the Institute of Psychiatry & Human Behaviour, Goa, with these diagnoses were compared between FM, NM and OM days. Numbers of patients with these diagnoses on eclipse days (lunar/solar) were also examined. A significant trend was observed for greater numbers of patients with non-affective psychoses on FM days, but no pattern was observed for mania or depression. The excess of non-affective psychoses was more marked on days of a visible lunar eclipse. A relationship between FM and non-affective psychoses has been demonstrated. Its implications for further research and the potential mechanism to explain these findings are discussed. PMID:21455355

  9. LUNAR PHASE AND PSYCHIATRIC ILLNESS IN GOA

    PubMed Central

    Parmeshwaran, R.; Patel, V.; Fernandes, J.M.

    1999-01-01

    There has been considerable research on the influence of the lunar cycle on mental illness with conflicting findings. The objective of this study was to determine the relationship between full moon (FM), new moon (NM), and other moon (OM) days and the frequency of specific psychiatric disorders in patients seen at a tertiary psychiatric hospital in Goa and to examine relationships with eclipses. Analysis of all new patients in two calendar years (1997 & 1993) was carried out. Diagnoses of interest were : Non affective psychoses; depression; and mania. The numbers of new patients seen at the OPD of the Institute of Psychiatry & Human Behaviour, Goa, with these diagnoses were compared between FM, NM and OM days. Numbers of patients with these diagnoses on eclipse days (lunar/solar) were also examined. A significant trend was observed for greater numbers of patients with non-affective psychoses on FM days, but no pattern was observed for mania or depression. The excess of non-affective psychoses was more marked on days of a visible lunar eclipse. A relationship between FM and non-affective psychoses has been demonstrated. Its implications for further research and the potential mechanism to explain these findings are discussed. PMID:21455355

  10. How can a change in the operating system of the mental health review board promote the discharge of long-term hospitalized psychiatric patients? A case study of Seoul city

    PubMed Central

    2014-01-01

    Background One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers’ awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is based on Mental Health Act since 1995. However, the discharge order rate was very low and there community care system after discharge order is still very weak. Case description The Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the MHRB from a regional level to a local level to strengthen the function of MHRB. However, the discharge order rate versus the whole evaluation requests still remains at a very low level or less than 5%. And it is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies. Discussion Any policies to promote psychiatric discharge including MHRB are needed to take the comprehensive factors into consideration, such as payment program, community infrastructure, increasing care-givers’ acceptance and so on. Conclusion Despite of the political trial of Korean government to reduce length of stay of chronic psychiatric patients, it was not successful. Still it had failed to propose a detailed policy measure in terms of the above-mentioned prerequisites. Therefore, new system and program developments including reform of payment system which reflect prior studies’ recommendations are essential. PMID:25114716

  11. Consultation-liaison Approach for the Management of Psychiatric Manifestations in Parkinson's Disease and Related Disorders: A Report from Neuropsychiatric Hospital, India

    PubMed Central

    Thippeswamy, Harish; Viswanath, Biju; Babu, Girish N.; Reddi, V. Senthil K.; Chaturvedi, Santosh K.

    2014-01-01

    Background: Non-motor psychiatric manifestations of Parkinson's disease have been increasingly noted to contribute to morbidity and mortality. Materials and Methods: We studied the psychiatric manifestations among inpatients with Parkinson's disease and other movement disorders by examining the referrals (N = 127) to consultation-liaison psychiatry services from neurology/neurosurgery between July 2009 and April 2010 using structured clinical proforma. Results: Parkinson's disease and other movement disorders was the most common neurological diagnosis (19%). The most common reason for referral was depression (38%) followed by behavioral problems (33%). Post-assessment, depression rates were higher (54%) and behavioral manifestations were diagnosed as sleep problems (13%), organic psychiatric syndrome (13%), psychosis (8%), anxiety and obsessive compulsive disorder (8%), nil psychiatry (4%). Conclusion: Psychiatric comorbidity is high among in-patients with movement disorders and affective changes are common. Timely assessment using structured clinical proforma would help in enhanced detection of depression in patients with movement disorders. PMID:24860212

  12. Managing acutely III substance-abusing patients in an integrated day hospital outpatient program

    Microsoft Academic Search

    Thomas P. O'Toole; Alicia Conde-Martel; J. Hunter Young; Jennifer Price; George Bigelow; Daniel E. Ford

    2006-01-01

    BACKGROUND: Substance-abusing adults are admitted to hospitals for medical complications from their drug and alcohol use at substantially\\u000a higher rates than the general public; yet, their care is often defined by against medical advice (AMA) discharges and low\\u000a rates of referral to addiction treatment programs.\\u000a \\u000a \\u000a METHODS: We present findings from a chart review of consecutive admissions to an integrated medical-substance

  13. Oral gemifloxacin once daily for 5 days compared with sequential therapy with i.v. ceftriaxone\\/oral cefuroxime (maximum of 10 days) in the treatment of hospitalized patients with acute exacerbations of chronic bronchitis

    Microsoft Academic Search

    R. WILSON; C. LANGAN; P. BALL; K. BATEMAN; R. PYPSTRA

    2003-01-01

    In a randomized, open-label, controlled, multicentre study, the clinical and bacteriological efficacy, safety and tolerability of oral gemifloxacin (320 mg once daily, 5 days) was compared with sequential intravenous (i.v.) ceftriaxone (1 g once daily, maximum 3 days) followed by oral cefuroxime axetil (500 mg twice daily, maximum 7 days) in adult hospitalized patients with acute exacerbations of chronic bronchitis

  14. Reasons for 30-day Postoperative Readmissions for Medicare Patients at a Community-based Teaching Hospital.

    PubMed

    Kirsch, Jennifer L; Kothari, Shanu N; Ausloos, Janelle M; Gundrum, Jacob D; Kallies, Kara J

    2015-04-01

    Healthcare reform initiatives have proposed reducing reimbursement for certain 30-day readmissions among Medicare patients. Our objective was to evaluate the incidence and reasons for 30-day postoperative readmissions at our institution. The medical records of Medicare patients who underwent surgery from January 1, 2010, through May 16, 2011, were reviewed. Statistical analysis included ?(2), Wilcoxon rank sum, and t tests. Two thousand eight hundred sixty-five patients were included; 199 (7%) had a 30-day readmission. The readmission group included a higher proportion of men (53.8 vs 43.6%, P = 0.005), and patients with an American Society of Anesthesiologists (ASA) Class 3 or greater (84 vs 66%, P < 0.001) versus the nonreadmission group. Mean index length of stay and operative time were longer in the readmitted versus nonreadmitted group (4.8 vs 2.8 days, P < 0.001; 122.8 vs 98.2 minutes, P < 0.001). Readmission reasons were surgically related (53%), surgically unrelated (35%), planned (7%), and patient-related (5%). Higher 30-day postoperative readmission rates were associated with male sex, higher ASA class, and longer index length of stay and operative time. Reasons for readmission included surgical- and patient-related factors. Decreased reimbursement should be discouraged for readmissions directly related to patient noncompliance. PMID:25831185

  15. Predictors of Peritonitis, Hospital Days, and Technique Survival for Peritoneal Dialysis Patients in a Managed Care Setting

    PubMed Central

    Kumar, Victoria A.; Sidell, Margo A.; Yang, Wan-Ting; Jones, Jason P.

    2014-01-01

    ? Introduction: Many clinicians perceive that peritoneal dialysis (PD) should be reserved for younger, healthier, more affluent patients. Our aim was to examine outcomes for PD patients in a managed care setting and to identify predictors of adverse outcomes. ? Methods: We identified all patients who initiated PD at our institution between 1 January 2001 and 31 December 2010. Predictor variables studied included age, sex, race, PD modality, cause of end-stage renal disease (ESRD), dialysis vintage, Charlson comorbidity index (CCI) score, education, and income level. Poisson models were used to determine the relative risk (RR) of peritonitis and the number of hospital days per patient-year. The log-rank test was used to compare technique survival by patient strata. ? Results: Among the 1378 patients who met the inclusion criteria, only female sex [RR: 0.85; 95% confidence interval (CI): 0.74 to 0.98; p = 0.02] and higher education (RR: 0.77; 95% CI: 0.60 to 0.98; p = 0.04) were associated with peritonitis. For hospital days, dialysis vintage (RR: 1.11; 95% CI: 1.04 to 1.18; p = 0.002), CCI score (RR: 1.06; 95% CI: 1.02 to 1.20; p = 0.002), and cause of ESRD (RR for glomerulonephritis: 0.59; 95% CI: 0.43 to 0.80; p = 0.0006; and RR for hypertension: 0.69; 95% CI: 0.55 to 0.88; p = 0.002) were associated with 1 extra hospital day per patient-year. The 2-year technique survival was 61% for patients who experienced at least 1 episode of peritonitis and 72% for those experiencing no peritonitis (p = 0.0001). Baseline patient age, primary cause of ESRD, and PD modality were the only other variables associated with technique survival in the study. ? Conclusions: Neither race nor socio-economic status predicted technique survival or hospital days in our study. Female sex and higher education were the only two variables studied that had an association with peritonitis. PMID:24084841

  16. Psychiatric medication refill practices of juvenile detainees.

    PubMed

    Neff, Mallery R; Aalsma, Matthew C; Rosenman, Marc B; Wiehe, Sarah E

    2013-12-01

    To examine the psychiatric medication fill rates of adolescents after release from juvenile detention. The team reviewed 177 charts. A fill was defined as a psychiatric medication charge to Medicaid 30- or 90-days after release. Differences in demographic characteristics were compared among individuals with fills at 30- or 90-days and those with no medication fills. Forty-five percent of patients were on at least one psychiatric medication. Among detainees on a psychiatric medication, 62 % had a fill by 30 days after release, and 78 % by 90 days. At least 50 % of the adolescents on a psychiatric medication were on an atypical antipsychotic. There was no significant relationship between medication fill and race, age, or sex. Despite the known associations between mental health diagnosis and treatment-seeking with age, sex, and race, it appears that psychiatric medication fill patterns after release from detention are not associated with these factors. PMID:23381007

  17. Survival curves to support quality improvement in hospitals with excess 30-day mortality after acute myocardial infarction, cerebral stroke and hip fracture: a before–after study

    PubMed Central

    Kristoffersen, Doris Tove; Helgeland, Jon; Waage, Halfrid Persdatter; Thalamus, Jacob; Clemens, Dirk; Lindman, Anja Schou; Rygh, Liv Helen; Tjomsland, Ole

    2015-01-01

    Objectives To evaluate survival curves (Kaplan-Meier) as a means of identifying areas in the clinical pathway amenable to quality improvement. Design Observational before–after study. Setting In Norway, annual public reporting of nationwide 30-day in-and-out-of-hospital mortality (30D) for three medical conditions started in 2011: first time acute myocardial infarction (AMI), stroke and hip fracture; reported for 2009. 12 of 61 hospitals had statistically significant lower/higher mortality compared with the hospital mean. Participants Three hospitals with significantly higher mortality requested detailed analyses for quality improvement purposes: Telemark Hospital Trust Skien (AMI and stroke), Østfold Hospital Trust Fredrikstad (stroke), Innlandet Hospital Trust Gjøvik (hip fracture). Outcome measures Survival curves, crude and risk-adjusted 30D before (2008–2009) and after (2012–2013). Interventions Unadjusted survival curves for the outlier hospitals were compared to curves based on pooled data from the other hospitals for the 30-day period 2008–2009. For patients admitted with AMI (Skien), stroke (Fredrikstad) and hip fracture (Gjøvik), the curves suggested increased mortality from the initial part of the clinical pathway. For stroke (Skien), increased mortality appeared after about 8?days. The curve profiles were thought to reflect suboptimal care in various phases in the clinical pathway. This informed improvement efforts. Results For 2008–2009, hospital-specific curves differed from other hospitals: borderline significant for AMI (p=0.064), highly significant (p?0.005) for the remainder. After intervention, no difference was found (p>0.188). Before–after comparison of the curves within each hospital revealed a significant change for Fredrikstad (p=0.006). For the three hospitals, crude 30D declined and they were non-outliers for risk-adjusted 30D for 2013. Conclusions Survival curves as a supplement to 30D may be useful for identifying suboptimal care in the clinical pathway, and thus informing design of quality improvement projects. PMID:25808167

  18. Protocol for the OUTREACH trial: a randomised trial comparing delivery of cancer systemic therapy in three different settings -patient's home, GP surgery and hospital day unit

    E-print Network

    Corrie, Pippa G; Moody, Margaret; Wood, Victoria; Bavister, Linda; Prevost, Toby; Parker, Richard A; Sabes-Figuera, Ramon; McCrone, Paul; Balsdon, Helen; McKinnon, Karen; O'Sullivan, Brendan; Tan, Ray S; Barclay, Steven IG

    2011-10-29

    ) surgeries. Methods/design Patients due to receive a minimum 12 week course of standard intravenous cancer treatment at two hospitals in the Anglia Cancer Network are randomised on a 1:1:1 basis to receive treatment in the hospital day unit (control arm...

  19. PSYCHIATRIC MORBIDITY AMONG VICTIMS OF BOMB BLAST

    PubMed Central

    Gautam, Shiv; Gupta, I.D.; Batra, Lalit; Sharma, Himanshiu; Khandelwal, Rakesh; Pant, Anshuman

    1998-01-01

    Thirty one victims of bomb blast in a bus caused by terrorist activity in Dausa district, Rajasthan on 22.5.96, were evaluated for psychological reactions 3 days & 2 weeks after the incident. All hospitalized & non hospitalised bomb blast victims were assessed within 3 days of injury by objective predictors (percent of burnt area, facial disfigurement, limb amputations, fractures etc.) and subjective predictors (emotional distress and perceived social support). Detailed history, physical and mental state examination of all patients was carried out and for those having scores more then 17 on GHQ-60 (Hindi version), IPIS was administered. Diagnosis was made by 3 senior consultant psychiatrists of Psychiatric Centre, Jaipur, on the basis oflCD-10. At day 3 of 31 patients studied 11 (35.45%) had psychiatric morbidity. Out of which 6 (19.35%) had acute stress reaction, 3 (9.68%) had depression and 2 (6.45%) dissociative amnesia. Most commonly reported symptoms on IPIS were depersonalisation, derealisation, sleep disturbances specially generalised sleep loss, loss of appetite, nightmares, situational anxiety, depression, mental irritability, dulness of feelings, self blame, guilt, loss of interest, suicidal ideas, and worry about money, spouse, work and children. Most common physical injury was burns, followed by hearing disturbances, wounds received due to glass <& metal pieces and non specific pains and aches. Findings of follow up have been discussed and battery of tests for evaluation of victims of acute trauma has been suggested. PMID:21494441

  20. Trauma Recovery Services for Psychiatric Inpatients

    Microsoft Academic Search

    David McDuff; Monya Cohen; Lyndyl Blais; Wendy Stevenson; Elaina McWilliams

    2008-01-01

    This study describes the creation, operation, patient characteristics, and outcomes of a new hospital-wide, trauma-recovery service in a Maryland state psychiatric hospital. We identified psychiatric admissions who had trauma, causing current distress. Our assessments included a structured clinical interview, the Trauma Symptom Checklist-40, and the Trauma Symptom Inventory. Outcomes included service utilization, average group attendance, and patient satisfaction. During the

  1. Regionalised Tertiary Psychiatric Residential Facilities

    Microsoft Academic Search

    C. Tansella; ALAIN LESAGE; DAVID GRODEN; ELLIOT M. GOLDNER; DANIEL GELINAS; LESLIE M. ARNOLD

    SUMMARY. Aims - Psychiatric hospitals remain the main venue for long-term mental health care and, despite widespread clo- sures and downsizing, no country that built asylums in the last century has done away with them entirely - with the recent excep- tion of Italy. Differentiated community-based residential alternatives have been developed over the past decades, with staffing lev- els that

  2. Patient Outcomes on Day 4 of Intravenous Antibiotic Therapy in Non–Intensive Care Unit Hospitalized Adults With Community-Acquired Bacterial Pneumonia

    PubMed Central

    Robinson, Scott B.; Ernst, Frank R.; Lipkin, Craig; Huang, Xingyue

    2014-01-01

    Background Community-acquired bacterial pneumonia (CABP) is a leading cause of morbidity and mortality especially in hospitalized patients. In place of clinical end points traditionally used to evaluate antimicrobial efficacy for its treatment, Food and Drug Administration guidelines now require all registration trials to assess clinical response at day 4. The primary objective of this study was to assess health outcomes (length of stay [LOS] and hospital charges) between responders and nonresponders at this time point. Methods The Premier database was used to identify adult patients from 4 participating hospitals with a principal diagnosis of CABP (International Classification of Diseases, Ninth Revision, Clinical Modification, codes 481, 482.0, 483.8, 484.3, 484.5, 485, 486, or 487.0) hospitalized between July 1, 2010, and June 30, 2011. Only non–intensive care unit patients with hospital stays exceeding 2 days and receiving intravenous antibiotic agents within 24 hours of admission were included. After institutional review board approvals, a retrospective chart review extracted data for patient demographics, clinical efficacy variables at day 4, LOS, and total hospital charges. Data analysis included multivariable gamma regression models to control for patient demographics and clinical differences between responders and nonresponders. Results A total of 666 patients met study the criteria. Mean (SD) age was 70.7 (17.9) years, and 42.5% were males. Among these patients, 277 (41.6%) achieved clinical response by day 4 of initial antibiotic therapy. The unadjusted mean (SD) LOS was 6.3 (2.8) days for responders and 7.4 (5.6) days for nonresponders (P = 0.0009). Respective unadjusted total hospital charges were $22,827 (SD, $17,724) and $26,403 ($36,882) (P = 0.0031). Adjusted for demographics and clinical factors, nonresponders compared with responders had an increased LOS of 0.9 days (8.4 vs 7.5 days; P = 0.0008), resulting in associated charges of approximately $2500 ($34,139 vs $36,629; P = 0.0768). Conclusions In this real-world chart study, less than half of hospitalized patients with CABP achieved clinical response at day 4 of initial intravenous antibiotic therapy. The observed clinical response was associated with a significantly shorter hospital stay and trended toward lower total hospital charges. These findings corroborate the Food and Drug Administration guidance for assessing antimicrobial therapy at day 4 because responder is associated with improved health outcomes. PMID:25411532

  3. The direct and interactive effects of physical abuse severity and negative affectivity on length of psychiatric hospitalization: evidence of differential reactivity to adverse environments in psychiatrically high-risk youth.

    PubMed

    Comas, Michelle; Valentino, Kristin; Bridgett, David J; Hayden, Lisa C

    2014-01-01

    The current study examined the interactive influence of multiple factors (i.e., physical abuse severity and negative affectivity) in predicting youth's inpatient psychiatric length of stay (LOS), extending previous research focused on identification of only single LOS predictors. Elevated physical abuse severity was hypothesized to predict longer youth LOS, and negative affectivity was anticipated to exacerbate this relationship. This study included 42 youth. Clinicians rated youth temperament, whereas physical abuse severity and LOS were coded from youth medical records. Controlling for other previously determined predictors of LOS (i.e., age, gender, and GAF), moderation analyses confirmed hypotheses, revealing a temperament by environment interaction. Specifically, physical abuse severity was positively associated with LOS only in the context of high negative affectivity. Findings highlighted the importance of disentangling the interactive effects of multiple factors in predicting LOS. Moreover, critical clinical implications involving prioritized trauma assessment and treatment for inpatient youth are discussed. PMID:23824554

  4. Psychiatric manifestations in cerebrotendinous xanthomatosis

    PubMed Central

    Fraidakis, M J

    2013-01-01

    Cerebrotendinous xanthomatosis (CTX) is a rare and severe, but treatable, inborn disorder of bile acid biosynthesis and sterol storage with autosomal recessive inheritance and variable clinical presentation. CTX treatment consists of chenodeoxycholic acid and must be started as early as possible to prevent permanent disability. Psychiatric manifestations are rare and non-specific, and often lead to significant diagnostic and treatment delay. Therefore, better recognition of the gamut of psychiatric manifestations in CTX can diminish the risk of misdiagnosis and irreversible neurological deterioration. We hereby describe the psychiatric features in CTX. A complete review of all published cases of CTX in the medical literature was undertaken and the case reports with psychiatric presentation were collected and analyzed. We also describe the psychiatric features in relation to the neurological semeiology in six patients with CTX diagnosed at the La Salpêtrière Hospital. We conclude that psychiatric manifestations in CTX follow a bimodal/bitemporal pattern, appearing early in the disease course in the form of a behavioral/personality disorder associated with learning difficulties or mental retardation, or manifesting in advanced disease in the setting of dementia as rich neuropsychiatric syndromes, such as frontal, orbitofrontal or frontotemporal syndromes of cortico-subcortical dementia encompassing behavioral/personality disturbance, affective/mood disorders or psychotic disorders. Behavioral/personality disturbance in childhood or adolescence, especially when accompanied by learning difficulties, should therefore lead to further investigation to exclude CTX, as early diagnosis and treatment is critical for prognosis. PMID:24002088

  5. Outcomes for Elderly Patients with Mental Illness Following Relocation from a Stand-Alone Psychiatric Hospital to Community-Based Extended Care Units

    Microsoft Academic Search

    Tom Meehan; Samantha Robertson; Terry Stedman; Gerard Byrne

    2004-01-01

    Objective: To assess the outcomes for a group of elderly patients with mental illness following their discharge from a stand-alone psychiatric facility to seven extended care units (ECUs).Method: All patients (n = 60) who were relocated to the ECUs were assessed using a number of standardized clinical and general functioning instruments at 6 months and 6 weeks pre-move, and again

  6. The Revolving Door Phenomenon Revisited: Time to Readmission in 17’415 Patients with 37’697 Hospitalisations at a German Psychiatric Hospital

    PubMed Central

    Frick, Ulrich; Frick, Hannah; Langguth, Berthold; Landgrebe, Michael; Hübner-Liebermann, Bettina; Hajak, Göran

    2013-01-01

    Objective Despite the recurring nature of the disease process in many psychiatric patients, individual careers and time to readmission rarely have been analysed by statistical models that incorporate sequence and velocity of recurrent hospitalisations. This study aims at comparing four statistical models specifically designed for recurrent event history analysis and evaluating the potential impact of predictor variables from different sources (patient, treatment process, social environment). Method The so called Andersen-Gil counting process model, two variants of the conditional models of Prentice, Williams, and Peterson (gap time model, conditional probability model), and the so called frailty model were applied to a dataset of 17’415 patients observed during a 12 years period starting from 1996 and leading to 37’697 psychiatric hospitalisations. Potential prognostic factors stem from a standardized patient documentation form. Results Estimated regression coefficients over different models were highly similar, but the frailty model best represented the sequentiality of individual treatment careers and differing velocities of disease progression. It also avoided otherwise likely misinterpretations of the impact of gender, partnership, historical time and length of stay. A widespread notion of psychiatric diseases as inevitably chronic and worsening could be rejected. Time in community was found to increase over historical time for all patients. Most important protective factors beyond diagnosis were employment, partnership, and sheltered living situation. Risky conditions were urban living and a concurrent substance use disorder. Conclusion Prognostic factors for course of diseases should be determined only by statistical models capable of adequately incorporating the recurrent nature of psychiatric illnesses. PMID:24116059

  7. Joint crisis plans and psychiatric advance directives in German psychiatric practice.

    PubMed

    Radenbach, Katrin; Falkai, Peter; Weber-Reich, Traudel; Simon, Alfred

    2014-05-01

    This study explores the attitude of German psychiatrists in leading positions towards joint crisis plans and psychiatric advance directives. This topic was examined by contacting 473 medical directors of German psychiatric hospitals and departments. They were asked to complete a questionnaire developed by us. That form contained questions about the incidence and acceptance of joint crisis plans and psychiatric advance directives and previous experiences with them. 108 medical directors of psychiatric hospitals and departments responded (response rate: 22.8%). Their answers demonstrate that in their hospitals these documents are rarely used. Among the respondents, joint crisis plans are more accepted than psychiatric advance directives. There is a certain uncertainty when dealing with these instruments. Our main conclusion is that German psychiatry needs an intensified discussion on the use of instruments for patients to constitute procedures for future critical psychiatric events. For this purpose it will be helpful to collect more empirical data. Furthermore, the proposal of joint crisis plans in psychiatric hospitals and departments should be discussed as well as the possibility of consulting an expert during the preparation of a psychiatric advance directive. PMID:23793058

  8. North vs south differences in acute peptic ulcer hemorrhage in Croatia: hospitalization incidence trends, clinical features, and 30-day case fatality

    PubMed Central

    Ljubi?i?, Neven; Pavi?, Tajana; Budimir, Ivan; Puljiz, Željko; Biš?anin, Alen; Bratani?, Andre; Nikoli?, Marko; Hrabar, Davor; Troskot, Branko

    2014-01-01

    Aim To assess the seven-year trends of hospitalization incidence due to acute peptic ulcer hemorrhage (APUH) and associated risk factors, and examine the differences in these trends between two regions in Croatia. Methods The study collected sociodemographic, clinical, and endoscopic data on 2204 patients with endoscopically confirmed APUH who were admitted to the Clinical Hospital Center “Sestre Milosrdnice,” Zagreb and Clinical Hospital Center Split between January 1, 2005 and December 31, 2011. We determined hospitalization incidence rates, 30-day case fatality rate, clinical outcomes, and incidence-associated factors. Results No differences were observed in APUH hospitalization incidence rates between the regions. Age-standardized one-year cumulative APUH hospitalization incidence rate calculated using the European Standard Population was significantly higher in Zagreb than in Split region (43.2/100?000 vs 29.2/100,000). A significantly higher APUH hospitalization incidence rates were observed in the above 65 years age group. Overall 30-day case fatality rate was 4.9%. Conclusion The hospitalization incidence of APUH in two populations did not change over the observational period and it was significantly higher in the Zagreb region. The incidence of acute duodenal ulcer hemorrhage also remained unchanged, whereas the incidence of acute gastric ulcer hemorrhage increased. The results of this study allow us to monitor epidemiological indicators of APUH and compare data with other countries. PMID:25559836

  9. Psychiatric Treatment

    PubMed Central

    Rudin, Edward; Zimmerman, Rick

    1978-01-01

    The California legislature enacted tight constraints on the use of psychosurgery and electroconvulsive therapy in 1974. In April 1976 a State Court of Appeals declared part of the law to be unconstitutional. In doing so, the court enunciated several principles for regulating medical procedures. It affirmed the inherent police powers which permit the state to safeguard the public, especially incompetent, involuntary or confined persons, with respect to intrusive and hazardous medical procedures and to procedures which affect thought or feeling. Although limited to legislation concerning two psychiatric procedures, the court's decision, and subsequently enacted legislation governing these procedures, has implications for other medical procedures and for other parts of the nation. PMID:664647

  10. Critical Behaviors in Psychiatric-Mental Health Nursing. Volume 2: Behavior of Nurses.

    ERIC Educational Resources Information Center

    Jacobs, Angeline Marchese; And Others

    Part of a three-volume document, this volume is concerned with providing source data about the activities of mental health nursing personnel as these activities relate to patient care, and contains abstracts of more than 4,000 critical behaviors of psychiatric nurses in 50 psychiatric hospitals, general hospitals with psychiatric units, and…

  11. Critical Behaviors in Psychiatric-Mental Health Nursing. Volume 3: Behavior of Attendants.

    ERIC Educational Resources Information Center

    Jacobs, Angeline Marchese; And Others

    Part of a three-volume document, this volume is concerned with providing source data about the activities of mental health nursing personnel as the activities relate to patient care and contains abstracts of more than 4,000 critical behaviors of psychiatric attendants in 50 psychiatric hospitals, general hospitals with psychiatric units, and…

  12. Is Readmission a Valid Indicator of the Quality of Inpatient Psychiatric Care?

    Microsoft Academic Search

    Janet Durbin; Elizabeth Lin; Crystal Layne; Moira Teed

    2007-01-01

    Early return to hospital is a frequently measured outcome in mental health system performance monitoring yet its validity\\u000a for evaluating quality of inpatient care is unclear. This study reviewed research conducted in the last decade on predictors\\u000a of early readmission (within 30 to 90 days of discharge) to assess the association between this indicator and quality of inpatient\\u000a psychiatric care. Only

  13. Radioelectric brain stimulation in the treatment of generalized anxiety disorder with comorbid major depression in a psychiatric hospital: a pilot study

    PubMed Central

    Olivieri, Elisabetta Bourget; Vecchiato, Caterina; Ignaccolo, Nunziatina; Mannu, Piero; Castagna, Alessandro; Aravagli, Lucia; Fontani, Vania; Rinaldi, Salvatore

    2011-01-01

    Background: Generalized anxiety disorder (GAD) is often presented with major depression (MD). GAD-MD can be a chronic and disabling condition, and patients suffering from this disorder often respond poorly to psychopharmacological treatment and experience side effects with medication. Therefore, there is a high demand for effective nonpharmacological therapy for GAD-MD patients. The current study explores the use of a radioelectric asymmetric conveyer (REAC) device in the treatment of GAD-MD. Methods: Participants were 24 patients diagnosed with GAD-MD being treated at a public psychiatric center. All patients were dissatisfied with their current pharmacological treatment. Patients were evaluated using the 21-item Hamilton Depression (HAM-D) rating scale and the Symptom Check List-90-Revised (SCL-90R) before and after REAC brain stimulation treatment cycles. Results: After REAC brain stimulation treatment, all patients experienced a significant reduction in anxiety and depression. These results were confirmed by physician examination, HAM-D scores, and SCL-90R total scores. Conclusion: These results indicate a role for REAC brain stimulation in the management of psychiatric conditions, specifically, GAD-MD comorbidity. REAC treatments are synergistic to drug therapy and appear to be helpful in reducing the side effects of medication. Future studies should evaluate the long-term effects of REAC treatment. PMID:21857785

  14. [Shift of usage of medical psychiatric and psychosocial services in Upper Austria (whole territory of Austria) in the period 1965-2005].

    PubMed

    Hofmann, Gustav; Schöny, Werner; Donabauer, Rita; Rachbnauer, Christian

    2005-06-01

    Psychiatric reforms in Upper Austria have considerably improved the quality of life of psychiatric patients. Modernizing the status of acute psychiatric departments based on a bio- psycho-, social concept implemented multidimensional approach in diagnostics and therapeutic methods applied by multiprofessional teams. Prophylactic procedures and rehabilitation programs have minimized chronification of psychiatric diseases. By "late rehabilitation programs" increased autonomy, more individualized planning of life processes could be achieved even with "chronic" patients. We do not see any need to confine "chronic" psychiatric patients in psychiatric hospitals. These patients are cared for, socially integrated by special rehabilitation measures and professional rehabilitation in community-based services and units of Pro Mente Upper Austria--a non-profit organization. Problems decreased the duration of stay in psychiatric hospitals, and increased admission rates when the number of beds in psychiatric departments was considerably decreased in the course of psychiatric reforms in Austria. In our province--Upper Austria--these problems are of lesser importance because private non-profit organizations like Pro Mente Upper Austria have provided a variety of community-based services (mental health centres, day clinics, housing facilities and special services for drug addicts and geriatric patients) in ever increasing numbers. Still there is the need for further development of community-based services provided by specially trained professionals. These services are financed mainly by the state, the provincial government, the labour market services and to a small degree by funds of the European Union. In these days of reduced social budgets of the state and social departments of provincial governments it is not easy to keep our standards and meet the increased needs of our clients. PMID:16395839

  15. Observational follow-up study following two cohorts of children with severe pneumonia after discharge from day care clinic/hospital in Dhaka, Bangladesh

    PubMed Central

    Alam, Nur H; Chisti, Mohammod Jobayer; Salam, Mohammed Abdus; Ahmed, Tahmeed; Gyr, Niklaus

    2012-01-01

    Objectives To compare the features of relapse, morbidity, mortality and re-hospitalisation following successful discharge after severe pneumonia in children between a day care group and a hospital group and to explore the predictors of failures during 3?months of follow-up. Design An observational study following two cohorts of children with severe pneumonia for 3?months after discharge from hospital/clinic. Setting Day care was provided at the Radda Clinic and hospital care at a hospital in Dhaka, Bangladesh. Participants Children aged 2–59?months with severe pneumonia attending the clinic/hospital who survived to discharge. Intervention No intervention was done except providing some medications for minor illnesses, if indicated. Primary outcome measures The primary outcome measures were the proportion of successes and failures of day care at follow-up visits as determined by estimating the OR with 95% CI in comparison to hospital care. Results The authors enrolled 360 children with a mean (SD) age of 8 (7)?months, 81% were infants and 61% were men. The follow-up compliance dropped from 95% at first to 85% at sixth visit. The common morbidities during the follow-up period included cough (28%), fever (17%), diarrhoea (9%) and rapid breathing (7%). During the follow-up period, significantly more day care children (n=22 (OR 12.2 (95% CI 8.2–17.8))) required re-hospitalisation after completion of initial day care compared with initial hospital care group (n=11 (OR 6.1 (95% CI 3.4–10.6))). The predictors for failure were associated with tachycardia, tachypnoea and hypoxaemia on admission and prolonged duration of stay. Conclusions There are considerable morbidities in children discharged following treatment of severe pneumonia like cough, fever, rapid breathing and diarrhoea during 3-month period. The findings indicate the importance of follow-up for early detection of medical problems and their management to reduce the risk of death. Establishment of an effective community follow-up would be ideal to address the problem of ‘non-compliance with follow-up’. Trial registration The original randomised control trial comparing day care with hospital care was registered at http://www.clinicaltrials.gov (identifier NCT00455468). PMID:22842561

  16. The Impact of the Day of the Week and Month of Admission on the Length of Hospital Stay in Stroke Patients

    Microsoft Academic Search

    Wolf-Peter Schmidt; Dirk Taeger; Hans-Joachim Buecker-Nott; Klaus Berger

    2003-01-01

    Background: Length of hospital stay (LOS) in many diseases is determined by patient-related sociodemographic and clinical factors but also by the management of treatment and care. We examined the influence of the day of the week (DW) and month of admission on LOS in stroke patients. Methods: We used data from a large regional stroke registry in the northwest of

  17. Cohesion to the Group and Its Association with Attendance and Early Treatment Response in an Adult Day-Hospital Program for Eating Disorders: A Preliminary Clinical Investigation

    ERIC Educational Resources Information Center

    Crino, Natalie; Djokvucic, Ivana

    2010-01-01

    Treatment outcome studies demonstrate that day-hospital programs are effective in the treatment of eating disorders. Few descriptions are available on the specifics of treatment, particularly the process of therapy. The group therapy modality is thought to provide important therapeutic benefits. The present study aimed to examine the association…

  18. Treatment outcomes and medication compliance for children and adolescents, 30 days post-discharge from an in-patient psychiatric hospital.

    PubMed

    Talley, Jan Anderson

    2011-01-01

    A variety of authors have suggested that children and adolescents are at risk for serious adverse health outcomes because of a lack of compliance with medication regimens. A lack of compliance includes taking less or more medication than prescribed, and taking medication at the wrong times. One study that examined the medication compliance of 81 students who were 10 years of age or older, and were enrolled in a school-based health center, determined that only 45 students (56%) filled the prescription given to them by the doctor. Of those students who filled the prescription, 76% reported that they always took the medication on time, 22% reported forgetting to take the medication some of the time and 2% reported never taking the medication. PMID:22338738

  19. Comparing the stigma of mental illness in a general hospital with a state mental hospital

    Microsoft Academic Search

    Cornelia Y. I. Chee; Tze Pin Ng; Ee Heok Kua

    2005-01-01

    The stigma faced by psychiatric patients associated with the type of psychiatric facilities is controversial. This study was conducted to compare the stigma faced by patients with schizophrenia and non-schizophrenia psychiatric disorders in the outpatient departments of a state mental hospital with those in a general hospital in Singapore. A cross-sectional study involving two groups of outpatients in a state

  20. Psychiatric Thoughts in Ancient India*

    PubMed Central

    Abhyankar, Ravi

    2015-01-01

    A review of the literature regarding psychiatric thoughts in ancient India is attempted. Besides interesting reading, many of the concepts are still relevant and can be used in day-to-day practice especially towards healthy and happy living. Certain concepts are surprisingly contemporary and valid today. They can be used in psychotherapy and counselling and for promoting mental health. However, the description and classification of mental illness is not in tune with modern psychiatry.

  1. The prevalence and correlates of the positive Androgen Deficiency in the Aging Male (ADAM) questionnaire among psychiatric outpatients: a cross-sectional survey of 176 men in a general hospital in Taiwan

    PubMed Central

    Lee, Chin-Pang; Chen, Yu; Jiang, Kun-Hao; Chu, Chun-Lin; Hsu, Shih-Chieh; Chen, Jiun-Liang; Chen, Ching-Yen

    2015-01-01

    Introduction The Androgen Deficiency in the Aging Male (ADAM) questionnaire is widely used to screen for late-onset hypogonadism. The positive response to the ADAM questionnaire (positive ADAM) has been associated with depression and poorer quality of life in a number of studies. It is unclear whether there is any value of the ADAM questionnaire in psychiatric populations. In this study, we aimed to determine the utility of the ADAM questionnaire in a convenient sample of male psychiatric outpatients. Methods One hundred and seventy-six men (mean age: 54.3 years; standard deviation: 10.7 years; range: 40–80 years) completed the ADAM questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Aging Males’ Symptoms (AMS) scale. Anxiety was defined as a HADS anxiety subscore ?8; depression as a HADS depression subscore ?8; and moderate/severe impairment of health-related quality of life (HQoL) as AMS ?37. ADAM, anxiety, and depression was used to model the moderate/severe impairment of HQoL. Results One hundred and sixty-four (93%) men had positive ADAM. Positive ADAM was associated with a lower body mass index (P<0.05) and moderate/severe impairment of HQoL (P<0.001), but was not associated with anxiety or depression (P>0.05). Positive ADAM was associated with five symptoms of the AMS scale: “decline of one’s feeling of general well-being”, “depressive mood”, and three sexual symptoms. In regression analysis, positive ADAM was associated with increased risk of moderate/severe impairment of HQoL (unadjusted odds ratio 20.1, 95% confidence interval 3.77–372, P<0.01), which remained significant with covariates of anxiety and depression (adjusted odds ratio 15.6, 95% confidence interval 2.52–309, P<0.05). Conclusion The ADAM questionnaire can be used to screen the sexual symptoms but not depression/anxiety in male psychiatric outpatients. Positive ADAM may indicate moderate/severe impairment of HQoL. PMID:25653527

  2. Protocol for the OUTREACH trial: a randomised trial comparing delivery of cancer systemic therapy in three different settings - patient's home, GP surgery and hospital day unit

    PubMed Central

    2011-01-01

    Background The national Cancer Reform Strategy recommends delivering care closer to home whenever possible. Cancer drug treatment has traditionally been administered to patients in specialist hospital-based facilities. Technological developments mean that nowadays, most treatment can be delivered in the out-patient setting. Increasing demand, care quality improvements and patient choice have stimulated interest in delivering some treatment to patients in the community, however, formal evaluation of delivering cancer treatment in different community settings is lacking. This randomised trial compares delivery of cancer treatment in the hospital with delivery in two different community settings: the patient's home and general practice (GP) surgeries. Methods/design Patients due to receive a minimum 12 week course of standard intravenous cancer treatment at two hospitals in the Anglia Cancer Network are randomised on a 1:1:1 basis to receive treatment in the hospital day unit (control arm), or their own home, or their choice of one of three neighbouring GP surgeries. Overall patient care, treatment prescribing and clinical review is undertaken according to standard local practice. All treatment is dispensed by the local hospital pharmacy and treatment is delivered by the hospital chemotherapy nurses. At four time points during the 12 week study period, information is collected from patients, nursing staff, primary and secondary care teams to address the primary end point, patient-perceived benefits (using the emotional function domain of the EORTC QLQC30 patient questionnaire), as well as secondary end points: patient satisfaction, safety and health economics. Discussion The Outreach trial is the first randomised controlled trial conducted which compares delivery of out-patient based intravenous cancer treatment in two different community settings with standard hospital based treatment. Results of this study may better inform all key stakeholders regarding potential costs and benefits of transferring clinical services from hospital to the community. Trial registration number ISRCTN: ISRCTN66219681 PMID:22035502

  3. ACUTE PORPHYRIA AMONGST PSYCHIATRIC PATIENTS

    PubMed Central

    Golechha, G. R.; Chatterjee, S. B.; Sethi, B. B.; Agarwal, S. S.

    1981-01-01

    SUMMARY A total of 519 consecutive patients, admitted to psychiatric wards of two different hospitals, were screened for evidence of increased excretion of porphobilinogen in the urine by original Watson Schwartz test and modified Watson Schwartz test supported with quantitative estimation of porphobilinogen by Remington's method in search of cases of acute porphyria amongst psychiatric patients. An additional 273 normal healthy volunteers were also screened as controls. Two cases (0.38%) were found which could be unequivocally diagnosed to be suffering from acute intermittent porphyria amongst psychiatric patients. These cases belonged to the category of missed diagnosis being labelled as hysterical. Seven more cases were positive by modified Watson Schwartz test but the test was only transiently positive and the Ehrlichaldehyde reactor substance was unstable. In the absence of detailed enzymatic and family studies, these cases have been kept under the category of suspected prophyria. A significant number of psychiatric patients (12.9%) gave positive original Watson-Schwartz test but were negative for modified test. Similar reaction was seen in 2.6% of healthy controls. The significance of this finding needs to be evaluated. PMID:22058565

  4. Substance use and response to psychiatric treatment in methadone-treated outpatients with comorbid psychiatric disorder.

    PubMed

    Kidorf, Michael; King, Van L; Peirce, Jessica; Gandotra, Neeraj; Ghazarian, Sharon; Brooner, Robert K

    2015-04-01

    The psychiatric care of opioid users receiving agonist therapies is often complicated by high rates of illicit drug use (Brooner et al., 2013). The present study evaluates if illicit drug use (i.e., opioids, cocaine, sedatives) detected at the start of psychiatric care affects treatment response. Methadone maintenance patients (n=125) with at least one current psychiatric disorder completed a 3-month randomized clinical trial evaluating the efficacy of financial incentives on attendance to on-site integrated substance abuse and psychiatric services (Kidorf et al., 2013). The present study re-analyzes the data set by grouping participants into one of two conditions based on the 4-week baseline observation: (1) no illicit drug use (baseline negative; n=50), or (2) any illicit drug use (baseline positive; n=75). All participants received a similar schedule of psychiatric services, and had good access to prescribed psychiatric medications. The Global Severity Index (GSI) of the Hopkins Symptom Checklist-Revised was administered monthly to evaluate changes in psychiatric distress. Results showed that while both conditions evidenced similar utilization of on-site psychiatric services, baseline negative participants remained in treatment somewhat longer (80.7 vs. 74.8days, p=.04) and demonstrated greater reductions in GSI scores than baseline positive participants at month 3 (p=.004). These results have implications for interpreting previous studies that have shown inconsistent efficacy of pharmacotherapy and other psychiatric treatments, and for providing clinical care for patients with co-occurring substance use and psychiatric disorders. PMID:25468006

  5. Exploring identity dynamics in mental help-seeking trajectories: an ethnographic study among inpatient service users of two belgian psychiatric hospitals.

    PubMed

    Sercu, Charlotte; Pattyn, Elise; Bracke, Piet

    2015-04-01

    Using an ethnographic approach, in combining interviews with forty-two inpatient service users and participant observations, this research explored service users' experiences of their help seeking trajectories in an effort to uncover identity dynamics by which these are informed. They described both identity dynamics that made them postpone their search for help, like their belief in the essential difference between themselves and mental health service users; and dynamics that catalyzed their hospitalization, like the loss of social roles. Their accounts illustrate how experiences of barriers and facilitators for help seeking are closely intertwined with identity and therefore context related dynamics. PMID:25858204

  6. Psychiatric Home Health: Patient Advocacy in the Home Setting

    Microsoft Academic Search

    Toni Rhein; Rita R. Callahan

    1999-01-01

    Patient transition from hospital to home can be a devastating experience. A change in environment requires time for adjusting appropriately; the amount of time differs for each individual. This transition can be more stressful for psychiatric patients readjusting to their environment. Home health psychiatric nursing is a unique and intriguing specialty. For patients requiring in-home care management, it is essential

  7. Chromosomal abnormalities in a psychiatric population

    SciTech Connect

    Lewis, K.E.; Lubetsky, M.J.; Wenger, S.L.; Steele, M.W. [Univ. of Pittsburgh Medical Center, PA (United States)

    1995-02-27

    Over a 3.5 year period of time, 345 patients hospitalized for psychiatric problems were evaluated cytogenetically. The patient population included 76% males and 94% children with a mean age of 12 years. The criteria for testing was an undiagnosed etiology for mental retardation and/or autism. Cytogenetic studies identified 11, or 3%, with abnormal karyotypes, including 4 fragile X positive individuals (2 males, 2 females), and 8 with chromosomal aneuploidy, rearrangements, or deletions. While individuals with chromosomal abnormalities do not demonstrate specific behavioral, psychiatric, or developmental problems relative to other psychiatric patients, our results demonstrate the need for an increased awareness to order chromosomal analysis and fragile X testing in those individuals who have combinations of behavioral/psychiatric, learning, communication, or cognitive disturbance. 5 refs., 1 fig., 2 tabs.

  8. Approaches to substance abuse in Cuba: Ricardo A. González MD PhD DrSc. Psychiatrist and consulting professor, Eduardo B. Ordaz Psychiatric Hospital, Havana. Interviewed by Christina Mills.

    PubMed

    González, Ricardo

    2013-10-01

    For over 40 years, he has done one of the most difficult jobs in medicine; 4000 of his patients are among those many might write off as "lost causes." Yet he radiates optimism, his stories and experience reflecting a belief in the human potential to change and grow and a vocation to help his patients do so. Now an internationally recognized expert on addictions, in 1976 Dr González founded Cuba's first patient service for substance abuse at the Eduardo B. Ordaz Psychiatric Hospital in Havana, a program he directed until last year. It is now the national reference center for another 17 such programs, two more in Havana and one in every other Cuban province. In addition, it serves as a model for treatment centers catering to international patients (undoubtedly the most well known among them Diego Maradona, the Argentine soccer star): two in Holguin Province and one in Santiago Province, with another being developed at Las Praderas International Health Center in Havana. Dr González's 25 books on psychiatry, medical ethics and addictions attest to a prolific career in research and practice. Today, he continues to work "from retirement" as consulting professor and psychiatrist in the addiction service he founded, and also chairs Cuba's National Medical Ethics Commission. In this interview, Dr González shares insights from his years of experience addressing substance abuse, as well as on repercussions and management of such conditions in Cuba. PMID:24253343

  9. The Relationship between Body Mass Index and Hospitalisation Rates, Days in Hospital and Costs: Findings from a Large Prospective Linked Data Study

    PubMed Central

    Korda, Rosemary J.; Joshy, Grace; Paige, Ellie; Butler, James R. G.; Jorm, Louisa R.; Liu, Bette; Bauman, Adrian E.; Banks, Emily

    2015-01-01

    Background Internationally there is limited empirical evidence on the impact of overweight and obesity on health service use and costs. We estimate the burden of hospitalisation—admissions, days and costs—associated with above-normal BMI. Methods Population-based prospective cohort study involving 224,254 adults aged ?45y in Australia (45 and Up Study). Baseline questionnaire data (2006-2009) were linked to hospitalisation and death records (median follow-up 3.42y) and hospital cost data. The relationships between BMI and hospital admissions and days were modelled using zero-inflated negative binomial regression; generalised gamma models were used to model costs. Analyses were stratified by sex and age (45-64, 65-79, ?80y), and adjusted for age, area of residence, education, income, smoking, alcohol-intake and private health insurance status. Population attributable fractions were also calculated. Results There were 459,346 admissions (0.55/person-year) and 1,483,523 hospital days (1.76/person-year) during follow-up. For ages 45-64y and 65-79y, rates of admissions, days and costs increased progressively with increments of above-normal BMI. Compared to BMI 22.5-<25kg/m2, rates of admissions and days were 1.64-2.54 times higher for BMI 40-50kg/m2; costs were 1.14-1.24 times higher for BMI 27.5-<30kg/m2, rising to 1.77-2.15 times for BMI 40-50kg/m2. The BMI-hospitalisation relationship was less clear for ?80y. We estimated that among Australians 45-79y, around 1 in every 8 admissions are attributable to overweight and obesity (2% to overweight, 11% to obesity), as are 1 in every 6 days in hospital (2%, 16%) and 1 in every 6 dollars spent on hospitalisation (3%, 14%). Conclusions The dose-response relationship between BMI and hospital use and costs in mid-age and older Australians in the above-normal BMI range suggests even small downward shifts in BMI among these people could result in considerable reductions in their annual health care costs; whether this would result in long-term savings to the health care system is not known from this study. PMID:25739093

  10. [Cerebral hydatic cyst and psychiatric disorders. Two cases].

    PubMed

    Asri, F; Tazi, I; Maaroufi, K; El Moudden, A; Ghannane, H; Ait Benali, S

    2007-01-01

    The hydatidosis is an endemic illness in regions of the Middle Orient, Mediterranean, south of America, north Africa and the Australia. The preferential localization of cyst hydatic is the liver (48%), the lung (36%) and in 6% of cases it localizes in unaccustomed place as the brain. Intracerebral localization is relatively rare, its impact is 1 to 5% of all cases of hydatidose. This localization is the child's appendage with a masculine predominance. The cyst hydatic intracranien is often lone, of localization usually supratentorielle, sometimes infratentorielle. Symptoms are especially the diffuse headache associated to various neurological signs in relation with sits of the tumor. The psychiatrics symptoms depends on its localization, sides, intracranial hypertension, and the previous personality. In 15 to 20% of cases these tumors can appear in the beginning of their evolution by the isolated psychiatric symptoms. We report the case of two patients that have been hospitalized first in the Academic Psychiatric Unit of Marrakech for isolates psychiatric disorders and whose scanning revealed the presence of cerebral hydatic cyst and that required a surgical intervention in neurosurgery. Case 1 - Patient 29 years old, bachelor, uneducated, leaving in country outside, fermar, in permanent contact with dogs. No particular medical history. The patient has been brought by his family to the psychiatric emergencies after behavior disorders. The beginning of his symptomatology was one year ago by behavior disorders: instability, violence, isolation, and a corporo-sartorial carelessness. His symptomatology worsened and the patient became very aggressive. In psychiatric unit, he was disregarded, sad, anguished, indifferent to his state, very dissonant, completely detached, depersonalized. He brought back some visual and auditory hallucinations with attitude of monitoring. He was raving with delirium of persecution, of ideas of reference and delirium of bewithment. He was unconscious of his disorders. The patient has first been put under classical neuroleptic 9 mg/day of Haloperidol and 200 mg/day of chlorpromazine. The diagnosis of schizophrenia has been kept according to criteria of DSM IV. The PANSS (Positive and Negative Syndrome Scale) was to 137 (score on a positive scale was to 34, score on a negative scale was to 35 and the general psychopathologie scale was to 58). One week after his hospitalization, he developed headache with subconfusion, a cerebral scanning has been made in emergency and showed a voluminous cyst in oval foramen compressing the mesencephalon strongly. The cyst was well limited, hypodense, not taking the contrast, and without intracerebral oedema, the diagnosis of cerebral hydatic cyst has been made. The complementary exploration didn't show any other localizations, and biologic exam results didn't show any particular anomalies. The patient has been operated in neurosurgery. The immediate evolution was favorable with disappearance of confusion and absence of complications. The patient was lost of view. Six months after, the patient has been readmitted to the psychiatric emergency. He dropped his neuroleptic treatment. He was aggressive, raving, hallucinated and depersonalized. The global score to the PANSS was 63. He has been put back under neuroleptics. Three weeks after improvement and passage of the PANSS to 30, the patient went out. We couldn't have a cerebral scanner of control because the patient had no medical assurance and no money for cerebral scanner. Case 2 - Patient aged of 53 years, father of four children, uneducated, native and resident of Marrakech, confectioner as profession. He is in contact with dogs since 12 years. He has been brought to the psychiatric emergencies by his family after an agitation. The history of his illness seemed to go back at eight months ago, by the progressive apparition of an instability, sleep disorders, hostility, associated with an emotional lability. To the interview he was agitated and had a delirium of persecution. He was convinced that his wife and his ch

  11. Psychiatric disorders among infertile and fertile women

    Microsoft Academic Search

    Ahmad Ali Noorbala; Fatemeh Ramezanzadeh; Nasrin Abedinia; Mohammad Mehdi Naghizadeh

    2009-01-01

    This study was performed in order to determine the prevalence and predisposing factors of psychiatric disorders among infertile\\u000a and fertile women attending Vali-e-Asr Hospital. A total of 150 fertile women from Vali-e-Asr Reproduction Health Research\\u000a Center and fertile women from the Gynecology Clinic of Imam Khomeini Hospital were chosen by consecutive sampling. Data included\\u000a demographic information, SCL-90-R, and a semi-structured

  12. Perceived stress, life events, dysfunctional attitudes, and depression in adolescent psychiatric inpatients

    Microsoft Academic Search

    Rod A. Martin; Shahe S. Kazarian; Hans J. Breiter

    1995-01-01

    Hewitt, Flett, and Mosher (1992) examined the factor structure of the Perceived Stress Scale (PSS) and its relation to depression in adult psychiatric patients. This study sought to replicate and extend their findings, using a sample of 203 adolescent psychiatric inpatients. All patients admitted to the adolescent unit in a psychiatric hospital over a 3-year period were administered the PSS,

  13. PSYCHIATRIC DISORDERS AND SLEEP

    PubMed Central

    Krystal, Andrew D.

    2012-01-01

    SYNOPSIS Psychiatric disorders and sleep are related in important ways. In contrast to the longstanding view of this relationship which viewed sleep problems as symptoms of psychiatric disorders, there is growing experimental evidence that the relationship between psychiatric disorders and sleep is complex and includes bi-directional causation. In this article we provide the evidence that supports this point of view, reviewing the data on the sleep disturbances seen in patients with psychiatric disorders but also reviewing the data on the impact of sleep disturbances on psychiatric conditions. Although much has been learned about the psychiatric disorders-sleep relationship, additional research is needed to better understand these relationships. This work promises to improve our ability to understand both of these phenomena and to allow us to better treat the many patients with sleep disorders and with psychiatric disorders. PMID:23099143

  14. An exploration looking at the impact of domiciliary and day hospital delivery of stroke rehabilitation on informal carers

    Microsoft Academic Search

    J. T. S. Low; Paul Roderick; Sheila Payne

    2004-01-01

    Objectives: To explore the impact of two methods of post-hospital stroke rehabilitation on both carers' perceptions of the health services offered and their quality of life.Setting: East Dorset Health Authority.Subjects: Forty-six informal carers were recruited from a sample of 106, initially identified from stroke patients participating in a larger randomized controlled trial.Design: Qualitative methods.Methods: Semi-structured interviews were used at baseline

  15. Colonization by Clostridium difficile of neonates in a hospital, and infants and children in three day-care facilities of Kanazawa, Japan.

    PubMed

    Matsuki, Shinichirou; Ozaki, Eijiro; Shozu, Makio; Inoue, Masaki; Shimizu, Shouji; Yamaguchi, Nobuo; Karasawa, Tadahiro; Yamagishi, Takayoshi; Nakamura, Shinichi

    2005-03-01

    The intestinal-carriage rates of Clostridium difficile in neonates hospitalized in the University Hospital's Center for Perinatal and Reproductive Health and in infants and children enrolled in two day-nurseries and a kindergarten were examined. Swab samples from the floors of these facilities were also analyzed to determine the extent of environmental contamination by this organism. C. difficile was found in the stool of only one of 40 neonates during the normal 1-week stay in the hospital after delivery. The isolate from the neonate was identical to that of her mother, as determined by PCR ribotyping, pulsed-field gel electrophoresis analysis, and toxin gene type, suggesting that the C. difficile-positive neonate acquired the organism from her mother rather than from the environment. By contrast, 47 (48.0%) of the 98 infants and children, comprising 50 enrolled in two day-nurseries who were >= 3 years old and 48 enrolled in a kindergarten who were 2-5 years old, carried C. difficile. The carriage rate in infants under 2 years of age was much higher (84.4%) than in children 2 years old and older (30.3%). When analyzed according to age group, the carriage rates were 100, 75.0, 45.5, 24.0, 38.5, and 23.5% in infants and children 0, 1, 2, 3, 4, and 5 years old, respectively. The observation that several children were colonized with the same type of C. difficile strain in each day-care facility, and that the floors of day-nursery A and kindergarten C were contaminated with C. difficile strains identical to those colonizing the intestines of children enrolled in those facilities suggests that cross-infection of C. difficile among children occurs through C. difficile-carrying children or their contaminated environments. PMID:15906260

  16. Parental psychiatric disorders and autism spectrum disorders

    PubMed Central

    Jokiranta, Elina; Brown, Alan S.; Heinimaa, Markus; Cheslack-Postava, Keely; Partanen, Auli; Sourander, Andre

    2013-01-01

    The present population-based, case-control study examines associations between specific parental psychiatric disorders and autism spectrum disorders (ASD) including childhood autism, Asperger’s syndrome and pervasive developmental disorder (PDD-NOS). The cohort includes 4713 children born between 1987 and 2005 with diagnoses of childhood autism, Asperger’s syndrome or PDD-NOS. Cases were ascertained from the Finnish Hospital Discharge Register, and each was matched to four controls by gender, date of birth, place of birth, and residence in Finland. Controls were selected from the Finnish Medical Birth Register. Parents were identified through the Finnish Medical Birth Register and Finnish Central Population Register. Parental psychiatric diagnoses from inpatient care were collected from the Finnish Hospital Discharge Register. Conditional logistic regression models were used to assess whether parents’ psychiatric disorders predicted ASD after controlling for parents’ age, smoking during pregnancy and weight for gestational age. In summary, parental schizophrenia spectrum disorders and affective disorders were associated with the risk of ASD regardless of the subgroup. PDD-NOS was associated with all parental psychiatric disorders investigated. Further studies are needed to replicate these findings. These results may facilitate the investigation of shared genetic and familial factors between ASD and other psychiatric disorders. PMID:23391634

  17. Ethological assessment of stable and labile social behaviors during acute psychiatric disorders: clinical applications.

    PubMed

    McGuire, M T; Polsky, R H

    1980-12-01

    Results are presented which illustrate the use of naturalistic observation techniques to study ongoing patterns of postural, gestural, and spacing behaviors among psychiatric patients hospitalized for acute psychiatric disorders. Behavioral frequencies are analyzed in terms of stable and labile characteristics by week of hospitalization, clinical diagnosis, and clinical outcome. Findings are interpreted from both clinical psychiatric and ethological perspectives. The discussion emphasizes the potential value of observational data gathering techniques for disorder assessment and theory development. PMID:6936724

  18. Multisystemic Therapy Effects on Attempted Suicide by Youths Presenting Psychiatric Emergencies

    ERIC Educational Resources Information Center

    Huey, Stanley J.; Henggeler, Scott W.; Rowland, Melisa D.; Halliday-Boykins, Colleen A.; Cunningham, Phillippe B.; Pickrel, Susan G.; Edwards, James

    2004-01-01

    Objective: To evaluate the efficacy of multisystemic therapy (MST) in reducing attempted suicide among predominantly African American youths referred for emergency psychiatric hospitalization. Method: Youths presenting psychiatric emergencies were randomly assigned to MST or hospitalization. Indices of attempted suicide, suicidal ideation,…

  19. Using continuous quality improvement strategies to reduce repeated admissions for inpatient psychiatric treatment.

    PubMed

    Frazier, R S; Amigone, D K; Sullivan, J P

    1997-01-01

    A multidisciplinary performance improvement team was chartered to examine the problem of repeated admissions to psychiatric hospitals. It was also asked to devise an intervention strategy to reduce the number of readmissions, including the number of patients with three or more admissions in a 12-month period and the number of days patients spend in hospital beds. Multivoting, benchmarking, and a review of medical records for 88 psychiatric patients who had been hospitalized three or more times in 1 year were the methods used to gather data on client characteristics. An analysis of the data suggested that these high-end users had similar patterns of service utilization prior to their hospitalizations. The team identified 11 of these patterns as triggers that appear to signal early stages of decompensation that can lead to hospitalization. The team implemented an early intervention and prevention system by using the triggers as criteria for initiating a change in treatment plans. A study of the effectiveness of the Triggers Intervention and Prevention System (TIPS) was undertaken over the next 2 years. An automated program for deriving the triggers from the emergency services database was developed. Initial results that TIPS is an effective means of reducing recidivism and that the triggers can identify high-end users. Some of the triggers were deemed to be more effective than others in the early identification of individuals who may need to be hospitalized. A comparison of hospitalization rates for the pre- and postimplementation periods of TIPS showed a significant reduction in the number of patients who had three or more hospitalizations, fewer total admissions, and a shorter average length of stay. During 1995, the triggers were successful in the early identification of all patients who had more than one admission. The teams used the Design, Measure, Assess, Improve method recommended by the Joint Commission on Accreditation of Healthcare Organizations. PMID:10167162

  20. A 5-Day Dialectical Behavior Therapy Partial Hospital Program for Women with Borderline Personality Disorder: Predictors of Outcome from a 3-Month Follow-up Study

    PubMed Central

    YEN, SHIRLEY; JOHNSON, JENNIFER; COSTELLO, ELLEN; SIMPSON, ELIZABETH B.

    2010-01-01

    Objective This study describes naturalistic 3-month follow-up after discharge from a 5-day partial hospitalization dialectical behavior therapy (DBT) program for women diagnosed with borderline personality disorder (BPD). We also examined individual BPD criteria as predictors of treatment response. Methods Fifty women diagnosed with BPD were consecutively recruited from a partial hospital DBT program, 47 of whom (94%) completed all assessments including baseline (prior to discharge) and 3-months post-discharge assessments. Most continued with some combination of individual psychotherapy and pharmacotherapy, and all had the option of continuing with weekly DBT skills classes. Baseline scores were compared to 3-month scores using paired two-tailed non-parametric (sign) tests. Regression analyses were conducted to identify predictors of outcome. Results Depression, hopelessness, anger expression, dissociation, and general psychopathology scores significantly decreased over the 3-month follow-up interval, although scores on several measures remained in the clinical range. Those who endorsed emptiness, impulsivity, and relationship disturbance demonstrated improvement on a number of outcomes, while those who endorsed identity disturbance and fear of abandonment had less improvement on some outcomes. Conclusion These findings illustrate 1) that improvement occurred over a 3-month interval on a number of measures in patients receiving treatment as usual following discharge from a partial hospitalization program, and 2) that BPD is a complex, heterogeneous disorder for which there is no single pathognomonic criterion, so that each criterion should be considered individually in determining its potential effect on treatment outcomes. PMID:19461390

  1. Zonisamide produces weight loss in psychotropic drug-treated psychiatric outpatients.

    PubMed

    Lim, JaeHyoung; Ko, Young-Hoon; Joe, Sook-Haeng; Han, Changsu; Lee, Moon-Soo; Yang, Jaewon

    2011-12-01

    This study examined the long-term effectiveness and tolerability of zonisamide for weight control in psychiatric outpatients using various psychotropic medications. We conducted a systematic chart review of 82 psychiatric outpatients with unwanted weight gain after the introduction of psychotropic drugs between January 2008 and September 2009 at Korea University Ansan Hospital. The primary outcome measure was the effect of zonisamide on body mass index (BMI). Additional outcome measures included safety and tolerability as assessed by the clinical global impression-severity of illness scale (CGI-S) and discontinuation rate. The mean final dose of zonisamide was 124.6±53.4 mg/day and ranged from 50mg/day to 300 mg/day. The mean BMI reduction was 0.8±1.7 kg/m(2) and ranged from -2.9 kg/m(2) to 4.7 kg/m(2) (p<0.001). We also observed a significant reduction in CGI-S scores from the baseline (3.8±0.9) to the endpoint (3.3±0.8; p<0.001). Twelve patients (14.6%) discontinued their zonisamide treatment due to its side effects. Patients treated with zonisamide showed significant weight loss. Furthermore, its treatment was generally safe and well tolerated with few negative effects on patients' overall psychiatric symptoms. Additional research is required to confirm these results and to investigate whether patients have rebound weight gains after discontinuing zonisamide. PMID:21803114

  2. Differences in Epidemiological and Molecular Characteristics of Nasal Colonization with Staphylococcus aureus (MSSA-MRSA) in Children from a University Hospital and Day Care Centers

    PubMed Central

    Rodríguez, Erika A.; Correa, Margarita M.; Ospina, Sigifredo; Atehortúa, Santiago L.; Jiménez, J. Natalia

    2014-01-01

    Background Clinical significance of Staphylococcus aureus colonization has been demonstrated in hospital settings; however, studies in the community have shown contrasting results regarding the relevance of colonization in infection by community-associated MRSA (CA-MRSA). In Colombia there are few studies on S. aureus colonization. The aim of this study was to determine the molecular and epidemiological characteristics of nasal colonization by S. aureus (MSSA-MRSA) in children from a university hospital and day care centers (DCCs) of Medellin, Colombia. Methods An observational cross-sectional study was conducted in 400 children (200 in each setting), aged 0 months to 5 years, during 2011. Samples were collected from each nostril and epidemiological information was obtained from the parents. Genotypic analysis included spa typing, PFGE, MLST, SCCmec typing, detection of genes for virulence factors and agr groups. Results Frequency of S. aureus colonization was 39.8% (n?=?159) (hospital 44.5% and DCCs 35.0%) and by MRSA, 5.3% (n?=?21) (hospital 7.0% and DCCs 3.5%). Most S. aureus colonized children were older than two years (p?=?0.005), the majority of them boys (59.1%), shared a bedroom with a large number of people (p?=?0.028), with history of ?-Lactamase inhibitors usage (p?=?0.020). MSSA strains presented the greatest genotypic diversity with 15 clonal complexes (CC). MRSA isolates presented 6 CC, most of them (47.6%) belonged to CC8-SCCmec IVc and were genetically related to previously reported infectious MRSA strains. Conclusion Differences in epidemiological and molecular characteristics between populations may be useful for the understanding of S. aureus nasal colonization dynamics and for the design of strategies to prevent S. aureus infection and dissemination. The finding of colonizing MRSA with similar molecular characteristics of those causing infection demonstrates the dissemination capacity of S. aureus and the risk of infection among the child population. PMID:24987854

  3. Rehospitalization of Psychiatric Patients in a Managed Care Environment

    Microsoft Academic Search

    Peter W. Moran; Leonard A. Doerfler; Jeffrey Scherz; Jennifer D. Lish

    2000-01-01

    This study examined predictors of readmission to a general hospital psychiatric unit that provided acute inpatient care. Participants were 370 patients admitted to the inpatient unit over a 15-month period. During this period, 105 (28%) patients were readmitted to the unit. Readmitted patients were compared to patients who were not readmitted on (a) symptom improvement during hospitalization, (b) psychosocial and

  4. Psychiatric Pharmacy Residency Training*

    PubMed Central

    Ott, Carol A.; DiPaula, Bethany A.

    2010-01-01

    The role of the psychiatric pharmacist in the care of the mentally ill has continually evolved since the late 1960s and early 1970s. Pharmacists in the field of psychiatric pharmacy work to improve the health, safety, and welfare of those impacted by one or more psychiatric conditions. Specialty residency training programs are accredited to establish minimum training standards and a board-certification process ensures that individuals provide a high level of quality of care. It is the position of the College of Psychiatric and Neurologic Pharmacists (CPNP) that Psychiatric Pharmacy residency programs obtain American Society of Health-System Pharmacy (ASHP) accreditation and help the profession move forward as a recognized specialty. PMID:21301597

  5. Teaching Scholarly Activity in Psychiatric Training: Years 6 and 7

    ERIC Educational Resources Information Center

    Zisook, Sidney; Boland, Robert; Cowley, Deborah; Cyr, Rebecca L.; Pato, Michele T.; Thrall, Grace

    2013-01-01

    Objective: To address nationally recognized needs for increased numbers of psychiatric clinician-scholars and physician-scientists, the American Association of Directors of Psychiatric Residency Training (AADPRT) has provided a series of full-day conferences of psychiatry residency training directors designed to increase their competence in…

  6. The American Psychiatric Publishing Group: Psychiatric Journals

    NSDL National Science Digital Library

    The American Psychiatric Publishing Group (APPG) has recently made six journals freely available online until September 1, 1999. Each journal provides tables of contents, abstracts, and a bibliographic search utility. Some journals offer full-text articles. All six journals are offered through Stanford University's HighWire Press.

  7. 78 FR 27485 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ...and Postacute Care Transfer Issues...786-2590, Long-Term Care Hospital Prospective...Hospital Consumer Assessment of Healthcare...Prospective Payment Assessment Commission...nonmedical health care institution...psychiatric long-term care...

  8. [Experiences with residential communities for psychiatric patients].

    PubMed

    Hülsmeier, H

    1986-07-01

    We report about 3 1/2 years experience with sheltered apartments in Bern Switzerland. Now 53 psychiatric ex-patients have been living in 9 apartments. After a survey of the literature, we describe the organizational model and the goals of the project. A big mental state hospital and a small social-psychiatric service with different needs and views of the problems work together. The two different groups of residents, their social- and illness-data are analyzed and compared. Indications, the expense of care and the results are described. The most important effect seems to be the reduction of the need of hospitalization p.a. in the group of residents in a ratio of 10 to 1. PMID:3749374

  9. Velocity during Strength and Power Training of the Ankle Plantar and Dorsiflexor Muscles in Older Patients Attending Day Hospital Rehabilitation

    PubMed Central

    Porter, Michelle M.

    2015-01-01

    Power training has been proposed as a more effective type of resistance training for older adults for functional performance. It is not yet known whether older adults respond appropriately to instructions for power versus strength training. The purpose of this study was to determine the velocity during strength and power training, with elastic resistance bands, in older adults attending a geriatric rehabilitation day program. It was hypothesized that power training would be faster than strength training, but that there would be large interindividual differences. Nine older patients (70 to 86 years) performed power and strength training of the ankle dorsiflexor and plantar flexor muscles using elastic resistance bands. Training sessions were filmed to assess the velocity of training. Power training occurred at faster velocities as compared to strength training (P < 0.01) for both muscle groups. However, a wide variation was observed between participants in the training velocities. Older adults attending geriatric rehabilitation do have the potential to develop faster contractions during power training as compared to strength training. Nevertheless, the actual velocities achieved differed between individuals. This could explain some of the mixed findings of studies on power training. Hence, researchers should monitor velocity when comparing different types of resistance training. PMID:25802760

  10. Religious Affiliation as a Predictor of Involuntary Psychiatric Admission: A Brazilian 1-Year Follow-Up Study

    PubMed Central

    Casella, Caio Borba; Loch, Alexandre Andradade

    2014-01-01

    Objective: The aim of this study was to analyze factors associated with the legal status at psychiatric admission of individuals with psychosis or bipolar disorder in a Latin-American cultural setting. Methods: Prospective observational study was conducted in São Paulo, Brazil. We analyzed 169 individuals with bipolar or psychotic disorder in need of hospitalization. Sociodemographic data, data on the psychiatric disorder, information about the hospital stay, and data at time of discharge were collected. Their families were also contacted by telephone and interviews were conducted at 1, 2, 6, and 12?months post-discharge as a follow-up. Results: Eighty-eight patients (52%) had a voluntary admission and 81 (48%) had an involuntary admission (IA). The average length of admission was similar in both groups (17.4 vs. 17.3?days, p?=?0.22). It was significantly more common for IA patients to be admitted because of other-directed aggressiveness (47.7 vs. 65.4%, p?=?0.02). The percentage of individuals that needed physical restraint during hospital stay among IA patients was also significantly higher (11.4 vs. 25.9%, p?=?0.01). Having any religious affiliations was significantly related to an IA status as well (OR?=?4–6.48). Conclusion: Our results suggest that cultural factors related to religious affiliations might play an important role in determining psychiatric hospitalization legal status. Religion might possibly influence someone’s judgment and insight about his/her psychiatric disorder. This study restates the importance of dealing with the subject of religion with patients. PMID:25157344

  11. How a Stressed Local Public System Copes With People in Psychiatric Crisis

    PubMed Central

    Wells, Rebecca; La, Elizabeth Holdsworth; Morrissey, Joseph; Hall, Marissa; Lich, Kristen Hassmiller; Blouin, Rachel

    2012-01-01

    In order to bolster the public mental health safety net, we must first understand how these systems function on a day-to-day basis. This study explored how individual attributes and organizational interdependencies within one predominantly urban US county affected responses to individuals’ needs during psychiatric crises. We interviewed clinicians and managers within the crisis response network about people at immediate risk of psychiatric hospitalization, what had happened to them during their crises, and factors affecting services provided (N = 94 individuals and 9 agencies). Social network diagrams depicted patterns of referrals between agencies. Iterative coding of interview transcripts was used to contextualize the social network findings. Often, agencies saw crises through to resolution. However, providers also limited the types of people they served, leaving many people in crisis in limbo. This study illustrates how attributes of individuals with mental illness, service providers and their interactions, and state and federal policies intersect to shape the trajectories of individuals during psychiatric crises. Understanding both the structures of current local systems and their contexts may support continued evolution toward a more humane and robust safety net for some of our society’s most vulnerable members. PMID:23065371

  12. How a stressed local public system copes with people in psychiatric crisis.

    PubMed

    Wells, Rebecca; La, Elizabeth Holdsworth; Morrissey, Joseph; Hall, Marissa; Lich, Kristen Hassmiller; Blouin, Rachel

    2013-06-01

    In order to bolster the public mental health safety net, we must first understand how these systems function on a day-to-day basis. This study explored how individual attributes and organizational interdependencies within one predominantly urban US county affected responses to individuals' needs during psychiatric crises. We interviewed clinicians and managers within the crisis response network about people at immediate risk of psychiatric hospitalization, what had happened to them during their crises, and factors affecting services provided (N = 94 individuals and 9 agencies). Social network diagrams depicted patterns of referrals between agencies. Iterative coding of interview transcripts was used to contextualize the social network findings. Often, agencies saw crises through to resolution. However, providers also limited the types of people they served, leaving many people in crisis in limbo. This study illustrates how attributes of individuals with mental illness, service providers and their interactions, and state and federal policies intersect to shape the trajectories of individuals during psychiatric crises. Understanding both the structures of current local systems and their contexts may support continued evolution toward a more humane and robust safety net for some of our society's most vulnerable members. PMID:23065371

  13. Distribution of liver disease in a cohort of immigrants in Sicily: analysis of day-hospital admissions in a migration medicine unit.

    PubMed

    Affronti, Marco; Affronti, Andrea; Soresi, Maurizio; Giannitrapani, Lydia; Campagna, Elisa; Tramuto, Fabio; Brunori, Giuseppe; Montalto, Giuseppe

    2014-09-01

    The objective of this study was to evaluate the frequency of liver disease and its aetiology in a cohort of immigrants. We retrospectively examined the hospital discharge charts of all the immigrant patients presenting at our day hospital from July 2009 to June 2013, and after evaluating the anamnestic, clinical and laboratory data on these charts we identified subjects with liver disease and its various aetiologies. The total sample population consisted of 1218 patients, of whom 112 (9.2%) had a diagnosis of liver disease. More than two-thirds of the latter (67.8%) came from Africa, while 15.2% were from Asia and 17.0% from Eastern Europe. In most patients the disease was related to HBV (44.6%), followed by alcohol (25%) and then HCV or cryptogenic disease (both 15.2%). Forty-six patients had undergone liver biopsy, which showed eight cases of varying degrees of liver steatosis, 29 cases with a variable severity of chronic liver disease, eight cases with a definite picture of liver cirrhosis and one case of alcoholic hepatitis. These data show that a significant proportion of our immigrant population has liver disease and that the most frequent cause is hepatitis B infection. PMID:25269961

  14. Advance Directives (Psychiatric)

    MedlinePLUS

    ... in Minnesota in 1991. Alaska, Hawaii, Idaho, Illinois, Maine, North Carolina, Oklahoma, Oregon, South Dakota, Texas and ... the state laws authorizing psychiatric advance directives except Maine specify that declarants may use these directives to ...

  15. Neuromodulation in psychiatric disorders.

    PubMed

    Temel, Yasin; Hescham, Sarah A; Jahanshahi, Ali; Janssen, Marcus L F; Tan, Sonny K H; van Overbeeke, Jacobus J; Ackermans, Linda; Oosterloo, Mayke; Duits, Annelien; Leentjens, Albert F G; Lim, Leewei

    2012-01-01

    Psychiatric disorders are worldwide a common cause of severe and long-term disability and socioeconomic burden. The management of patients with psychiatric disorders consists of drug therapy and/or psychotherapy. However, in some patients, these treatment modalities do not produce sufficient therapeutic effects or induce intolerable side effects. For these patients, neuromodulation has been suggested as a potential treatment modality. Neuromodulation includes deep brain stimulation, vagal nerve stimulation, and transcranial magnetic and electrical stimulation. The rationale for neuromodulation is derived from the research identifying neurobiologically localized substrates for refractory psychiatric symptoms. Here, we review the clinical data on neuromodulation in the major psychiatric disorders. Relevant data from animal models will also be discussed to explain the neurobiological basis of the therapy. PMID:23206687

  16. Neuroinflammation and psychiatric illness

    PubMed Central

    2013-01-01

    Multiple lines of evidence support the pathogenic role of neuroinflammation in psychiatric illness. While systemic autoimmune diseases are well-documented causes of neuropsychiatric disorders, synaptic autoimmune encephalitides with psychotic symptoms often go under-recognized. Parallel to the link between psychiatric symptoms and autoimmunity in autoimmune diseases, neuroimmunological abnormalities occur in classical psychiatric disorders (for example, major depressive, bipolar, schizophrenia, and obsessive-compulsive disorders). Investigations into the pathophysiology of these conditions traditionally stressed dysregulation of the glutamatergic and monoaminergic systems, but the mechanisms causing these neurotransmitter abnormalities remained elusive. We review the link between autoimmunity and neuropsychiatric disorders, and the human and experimental evidence supporting the pathogenic role of neuroinflammation in selected classical psychiatric disorders. Understanding how psychosocial, genetic, immunological and neurotransmitter systems interact can reveal pathogenic clues and help target new preventive and symptomatic therapies. PMID:23547920

  17. American Psychiatric Association

    MedlinePLUS

    ... for Compliance with the Mental Health Parity and Addiction Equity Act . It provides employers a concise guide ... 5 ® Preventive Medical Care in Psychiatry The Behavioral Addictions Learn Annual Meeting Institute on Psychiatric Services CME ...

  18. Psychiatric morbidity in prisoners

    PubMed Central

    Kumar, Vinod; Daria, Usha

    2013-01-01

    Background: Prisoners are having high percentage of psychiatric disorders. Majority of studies done so far on prisoners are from Western countries and very limited studies from India. Aim: Study socio-demographic profile of prisoners of a central jail and to find out current prevalence of psychiatric disorders in them. Materials and Methods: 118 prisoners were selected by random sampling and interviewed to obtain socio-demographic data and assessed on Indian Psychiatric Interview Schedule (IPIS) with additional required questions to diagnose psychiatric disorders in prisoners. Results: Mean age of prisoners was 33.7 years with 97.5% males, 57.6% from rural areas and 65.3% were married. Average education in studied years was 6.6 years and 50.8% were unskilled workers. 47.4% were murderers while 20.3% of drugs related crimes. 47.5% were convicted and history of criminal behavior in family was in 32.2% prisoners. Current prevalence of psychiatric disorders was 33%. Psychotic, depressive, and anxiety disorders were seen in 6.7%, 16.1%, and 8.5% prisoners respectively. 58.8% had history of drug abuse/dependence prior to imprisonment. Conclusion: One prison of Hadoti region of Rajasthan is full of people with mental-health problems who collectively generate significant levels of unmet psychiatric treatment need. Prisons are detrimental to mental-health. Beginning of reforms is the immediate need. PMID:24459308

  19. Measurement of Psychiatric Treatment Adherence

    PubMed Central

    Sajatovic, Martha; Velligan, Dawn; Weiden, Peter J.; Valenstein, Marcia; Ogedegbe, Gbenga

    2014-01-01

    Objective Nonadherence to medications for mental disorders substantially limits treatment effectiveness and results in higher rates of relapse, hospitalization, and disability. Accurate measurement of medication adherence is important not only in adherence research, but also in clinical trials in which medications are being evaluated, and in clinical practice where failure to detect nonadherence results in premature medication changes, unnecessary polypharmacy, and greater likelihoods of functional deteriorations and hospitalizations. This is a review of psychiatric treatment adherence methods and measures arising from a meeting on “Methodological Challenges in Psychiatric Treatment Adherence Research” held on September 27-28, 2007 in Bethesda, MD and organized by the National Institute of Mental Health (NIMH). Methods This paper reviews the range of modalities currently available for assessing adherence behavior including pill counts, pharmacy records, technology-assisted monitoring, biological assays, and a range of self-report and interviewer-rated scales. Measures of adherence attitudes are also reviewed. Results Each of the adherence measures described are imperfect estimates of actual medication ingestion but each provides informative estimates of adherence or the attitudinal factors associated with adherence. Measure selection depends on a range of factors including the patient sample, the context in which the measure is being used, and the clinical outcomes expected from various levels of nonadherence. The use of multiple measures of adherence is encouraged to balance the limitations of individual measures. Conclusion While adherence assessment has become increasingly sophisticated in recent years there remains a need for refinement and expansion on currently available methods and measures. PMID:21109048

  20. Frequency of contact with community-based psychiatric services and the lunar cycle: a 10-year case-register study

    Microsoft Academic Search

    F. Amaddeo; G. Bisoffi; R. Micciolo; M. Piccinelli; M. Tansella

    1997-01-01

    The relationship between the lunar cycle and the frequency of contact with community-based psychiatric services was assessed using the South Verona Psychiatric Case Register data. For each day of the study period (January 1982–December 1991) we recorded the number of contacts made by South Verona residents with psychiatric services and the corresponding day of the lunar cycle. First, the synodic

  1. [The practice of restraint in a psychiatric emergency unit].

    PubMed

    Guedj, M J; Raynaud, Ph; Braitman, A; Vanderschooten, D

    2004-01-01

    The practice of physical restraint is relatively frequent in medical emergency and geriatric units. Its use in psychiatry is controversial. Although distinct, it is often associated with seclusion, as a response to or prevention of agitated mentally ill patients'behavior. A detailed review of the literature shows the scarceness of work defining the exclusive use of restraint without seclusion. We report a naturalistic study over 6 Months, covering 76 cases having required restraint. The study of the international literature concerns nursing care, geriatric, child-adolescent psychiatric and adult psychiatric reviews. The restraint is a usual practice in general care like emergency, intensive care or geriatric units in order to prevent the patients from falling or to administrate certain care. Legal action has been reported as a consequence of lack of information or agreement of the family. The psychiatric use of restraint is conceived as an additional measure to seclusion, which is a controversial procedure from a therapeutic point of view as well as because of its long duration of application. The practice of restraint described in French literature, from Pinel (in to Daumézon and from French hospital regulations to "transparency forms", seems to be more easily accepted for its short duration and its careful prescription in order to maintain relations with the patients, including agitated children. We made a 6 Months retrospective study in a Parisian psychiatric emergency unit receiving an average of 30 patients a day. The rate of restraint is 1.4%. The objective was to describe the main clinical, epidemiological and situational characteristics and to define quality criteria concerning restraint regarding to the existing standards. We had at our disposal a restraint protocol in order to avoid its prescription as a punishment or for the comfort or the convenience of an insufficient staff. The decision of the restraint is directly prescribed by a physician or decided in emergency by the nurses and then rapidly confirmed by medical prescription. In short, most restrained patients are male, the average age is 32 Years old, and the diagnoses associated with restraint in order of frequency are schizophrenia, personality disorders, acute psychotic episodes, manic episodes and toxic abuses. The main early-warning signs are aggressiveness, delusions, opposition, paranoiac thoughts and distrust. The average duration is 2 hours with continuous clinical supervision and a relational contact maintained. Our study confirms the notion of cumulate restraint days. Actually, 43% of the restraints happen on the same day as others do. The high rate on those days could be as Fischer hypothesized the result of instinctive, aggressive and sexual release of the staff, as well as the consequence of an increase in anxiety and agitation of the other patients. The legal framework is more the duty of assistance to a person in danger than constrained hospitalization, which is not systematically pronounced. No injury or somatic complication occurred during restraint. Neither complaint from the patient or his family nor sick leave of staff was recorded. The specific use of restraint can be compared to the existing standards for using the seclusion room. Among those standards only 1 of 23 criteria was not verified. The others was applicable or without object. The therapeutic use of restraint requires the development of specific quality standards, and the existing criteria concerning seclusion represent a necessary but insufficient answer. We emphasize the need to take into account the early warning signs, a response to the cumulative restraint days, as well as a satisfaction study on patients and the feasibility of such a study in an emergency service. PMID:15029074

  2. Organic Brain Dysfunction and Child Psychiatric Disorder

    PubMed Central

    Graham, Philip; Rutter, Michael

    1968-01-01

    The total population of 11,865 children of compulsory school age resident on the Isle of Wight was studied to determine the prevalence of epilepsy, cerebral palsy, and other neurological disorders. With the use of reliable methods, children selected from screening of the total population were individually studied by means of parental interviews and questionaries, neurological examination and psychiatric assessment of each child, information from school teachers, and perusal of the records of hospitals and other agencies. The association between organic brain dysfunction and psychiatric disorder was studied by comparing the findings in the children with epilepsy or with lesions above the brain stem (cerebral palsy and similar disorders) with those in (1) a random sample of the general population, (2) children with lesions below the brain stem (for example, muscular dystrophy or paralyses following poliomyelitis), and (3) children with other chronic physical handicaps not involving the nervous system (for example, asthma, heart disease, or diabetes). Psychiatric disorders in children with neuro-epileptic conditions were five times as common as in the general population and three times as common as in children with chronic physical handicaps not involving the brain. It was concluded, on the basis of a study of factors associated with psychiatric disorder, that the high rate of psychiatric disorder in the neuro-epileptic children was due to the presence of organic brain dysfunction rather than just the existence of a physical handicap (though this also played a part). However, organic brain dysfunction was not associated with any specific type of disorder. Within the neuro-epileptic group the neurological features and the type of fit, intellectual/educational factors, and socio-familial factors all interacted in the development of psychiatric disorder. PMID:4233874

  3. Organic brain dysfunction and child psychiatric disorder.

    PubMed

    Graham, P; Rutter, M

    1968-09-21

    The total population of 11,865 children of compulsory school age resident on the Isle of Wight was studied to determine the prevalence of epilepsy, cerebral palsy, and other neurological disorders. With the use of reliable methods, children selected from screening of the total population were individually studied by means of parental interviews and questionaries, neurological examination and psychiatric assessment of each child, information from school teachers, and perusal of the records of hospitals and other agencies. The association between organic brain dysfunction and psychiatric disorder was studied by comparing the findings in the children with epilepsy or with lesions above the brain stem (cerebral palsy and similar disorders) with those in (1) a random sample of the general population, (2) children with lesions below the brain stem (for example, muscular dystrophy or paralyses following poliomyelitis), and (3) children with other chronic physical handicaps not involving the nervous system (for example, asthma, heart disease, or diabetes).Psychiatric disorders in children with neuro-epileptic conditions were five times as common as in the general population and three times as common as in children with chronic physical handicaps not involving the brain. It was concluded, on the basis of a study of factors associated with psychiatric disorder, that the high rate of psychiatric disorder in the neuro-epileptic children was due to the presence of organic brain dysfunction rather than just the existence of a physical handicap (though this also played a part). However, organic brain dysfunction was not associated with any specific type of disorder. Within the neuro-epileptic group the neurological features and the type of fit, intellectual/educational factors, and socio-familial factors all interacted in the development of psychiatric disorder. PMID:4233874

  4. Knowledge of thromboprophylaxis guidelines pre- and post-didactic lectures during a venous thromboembolism awareness day at a tertiary-care hospital

    PubMed Central

    Al-Dorzi, Hasan M.; Cherfan, Antoine; Al-Harbi, Shmylan; Al-Askar, Ahmad; Al-Azzam, Saleh; Hroub, Ahmad; Olivier, Joan; Al-Hameed, Fahad; Al-Moamary, Mohamed; Abdelaal, Mohamed; Poff, Gregory A.; Arabi, Yaseen M.

    2013-01-01

    BACKGROUND: Didactic lectures are frequently used to improve compliance with practice guidelines. This study assessed the knowledge of health-care providers (HCPs) at a tertiary-care hospital of its evidence-based thromboprophylaxis guidelines and the impact of didactic lectures on their knowledge. METHODS: The hospital launched a multifaceted approach to improve thromboprophylaxis practices, which included posters, a pocket-size guidelines summary and didactic lectures during the annual thromboprophylaxis awareness days. A self-administered questionnaire was distributed to HCPs before and after lectures on thromboprophylaxis guidelines (June 2010). The questionnaire, formulated and validated by two physicians, two nurses and a clinical pharmacist, covered various subjects such as risk stratification, anticoagulant dosing and the choice of anticoagulants in specific clinical situations. RESULTS: Seventy-two and 63 HCPs submitted the pre- and post-test, respectively (62% physicians, 28% nurses, from different clinical disciplines). The mean scores were 7.8 ± 2.1 (median = 8.0, range = 2-12, maximum possible score = 15) for the pre-test and 8.4 ± 1.8 for the post-test, P = 0.053. There was no significant difference in the pre-test scores of nurses and physicians (7.9 ± 1.7 and 8.2 ± 2.4, respectively, P = 0.67). For the 35 HCPs who completed the pre- and post-tests, their scores were 7.7 ± 1.7 and 8.8 ± 1.6, respectively, P = 0.003. Knowledge of appropriate anticoagulant administration in specific clinical situations was frequently inadequate, with approximately two-thirds of participants failing to adjust low-molecular-weight heparin doses in patients with renal failure. CONCLUSIONS: Education via didactic lectures resulted in a modest improvement of HCPs? knowledge of thromboprophylaxis guidelines. This supports the need for a multifaceted approach to improve the awareness and implementation of thromboprophylaxis guidelines. PMID:23922612

  5. Impressions of psychiatric problems and their management: China, 1977.

    PubMed

    Visher, J S; Visher, E B

    1979-01-01

    The authors, who visited the People's Republic of China in October 1977, describe the treatment methods used there, particularly in the Shanghai Mental Hospital, a 1,000-bed hospital for acutely ill patients. Psychiatric treatment there appears to be a blend of Western pharmacology, traditional Chinese medicine, and group therapy. The authors also speculate on the possible cultural sources of stress-related and interpersonal problems, provide a review of the literature regarding psychiatry in modern China, and outline the history of psychiatric treatment there. PMID:31800

  6. The adult children of alcoholics in a psychiatric population.

    PubMed

    el-Guebaly, N; Staley, D; Rockman, G; Leckie, A; Barkman, K; O'Riordan, J; Koensgen, S

    1991-06-01

    The issues confronting adult children of alcoholics (ACOA) are well publicized but their empirical basis remains limited. The screening of 250 consecutive psychiatric admissions to a general hospital revealed a significant prevalence of ACOAs across diagnoses. Compared to the other patients, the ACOA group was younger but with no other socioeconomic difference. The diagnoses of substance abuse and phobic disorders were more frequent. The group was psychiatrically hospitalized at an earlier age. The impact of an ACOA status varied with the parental biological relation and gender, and with the premorbid antecedents of parental alcoholism. PMID:1862794

  7. Nutraceuticals in psychiatric practice.

    PubMed

    Chiappedi, Matteo; de Vincenzi, Silvia; Bejor, Maurizio

    2012-08-01

    Nutraceuticals can be defined as food components or active principles present in aliments which have positive effects for health and quality of life, including preventing or treating disorders. Herbal and "natural" food supplements are increasingly used to treat different psychiatric disorders, often as "self-prescribed" therapies. With factors such as chronic illness, poor health, emotional distress, and quality of life influencing the desire for complementary medicine, patients with comorbid medical and psychiatric problems seem likely to turn to this approach. We reviewed the most commonly used herbal and dietary supplements for which a certain efficacy on psychiatric symptoms or disorders has been claimed, checking current Pubmed-indexed literature (the most important being St. John's wort, Omega-3 fatty acids, valerian, Kava, Ginkgo, folate, B vitamins, S-Adenosylmethionine, inositol, alfa-lactoalbumin and passionflower). There is evidence of efficacy for some of these herbs an supplements, proved also by Cochrane's meta-analysis. However many different areas (including efficacy, tolerability, optimal dosing, adequate shelf life, drug and non-pharmacological interactions) need to be thoroughly studied; moreover political decisions need to be scientifically guided in order to best serve psychiatric patients' interests and to prevent using of expensive and sometimes un-useful therapies. This implies that a scientific strategy is needed to rule out any third-part economical interest which could in any way influence therapeutic choices. The article presents some promising patents on nutraceuticals in psychiatric practice. PMID:22472025

  8. Psychiatric Rehospitalization of Children and Adolescents: Implications for Social Work Intervention

    Microsoft Academic Search

    Walter Chung; Susan Edgar-Smith; Ruth Baugher Palmer; Elizabeth Bartholomew; David Delambo

    2008-01-01

    This study explored factors associated with the psychiatric rehospitalization of children and adolescents. A retrospective\\u000a archival review was conducted on 403 children and adolescents admitted into an inpatient psychiatric hospital. Results indicated\\u000a that 16% were readmitted in the same year. Children and adolescents who had a prior history of psychiatric rehospitalization,\\u000a lived in a residential treatment facility, and had a

  9. Cigarette smoking among psychiatric patients in Brazil.

    PubMed

    Barros, Fabiana Cristina Ribeiro de; Melo, Ana Paula Souto; Cournos, Francine; Cherchiglia, Mariângela Leal; Peixoto, Eliane Rezende de Morais; Guimarães, Mark Drew Crosland

    2014-06-01

    The aim of this study was to estimate tobacco smoking prevalence among psychiatric patients attended in care facilities in Brazil and assess associated factors. A cross-sectional multicenter study was conducted of psychiatric patients (N = 2,475) selected from 26 care facilities. Current and ex-smokers were compared to those who had never smoked. Odds ratios were estimated using logistic regression. The current and past smoking prevalence rates were 52.7% and 18.9%, respectively. Being male, aged 40 years or over, drug and alcohol use, unprotected sex and a history of physical violence were factors associated with both current and past smoking, while a low education level (? 8 years of schooling), history of homelessness, not practicing a religion, current or previous psychiatric hospitalization, and main psychiatric diagnosis substance use disorders, were factors only associated with current smoking. Tobacco smoking prevalence among this population was high and was higher than the rate in the general population. Appropriate interventions and smoking prevention policies should be incorporated into mental health services. PMID:25099043

  10. Psychiatric consultation to the postpartum mother.

    PubMed

    Anderson, Eleanor A; Kim, Deborah R

    2015-04-01

    The immediate postpartum period is a time of acute vulnerability to mental illness, which presents unique challenges for the psychiatric consultant. Because the postpartum hospital stay is typically brief, the consultant must have a working knowledge of postpartum physiology and the myriad forms of mental illness that may emerge in this vulnerable time, in order to quickly make a diagnosis and formulate a treatment plan. This review aims to characterize the most common reasons for postpartum consultation, review postpartum physiology and psychiatric conditions, and propose an evidence-based, practical approach to treatment. A literature search using the terms "postpartum," "obstetric," "consultation," and "psychiatry" yielded six studies that identified reasons for psychiatric consultation to the obstetrics and gynecology services. These studies informed the structure of the article such that we review the most common reasons for consultation and how to approach each issue. The most common reason for consultation is past psychiatric history, often in the absence of current symptoms. For each clinical situation, including depression, adverse birth events, and psychosis, we present a differential diagnosis, as well as risk factors, clinical signs, and recommended treatment. PMID:25764006

  11. The periodicities in and biometeorological relationships with bed occupancy of an acute psychiatric ward in Antwerp, Belgium

    NASA Astrophysics Data System (ADS)

    Maes, M.; de Meyer, F.; Peeters, D.; Meltzer, H.; Schotte, C.; Scharpe, S.; Cosyns, P.

    1993-06-01

    Recently, some investigators have established a seasonal pattern in normal human psychology, physiology and behaviour, and in the incidence of psychiatric psychopathology. In an attempt to elucidate the chronopsy and meteotropism in the latter, we have examined the chronograms of, and the biometeorological relationships to bed occupancy of the psychiatric ward of the Antwerp University Hospital during three consecutive calendar years (1987 1989). Weather data for the vicinity were provided by a local meteorological station and comprise mean atmospheric pressure, air temperature, relative humidity, wind speed and minutes of sunlight and precipitation/day. The number of psychiatric beds occupied during the study period exhibited a significant seasonal variation. Peaks in bed occupancy were observed in March and November, with lows in August. An important part of the variability in the number of beds occupied could be explained by the composite effects of weather variables of the preceding weeks. Our results suggest that short-term fluctuations in atmospheric activity may dictate some of the periodicities in psychiatric psychopathology.

  12. Examination of insomnia and insomnia treatment in psychiatric inpatients.

    PubMed

    Haynes, Patricia L; Parthasarathy, Sairam; Kersh, Brian; Bootzin, Richard R

    2011-04-01

    Despite the high comorbidity of insomnia with psychiatric illness, few studies have examined insomnia or insomnia treatments in psychiatric inpatients. The present study had two overall goals. First, we sought to describe insomnia symptoms in 76 US veterans hospitalized for a wide-range of psychiatric illnesses. Next, we sought to examine whether participation in one session of group therapy for insomnia was associated with improvement in Insomnia Severity Index (ISI) scores for a subset of these inpatients (n = 19). Data were extracted from the clinical charts of 140 inpatients admitted into the 26-bed psychiatric ward at the New Mexico VA Healthcare System. The majority of the veterans had clinical insomnia in the moderate-to-severe range, and only 18% of the sample reported no clinically-significant insomnia. There was a significant reduction in ISI scores approximately 1 week after attendance at the group therapy session, which appears to be unrelated to the length of hospitalization, but might be related to psychiatric stabilization. This is the first study to examine insomnia symptoms in a mixed, psychiatric inpatient population. Group therapy for insomnia might be a particularly useful treatment option given polypharmacy and substance dependency issues often arising in this population. PMID:21371228

  13. Wisconsin Psychiatric 608.263.6100 Institute & Clinics 608.263.0265 Fax

    E-print Network

    Wisconsin at Madison, University of

    __________________________________________________________________________________________________ Have you ever been diagnosed with a psychiatric or mental health disorder? YES NO Depression Y N Addictions of any kind Y N Have you ever been hospitalized for mental health treatment? YES NO If you? __________________________________________________________________________________________________ Psychiatric History: Have you seen a psychiatrist or therapist in the past? YES NO Please list below

  14. Traditional Healing Practices Sought by Muslim Psychiatric Patients in Lahore, Pakistan

    ERIC Educational Resources Information Center

    Farooqi, Yasmin Nilofer

    2006-01-01

    This research explored the type of traditional healing practices sought by Muslim psychiatric patients treated at public hospitals of Lahore city, Pakistan. The sample comprised 87 adult psychiatric patients (38% male and 62% female). The patients self-reported on the Case History Interview Schedule that they had sought diverse traditional healing…

  15. Traditional Healing Practices Sought by Muslim Psychiatric Patients in Lahore, Pakistan

    Microsoft Academic Search

    Yasmin Nilofer Farooqi

    2006-01-01

    This research explored the type of traditional healing practices sought by Muslim psychiatric patients treated at public hospitals of Lahore city, Pakistan. The sample comprised 87 adult psychiatric patients (38% male and 62% female). The patients self?reported on the Case History Interview Schedule that they had sought diverse traditional healing methods, including Homeopathy, Naturopathy (Tibb), Islamic Faith Healing, and Sorcery,

  16. Adolescent Inpatient Psychiatric Admission Rates and Subsequent One-Year Mortality in England: 1998-2004

    ERIC Educational Resources Information Center

    James, Anthony; Clacey, Joe; Seagroatt, Valerie; Goldacre, Michael

    2010-01-01

    Background: Adolescence is a time of very rapid change not only in physical but also psychological development. During the teenage years there is a reported rise in the prevalence of psychiatric disorders. The aim of this study was to investigate age- and sex-specific National Health Service (NHS) hospital inpatient admission rates for psychiatric

  17. Measuring Family Engagement in Psychiatric Service: An Evaluation of the Family\\/Visitor Survey

    Microsoft Academic Search

    David C. Kondrat; Theresa J. Early; Keith Warren

    2011-01-01

    Family and friend involvement in the psychiatric treatment of persons with mental illness is vital to consumer recovery and an important quality measure, yet few instruments exist to measure such involvement. This article examines the Family\\/Visitor Survey (FVS), a brief instrument designed to measure family\\/friend involvement at Ohio's Behavioral Health Organizations (BHO), the state system of psychiatric hospitals. The researchers

  18. Alcohol and Other Psychiatric Disorders

    MedlinePLUS

    ... Diagnostic and Statistical Manual of Mental Disorders (DSM), alcohol abuse and other substance abuse are defined as psychiatric ... Additionally, other psychiatric disorders often co-occur with alcohol abuse. This is referred to as co-morbidity. Over ...

  19. Psychiatric Advance Directives: Getting Started

    MedlinePLUS

    ... Getting Started State by State Info FAQs Educational Webcasts Links Current Research In the News Legal Issues ... How to write a Psychiatric Advance Directive?" View webcast (15:04) What are Psychiatric Advance Directives? View ...

  20. Factors Influencing Long-Term Psychiatric Hospitalisation of the Elderly in Kuwait

    Microsoft Academic Search

    T. H. Malasi; Iman A. Mirza; M. Fakhr El-Islam

    1989-01-01

    In this study both psychosocial and clinical aspects of elderly patients were investigated in relation to long hospital stay in the only psychiatric hospital in Kuwait. Patients with longer stay did not differ statistically from short stay patients in distributions of sex, age, nationality, marital status, family system, diagnostic categories or factors blocking patients' discharge from hospital. Significant association was

  1. Psychiatric nursing care in Brazil: legal and ethical aspects.

    PubMed

    Ventura, Carla A Arena; Mendes, Isabel Amélia Costa; Trevizan, Maria Auxiliadora

    2007-12-01

    Human rights, considered as rights inherent to all human beings, must be respected unconditionally, especially during health care delivery. These rights became actually protected by International Law when the UN was created in 1945 and, later, when the Universal Declaration of Human Rights was issued in 1948, giving rise to various subsequent treaties. Based on the historical evolution of Human Rights in the international sphere, associated with the principles of constitutional, penal and civil law and psychiatric patient rights in Brazil, we aim to understand some dilemmas of psychiatric nursing care: individuals' rights as psychiatric patients, hospitalization and nursing professionals' practice. In their practice, nurses attempt to conciliate patients' rights with their legal role and concerns with high-quality psychiatric care. In coping with these dilemmas, these professionals are active in three spheres: as health care providers, as employees of a health organization and as citizens. PMID:18284121

  2. Increased rate of day surgery use for inguinal and femoral hernia repair in a decade of hospital admissions in the Veneto Region (north-east Italy): a record linkage study

    PubMed Central

    2013-01-01

    Background Worldwide, there has been a marked increase in the number of inguinal and femoral hernia repairs performed as day surgery procedures. This study aimed to outline the epidemiology of the procedures for repairing unilateral inguinal and femoral hernia in the Veneto Region, and to analyze the time trends and organizational appropriateness of these procedures. Methods Drawing from the anonymous computerized database of hospital discharge records for the Veneto Region, we identified all unilateral groin hernia repair procedures completed in Veneto residents between 2000 and 2009 at both public and accredited private hospitals. Results A total 141,329 hernias were repaired in the Veneto Region during the decade considered, with an annual rate of 291.2 per 100,000 population for inguinal hernia (IH) repairs and 11.2 per 100,000 population for femoral hernia (FH) repairs. Day surgery was used more for inguinal than for femoral hernia repairs, accounting for 76% and 43% (phospital ordinary admissions (day surgery or ambulatory surgery) during the decade considered rose from 61.7% to 86.7% for IH and from 33.0% to 61.8% for FH. Conclusions In the last decade, the Veneto Region has reduced the rate of ordinary hospital admissions for groin hernia repair with a view to improving the efficiency of the hospital network. PMID:24028397

  3. 42 CFR 488.5 - Effect of JCAHO or AOA accreditation of hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...Institutions accredited as hospitals by the JCAHO or AOA are deemed...conditions of participation for hospitals, except— (1) The requirement...2) The additional special staffing and medical records requirements...active treatment in psychiatric hospitals (section 1861(f) of...

  4. 42 CFR 488.5 - Effect of JCAHO or AOA accreditation of hospitals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...Institutions accredited as hospitals by the JCAHO or AOA are deemed...conditions of participation for hospitals, except— (1) The requirement...2) The additional special staffing and medical records requirements...active treatment in psychiatric hospitals (section 1861(f) of...

  5. 42 CFR 488.5 - Effect of JCAHO or AOA accreditation of hospitals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...Institutions accredited as hospitals by the JCAHO or AOA are deemed...conditions of participation for hospitals, except— (1) The requirement...2) The additional special staffing and medical records requirements...active treatment in psychiatric hospitals (section 1861(f) of...

  6. 42 CFR 488.5 - Effect of JCAHO or AOA accreditation of hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...Institutions accredited as hospitals by the JCAHO or AOA are deemed...conditions of participation for hospitals, except— (1) The requirement...2) The additional special staffing and medical records requirements...active treatment in psychiatric hospitals (section 1861(f) of...

  7. 42 CFR 488.5 - Effect of JCAHO or AOA accreditation of hospitals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...Institutions accredited as hospitals by the JCAHO or AOA are deemed...conditions of participation for hospitals, except— (1) The requirement...2) The additional special staffing and medical records requirements...active treatment in psychiatric hospitals (section 1861(f) of...

  8. Psychiatric-Mental Health Nursing.

    ERIC Educational Resources Information Center

    Reighley, Joan

    A description is provided of a course, "Psychiatric-Mental Health Nursing," designed to teach students at Level 3 of a two-year college nursing program about the role of the nurse in a psychiatric setting and about concepts of mental health and psychiatric disorders, using both classroom and clinical instruction. The first section of the course…

  9. Is psychiatric research scientific?

    Microsoft Academic Search

    Rachel Cooper

    2009-01-01

    It is generally assumed that asking whether psychiatric research can be scientific is a reasonable question to ask and that the answer matters. In this chapter I contest both these claims. I start by arguing that the search for a 'demarcation criterion' that would distinguish science from non-science has failed. I then defend the claim that 'science' is best considered

  10. Pathological Gambling: Psychiatric Models

    ERIC Educational Resources Information Center

    Westphal, James R.

    2008-01-01

    Three psychiatric conceptual models: addictive, obsessive-compulsive spectrum and mood spectrum disorder have been proposed for pathological gambling. The objectives of this paper are to (1) evaluate the evidence base from the most recent reviews of each model, (2) update the evidence through 2007 and (3) summarize the status of the evidence for…

  11. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...under the inpatient psychiatric facility prospective payment system. 412.405 Section...HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient...

  12. 42 CFR 412.432 - Method of payment under the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...under the inpatient psychiatric facility prospective payment system. 412.432 Section...HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient...

  13. 42 CFR 412.428 - Publication of Updates to the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...to the inpatient psychiatric facility prospective payment system. 412.428 Section...HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient...

  14. Mapping Common Psychiatric Disorders

    PubMed Central

    Blanco, Carlos; Krueger, Robert F.; Hasin, Deborah S.; Liu, Shang-Min; Wang, Shuai; Kerridge, Bradley T.; Saha, Tulshi; Olfson, Mark

    2013-01-01

    Context Clinical experience and factor analytic studies suggest that some psychiatric disorders may be more closely related to one another, as indicated by the frequency of their co-occurrence, which may have etiologic and treatment implications. Objective To construct a virtual space of common psychiatric disorders, spanned by factors reflecting major psychopathologic dimensions, and locate psychiatric disorders in that space, as well as to examine whether the location of disorders at baseline predicts the prevalence and incidence of disorders at 3-year follow-up. Design, Setting, and Patients A total of 34 653 individuals participated in waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Main Outcome Measures The distance between disorders at wave 1, calculated using the loadings of the factors spanning the space of disorders as coordinates. This distance was correlated with the adjusted odds ratios for age, sex, and race/ethnicity of the prevalence and incidence of Axis I disorders in wave 2, with the aim of determining whether smaller distances between disorders at wave 1 predicts higher disorder prevalence and incidence at wave 2. Results A model with 3 correlated factors provided an excellent fit (Comparative Fit Index = 0.99, Tucker-Lewis Index=0.98, root mean square error of approximation=0.008) for the structure of common psychiatric disorders and was used to span the space of disorders. Distances ranged from 0.070 (between drug abuse and dysthymia) to 1.032 (between drug abuse and avoidant personality disorder). The correlation of distance between disorders in wave 1 with adjusted odds ratios of prevalence in wave 2 was ?0.56. The correlation of distance in wave 1 with adjusted odds ratios of incidence in wave 2 was ?0.57. Conclusions Mapping psychiatric disorders can be used to quantify the distances among disorders. Proximity in turn can be used to predict prospectively the incidence and prevalence of Axis I disorders. PMID:23266570

  15. Mental hospitals in India.

    PubMed

    Krishnamurthy, K; Venugopal, D; Alimchandani, A K

    2000-04-01

    This review traces the history of the mental hospital movement, initially on the world stage, and later in India, in relation to advances in psychiatric care. Mental hospitals have played a significant role in the evolution of psychiatry to its present statusThe earliest hospital in India were established during the British colonial rule. They served as a means to isolate mentally ill persons from the societal mainstream and provide treatments that were in vogue at the time. Following India's independence, there has been a trend towards establishing general hospital psychiatry units and deinstitutionalization, while at the same time improving conditions in the existing mental hospitals.Since 1947, a series of workshops of superintendents was conducted to review the prevailing situations in mental hospitals and to propose recommendations to improve the same. Implementation of the Mental Health Act, 1987, and grovernmental focus upon mental hospital reform have paved way for a more specific and futuristic role for mental hospitals in planning psychiatric services for the new millenium, especially for severe mental illnesses. PMID:21407925

  16. Common types of medication errors on long-term psychiatric care units

    Microsoft Academic Search

    HIROTO ITO; SYUN YAMAZUMI

    2003-01-01

    Objective. This multi-center study identified the most frequent types of medication errors in long-term psychiatric care hospitals. Setting. Japan. Design and study participants. We asked 132 units in 44 Japanese psychiatric hospitals to introduce an in-patient incident reporting system on potential adverse drug events (PADEs) for the period 1 October to 30 November 2000. We analyzed types of PADE, outcomes,

  17. Comorbidity of Psychiatric and Personality Disorders in First Suicide Attempters

    PubMed Central

    Rao, K. Nagaraja; Kulkarni, Ranganath R.; Begum, Shamshad

    2013-01-01

    Background: Attempted suicide is a common clinical problem in a general hospital setting. It has a serious clinical and socio-economical impact too. Aims: To study the psychosocial, psychiatric, and personality profile of the first suicide attempters in a general hospital. Settings and Design: Cross-sectional, hospital-based, descriptive study. Materials and Methods: All the consecutive cases of first suicide attempt (n=100) treated in a general hospital were studied to know the clinical profile. Variables related to socio-demographic characteristics, family background, suicide characteristics, psychiatric morbidity, and comorbidity were analyzed. Risk-Rescue rating was applied to know the medical seriousness of the suicide attempt. Presumptive stressful life event scale was utilized to calculate life events score. Structured clinical interview (MINI Plus) and semi-structured clinical interview (IPDE) were used for axis-I and axis-II (personality) diagnoses. The results were analyzed using appropriate statistical measures. Results: Family history of psychiatric illnesses (31%) and suicide (11%) were noted. Insecticides and pesticides were the most common agents (71%) employed to attempt suicide. Interpersonal difficulties (46%) were the most frequent stressor. Overall medical seriousness of the suicide attempt was of moderate lethality. 93% of the suicide attempters had at least one axis-I and/or axis-II psychiatric disorder. Most common diagnostic categories were mood disorders, adjustment disorders, and substance-related disorders, with axis-I disorders (89%), personality disorders (52%), and comorbidity of psychiatric disorders (51.6%). Conclusion: Individuals who made first suicide attempt were young adults, had lower educational achievement; overall seriousness of the suicide attempt was of moderate lethality, high prevalence of psychiatric morbidity, personality disorders, and comorbidity, and had sought medical help from general practitioners. PMID:23833346

  18. Some Determinants of Employee Turnover in a Psychiatric Facility.

    ERIC Educational Resources Information Center

    Zautra, Alex J.; And Others

    1987-01-01

    Used research from illness-prevention and job-enrichment approaches to enhancing quality of work environments to create instruments assessing number of job stressors and level of task interest on psychiatric hospital units. Instruments successfully predicted employee turnover during one year. Job stress and interaction between job stress and task…

  19. Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers

    ERIC Educational Resources Information Center

    Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina

    2011-01-01

    Purpose: The authors compared the levels of job burden and stress in psychiatry residents with those of other healthcare professionals at inpatient and outpatient psychiatric hospitals in a medium-sized Brazilian city. Method: In this study, the levels of job burden and stress of 136 healthcare workers and 36 psychiatry residents from six various…

  20. Hospitality Management Hospitality Management

    E-print Network

    McConnell, Terry

    Hospitality Management Hospitality Management Norm Faiola, Chair, 315-443-1710 Lyman Hall Faculty PROGRAM The Department of Hospitality Management requires a diversity of skills from many disciplines of the global hospitality industry. Academic Offerings HOSPITALITY AND FOOD SERVICE MANAGEMENT MINOR HOSPITALITY

  1. Culture and psychiatric diagnosis.

    PubMed

    Lewis-Fernández, Roberto; Aggarwal, Neil Krishan

    2013-01-01

    Since the publication of DSM-IV in 1994, neurobiologists and anthropologists have criticized the rigidity of its diagnostic criteria that appear to exclude whole classes of alternate illness presentations, as well as the lack of attention in contemporary psychiatric nosology to the role of contextual factors in the emergence and characteristics of psychopathology. Experts in culture and mental health have responded to these criticisms by revising the very process of diagnosis for DSM-5. Specifically, the DSM-5 Cultural Issues Subgroup has recommended that concepts of culture be included more prominently in several areas: an introductory chapter on Cultural Aspects of Psychiatric Diagnosis - composed of a conceptual introduction, a revised Outline for Cultural Formulation, a Cultural Formulation Interview that operationalizes this Outline, and a glossary on cultural concepts of distress - as well as material directly related to culture that is incorporated into the description of each disorder. This chapter surveys these recommendations to demonstrate how culture and context interact with psychiatric diagnosis at multiple levels. A greater appreciation of the interplay between culture, context, and biology can help clinicians improve diagnostic and treatment planning. PMID:23816860

  2. A Tobacco Reconceptualization in Psychiatry (TRIP): Towards the Development of Tobacco-Free Psychiatric Facilities

    PubMed Central

    Moss, Taryn G.; Weinberger, Andrea H.; Vessicchio, Jennifer C.; Mancuso, Vincenza; Cushing, Sandra J.; Pett, Michael; Kitchen, Kate; Selby, Peter; George, Tony P.

    2010-01-01

    Tobacco dependence is the leading cause of death in persons with psychiatric and substance use disorders. This has lead to interest in the development of pharmacological and behavioral treatments for tobacco dependence in this subset of smokers. However, there has been little attention paid to the development of tobacco-free environments in psychiatric institutions despite the creation of smoke-free psychiatric hospitals mandated by the Joint Commission for Accreditation of Health Organizations (JCAHO) in 1992. This review article addresses the reasons why tobacco should be excluded from psychiatric and addictions treatment settings, and strategies that can be employed to initiate and maintain tobacco-free psychiatric settings. Finally, questions for further research in this field are delineated. This Tobacco Reconceptualization in Psychiatry (TRIP) is long overdue, given the clear and compelling benefits of tobacco-free environments in psychiatric institutions. PMID:20653636

  3. A Longitudinal Analysis of Psychiatric Severity upon Outcomes Among Substance Abusers Residing in Self-Help Settings

    Microsoft Academic Search

    John M. Majer; Leonard A. Jason; Carol S. North; Joseph R. Ferrari; Nicole S. Porter; Bradley Olson; Margaret Davis; Darrin Aase; J. Paul Molloy

    2008-01-01

    A longitudinal analysis of psychiatric severity was conducted with a national sample of recovering substance abusers living\\u000a in Oxford Houses, which are self-run, self-help settings. Outcomes related to residents’ psychiatric severity were examined\\u000a at three follow-up intervals over one year. Over time, Oxford House residents with high versus low baseline psychiatric severity\\u000a reported significantly more days using psychiatric medication, decreased

  4. Who’s Boarding in the Psychiatric Emergency Service?

    PubMed Central

    Simpson, Scott A.; Joesch, Jutta M.; West, Imara I.; Pasic, Jagoda

    2014-01-01

    Introduction When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES) has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. Methods We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student’s t-tests and multivariate regression. Results 521 of 5363 patient encounters (9.7%) resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Conclusion Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients. PMID:25247041

  5. Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring

    PubMed Central

    2012-01-01

    Background The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients’ perceived coercion and to increase patient satisfaction, their quality of life and empowerment. Methods/Design This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care procedures (control group). 200 patients each will be assigned to the intervention group or to the control group. Detailed follow-up assessments of service use, psychopathology and patient perceptions are scheduled 12 and 24 months after discharge. Discussion Innovative interventions have to be established to prevent patients with mental disorders from undergoing the experience of compulsory admission and, with regard to society as a whole, to reduce the costs of health care (and detention). The current study will allow for a prospective analysis of the effectiveness of an intervention programme, providing insight into processes and factors that determine involuntary placement. Trial registration Current Controlled Trials ISRCTN63162737. PMID:22946957

  6. The Effects of Sociodemographic Factors on Psychiatric Diagnosis

    PubMed Central

    Choi, Mal Rye; Eun, Hun-Jeong; Yoo, Tai P.; Yun, Youngmi; Wood, Christopher; Kase, Michael; Park, Jong-Il

    2012-01-01

    Objective Several studies have reported that ethnic differences influence psychiatric diagnoses. Some previous studies reported that African Americans and Hispanics are diagnosed with schizophrenia spectrum disorders more frequently than Caucasians, and that Caucasians are more likely to be diagnosed with affective disorders than other ethnic groups. We sought to identify associations between sociodemographic factors and psychiatric diagnosis. Methods We retrospectively examined the medical records of all psychiatric inpatients (ages over 18 years) treated at Kern county mental hospital (n=2,051) between July 2003 and March 2007 for demographic, clinical information, and discharge diagnoses. Results African American and Hispanic males were more frequently diagnosed with schizophrenia spectrum disorders than Caucasians, whereas Caucasian females were more frequently diagnosed with affective disorders than females in the other ethnic groups, suggesting that patient ethnicity and gender may influence clinical diagnoses. Demographic variables, that is, a lower education, failure of marriage, homelessness, and low quality insurance, were found to be significantly associated with a diagnosis of schizophrenia spectrum disorders after adjusting for clinical variables. And, the presence of a family psychiatric history, failure of marriage, not-homelessness, and quality insurance were found to be associated with a diagnosis of affective disorders. Conclusion Our results show that these demographic factors, including ethnicity, have effects on diagnoses in psychiatric inpatients. Furthermore, these variables may help prediction of psychiatric diagnoses. PMID:22993517

  7. Day Hospital Mentalization-Based Treatment (MBT-DH) versus treatment as usual in the treatment of severe borderline personality disorder: protocol of a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Severe borderline personality disorder is associated with a very high psychosocial and economic burden. Current treatment guidelines suggest that several manualized treatments, including day hospital Mentalization-Based Treatment (MBT-DH), are effective in these patients. However, only two randomized controlled trials have compared manualized MBT-DH with treatment as usual. Given the relative paucity of data supporting the efficacy and cost-effectiveness of MBT-DH, the possible influence of researcher allegiance in one of the trials, and potential problems with the generalization of findings to mental health systems in other countries, this multi-site randomized trial aims to investigate the efficacy and cost-effectiveness of manualized MBT-DH compared to manualized specialist treatment as usual in The Netherlands. Methods/design The trial is being conducted at two sites in The Netherlands. Patients with a DSM-IV-TR diagnosis of borderline personality disorder and a score of???20 on the Borderline Personality Disorder Severity Index were randomly allocated to MBT-DH or treatment as usual. The MBT-DH program consists of a maximum of 18 months’ intensive treatment, followed by a maximum of 18 months of maintenance therapy. Specialist treatment as usual is provided by the City Crisis Service in Amsterdam, a service that specializes in treating patients with personality disorders, offering manualized, non-MBT interventions including family interventions, Linehan training, social skills training, and pharmacotherapy, without a maximum time limit. Patients are assessed at baseline and subsequently every 6 months up to 36 months after the start of treatment. The primary outcome measure is the frequency and severity of manifestations of borderline personality disorder as assessed by the Borderline Personality Disorder Severity Index. Secondary outcome measures include parasuicidal behaviour, symptomatic distress, social and interpersonal functioning, personality functioning, attachment, capacity for mentalizing and quality of life. Cost-effectiveness is assessed in terms of the cost per quality-adjusted life year. Outcomes will be analyzed using multilevel analyses based on intention-to-treat principles. Discussion Severe borderline personality disorder is a serious psychological disorder that is associated with high burden. This multi-site randomized trial will provide further data concerning the efficacy and cost-effectiveness of MBT-DH for these patients. Trial registration NTR2175 PMID:24886402

  8. [Integration and reintegration of first admission psychiatric patients].

    PubMed

    Bell, V; Blumenthal, S; Neumann, N U; Schüttler, R; Vogel, R

    1990-07-01

    In the framework of a prospective follow-up study, development and outcome of the occupational and social status in 258 first-admission psychiatric patients was investigated. Interviews were made at the time of discharge, 1 year and 5 years later. For that reason prospective data exist on the prehospital and hospital time as well as on short-term and long-term course. Social adjustment, occupational rehabilitation, early retirement, social status and pre- and post-hospital occupational integration were investigated. It must be placed on record, that psychiatric patients are subjected to severe negative changes in their occupational and social life even after the first hospital treatment. Type and quantity of disintegration depended on the diagnostic group. Schizophrenic patients differed from the other patients in every intergration area. PMID:2395939

  9. Workplace violence prevention programs in psychiatric units and facilities.

    PubMed

    Peek-Asa, Corinne; Casteel, Carri; Allareddy, Veerasathpurush; Nocera, Maryalice; Goldmacher, Suzi; Ohagan, Emily; Blando, James; Valiante, David; Gillen, Marion; Harrison, Robert

    2009-04-01

    Psychiatric health care providers have high rates of workplace violence victimization, yet little is known about the strategies used by facilities to reduce violence. This study compared workplace violence prevention (WVP) programs in psychiatric units and facilities in California and New Jersey. Information was collected through interviews, a facility walk-through, and a review of written policies and training material. A similar proportion of hospitals in both states had WVP training programs. A higher proportion of hospitals in California had written WVP policies, and a higher proportion of New Jersey hospitals had implemented environmental and security modifications to reduce violence. Legislation is one of many potential approaches to increase workplace violence prevention programs in health care settings. PMID:19327559

  10. 78 FR 50495 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ...786-2590, Long-Term Care Hospital...Consumer Assessment of Healthcare...ALTHA Acute Long Term Hospital...hospital CARE [Medicare] Continuity Assessment Record...Prospective Payment Assessment Commission...nonmedical health care institution...psychiatric long-term care...

  11. Predictors of Psychiatric Boarding in the Emergency Department

    PubMed Central

    Misek, Ryan K.; DeBarba, Ashley E.; Brill, April

    2015-01-01

    Introduction The emergency psychiatric care is system is overburdened in the United States. Patients experiencing psychiatric emergencies often require resources not available at the initial treating facility and frequently require transfer to an appropriate psychiatric facility. Boarding of psychiatric patients, defined as a length of stay greater than four hours after medical clearance, is ubiquitous throughout emergency departments (EDs) nationwide. Boarding is recognized as a major cause of ambulance diversions and ED crowding and has a significant adverse impact on healthcare providers, patient satisfaction, and hospital costs. We sought to identify differences between patients who boarded versus patients who did not board, to identify factors amenable to change and identify interventions that could lead to a decrease in overall psychiatric patient length of stay and improve patient care. Methods This study is a retrospective multicenter cohort study of all patients assessed to require inpatient psychiatric hospitalization at two community EDs in Illinois from July 1, 2010 through June 30, 2012. We identified 671 patients and collected insurance status, sex, age, time of arrival, time of disposition and time of transfer. Results There was a statistically significant difference in the insurance status between the cohort of patients boarding in the ED compared to non-boarders prior to inpatient psychiatric admission. Our study identified 95.4% of uninsured patients who were boarded in the ED, compared to 71.8% of Medicare/Medicaid patients and 78.3% of patients with private insurance (?2=50.6, df=2, p<0.001). We found the length of stay to be longer for patients transferred to publicly funded psychiatric facilities compared to those transferred to private facilities, with a mean time spent in the ED of 1,661 minutes and 705 minutes, respectively (p<0.001). Patients with Medicare/Medicaid were nearly twice as likely to return to the ED for psychiatric emergencies than self-pay and privately insured patients, requiring repeat inpatient psychiatric admission (estimate=0.649, p=0.035, OR=1.914). Conclusion This study found that unfunded patients boarded significantly longer than Medicare/Medicaid and privately insured patients. Patients with private insurance boarded longer than those with Medicare/Medicaid. Patients transferred to publicly funded facilities had significantly longer ED length of stay than patients transferred to private facilities. PMID:25671012

  12. National Hospital Discharge Survey

    Cancer.gov

    The National Hospital Discharge Survey (NHDS), which has been conducted annually since 1965, collects data from a sample of approximately 270,000 inpatient records acquired from a national sample of about 500 hospitals. Only hospitals with an average length of stay of fewer than 30 days for all patients, general hospitals, or children's general hospitals are included in the survey. Information collected includes diagnoses, surgical and nonsurgical procedures, prescription and over-the-counter drugs, immunizations, allergy shots, anesthetics, and dietary supplements.

  13. Drug-induced psychiatric disorders.

    PubMed

    Johnson, D A

    1981-07-01

    This article is a review of the principal drug-induced psychiatric symptoms that are likely to be encountered in daily clinical practice as a result of drug abuse, overdoses or side effects of drugs prescribed for treatment. Many categories of medication have the potential to produce psychiatric symptoms, but antitubercular drugs, hypotensive agents and steroids have the highest incidence in clinical practice. Additionally, the problems of alcohol are all too frequently overlooked. The variety and frequency of secondary psychiatric symptoms which may be drug-related emphasise the importance of a careful consideration of all drugs taken by a patient with psychiatric complaints, to determine causal association with symptoms. PMID:6114850

  14. NPR: Day to Day

    NSDL National Science Digital Library

    Hosted by award-winning National Public Radio (NPR) correspondent Alex Chadwick, Day to Day is a way for regular NPR listeners to listen to smart news coverage during the middle of the day or during their lunch-hour. Fortunately, Day to Day is available online, complete with an archive dating back to January 2003. Produced in the NPR West office in Los Angeles, and includes a number of NPR regulars and contributors from the online publication Slate. Day to Day also features the helpful daily reports from the Minnesota Public Radio show, Marketplace, which is "an informative conversation about business and economic news". Other regular features on Day to Day include commentaries on recent music releases from independent music critic Christian Bordal and curious and novel exposes and reports on the "odd underbelly" of the City of Angels, direct from Southern California.

  15. [Psychiatric aspects of epileptic disorders].

    PubMed

    Schmitz, B

    2012-02-01

    Psychiatric complications are common in people with epilepsy and contribute significantly to the impaired quality of life of patients and relatives. This paper discusses psychosis, depression and psychiatric adverse events of anticonvulsants with a focus on practical issues of diagnosis and treatment. PMID:22212216

  16. Psychiatric Effects of Solitary Confinement

    Microsoft Academic Search

    Stuart Grassian

    2006-01-01

    The author, Dr. Grassian, is a Board Certified Psychiatrist who was on the faculty of the Harvard Medical School for over twenty-five years. He has had extensive experience in evaluating the psychiatric effects of solitary confinement, and in the course of his professional involvement, has been involved as an expert regarding the psychiatric impact of federal and state segregation and

  17. College Students with Psychiatric Disabilities

    ERIC Educational Resources Information Center

    Singh, Delar K.

    2011-01-01

    This paper focuses on college students with psychiatric disabilities. It defines and discusses various psychiatric conditions such as mood disorders, anxiety disorders, eating disorders, and personality disorders. It concludes with accommodations that a college professor can make to help these students succeed in higher education. (Contains 1…

  18. Validity of Childhood Autism in the Danish Psychiatric Central Register: Findings from a Cohort Sample Born 1990-1999

    ERIC Educational Resources Information Center

    Lauritsen, Marlene B.; Jorgensen, Meta; Madsen, Kreesten M.; Lemcke, Sanne; Toft, Susanne; Grove, Jakob; Schendel, Diana E.; Thorsen, Poul

    2010-01-01

    The purpose of this study was to assess the validity of the diagnosis of childhood autism in the Danish Psychiatric Central Register (DPCR) by reviewing medical records from 499 of 504 total children with childhood autism born 1990-1999. Based on review of abstracted behaviors recorded in case records from child psychiatric hospitals, case status…

  19. Smoking attitudes, beliefs, and readiness to change among acute and long term care inpatients with psychiatric diagnoses

    Microsoft Academic Search

    Ann Marie Carosella; DEBORAH J. OSSIP-KLEIN; CHRISTINA A. OWENS

    1999-01-01

    The present study represents an initial assessment of barriers and motives for quitting, health risk knowledge, and readiness to change in a hospitalized acute and long term care population with psychiatric diagnoses, and dual diagnoses of substance abuse and psychiatric disorders. Ninety-two patients residing in admissions, long term care, and mentally impaired\\/chemically addicted (MICA) units of a VA Medical Center

  20. Spouses of Discharged Psychiatric Patients: Factors Associated with Their Experience of Burden.

    ERIC Educational Resources Information Center

    Noh, Samuel; Avison, William R.

    1988-01-01

    Examined variations in experience of burden among men and women married to formerly hospitalized psychiatric patients. Substantial proportion of individuals found living with previously hospitalized spouse burdensome. Experience of burden was not simply function of patient's behavioral problems as indexed by measure of symptomatology; psychosocial…

  1. A case of graves' disease with remarkable psychiatric symptoms.

    PubMed

    Kuno, Fumi; Okada, Yosuke; Arao, Tadashi; Kurozumi, Akira; Tanaka, Yoshiya

    2015-03-01

    A 42-year-old woman visited our hospital with palpitations, excessive sweating, and finger tremors in March 2011. She was diagnosed with Graves' disease based on the following test results: thyroid stimulating hormone < 0.01 ?U/ml, free thyroxine 6.15 ng/ml, and thyrotropin receptor antibody 7.8 U/ml. Treatment with methimazole 30 mg and propranolol 30 mg was started, and her thyroid function showed improvement. However, significant manic symptoms, irritability, hallucinations, and delusions were noted, and she was hospitalized for her own protection in May 2011. Although treatment with aripiprazole 24 mg and lithium 400 mg was started, the hallucinatory and delusional symptoms persisted, necessitating adjustment of the antipsychotics. Her psychiatric symptoms showed amelioration in July 2011 after improvement in her thyroid function, and she was discharged from our hospital. After discharge, her thyroid function remained normal with methimazole 10 mg, and administration of the antipsychotics was discontinued. Affective psychotic symptoms such as altered mood and activity are frequently observed in cases with Graves' disease, but there have been few reports describing cases with full-blown psychiatric disorders manifesting with features such as hallucinations and delusions as the chief symptoms requiring hospitalized treatment, as in the present case. In symptomatic psychosis associated with Graves' disease, prolonged psychiatric symptoms might develop, and close cooperation with psychiatrists is thus important. PMID:25787102

  2. Who will treat psychiatrically disturbed developmentally disabled patients? A health care nightmare.

    PubMed

    Marcos, L R; Gil, R M; Vazquez, K M

    1986-02-01

    The authors assess the impact of a policy adopted briefly in New York State to facilitate short-term hospitalization and long-term aftercare of psychiatrically disturbed, developmentally disabled patients. Denied admission to New York State facilities that provide long-term care for the psychiatrically disturbed or the developmentally disabled, these dually diagnosed patients have often languished in the emergency room of municipal hospitals or been inappropriately hospitalized in the acute-care psychiatric unit, sometimes for several months. The authors conclude that the policy expedited hospitalization but failed to facilitate patients' discharge because it did not address the underlying need for suitable aftercare facilities. Overlapping clinical and administrative issues and political exigencies that complicated the policymaking process are discussed. PMID:3943807

  3. Exorcism: a psychiatric viewpoint.

    PubMed Central

    Trethowan, W. H.

    1976-01-01

    Doctors, for several reasons, should be concerned with exorcism is the view of Professor Trethowan, who in this paper, looks at the main features of exorcism as practised in the middle ages and now appearing in the modern world, as was seen in the recent Ossett case in Britain. He examines in some detail the nature of supposed demoniacal possession and describes its symptoms and signs. He also touches on the social, as opposed to the religious, background in which demoniacal possession flourished (not lacking in the world today), so leading to an examination of the psychodynamic aspects of demoniacal possession and the question of absolute evil. Finally he compares the techniques of exorcism and of modern psychiatric practice. PMID:966260

  4. Surgery for psychiatric disorders.

    PubMed

    Luigjes, Judy; de Kwaasteniet, Bart P; de Koning, Pelle P; Oudijn, Marloes S; van den Munckhof, Pepijn; Schuurman, P Richard; Denys, Damiaan

    2013-01-01

    Surgery in psychiatric disorders has a long history and has regained momentum in the past few decades with deep brain stimulation (DBS). DBS is an adjustable and reversible neurosurgical intervention using implanted electrodes to deliver controlled electrical pulses to targeted areas of the brain. It holds great promise for therapy-refractory obsessive-compulsive disorder. Several double-blind controlled and open trials have been conducted and the response rate is estimated around 54%. Open trials have shown encouraging results with DBS for therapy-refractory depression and case reports have shown potential effects of DBS on addiction. Another promising indication is Tourette syndrome, where potential efficacy of DBS is shown by several case series and a few controlled trials. Further research should focus on optimizing DBS with respect to target location and increasing the number of controlled double-blinded trials. In addition, new indications for DBS and new target options should be explored in preclinical research. PMID:22465369

  5. The last mental hospital.

    PubMed

    Gilligan, J

    2001-01-01

    The public mental hospital system was created in part because many mentally ill people were being held in prisons and jails. Support for those hospitals waned over time, however, and by the time they had degenerated into "snake pits" a consensus was reached to close them down. Unfortunately, they were not replaced with adequate community mental health resources, so as the hospitals have emptied, the prisons and jails have filled, partly with the mentally ill. That is the destructive reason for the growth of prison psychiatry in this country: the prison has become the last mental hospital. The constructive one has been a new emphasis on bringing psychiatric treatment to a previously neglected population: people who have committed serious violence, whether because of Axis I mental illnesses or Axis II character disorders. Unfortunately, four inter-related, mutually reinforcing nationwide trends threaten to reinforce that destructive development and vitiate the constructive one. PMID:11293201

  6. Psychiatric consultation with children in underserviced areas: lessons from experiences in northern Ontario.

    PubMed

    Dubois, J R; Nugent, K; Broder, E

    1991-08-01

    There are only 350 child psychiatrists in Canada. It is therefore unrealistic to expect them to be able to provide sufficient direct treatment, even in small densely populated communities with abundant resources. Such expectations are even more unrealistic in underserviced, sparsely populated areas. A review of the literature on psychiatric consultation in underserviced areas is presented along with a description of the consultation process, taking advantage of the "multiplier effect." Some of the realities of mental health consultation in underserviced areas are discussed, stressing the importance of consultation as a way of professional life. Some guidelines for the psychiatric consultant are outlined which would enhance the "multiplier effect". It is maintained that the training of psychiatric residents should include a supervised experience consulting in underserviced areas. Finally, it is hoped that psychiatric training programs, funding bodies, hospitals, and agencies, will recognize the value of this use of psychiatric expertise. PMID:1933752

  7. Decision-making capacity for treatment in psychiatric and medical in-patients: cross-sectional, comparative study†

    PubMed Central

    Owen, Gareth S.; Szmukler, George; Richardson, Genevra; David, Anthony S.; Raymont, Vanessa; Freyenhagen, Fabian; Martin, Wayne; Hotopf, Matthew

    2013-01-01

    Background Is the nature of decision-making capacity (DMC) for treatment significantly different in medical and psychiatric patients? Aims To compare the abilities relevant to DMC for treatment in medical and psychiatric patients who are able to communicate a treatment choice. Method A secondary analysis of two cross-sectional studies of consecutive admissions: 125 to a psychiatric hospital and 164 to a medical hospital. The MacArthur Competence Assessment Tool - Treatment and a clinical interview were used to assess decision-making abilities (understanding, appreciating and reasoning) and judgements of DMC. We limited analysis to patients able to express a choice about treatment and stratified the analysis by low and high understanding ability. Results Most people scoring low on understanding were judged to lack DMC and there was no difference by hospital (P = 0.14). In both hospitals there were patients who were able to understand yet lacked DMC (39% psychiatric v. 13% medical in-patients, P<0.001). Appreciation was a better ‘test’ of DMC in the psychiatric hospital (where psychotic and severe affective disorders predominated) (P<0.001), whereas reasoning was a better test of DMC in the medical hospital (where cognitive impairment was common) (P = 0.02). Conclusions Among those with good understanding, the appreciation ability had more salience to DMC for treatment in a psychiatric setting and the reasoning ability had more salience in a medical setting. PMID:23969482

  8. The Role of Personal Social Networks in Risk Assessment and Management of Forensic Psychiatric Patients

    Microsoft Academic Search

    Lydia Pomp; Marinus Spreen; Stefan Bogaerts; Beate Völker

    2010-01-01

    Social network factors are usually not accounted for in the clinical practice of risk assessment\\/management.This article introduces a social network analysis as an instrument to systematically chart the relationships and personal networks of forensic psychiatric patients. During the period 2005 to 2007, the so-called Forensic Social Network Analysis (FSNA) was developed in a Dutch forensic psychiatric hospital. A case study

  9. Strategies of social and sexual control of Malaysian women in psychiatric institutional care.

    PubMed

    Crabtree, Sara Ashencaen

    2004-01-01

    An ethnographic study of female psychiatric patients was undertaken in East Malaysia. Findings indicate that these service users were subject to a number of sexist and oppressive practices that militate against their freedom of movement on the wards as well as their social interaction in the wider context of the hospital. Stereotypic notions of female sexuality and morality act as forms of moral containment and are interpreted in the hospital context as requiring heavy custodial care by the hospital authorities. PMID:15354623

  10. Association of hospital volume with readmission rates: a retrospective cross-sectional study

    PubMed Central

    Lin, Zhenqiu; Herrin, Jeph; Bernheim, Susannah; Drye, Elizabeth E; Krumholz, Harlan M; Ross, Joseph S

    2015-01-01

    Objective To examine the association of hospital volume (a marker of quality of care) with hospital readmission rates. Design Retrospective cross-sectional study. Setting 4651US acute care hospitals. Study data 6?916?644 adult discharges, excluding patients receiving psychiatric or medical cancer treatment. Main outcome measures We used Medicare fee-for-service data from 1 July 2011 to 30 June 2012 to calculate observed-to-expected, unplanned, 30 day, standardized readmission rates for hospitals and for specialty cohorts medicine, surgery/gynecology, cardiorespiratory, cardiovascular, and neurology. We assessed the association of hospital volume by quintiles with 30 day, standardized readmission rates, with and without adjustment for hospital characteristics (safety net status, teaching status, geographic region, urban/rural status, nurse to bed ratio, ownership, and cardiac procedure capability. We also examined associations with the composite outcome of 30 day, standardized readmission or mortality rates. Results Mean 30 day, standardized readmission rate among the fifth of hospitals with the lowest volume was 14.7 (standard deviation 5.3) compared with 15.9 (1.7) among the fifth of hospitals with the highest volume (P<0.001). We observed the same pattern of lower readmission rates in the lowest versus highest volume hospitals in the specialty cohorts for medicine (16.6 v 17.4, P<0.001), cardiorespiratory (18.5 v 20.5, P<0.001), and neurology (13.2 v 14.0, p=0.01) cohorts; the cardiovascular cohort, however, had an inverse association (14.6 v 13.7, P<0.001). These associations remained after adjustment for hospital characteristics except in the cardiovascular cohort, which became non-significant, and the surgery/gynecology cohort, in which the lowest volume fifth of hospitals had significantly higher standardized readmission rates than the highest volume fifth (difference 0.63 percentage points (95% confidence interval 0.10 to 1.17), P=0.02). Mean 30 day, standardized mortality or readmission rate was not significantly different between highest and lowest volume fifths (20.4 v 20.2, P=0.19) and was highest in the middle fifth of hospitals (range 20.6–20.8). Conclusions Standardized readmission rates are lowest in the lowest volume hospitals—opposite from the typical association of greater hospital volume with better outcomes. This association was independent of hospital characteristics and was only partially attenuated by examining mortality and readmission together. Our findings suggest that readmissions are associated with different aspects of care than mortality or complications. PMID:25665806

  11. Behavior modification of overeating in a psychiatric population

    Microsoft Academic Search

    Morton G. Harmatz; Paul Lapuc

    1968-01-01

    Evaluates a procedure for controlling overeating through reinforcement. 21 overweight psychiatric Ss were placed on an 1800-calorie\\/day diet for regular meals but were not restricted in their use of the canteen or vending machines. 3 groups were employed: (1) a behavior modification condition in which S lost money (the source of cigarettes, beverages, supplies, food, etc.) for failure to lose

  12. Dietary Intake of a Group of Chronic Geriatric Psychiatric Patients

    Microsoft Academic Search

    Merville Vincent; Rosalind S. Gibson

    1982-01-01

    The nutrient intakes of 19 chronic geriatric psychiatric patients were determined by recording all food items consumed over a 3-day period and evaluated using the Canadian Dietary Standard. Mean intakes exceeded the recommendations of the Canadian Dietary Standard for calories and all nutrients except calcium, vitamin D, free folate and zinc. Wide individual variations in nutrient intakes were observed. Supplementation

  13. Secondary Psychiatric Schools: Characteristics and Approaches to Curriculum

    ERIC Educational Resources Information Center

    Gagnon, Joseph Calvin; Van Loan, Christopher L.; Barber, Brian R.

    2011-01-01

    This study focused on approaches to curriculum, as well as school, principal, and student characteristics in secondary day treatment and residential psychiatric schools. A national random sample of 148 principals responded to a survey. No statistically significant differences existed between respondent and nonrespondent schools with regard to…

  14. Secondary Psychiatric Schools: Characteristics and Approaches to Curriculum

    Microsoft Academic Search

    Joseph Calvin Gagnon; Christopher L. Van Loan; Brian R. Barber

    2011-01-01

    This study focused on approaches to curriculum, as well as school, principal, and student characteristics in secondary day treatment and residential psychiatric schools. A national random sample of 148 principals responded to a survey. No statistically significant differences existed between respondent and nonrespondent schools with regard to region, public versus nonpublic, enrollment, or locale. More than 80% of schools were

  15. Epigenetic approaches to psychiatric disorders

    PubMed Central

    Ptak, Carolyn; Petronis, Arturas

    2010-01-01

    Psychiatric diseases place a tremendous burden on affected individuals, their caregivers, and the health care system. Although evidence exists for a strong inherited component to many of these conditions, dedicated efforts to identify DNA sequence-based causes have not been exceptionally productive, and very few pharmacologic treatment options are clinically available. Many features of psychiatric diseases are consistent with an epigenetic dysregulation, such as discordance of monozygotic twins, late age of onset, parent-of-origin and sex effects, and fluctuating disease course. In recent years, experimental technologies have significantly advanced, permitting indepth studies of the epigenome and its role in maintenance of normal genomic functions, as well as disease etiopathogenesis. Here, we present an epigenetic explanation for many characteristics of psychiatric disease, review the current literature on the epigenetic mechanisms involved in major psychosis, Alzheimer's disease, and autism spectrum disorders, and describe some future directions in the field of psychiatric epigenomics. PMID:20373664

  16. Circadian Rhythms and Psychiatric Illness

    PubMed Central

    Asarnow, Lauren D.; Soehner, Adriane M.; Harvey, Allison G.

    2014-01-01

    Purpose of review The present review provides a conceptual introduction to sleep and circadian research in psychiatric illness, and discusses recent experimental and intervention findings in this area. Recent Findings In this review, studies published since January 2011 on circadian disturbance and psychiatric illness have been summarized. Summary Exciting new results have increasingly utilized objective and validated instruments to measure the circadian system in experimental studies. Since 2011, treatment research has still predominantly utilized self-report measures as outcome variables. However, research in the treatment domain for sleep/circadian disturbances comorbid with psychiatric illness has advanced the field in its work to broaden the validation of existing sleep treatments to additional patient populations with comorbid sleep/circadian disruptions, address how to increase access to and affordability of treatment for sleep and circadian dysfunction for patients with psychiatric disorders, and how to combine psychosocial treatments with psychopharmacology to optimize treatment outcomes. PMID:24060916

  17. Psychiatric Symptoms in Patients with Shiga Toxin-Producing E. coli O104:H4 Induced Haemolytic-Uraemic Syndrome

    PubMed Central

    Eberlein, Christian K.; Kielstein, Jan T.; Bleich, Stefan

    2014-01-01

    Background In May 2011 an outbreak of Shiga toxin-producing enterohaemorrhagic E. coli (STEC) O104:H4 in Northern Germany led to a high number of in-patients, suffering from post-enteritis haemolytic-uraemic syndrome (HUS) and often severe affection of the central nervous system. To our knowledge so far only neurological manifestations have been described systematically in literature. Aim To examine psychiatric symptoms over time and search for specific symptom clusters in affected patients. Methods 31 in-patients suffering from E. coli O104:H4 associated HUS, were examined and followed up a week during the acute hospital stay. Psychopathology was assessed by clinical interview based on the AMDP Scale, the Brief Symptom Inventory and the Clinical Global Impressions Scale. Results At baseline mental disorder due to known physiological condition (ICD-10 F06.8) was present in 58% of the examined patients. Patients suffered from various manifestations of cognitive impairment (n?=?27) and hallucinations (n?=?4). Disturbances of affect (n?=?28) included severe panic attacks (n?=?9). Psychiatric disorder was significantly associated with higher age (p<0.0001), higher levels of C-reactive protein (p<0.05), and positive family history of heart disease (p<0.05). Even within the acute hospital stay with a median follow up of 7 days, symptoms improved markedly over time (p <0.0001). Conclusions Aside from severe neurological symptoms the pathology in E.coli O104:H4 associated HUS frequently includes particular psychiatric disturbances. Long term follow up has to clarify whether or not these symptoms subside. PMID:25007072

  18. Psychiatric aspects of Parkinson's disease.

    PubMed

    Grover, Sandeep; Somaiya, Mansi; Kumar, Santhosh; Avasthi, Ajit

    2015-01-01

    Parkinson's disease (PD) is essentially characterized by the motor symptoms in the form of resting tremor, rigidity and bradykinesia. However, over the years it has been recognized that motor symptoms are just the "tip of the iceberg" of clinical manifestations of PD. Besides motor symptoms, PD characterized by many non-motor symptoms, which include cognitive decline, psychiatric disturbances (depression, psychosis and impulse control), sleep difficulties, autonomic failures (gastrointestinal, cardiovascular, urinary, thermoregulation) and pain syndrome. This review evaluates the various aspects of psychiatric disorders including cognitive decline and sleep disturbances in patients with PD. The prevalence rate of various psychiatric disorders is high in patients with PD. In terms of risk factors, various demographic, clinical and treatment-related variables have been shown to be associated with higher risk of development of psychiatric morbidity. Evidence also suggests that the presence of psychiatric morbidity is associated with poorer outcome. Randomized controlled trials, evaluating the various pharmacological and non-pharmacological treatments for management of psychiatric morbidity in patients with PD are meager. Available evidence suggests that tricyclic antidepressants like desipramine and nortriptyline are efficacious for management of depression. Among the antipsychotics, clozapine is considered to be the best choice for management of psychosis in patients with PD. Among the various cognitive enhancers, evidence suggest efficacy of rivastigmine in management of dementia in patients with PD. To conclude, this review suggests that psychiatric morbidity is highly prevalent in patients with PD. Hence, a multidisciplinary approach must be followed to improve the overall outcome of PD. Further studies are required to evaluate the efficacy of various other measures for management of psychiatric morbidity in patients with PD. PMID:25552854

  19. Psychiatric aspects of Parkinson's disease

    PubMed Central

    Grover, Sandeep; Somaiya, Mansi; Kumar, Santhosh; Avasthi, Ajit

    2015-01-01

    Parkinson's disease (PD) is essentially characterized by the motor symptoms in the form of resting tremor, rigidity and bradykinesia. However, over the years it has been recognized that motor symptoms are just the “tip of the iceberg” of clinical manifestations of PD. Besides motor symptoms, PD characterized by many non-motor symptoms, which include cognitive decline, psychiatric disturbances (depression, psychosis and impulse control), sleep difficulties, autonomic failures (gastrointestinal, cardiovascular, urinary, thermoregulation) and pain syndrome. This review evaluates the various aspects of psychiatric disorders including cognitive decline and sleep disturbances in patients with PD. The prevalence rate of various psychiatric disorders is high in patients with PD. In terms of risk factors, various demographic, clinical and treatment-related variables have been shown to be associated with higher risk of development of psychiatric morbidity. Evidence also suggests that the presence of psychiatric morbidity is associated with poorer outcome. Randomized controlled trials, evaluating the various pharmacological and non-pharmacological treatments for management of psychiatric morbidity in patients with PD are meager. Available evidence suggests that tricyclic antidepressants like desipramine and nortriptyline are efficacious for management of depression. Among the antipsychotics, clozapine is considered to be the best choice for management of psychosis in patients with PD. Among the various cognitive enhancers, evidence suggest efficacy of rivastigmine in management of dementia in patients with PD. To conclude, this review suggests that psychiatric morbidity is highly prevalent in patients with PD. Hence, a multidisciplinary approach must be followed to improve the overall outcome of PD. Further studies are required to evaluate the efficacy of various other measures for management of psychiatric morbidity in patients with PD. PMID:25552854

  20. Day to day with COPD

    MedlinePLUS

    ... but there are things you can do every day to keep COPD from getting worse, to protect ... COPD - day to day; Chronic obstructive airways disease - day to day; Chronic obstructive lung disease - day to day ; Chronic ...

  1. Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms.

    PubMed

    Testa, A; Giannuzzi, R; Sollazzo, F; Petrongolo, L; Bernardini, L; Daini, S

    2013-02-01

    Psychiatric emergencies are conditions that mostly destabilize the already frenetic activity of the Emergency Department. Sometimes the emergency is clearly referable to primitive psychiatric illness. Other times, psychiatric and organic symptoms can independently coexist (comorbidity), or develop together in different conditions of substance abuse, including alcohol and prescription drugs. Differentiating between substance induced and pre-existing psychiatric disorder (dual diagnosis) may be difficult, other than controversial issue. Finally, an organic disease can hide behind a psychiatric disorder (pseudopsychiatric emergency). In this review (part I), psychiatric disorders that occur with organic symptoms are discussed. They include: (1) anxiety, conversion and psychosomatic disorders, and (2) simulated diseases. The physiologic mechanisms of the stress reaction, divided into a dual neuro-hormonal response, are reviewed in this section: (1) activation of the sympathetic nervous system and adrenal medulla with catecholamine production (rapid response), and (2) activation of the hypothalamic-pituitary-adrenal axis with cortisol production (slow response). The concept of the fight-or-flight response, its adaptive significance and the potential evolution in paralyzing response, well showing by Yerkes-Dodson curve, is explained. Abnormal short- and long-term reactions to stress evolving toward well codified cluster of trauma and stressor-related disorders, including acute stress disorder, adjustment disorder and post-traumatic stress disorder, are examined. A brief review of major psychiatric disorder and related behaviour abnormalities, vegetative symptoms and cognitive impairment, according to DMS IV-TR classification, are described. Finally, the reactive psychic symptoms and behavioral responses to acute or chronic organic disease, so called "somatopsychic disorders", commonly occurring in elderly and pediatric patients, are presented. The specific conditions of post-operative and intensive care unit patients, and cancer and HIV positive population are emphasized. PMID:23436668

  2. An educational program to promote competency in pediatric psychiatric mental health nursing.

    PubMed

    Parant, Rebecca L; Pingitore, Francine R B; LaRose, Jenifer A

    2014-07-01

    Hospital "boarding" of pediatric psychiatric patients awaiting inpatient placement is a growing problem. To address this need, a dedicated inpatient pediatric medical-psychiatric unit was opened at an urban university-affiliated pediatric hospital. An educational program for pediatric medical-surgical nurses who were expected to staff the pediatric medical-psychiatric unit was developed and implemented prior to the opening of the new unit. The rationale for the establishment of the new inpatient unit, educational program development, goals and objectives for the education, implementation, and evaluation of the program are described. Challenges, lessons learned, limitations, resource allocation, and staff attitudes are discussed. Implications for the future of this and similar hospitals are considered. J Contin Educ Nurs. 2014;45(7):321-326. PMID:24972097

  3. [The changing role of hospitals].

    PubMed

    Undritz, N

    1995-07-18

    The Hospital Committee of the European Union has redefined the role of the hospital within a changing society. In future the hospital will be dedicated to a clear vision of public health and will constitute part of a network of integrated care. From a bed-focused enterprise it will become a health centre providing all services requisite for the care of acute, psychiatric and chronically ill patients, whether stationary, as outpatients or in daycare. This center will be distinguished from other care services by its operative technical resources and by its highly motivated and well-trained staff. PMID:7631099

  4. Physician-Determined Worsening Heart Failure: A Novel Definition for Early Worsening Heart Failure in Patients Hospitalized for Acute Heart Failure – Association with Signs and Symptoms, Hospitalization Duration, and 60Day Outcomes

    Microsoft Academic Search

    Gad Cotter; Marco Metra; Beth Davison Weatherley; Howard C. Dittrich; Barry M. Massie; Piotr Ponikowski; Daniel M. Bloomfield; Christopher M. O’Connor

    2010-01-01

    Objectives: To evaluate physician-determined worsening heart failure (PD-WHF) in patients admitted with acute heart failure (AHF). Methods: The PROTECT pilot study evaluated rolofylline, an adenosine A1 receptor antagonist, versus placebo in patients with AHF and renal impairment. Signs and symptoms of heart failure (HF) and diuretic administration were prospectively recorded daily for 7 days and patients were followed for 60

  5. Psychiatric comorbidity in forensic psychiatry.

    PubMed

    Palijan, Tija Zarkovi?; Muzini?, Lana; Radeljak, Sanja

    2009-09-01

    For the past several years a numerous studies in the field of forensic psychiatry confirmed a close relationship between violent offenders and comorbid substance abuse. The comorbid substance abuse in violent offenders was usually unrecognized and misdiagnosed. Furthermore, comorbidity in forensic psychiatry describes the co-occurrence of two or more conditions or psychiatric disorder known in the literature as dual diagnosis and defined by World Health Organization (WHO). In fact, many violent offenders have multiple psychiatric diagnoses. Recent studies have confirmed causal relationship between major psychiatric disorders and concomitant substance abuse (comorbidity) in 50-80% of forensic cases. In general, there is a high level of psychiatric comorbidity in forensic patients with prevalence of personality disorders (50-90%), mood disorders (20-60%) and psychotic disorders (15-20%) coupled with substance abuse disorders. Moreover, the high prevalence of psychiatric comorbidities could be found in mentally retarded individuals, as well as, in epileptic patients. Drugs and alcohol abuse can produce serious psychotoxic effects that may lead to extreme violent behavior and consequently to serious criminal offence such as physical assault, rape, armed robbery, attempted murder and homicide, all due to an altered brain function and generating psychotic-like symptoms. Studies have confirmed a significant statistical relevance in causal relationship between substance abuse and violent offences. In terms of forensic psychiatry, the comorbidity strongly contributes in the process of establishing psychiatric diagnosis of diminished mental capacity or insanity at the time of the offence in the course of clinical assessment and evaluation of violent offenders. Today, the primary focus of forensic psychiatry treatment services (in-patient or community) is management of the violent offenders with psychiatric comorbidity which requires a multilevel, evidence based approach to the patient. Forensic treatment service effectiveness appears to be associated with individual case management and approach including psychotherapy, pharmacotherapy and occupational therapy in order to achieve optimal rehabilitation, prevention of recidivism and stability in social functioning of the patient in the community. PMID:19794370

  6. Day to Day

    ERIC Educational Resources Information Center

    Jurecki, Dennis

    2006-01-01

    A clean, healthy and safe school provides students, faculty and staff with an environment conducive to learning and working. However, budget and staff reductions can lead to substandard cleaning practices and unsanitary conditions. Some school facility managers have been making the switch to a day-schedule to reduce security and energy costs, and…

  7. Utility of compact ultrasound in a mass surgical selection program in Africa: experience of a sonologist at the MV Africa Mercy Hospital Ship's screening day.

    PubMed

    Harris, Robert D; Parker, Gary

    2015-02-01

    Compact ultrasound (US) was introduced in an austere setting with no other available imaging for an annual mass surgical screening day. Compact US examinations were performed on 25 patients from more than 7000 potential patients, as deemed possibly useful by the screening surgeons. Of the 20 patients with recorded data, compact US was helpful in 14 of 20 as a decision-making tool, obviating computed tomography for preoperative planning. Compact US was helpful in most cases, saving resources (computed tomography), technologist time, and radiation risk in this select population. PMID:25614408

  8. Culturally competent psychiatric nursing care.

    PubMed

    Wilson, D W

    2010-10-01

    Evidence-based descriptions of culturally competent psychiatric nursing care are scarce. This study explored the perceptions of clients with mental illness regarding the overall effectiveness of psychiatric nursing care in meeting their cultural needs, and psychiatric nurses' perceptions of how and to what extent they provided culturally competent psychiatric mental health nursing care to diverse client populations. This descriptive study employed a qualitative research design using a multi-method data collection approach consisting of in-depth individual client interviews and a self-administered nurse questionnaire. Client participants tended to minimize the importance of receiving care related to their cultural needs. They described (1) encouraging and reassuring me; (2) speaking up for me; and (3) praying a lot as essential to their care. Nurse participants perceived their psychiatric nursing care to be culturally competent; however, few described specific strategies for incorporating cultural beliefs and practices into nursing care. Client participant lacked awareness of their cultural needs and had difficulty identifying and describing specific nursing interventions that contributed to positive mental health outcomes. Nurses perceived that they provided culturally competent care but actually lacked specific knowledge and skills to do so effectively. PMID:21050338

  9. Psychiatric morbidity in geriatric people

    PubMed Central

    Tiple, Prashant; Sharma, S.N.; Srivastava, A.S.

    2006-01-01

    Background: The number of geropsychiatric patients is increasing but sufficient work has not been done in this area in many parts of India. Aim: This study explored the sociodemographic profile and clinical characteristics of patients aged 60 years and above, attending the psychiatric services of Institute of Medical Sciences and geropsychiatric patients of Mumukshu Bhavan (old age home) in Varanasi from September 1998 to September 1999. Methods: For the screening of psychiatric patients at Mumukshu Bhavan the Indian Psychiatric Survey Schedule was used. DSM-IV criteria were used for the diagnosis of patients and Chi-square test with Yate correction and Z-test were used for statistical analysis. Results: Depressive disorders were the most common psychiatric illnesses. Many patients had associated physical illnesses and among them hypertension was the most common. Family jointness was adequate for most of the patients. Objective social support was moderate for the majority of patients but perceived social support was poor. Patients of Mumukshu Bhavan perceived their social support to be either moderate or good. Conclusion: Depressive disorder was the most common psychiatric illness and among the physical illnesses hypertension was the commonest. People living in the old age home felt better than those who lived with their children's family. PMID:20703392

  10. Psychiatric rehabilitation today: an overview

    PubMed Central

    RÖSSLER, WULF

    2006-01-01

    All patients suffering from severe and persistent mental illness require rehabilitation. The goal of psychiatric rehabilitation is to help disabled individuals to develop the emotional, social and intellectual skills needed to live, learn and work in the community with the least amount of professional support. The overall philosophy of psychiatric rehabilitation comprises two intervention strategies. The first strategy is individual-centered and aims at developing the patient's skills in interacting with a stressful environment. The second strategy is ecological and directed towards developing environmental resources to reduce potential stressors. Most disabled persons need a combination of both approaches. The refinement of psychiatric rehabilitation has achieved a point where it should be made readily available for every disabled person. PMID:17139342

  11. How patients and nurses experience the acute care psychiatric environment.

    PubMed

    Shattell, Mona M; Andes, Melanie; Thomas, Sandra P

    2008-09-01

    The concept of the therapeutic milieu was developed when patients' hospitalizations were long, medications were few, and one-to-one nurse-patient interactions were the norm. However, it is not clear how the notion of 'therapeutic milieu' is experienced in American acute psychiatric environments today. This phenomenological study explored the experience of patients and nurses in an acute care psychiatric unit in the USA, by asking them, 'What stands out to you about this psychiatric hospital environment?' Three figural themes emerged, contextualized by time, which was a source of stress to both groups: for patients there was boredom, and for nurses, pressure and chaos. Although they shared some themes, nurses and patients experienced them differently. For instance, nurses felt caged-in by the Plexiglas-enclosed nursing station, and patients felt caged-in by the locked doors of the unit. The findings from this US study do not support the existence of the therapeutic milieu as described in the literature. Furthermore, although the nurse-patient relationship was yearned for by nurses, it was nearly absent from patients' descriptions. The caring experienced by patients was mainly derived from interactions with other patients. PMID:18786217

  12. Work and common psychiatric disorders

    PubMed Central

    Henderson, M; Harvey, SB; Øverland, S; Mykletun, A; Hotopf, M

    2011-01-01

    Psychiatric disorders are now the most common reason for long-term sickness absence. The associated loss in productivity and the payment of disability benefits places a substantial burden on the economies of many developed countries. The occupational dysfunction associated with psychiatric disorders can also lead to poverty and social isolation. As a result the area of work and psychiatric disorders is a high priority for policymakers. There are two main agendas: for many researchers and clinicians the focus is on the need to overcome stigma and ensure people with severe psychiatric disorders have meaningful work; however the public health agenda predominantly relates to the more common disorders such as depression and anxiety, which contribute a greater burden of disability benefits and pensions. In this review we attempt to address this second agenda. The relatively sparse evidence available reveals a complex field with significant interplay between medical, psychological social and cultural factors. Sick leave can be a ‘process’ as well as an ‘event’. In this review we propose a staged model where different risk and protective factors contribute to the onset of psychiatric disorders in the working population, the onset of short-term sickness absence, and the transition from short- to long-term absence. We also examine strategies to manage psychiatric disorder in the workforce with a view towards returning the employee to work. Our aim in this review is to highlight the complexity of the area, to stimulate debate and to identify important gaps in knowledge where further research might benefit both patients and wider society. PMID:21558098

  13. [Challenges for the future of psychiatry and psychiatric medical care].

    PubMed

    Higuchi, Teruhiko

    2013-01-01

    In addition to the prolonged economic recession and global financial crisis, the Great East Japan Earthquake of March 2011 has caused great fear and devastation in Japan. In the midst of these, Japanese people have felt to lose the traditional values and common sense they used to share, and it has become necessary to build a new consciousness. Engaged in psychiatry and psychiatric care under these circumstances, we have to analyze the challenges we face and to brainstorm on appropriate prescriptions that can be applied to solve the problems. Five points in particular were brought up: [1] The persistently high number of suicides. [2] The increase in depression and overflowing numbers of patients visiting clinics and outpatient departments at hospitals. [3] The absolute shortage of child psychiatrists. [4] Little progress with the transition from hospitalization-centered to community-centered medical care. [5] The disappearance of beds for psychiatry patients from general hospitals. The situations surrounding these five issues were briefly analyzed and problems were pointed out. The following are five problems that psychiatry is facing: 1) A lack of large clinical trials compared to the rest of the world. 2) The drug lag and handling of global trials. 3) The lack of staff involved in education and research (in the field of psychiatry). 4) Following the DSM diagnostic criteria dogmatically, without differentiating therapeutics. 5) Other medical departments, the industry, patients, and their families are demanding objective diagnostic techniques. After analyzing the problems, and discussing to some extent what kind of prescription may be considered to solve the problems, I gave my opinion. (1) The first problem is the deep-rooted prejudice and discrimination against psychiatric disorders that continue to be present among Japanese people. The second problem is the government's policy of low remuneration (fees) for psychiatric services. The third problem, symbolic of the situation, is the fact that the "psychiatry exception" system (unbalanced ratio of staff to psychiatric patients) is still present today. (2) To reach a fundamental solution, the policy of low fees for psychiatric services has to be abolished. (3) Multi-disciplinary medical teams, as practiced in other developed countries, is not yet adequately applied in Japan. From the aspect of medical fees, it is not adequately encouraged either. The only place where team medicine is actually practiced is in the "forced hospitalization" ward, but, as stated in the supplementary resolution of the Japanese diet (national assembly), high-quality medicine should not only be practiced in the "forced hospitalization" ward, but also in general psychiatry. (4) The policy of transition from hospitalization-centered to community-centered medical care, which was initiated a long time ago by the Japanese government, is not proceeding in reality, and it is time that we put our heads together and find ways to overcome this problem. It is significant that "psychiatric disorders" have been included as one of the "five diseases," (a system adopted by the government concerning community health care), and now we have the best opportunity to improve community-centered psychiatric care. PMID:23691798

  14. Psychiatric Disorders: Diagnosis to Therapy

    PubMed Central

    Krystal, John H.; State, Matthew W.

    2014-01-01

    Recent findings in a range of scientific disciplines are challenging the conventional wisdom regarding the etiology, classification and treatment of psychiatric disorders. This review focuses on the current state of the psychiatric diagnostic nosology and recent progress in three areas: genomics, neuroimaging, and therapeutics development. The accelerating pace of novel and unexpected findings is transforming the understanding of mental illness and represents a hopeful sign that the approaches and models that have sustained the field for the past 40 years are yielding to a flood of new data and presaging the emergence of a new and more powerful scientific paradigm. PMID:24679536

  15. Teaching Psychodynamics to Psychiatric Residents through Psychiatric Outpatient Interviews

    ERIC Educational Resources Information Center

    Cardoso Zoppe, Eva Helena C.; Schoueri, Patricia; Castro, Monica; Neto, Francisco Lotufo

    2009-01-01

    Objective: This study evaluates whether a course that was designed for first-year psychiatric residents and that specifically addressed psychodynamic principles fostered residents' progress in knowledge, skills, and attitudes regarding these concepts. Methods: The course was given in the 2005 academic year to all residents (N=18) in their first…

  16. Supplier-induced demand for psychiatric admissions in Northern New England

    PubMed Central

    2011-01-01

    Background The development of hospital service areas (HSAs) using small area analysis has been useful in examining variation in medical and surgical care; however, the techniques of small area analysis are underdeveloped in understanding psychiatric admission rates. We sought to develop these techniques in order to understand the relationship between psychiatric bed supply and admission rates in Northern New England. Our primary hypotheses were that there would be substantial variation in psychiatric admission across geographic settings and that bed availability would be positively correlated with admission rates, reflecting a supplier-induced demand phenomenon. Our secondary hypothesis was that the construction of psychiatric HSAs (PHSAs) would yield more meaningful results than the use of existing general medical hospital service areas. Methods To address our hypotheses, we followed a four-step analytic process: 1) we used small area analytic techniques to define our PHSAs, 2) we calculated the localization index for PHSAs and compared that to the localization index for general medical HSAs, 3) we used the number of psychiatric hospital beds, the number of psychiatric admissions, and census data to calculate population-based bed-supply and psychiatric admission rates for each PHSA, and 4) we correlated population-based admission rates to population-based psychiatric bed supply. Results The admission rate for psychiatric diagnosis varied considerably among the PHSAs, with rates varying from 2.4 per 100,000 in Portsmouth, NH to 13.4 per 100,000 in Augusta, ME. There was a positive correlation of 0.71 between a PHSA's supply of beds and admission rate. Using our PSHAs produced a substantially higher localization index than using general medical hospital services areas (0.69 vs. 0.23), meaning that our model correctly predicted geographic utilization at three times the rate of the existing model. Conclusions The positive correlation between admission and bed supply suggests that psychiatric bed availability may partially explain the variation in admission rates. Development of PHSAs, rather than relying on the use of established general medical HSAs, improves the relevance and accuracy of small area analysis in understanding mental health services utilization. PMID:21906290

  17. Comorbidity of Psychiatric Disorders and Parental Psychiatric Disorders in a Sample of Iranian Children with ADHD

    ERIC Educational Resources Information Center

    Ghanizadeh, Ahmad; Mohammadi, Mohammad Reza; Moini, Rozita

    2008-01-01

    Objective: To study the psychiatric comorbidity of a clinical sample of children with ADHD and the psychiatric disorders in their parents. Method: Structured psychiatric interviews assessing lifetime psychiatric disorders by "DSM-IV" criteria, using the Farsi version of the Schedule for Affective Disorders and Schizophrenia. Results: The mean age…

  18. [Psychiatric reform, federalism, and the decentralization of the public health in Brazil].

    PubMed

    Costa, Nilson do Rosário; Siqueira, Sandra Venâncio; Uhr, Deborah; Silva, Paulo Fagundes da; Molinaro, Alex Alexandre

    2011-12-01

    This study examines the relationships between Brazilian psychiatric reform, the adoption of the Centers for Psychosocial Care (CAPS) and the development of the Unified Health System (SUS). The adherence of municipal governments was a variable determinant for the spread of reform, especially due to the continental scale and fragmentation of the Brazilian federation. The article demonstrates the institutional stability of psychiatric reform in Brazil over two decades. The institutional nature of the decision-making process in the public arena has permitted the implementation of new organizational formats through imitation and financial incentives. The psychiatric reform was successful in defending the advantages of CAPS in relation to the asylum and hospital model dominant in past decades. The inductive policies, strengthened and upheld by Law 10.216/2001, transformed the agenda of psychiatric reform, limited to pioneering cities in a national public policy. PMID:22124901

  19. A prevalence study of folate deficiency in a psychiatric in-patient population.

    PubMed

    Skerritt, U M

    1998-03-01

    Controlled clinical trials in the UK have shown folate deficiency in psychiatric patients, and it has been suggested that such deficiency is most likely to occur among patients with affective disorders. Studies have led to the use of folate as an adjunct to therapy in such patients. The present paper describes a preliminary investigation into the red cell folate status of psychiatric patients in a general hospital unit compared with age- and sex-matched healthy controls, using up-to-date assays and strict entry criteria and overall improved methods on previous studies. The study showed that, although there is a trend for psychiatric patients to have lower serum folate levels than controls, there is no statistically significant difference in folate levels as measured by red cell folate, a more reliable measure of folate status, between healthy controls and psychiatric patients, and all but one of the patients had normal haematological indices. PMID:9543312

  20. Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus.

    PubMed

    Oliveira, Matheus F; Oliveira, João R M; Rotta, José M; Pinto, Fernando C G

    2014-06-01

    Normal pressure hydrocephalus (NPH) is characterized by gait disturbance, dementia and/or urinary incontinence associated with dilation of ventricular system with normal opening cerebrospinal fluid pressure. Wide scientifical evidence confirms association between NPH and psychiatric symptoms. We selected 35 patients with idiopathic normal pressure hydrocephalus from January 2010 to January 2012 in a Brazilian tertiary hospital and performed a formal psychiatric evaluation to identify psychiatric disorders. Psychiatric disorders were present in 71% of these patients, especially anxiety, depression and psychotic syndromes. NPH patients may develop symptoms with frontal dominance, such as personality changes, anxiety, depression, psychotic syndromes, obsessive compulsive disorder, Othello syndrome; shoplifting and mania. Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment. PMID:24964110

  1. [Applying the human dignity ideals of Confucianism and Kant to psychiatric nursing: from theory to practice].

    PubMed

    Lee, Mei-Hsiu; Lee, Shui-Chuen; Lee, Shu-Chen

    2012-04-01

    Literature articles and clinical observation suggest disease and environmental factors as primary causes of the low self-esteem and stigmatization that typify most psychiatric patients. These patients are at risk of injury when subjected to inappropriate physical restraint. Hospital staffs, including nurses, are in immediate and close contact with psychiatric patients. Mencius's and Kant's thoughts on human dignity can enhance reflections on clinical nursing practices. Mencius's belief that preserving life is not the most desirable thing and death is not the most hated thing can help nurses realize the human dignity of psychiatric patients by understanding that, as an unrighteous act is more detestable than death, the meaning and value of righteousness are greater than life itself. In light of Kant's views on human dignity, nurses should treat patients as goals rather than means. Exploring such ideas can raise nursing quality, restore a positive sense of humanity to psychiatric patients, and develop nursing values and meaning to a higher plane. PMID:22469899

  2. The violation of psychiatric standards of care in prisons.

    PubMed

    Kaufman, E

    1980-05-01

    The author evaluated psychiatric care in three U.S. prison systems. Major problems included limitations imposed by prison architecture, inadequate staff, medication prescription and distribution by unlicensed, untrained personnel, and a punitive rather than therapeutic attitude. Following the standards of care recommended by American Correctional Association would correct most of these problems. Psychiatrists should guard against prescribing unnecessary medications, particularly minor tranquilizers and sedatives, and should be concerned with prison conditions conductive to mental illness, particularly overcrowding, abuses of solitary confinement, and inadequate programs for inmates who are mentally disturbed but not overtly psychotic. The author recommends minimum staffing standards and suggests considering the transfer of mentally ill inmates to appropriate psychiatric hospitals outside the prison system. PMID:7369400

  3. Acute behavioral crises in psychiatric inpatients with autism spectrum disorder (ASD): Recognition of concomitant medical or non-ASD psychiatric conditions predicts enhanced improvement.

    PubMed

    Guinchat, Vincent; Cravero, Cora; Diaz, Lautaro; Périsse, Didier; Xavier, Jean; Amiet, Claire; Gourfinkel-An, Isabelle; Bodeau, Nicolas; Wachtel, Lee; Cohen, David; Consoli, Angèle

    2015-03-01

    During adolescence, some individuals with autism spectrum disorder (ASD) engage in severe challenging behaviors, such as aggression, self-injury, disruption, agitation and tantrums. We aimed to assess risk factors associated with very acute behavioral crises in adolescents with ASD admitted to a dedicated neurobehavioral unit. We included retrospectively in 2008 and 2009 29 adolescents and young adults with ASD hospitalized for severe challenging behaviors and proposed a guideline (Perisse et al., 2010) that we applied prospectively for 29 patients recruited for the same indications between 2010 and 2012. In total, 58 patients were admitted (n=70 hospitalizations, mean age=15.66 (±4.07) years, 76% male). We systematically collected data describing socio-demographic characteristics, clinical variables (severity, presence of language, cognitive level), comorbid organic conditions, etiologic diagnosis of the episode, and treatments. We explored predictors of Global Assessment Functioning Scale (GAFS) score and duration of hospitalization at discharge. All but 2 patients exhibited severe autistic symptoms and intellectual disability (ID), and two-thirds had no functional verbal language. During the inpatient stay (mean=84.3 (±94.9) days), patients doubled on average their GAFS scores (mean=17.66 (±9.05) at admission vs. mean=31.4 (±9.48) at discharge). Most common etiologies for acute behavioral crises were organic causes [n=20 (28%), including epilepsy: n=10 (14%) and painful medical conditions: n=10 (14%)], environmental causes [n=17 (25%) including lack of treatment: n=11 (16%) and adjustment disorder: n=6 (9%)], and non-ASD psychiatric condition [n=33 (48%) including catatonia: n=5 (7%), major depressive episode: n=6 (9%), bipolar disorder: n=4 (6%), schizophrenia: n=6 (9%), other/unknown diagnosis: n=12 (17%)]. We found no influence of age, gender, socio-economic status, migration, level of ID, or history of seizure on improvement of GAFS score at discharge. Severity of autism at admission was the only negative predictor (p<.001). Painful medical conditions (p=.04), non-ASD psychiatric diagnoses (p=.001), prior usage of specialized ASD care programs (p=.004), functional language (p=.007), as well as a higher number of challenging behaviors upon admission (p=.001) were associated with higher GAFS scores at discharge. Clinical severity at admission, based on the number of challenging behaviors (r=.35, p=.003) and GAFS score (r=-.32, p=.008) was correlated with a longer inpatient stay. Longer hospitalization was however correlated (r=.27, p=.03) with higher GAFS score at discharge even after adjustment for confounding factors. Challenging behaviors among adolescents with ASD may stem from diverse risk factors, including environmental problems, comorbid acute psychiatric conditions, or somatic illness such as epilepsy or acute pain. The management of these behavioral challenges requires a unified, multidisciplinary approach. PMID:25575287

  4. Health service costs and clinical gains of psychotherapy for personality disorders: a randomized controlled trial of day-hospital-based step-down treatment versus outpatient treatment at a specialist practice

    PubMed Central

    2013-01-01

    Background Day-hospital-based treatment programmes have been recommended for poorly functioning patients with personality disorders (PD). However, more research is needed to confirm the cost-effectiveness of such extensive programmes over other, presumably simpler, treatment formats. Methods This study compared health service costs and psychosocial functioning for PD patients randomly allocated to either a day-hospital-based treatment programme combining individual and group psychotherapy in a step-down format, or outpatient individual psychotherapy at a specialist practice. It included 107 PD patients, 46% of whom had borderline PD, and 40% of whom had avoidant PD. Costs included the two treatment conditions and additional primary and secondary in- and outpatient services. Psychosocial functioning was assessed using measures of global (observer-rated GAF) and occupational (self-report) functioning. Repeated assessments over three years were analysed using mixed models. Results The costs of step-down treatment were higher than those of outpatient treatment, but these high costs were compensated by considerably lower costs of other health services. However, costs and clinical gains depended on the type of PD. For borderline PD patients, cost-effectiveness did not differ by treatment condition. Health service costs declined during the trial, and functioning improved to mild impairment levels (GAF?>?60). For avoidant PD patients, considerable adjuvant health services expanded the outpatient format. Clinical improvements were nevertheless superior to the step-down condition. Conclusion Our results indicate that decisions on treatment format should differentiate between PD types. For borderline PD patients, the costs and gains of step-down and outpatient treatment conditions did not differ. For avoidant PD patients, the outpatient format was a better alternative, leaning, however, on costly additional health services in the early phase of treatment. Trial registration Clinical Trials NCT00378248 PMID:24268099

  5. Internees in Poland: psychiatric abuse claim.

    PubMed

    Rich, Vera

    1982-09-30

    The World Psychiatric Association has been asked to intervene on behalf of four Polish internees who are claiming to be victims of psychiatric repression for political reasons. Under martial law, Poland's security forces have shown a renewed interest in psychiatric internment of disruptive persons. PMID:11643799

  6. An Approach to the Teaching of Psychiatric Nursing in Diploma and Associate Degree Programs: Final Report on the Project.

    ERIC Educational Resources Information Center

    Walsh, Joan E.

    The purpose of the project was to determine what goals, content, and learning experiences in psychiatric-mental health nursing should be included in diploma and associate degree education for nursing in the light of present-day trends in nursing and psychiatric care. The report follows the sequence of the project: (1) selection of associate degree…

  7. Drug Screens for Psychiatric Patients in the Emergency Department: Evaluation and Recommendations

    PubMed Central

    Kroll, David S.; Smallwood, Jennifer; Chang, Grace

    2013-01-01

    Objective To better understand how toxicology screening for psychiatric patients in the emergency department (ED) setting affects diagnostic decisions. Methods Retrospective chart review of 439 ED visits of adult patients receiving psychiatry consultations at two hospitals, one an academic medical center (n = 224) and the other a community hospital (n = 220), between July 2008 and February 2009. Clinical, demographic, and ED length of stay (LOS) information was abstracted from the psychiatry consultation notes and the medical records. Results Positive urine toxicology results, when combined with a basic substance abuse history, were not associated independently with a patient’s receiving a substance-related diagnosis as part of the psychiatric assessment. By contrast, a positive blood alcohol level was associated independently with a patient’s receiving one of these diagnoses while a positive alcohol use history was not. Conclusions Urine toxicology screens do not add significant diagnostic value to all ED psychiatric evaluations when combined with standard substance use histories. PMID:23194932

  8. Influence of aeroionotherapy on some psychiatric symptoms

    NASA Astrophysics Data System (ADS)

    Deleanu, M.; Stamatiu, C.

    1985-03-01

    Negative aeroionotherapy (daily 15 50 min sittings, for 10 30 days) was applied in 112 patients with various psychiatric disorders, especially neuroses, with the aim of ameliorating certain symptoms (target symptoms). Corona and water air ion generators, as well as electro-aerosol generators, were used. The aeroionization (small air ion concentration), at the patient's respiration level, was moderate: n-=10,000 15,000/ml air; n+s?1,000/ml air; q=n+/n-?0.1. In most treated patients a diminution or even the disappearance of the target symptoms was obtained. Those obviously ameliorated under the influence of aeroionotherapy were: asthenia, depressive reactions, anxiety, irascibility, cephalea, insomnia, and general indisposition.

  9. Does experienced seclusion or restraint affect psychiatric patients’ subjective quality of life at discharge?

    PubMed Central

    2013-01-01

    Background In Finland major effort has been invested in reducing the use of coercion in psychiatric treatment, and the goal is to diminish the use of coercion by 40% by 2015. Improving patients’ quality of life (QoL) has gained prominence in psychiatric treatment during the past decade. Numerous studies have shown that most secluded or restrained patients (S/R patients) would prefer not to have had this experience. Experience of S/R could affect negatively patients’ QoL, but empirical data on this issue are lacking. Aim The study aimed to explore the effect of experienced S/R on the subjective QoL of psychiatric in-patients. Method This study explored subjective QoL of the S/R patients. At discharge, S/R patients completed the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF). Results We found that S/R patients’ (n?=?36) subjective QoL was significantly better than that of non-S/R patients’ (n?=?228). Most non-S/R patients were diagnosed with mood disorders (mostly depression). Most of S/R patients were diagnosed with schizophrenia, schizotypal and delusional disorders. The mean duration of S/R was 2.3 days, median was one day and mean length of the hospitalization after S/R episode was 2.5 months. Conclusion Our cross-sectional findings suggest that S/R does not considerably influence patients’ QoL or that the influence is short-lived. Because baseline QoL was not measured this remains uncertain. There are also many other factors, such as negative mood, which decrease the patients’ QoL ratings. These factors may either mask the influence of S/R on QoL or modify the experience of QoL to such an extent that no independent association can be found at the time of discharge. PMID:24308388

  10. Psychiatric Diagnoses as Contemporaneous Risk Factors for Suicide Attempts among Adolescents and Young Adults: Developmental Changes

    ERIC Educational Resources Information Center

    Goldston, David B.; Daniel, Stephanie Sergent; Erkanli, Alaattin; Reboussin, Beth A.; Mayfield, Andrew; Frazier, Patricia H.; Treadway, Sarah L.

    2009-01-01

    The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12-19 years of age at hospitalization, repeatedly assessed for up to…

  11. Development of a Clinical Instrument to Record Sexual Aggression in an Inpatient Psychiatric Setting

    ERIC Educational Resources Information Center

    Jones, Nicole Tuomi; Sheitman, Brian; Hazelrigg, Mark; Carmel, Harold; Williams, Jim; Paesler, Betty

    2007-01-01

    While there are a number of instruments that assess historical factors related to sexual aggression for the purposes of risk assessment, there is a notable absence of measures that assess change in ongoing, sexually aggressive behaviours engaged in by people who reside in psychiatric hospitals. The purpose of this report is to describe the…

  12. Problematic Sexual Behaviour in a Secure Psychiatric Setting: Challenges and Developing Solutions

    ERIC Educational Resources Information Center

    Hughes, Gareth V.; Hebb, Jo

    2005-01-01

    Sexually abusive behaviours are common in a forensic psychiatric population, both before admission and while hospitalized. A survey of our medium security facility found that 41% of patients had a history of sexually abusive behaviours, ranging from convictions for sexual assault through to current episodes of sexual harassment. Most forensic…

  13. Psychiatric Morbidity, Violent Crime, and Suicide among Children and Adolescents Exposed to Parental Death

    ERIC Educational Resources Information Center

    Wilcox, Holly C.; Kuramoto, Satoko J.; Lichtenstein, Paul; Langstrom, Niklas; Brent, David A.; Runeson, Bo

    2010-01-01

    Objective: This retrospective cohort study examined the risk for suicide, psychiatric hospitalization, and violent criminal convictions among offspring of parents who died from suicide, accidents, and other causes. Method: Population-based data from multiple Swedish national registers were linked from 1969 to 2004. Participants were 44,397…

  14. Examining the Impact of Psychiatric Diagnosis and Comorbidity on the Medical Lethality of Adolescent "Suicide Attempts"

    ERIC Educational Resources Information Center

    Mc Manama O'Brien, Kimberly H.; Berzin, Stephanie C.

    2012-01-01

    Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of "suicide attempts" among adolescents presenting to an urban general hospital (N = 375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without…

  15. Which Family Factors Predict Children's Externalizing Behaviors Following Discharge from Psychiatric Inpatient Treatment?

    ERIC Educational Resources Information Center

    Blader, Joseph C.

    2006-01-01

    Objective: Parents' behavior management practices, parental stress, and family environment are highly pertinent to children's conduct problems. Preadolescents' psychiatric hospitalization usually arises because of severe conduct problems, so the relationships of family-related variables to postdischarge functioning warrant investigation. This…

  16. Substance abuse and the need for money management assistance among psychiatric inpatients

    Microsoft Academic Search

    Marc I Rosen; Robert A Rosenheck; Andrew L Shaner; Thad A Eckman; Gail R Gamache; Christopher W Krebs

    2002-01-01

    Patients who mismanage their funds may benefit from financial advice, case management or the involuntary assignment of a payee who restricts direct access to funds. Data from a survey of psychiatric inpatients at four VA hospitals (N=236) was used to evaluate the relationship between substance abuse and clinician-rated need for money management assistance. Multivariate analytic techniques were used to control

  17. Neuroimaging Correlates of Novel Psychiatric Disorders after Pediatric Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Max, Jeffrey E.; Wilde, Elisabeth A.; Bigler, Erin D.; Thompson, Wesley K.; MacLeod, Marianne; Vasquez, Ana C.; Merkley, Tricia L.; Hunter, Jill V.; Chu, Zili D.; Yallampalli, Ragini; Hotz, Gillian; Chapman, Sandra B.; Yang, Tony T.; Levin, Harvey S.

    2012-01-01

    Objective: To study magnetic resonance imaging (MRI) correlates of novel (new-onset) psychiatric disorders (NPD) after traumatic brain injury (TBI) and orthopedic injury (OI). Method: Participants were 7 to 17 years of age at the time of hospitalization for either TBI or OI. The study used a prospective, longitudinal, controlled design with…

  18. A profile of mentally disordered offenders admitted to inpatient psychiatric services in the United States

    Microsoft Academic Search

    Henry J. Steadman; Marilyn J. Rosenstein; Robin L. MacAskill; Ronald W. Manderscheidt

    1988-01-01

    This research note presents data about mentally disordered offenders (MDOs) treated in inpatient psychiatric services. Data are derived from 1980 admission surveys by the Survey and Reports Branch, National Institute of Mental Health (NIMH). These data report for the first time inpatient services provided to MDOs by non-Federal general and private hospitals. A total of 31,773 MDOs were admitted, with

  19. Study of attitude of interns toward psychiatry: A survey of a tertiary level hospital in Ahmedabad

    PubMed Central

    Parikh, Nimesh C.; Sharma, Prateek S.; Chaudhary, Pradhyuman J.; Gandhi, Hitendra A.; Banwari, Girish H.

    2014-01-01

    Background: Worldwide, multiple studies demonstrate a negative attitude of interns toward psychiatry. Scenario in Gujarat state has never been looked upon. The objective of this study is to identify the situation in this region by studying the attitude of interns toward various areas of psychiatry and to study the gender differences if any. Materials and Methods: For study, all 122 interns who attended psychiatry posting for the 1st time in their internship, over a period of 8 months were approached amongst which 100 (56 males and 44 females) consented to be a part. Attitude was measured with 30 items attitude toward psychiatry (ATP 30) questionnaire on the 1st day of their posting. The data thus collected were analyzed by SPSS version 20. Result: The results showed a neutral to the negative attitude in major areas of psychiatry. Most neutral responses were seen regarding contribution of psychiatric hospitals in the treatment, regarding psychiatric patients considered to be interesting and psychiatry enabling people to have rewarding relationships. Negative attitude toward areas on scientific information in psychiatry and psychotherapy's validity were obtained. While attitude was positive in areas of psychiatric knowledge and teaching, but female interns were lagging behind their male counterparts. Psychiatric treatment lessens worries and psychiatric illness should be considered at par with other medical illnesses, were most common positively viewed attitude. Conclusion: Interns overall shared a neutral to negative ATP. Adequate rectification is required in existing medical curriculum, and more exposure to the subject is essential to improve the attitude of interns toward mental health PMID:25788804

  20. General hospital services for deliberate self-poisoning: an expensive road to nowhere?

    PubMed Central

    Kapur, N.; House, A.; Creed, F.; Feldman, E.; Friedman, T.; Guthrie, E.

    1999-01-01

    This study was designed to investigate the clinical and economic aspects of deliberate self-poisoning services in four teaching hospitals in Leeds, Leicester, Manchester and Nottingham. We investigated the management of the current self-harm episode, including direct in-hospital costs, in 456 individuals who presented to hospital on a total of 477 occasions with deliberate self-poisoning during a 4-week period in 1996. Fewer than half of the patients received specialist psychosocial assessment or follow-up. Patients were more likely to receive an assessment if they were already in contact with psychiatric services, had a history of previous overdoses, if they presented during working hours, or if they lived near the hospital. Patients who were admitted were nearly twice as likely to receive specialist assessment, and those who received a specialist assessment were nearly three times as likely to be offered follow-up. In-patient days and days on the intensive care unit accounted for 47% and 8% of the total costs, respectively. This study suggests that general hospital services are disorganised, with evidence of inequitable access to specialist assessment and aftercare. This state of affairs cannot be justified on financial or clinical grounds.???Keywords: self-poisoning; service provision PMID:10621900

  1. Hospital Waste Management in Nonteaching Hospitals of Lucknow City, India

    PubMed Central

    Manar, Manish Kumar; Sahu, Krishna Kumar; Singh, Shivendra Kumar

    2014-01-01

    Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW) management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices. PMID:25657950

  2. Food Insecurity and Mental Health: A Pilot Study of Patients in a Psychiatric Emergency Unit in Israel

    Microsoft Academic Search

    Nimrod Grisaru; Roni Kaufman; Julia Mirsky; Eliezer Witztum

    The objective of this study was to examine food insecurity among psychiatric patients and as a concern for mental health practitioners.\\u000a Food security and psychological distress were measured among 113 patients hospitalized in a psychiatric emergency unit. Of\\u000a 113 respondents 67 (59.3%) enjoyed food security and 46 (40.7%) lacked food security. Food insecure respondents showed a higher\\u000a level of psychological

  3. Sexual Abuse Survivors and Psychiatric Hospitalization after Bariatric Surgery

    Microsoft Academic Search

    Matthew M. Clark; Barbara K. Hanna; Jane L. Mai; Karen M. Graszer; Jeanne Graner Krochta; Donald E. McAlpine; Stephanie Reading; Haitham S. Abu-Lebdeh; Michael D. Jensen; Michael G. Sarr

    2007-01-01

    \\u000a Background  Some investigators have postulated that a history of being the victim of childhood sexual abuse may impact outcome of bariatric\\u000a surgery.\\u000a \\u000a \\u000a \\u000a Methods  In this retrospective chart review, we examined the electronic medical records of 152 adults with morbid obesity who underwent\\u000a Roux-en-Y gastric bypass and who had a weight recorded in their medical record or reported in a follow-up surgery at

  4. [Death caused by a bolus at a psychiatric hospital].

    PubMed

    Fehlow, P; Tennstedt, A

    1988-06-01

    Among 2000 dead we found a frequency of death by bolus of about 1% in neuropsychiatric patients in the course of 17 years. Severe oligophrenia mostly combined with epilepsy was leading with almost 50% followed by depressive syndrome, schizophrenia and dementia. Organic cerebral lesion, disorders of activity and vigilance, longterm psychopharmacotherapy, alteration of condition by acute internal disease and perhaps disorders of the liver are considered to be risks of death by bolus. PMID:3264920

  5. [Role of the psychiatric liaison nurse in suicide risk prevention].

    PubMed

    Lemoine, Nathalie Cornet; Bossis, Marie Laure; Giffaud, Sandrine; Guitteny, Marie; Bulteau, Samuel; Vanelle, Jean-Marie; Sauvaget, Anne; Volkaert, Matthieu

    2014-01-01

    From suicide risk prevention to treatment, the suicidal crisis process must be known to all carers to ensure appropriate and effective care. The psychiatry liaison team at the Nantes University Hospital advocates it with somatic teams through its liaison and consultation work. At the heart of this care network, the clinical expertise of the psychiatric liaison nurse educates nursing colleagues in identifying suicide risk. The nurse's clinical assessment and knowledge of the care system optimises the overall management and the path of patient care. PMID:25335223

  6. Psychiatric Aspects of Organ Transplantation

    PubMed Central

    Kalra, G.; Desousa, A.

    2011-01-01

    Surgical transplantation of human organs from deceased as well as living donors to sick and dying patients began after the Second World War. Over the past 50 years the transplantation of human organs, tissues and cells has become a worldwide practice which has extended, and greatly enhanced the quality of hundreds of thousands of lives. The field of transplantation medicine provides an important chance for liaison between psychiatric professionals and other transplant physicians and surgeons. The discrepancy between the ever-increasing demand for organs but the decreasing supply makes it important to evaluate and prioritize individuals who are in dire need of the organ. However, this also gives rise to certain ethical questions. The following paper discusses various psychiatric aspects of organ transplantation in general. PMID:25013589

  7. [Assisted suicide and psychiatric disorders].

    PubMed

    Frei, A; Schenker, T; Finzen, A; Hoffmann-Richter, U

    1999-11-01

    In the region of Basel in Switzerland 43 assisted suicides were registered between 1992 and 1997, eight percent of all suicides in the region. Assisted suicide was administered by the help-to-die society Exit. There was a psychiatric history in six of the suicides. Four of them suffered of serious physical illness as well. The analyses of these six suicides focuses on the conditions of assisted suicide in people with mental illness and the ethical problems arising. PMID:10603596

  8. [Headaches associated with psychiatric disorders].

    PubMed

    Radat, F

    2005-07-01

    Attributing the cause of headache to psychiatric disorders implies a direct causal relationship between the former and the later. According to the 2nd version of the IHS classification, headache can be secondary to psychotic disorders, somatisation disorders, undifferentiated somatoform disorders, depressive disorders, anxiety disorders (separation anxiety disorders, generalized anxiety disorders, panic disorders, social phobia, and post traumatic stress disorders, especially in case of head injury). Psychosocial functioning of these patients is severely impaired and their medical costs are high. PMID:16141971

  9. Aerobic exercise improves gastrointestinal motility in psychiatric inpatients

    PubMed Central

    Kim, Yeon Soo; Song, Bong Kil; Oh, Ji Sun; Woo, Seung Seok

    2014-01-01

    AIM: To evaluate the benefit of aerobic exercise on colonic transit time (CTT) for psychiatric inpatients in a closed ward. METHODS: Sixty consecutive adult inpatients of the Somang Hospital Psychiatry Unit (Eumsung-gun, South Korea), without CTT-related diseases or drug therapies, were recruited for study from March to June of 2012. Upon enrollment, the patients were randomly assigned to partake in a 12-wk instructor-led group aerobic exercise program (exercise group; n = 30) or to maintain their ordinary daily activities (control group; n = 30). The exercise program was structured as 10 min warm-up (stretching), 40 min exercise, and 10 min cool-down (stretching) for three days each week. The exercise sessions consisted of walking only in week one and aerobics from weeks two to 12, with increasing intensity (50% heart rate reserve (HRR) for weeks one to four, 60% HRR for weeks five to eight, and 70% HRR for weeks nine to 12). CTT was measured before (baseline) and after (week 12) the exercise program, in duplicate (on days four and seven), using abdominal radiography and the multiple radio-opaque marker technique. Changes in the exercising patients’ CTT and weight-, cardiovascular- and fitness-related parameters were statistically assessed. RESULTS: The study dropout rate was 30.0%, with 23 patients in the exercise group and 19 patients in the control group completing the study. At week 12, the exercise group showed decreases in body weight (mean ± SE) baseline: 69.4 ± 2.8 vs study-end: 67.6 ± 2.7; P < 0.635) and body mass index (BMI) (25.2 ± 1.1 vs 24.9 ± 0.8; P < 0.810), but the extent of change was not significantly different from that experienced by the control group (body weight: 68.8 ± 4.0 vs 68.8 ± 3.9; BMI: 24.3 ± 1.1 vs 24.4 ± 1.2). However, the exercise group showed significant improvements in leg muscle strength (baseline: 41.7 ± 4.3 vs study-end: 64.1 ± 5.0; P < 0.001), cardio-respiratory endurance (120.5 ± 4.5 vs 105.4 ± 2.8; P < 0.004), and leg muscle elasticity and power output (21.5 ± 2.6 vs 30.6 ± 2.8; P < 0.001). The exercise group showed an exercise-induced reduction in total CTT (baseline: 54.2 ± 8.0 vs 30.3 ± 6.1), which was significantly different from that experienced by the control group over the 12-wk period (48.6 ± 9.3 vs 48.3 ± 12.3; P = 0.027); however, the exercise-induced decreases in CTT involving the three colonic segments examined (right, left and recto-sigmoid) showed no significant differences from the control group. CONCLUSION: A 12-wk aerobic exercise program can benefit psychiatric inpatients by increasing intestinal motility, possibly decreasing risk of metabolic- and cardiovascular-related disease. PMID:25132778

  10. Influence of patient characteristics on care time in patients hospitalized with schizophrenia

    PubMed Central

    Sugibayashi, Yukiko; Yoshimura, Kimio; Yamauchi, Keita; Inagaki, Ataru; Ikegami, Naoki

    2014-01-01

    Background In the current Japanese payment system for the treatment of psychiatric inpatients, the length of hospital stay and nurse staffing levels are key determinants of the amount of payment. These factors do not fully reflect the costs of care for each patient. The objective of this study was to clarify the relationship between patient characteristics and their care costs as measured by “care time” for patients with schizophrenia. Methods Patient characteristics and care time were investigated in 14,557 inpatients in 102 psychiatric hospitals in Japan. Of these 14,557 inpatients, data for 8,379 with schizophrenia were analyzed using a tree-based model. Results The factor exerting the greatest influence on care time was ”length of stay”, so subjects were divided into 2 groups, a “short stay group” with length of stay ?104 days, and “long stay group” ?105 days. Each group was further subdivided according to dependence with regard to “activities of daily living”, “psychomotor agitation”, “verbal abuse”, and “frequent demands/repetitive complaints”, which were critical variables affecting care time. The mean care time was shorter in the long-stay group; however, in some long-stay patients, the mean care time was considerably longer than that in patients in the short-stay group. Conclusion The results of this study suggest that it is necessary to construct a new payment system reflecting not only length of stay and nurse staffing levels, but also individual patient characteristics. PMID:25187720

  11. Compare Hospitals

    MedlinePLUS

    2014 Leapfrog Hospital Survey Results Now Available Thank you for visiting the Leapfrog Hospital Survey Results Website. These results are based on surveys submitted by hospitals across the country that have demonstrated a commitment ...

  12. Evidence based practice: decreasing psychiatric revisits to the emergency department.

    PubMed

    Adams, Priscilla; Nielson, Heather

    2012-08-01

    Inpatient psychiatric settings anticipate changes in reimbursement that will link payment rates to objective quality measures. Readmission rates are expected to be one of the quality measures. Inpatient areas are undertaking initiatives to decrease readmission rates in preparation for this change. The emphasis on avoiding readmission could cause an increase in emergency room revisit rates by psychiatric patients. In preparation for this potential impact, the mental health emergency service within the Emergency Department of a not-for-profit community based hospital implemented a proactive process improvement plan. The plan's goal was to insure that all patients' care was provided according to a defined standardize best practice process. Steps of the plan focused on (1) improving treatment providers' communications across the continuum of care, (2) enhancing communication between the mental health emergency department nurses and the on-call psychiatrists, (3) developing on-line decisional support to enhance communication, and (4) providing providers with feedback on the impact of changes. Implementation of the improvement process decreased the mean psychiatric emergency revisit rate from 5.7% to 4.3% and decreased the variability in monthly rates from a range of 1.83%-9.53% to a range of 3.53%-5.56%. PMID:22849781

  13. Indian Psychiatric epidemiological studies: Learning from the past.

    PubMed

    Math, Suresh Bada; Srinivasaraju, Ravindra

    2010-01-01

    The objective of this paper is to provide a systematic review on the epidemiology of psychiatric disorders in India based on the data published from 1960 to 2009. Extensive search of PubMed, NeuroMed, Indian Journal of Psychiatry website and MEDLARS using search terms "psychiatry" "prevalence", "community", and "epidemiology" was done along with the manual search of journals and cross-references. Retrieved articles were systematically selected using specific inclusion and exclusion criteria. Epidemiological studies report prevalence rates for psychiatric disorders varying from 9.5 to 370/1000 population in India. These varying prevalence rates of mental disorders are not only specific to Indian studies but are also seen in international studies. Despite variations in the design of studies, available data from the Indian studies suggests that about 20% of the adult population in the community is affected with one or the other psychiatric disorder. Mental healthcare priorities need to be shifted from psychotic disorders to common mental disorders and from mental hospitals to primary health centers. Increase in invisible mental problems such as suicidal attempts, aggression and violence, widespread use of substances, increasing marital discord and divorce rates emphasize on the need to prioritize and make a paradigm shift in the strategies to promote and provide appropriate mental health services in the community. Future epidemiological research need to focus on the general population from longitudinal prospective involving multi-centers with assessment of disability, co-morbidity, functioning, family burden and quality of life. PMID:21836725

  14. [Rectal prolapse: etiopathogenetic and therapeutic problems in psychiatric patients].

    PubMed

    D'Eredità, G; Balena, V; Castellano, M; Polizzi, R A

    1994-03-01

    Rectum prolapse is a pathological condition which has long been considered as rare but whose occurrence has been progressively increasing in the past decades. There still exists a degree of uncertainty as to the disease etiopathology: moreover the exact relationship between rectum prolapse and psychic disorders which have been found in up to 50% of the patients with prolapse has not been clarified. Neither on the therapeutic level is there a common opinion as to the ideal surgical approach and over one hundred techniques have been suggested for the surgical correction of the prolapse. A study has been carried out on 10 patients suffering from psychiatric pathology of different kinds (oligophrenia, schizophrenic psychosis), hospitalized at Istituti Ospedalieri Opera Don Uva in Bisceglie. They suffered from complete rectum prolapse and underwent surgical intervention. In this study the etiopathogenetic problems of prolapse are investigated according to recent developments, with particular reference to the very peculiar implications they have in the psychiatric patient. Finally the surgical techniques correctly used and their possible application in the psychiatric patient are examined. PMID:8028728

  15. Sexual behaviours on acute inpatient psychiatric units.

    PubMed

    Bowers, L; Ross, J; Cutting, P; Stewart, D

    2014-04-01

    The purpose of the study was to assess the types and frequency of sexual behaviours displayed by patients during the first 2 weeks of admission to acute psychiatric units and what relationship these have to other challenging patient behaviours. The method used was a survey of sexual behaviours, conflict and containment events carried out by 522 patients during the first 2 weeks of admission in 84 wards in 31 hospitals in the South East of England. Incidents of sexual behaviour were common, with 13% of patients responsible for at least one incident. Although exposure was the most frequent of these behaviours, non-consensual sexual touching, was instigated by 1 in 20 patients. There were no differences in the numbers of sexual events between single sex and mixed gender wards. Few associations were found with the demographic features of perpetrators, although all those engaging in public masturbation were male, and male patients were more likely to sexually touch another without their consent. Single sex wards do not seem to necessarily offer significant protection to potentially vulnerable victims. Perpetrators do not seem to be predictable in advance, nor was there any common set or pattern of disruptive behavioural events indicating that a sexual incident was about to occur. PMID:23627653

  16. Psychiatric morbidity in elderly patients attending OPD of tertiary care centre in western region of Nepal

    PubMed Central

    Thapa, Prakash; Chakraborty, Prasanta K.; Khattri, Jai B.; Ramesh, Krishnamurthy; Sharma, Bhaskkar

    2014-01-01

    Context: Aging of population is currently a global phenomenon. At least one in 5 people over the age of 65 years will suffer from a mental disorder by 2030. Study of psychiatric morbidities in this age group is essential to prepare for upcoming challenges. Aims: To find out the prevalence of different psychiatric morbidities in elderly population and to find out if there are any age and gender specific differences. Settings and Design: Retrospective review; Psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal. Materials and Methods: Data for patients ? 65 years of age attending the psychiatric outpatient department of Manipal Teaching Hospital, Pokhara, Nepal, from 1st January 2012 to 15th January 2013 were collected retrospectively in a predesigned proforma. Statistical Analysis Used: Risk of having different psychiatric disorders was estimated using odds ratio. Results: The mean age of 120 patients included in this study was 69.67 (SD = 5.94) years. Depressive disorder (26.7%) was the most common diagnosis. There was no statistically significant difference in psychiatric disorders in >75 years compared with ?75 years except for dementia [odd ratio (OR) (?75 years/>75 years)=0.055, 95% confidence interval (CI)=0.016; 0.194]. Alcohol dependence syndrome [OR (male/female)=7.826, 95% CI = 1.699;36.705] and dementia [OR (male/female)=3.394, 95% CI = 1.015;11.350] was more common in males. Conclusions: Depressive disorder was the most common psychiatric morbidity among the elderly patients. The odds suffering from dementia increased with increasing age. The odds of having alcohol related problems and dementia were more in males compared with females.

  17. Hospital catering. Hard to swallow.

    PubMed

    Deeming, Chris

    2002-08-22

    Hospital meals cost the NHS, on average, 2.50 Pounds per patient per day. Costs are higher in hospitals which prepare food on site, specialist trusts and those in London. The Wanless report has proposed that expenditure should rise to 4.80 Pounds per patient per day, at today's prices, by 2022. More effort should go into cutting food wastage which currently costs hospitals in England more than 18 m Pounds a year. PMID:12235893

  18. Preventing 30-day readmissions.

    PubMed

    Stevens, Sherri

    2015-03-01

    Preventing 30-day readmissions to hospitals is a top priority in the era of health care reform. New regulations will be costly to health care facilities because of payment guidelines. The most frequently readmitted medical conditions are acute myocardial infarction, heart failure, and pneumonia. The transition from the hospital and into the home has been classified as a vulnerable time for many patients. During this time of transition patients may fail to fully understand their discharge instructions. Ineffective communication, low health literacy, and compliance issues contribute to readmissions. Telehealth and the use of technology may be used to prevent some readmissions. PMID:25680492

  19. Serving street-dwelling individuals with psychiatric disabilities: outcomes of a psychiatric rehabilitation clinical trial.

    PubMed Central

    Shern, D L; Tsemberis, S; Anthony, W; Lovell, A M; Richmond, L; Felton, C J; Winarski, J; Cohen, M

    2000-01-01

    OBJECTIVES: This study tested a psychiatric rehabilitation approach for organizing and delivering services to street-dwelling persons with severe mental illness. METHODS: Street-dwelling persons with severe mental illness were randomly assigned to the experimental program (called Choices) or to standard treatment in New York City. We assessed study participants at baseline and at 6-month intervals over 24 months, using measures of service use, quality of life, health, mental health, and social psychological status. The average deviation from baseline summary statistic was employed to assess change. RESULTS: Compared with persons in standard treatment (n = 77), members of the experimental group (n = 91) were more likely to attend a day program (53% vs 27%), had less difficulty in meeting their basic needs, spent less time on the streets (55% vs 28% reduction), and spent more time in community housing (21% vs 9% increase). They showed greater improvement in life satisfaction and experienced a greater reduction in psychiatric symptoms. CONCLUSIONS: With an appropriate service model, it is possible to engage disaffiliated populations, expand their use of human services, and improve their housing conditions, quality of life, and mental health status. PMID:11111259

  20. Psychiatric disorders and stages of smoking

    Microsoft Academic Search

    Naomi Breslau; Scott P. Novak; Ronald C. Kessler

    2004-01-01

    Background: We examined the role of DSM-III-R psychiatric disorders in predicting the subsequent onset of daily smoking, smokers’ progression to nicotine dependence, and the persistence of smoking.Methods: The Tobacco Supplement of the National Comorbidity Survey was administered to a representative subsample of 4414 persons 15–54 years of age. DSM-III-R psychiatric disorders and information on age of onset of psychiatric disorders,

  1. Psychiatric Comorbidity Among Inpatient Substance Abusing Adolescents

    Microsoft Academic Search

    Ana M. Abrantes; Sandra A. Brown; Kristin L. Tomlinson

    2004-01-01

    We studied the association between type, severity and sequencing of psychopathology and these same dimensions of substance involvement among inpatient substance-abusing adolescents with comorbid psychiatric disorders. Adolescents (N = 140, 54% female; 15.9 years) meeting DSM-III-R criteria for a substance use disorder and at least one other Axis I psychiatric disorder were interviewed while inpatients in an adolescent psychiatric facility.

  2. The Correlation Between Psychiatric Disorders and Women’s Lives

    PubMed Central

    Bursalioglu, Fusun Sevimli; Aydin, Nazan; Yazici, Esra; Yazici, Ahmet Bulent

    2013-01-01

    Objective: Psychiatric disorders are important factors which affect the quality of life: employment rates, interpersonal and intrafamilial communications, marriage, child-bearing, parental skills and many other social – cognitive areas in different ways. Psychiatric disorders like schizophrenia, bipolar affective disorder and depressive disorder have a negative impact on women’s lives. This study has compared the relationship between these mental illnesses and the liabilities of women’s lives. Methods: For the purpose of this study, 61 schizophrenics, 35 bipolar and 40 unipolar female patients and 60 healthy controls from a university hospital of eastern Turkey were evaluated with SCID- I, a family environmental scale and a personal information questionnaire. Results: The women with psychiatric disorders had higher rates of unemployment, shorter durations of marriage and lower numbers of parity, as compared to their healthy counterparts, especially after the onset of their illnesses. The schizophrenia and bipolar groups are at risk due to the psychotropic medications which they take during pregnancy. The onset or the exacerbations of illnesses during the postpartum period are also seen more in the schizophrenia and the bipolar groups. However, the patients did not use medicines more than the healthy controls during lactation. The schizophrenia and bipolar groups seem to be failing in using reliable methods of contraception. This data is important due to the traditional and the socio-economical structure of eastern Turkey, which may interrelate with the results. Conclusion: Women have to play various roles in life and they have various challenges which are related to these roles. The female psychiatric patients should be evaluated in the special perspective of ‘being women’, along with other clinical parameters. The evaluation of the social, cultural and the economic aspects and the collaborative teams of different clinical disciplines which are related to women’s mental health would be beneficial. PMID:23730649

  3. Past trauma and present functioning of patients attending a women's psychiatric clinic.

    PubMed

    Borins, E F; Forsythe, P J

    1985-04-01

    A women's psychiatric clinic, incorporated within a university teaching general hospital and staffed entirely by women, was opened in March of 1980. The authors studied a sample of 100 women who came to the clinic and characterized them by demographic variables, psychiatric diagnoses, health problems, chronic illness, death in the family, and traumatic incidents. Death in the family before she was 18 was found to predict a woman's subsequent request for or completion of sterilization. Physical or sexual abuse was significantly related to abortion, and abortion and trauma were significantly correlated. PMID:3976919

  4. iPad-Assisted Measurements of Duration Estimation in Psychiatric Patients and Healthy Control Subjects

    PubMed Central

    Preuschoff, Irene; Müller, Helge H.; Sperling, Wolfgang; Biermann, Teresa; Bergner, Matthias; Kornhuber, Johannes; Groemer, Teja W.

    2013-01-01

    Handheld devices with touchscreen controls have become widespread in the general population. In this study, we examined the duration estimates (explicit timing) made by patients in a major general hospital and healthy control subjects using a custom iPad application. We methodically assessed duration estimates using this novel device. We found that both psychiatric and non-psychiatric patients significantly overestimated time periods compared with healthy control subjects, who estimated elapsed time very precisely. The use of touchscreen-based methodologies can provide valuable information about patients. PMID:23658689

  5. ASD, a Psychiatric Disorder, or Both? Psychiatric Diagnoses in Adolescents with High-Functioning ASD

    ERIC Educational Resources Information Center

    Mazefsky, Carla A.; Oswald, Donald P.; Day, Taylor N.; Eack, Shaun M.; Minshew, Nancy J.; Lainhart, Janet E.

    2012-01-01

    Varied presentations of emotion dysregulation in autism complicate diagnostic decision making and may lead to inaccurate psychiatric diagnoses or delayed autism diagnosis for high-functioning children. This pilot study aimed to determine the concordance between prior psychiatric diagnoses and the results of an autism-specific psychiatric interview…

  6. Psychiatric Service Use and Psychiatric Disorders in Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Bhaumik, S.; Tyrer, F. C.; McGrother, C.; Ganghadaran, S. K.

    2008-01-01

    Background: UK policies aim to facilitate access to general psychiatric services for adults with intellectual disability (ID). If this is to be achieved, it is important to have a clear idea of the characteristics and proportion of people with ID who currently access specialist psychiatric services and the nature and extent of psychiatric

  7. [A clinical psychiatric study about post-stroke depression].

    PubMed

    Sato, Shinji; Yamakawa, Yuriko; Terashimai, Yasushi; Asada, Takashi

    2006-01-01

    We examined the clinical characteristics of post stroke depression (PSD) patients in a rehabilitation hospital. The subjects were inpatients at the Ibaraki Prefectural University of Health Sciences Hospital who had been diagnosed with stroke and admitted between May 2002 and January 2004. Of 123 patients enrolled, 18 were diagnosed with PSD. We investigated the clinical differences between PSD patients and non-depressed (ND) patients. There were no significant differences between PSD and ND groups in terms of sex, age, past psychiatric history, family psychiatric history, stroke diagnosis, or neurological symptoms. The scores of PSD patients on Zung's self-rating depression scale and the Hamilton depression rating scale were significantly higher than those of ND patients. Furthermore, the Activities of Daily Living measured by the Functional Independence Measure and cognitive function evaluated by the Mini-Mental State Examination of ND patients were significantly better than those of PSD subjects. These results suggest that the detection of PSD in stroke patients is important for promoting their rehabilitation and improving their Activities of Daily Living and cognitive function. PMID:17137194

  8. Homeless and Housed Inpatients with Schizophrenia: Disparities in Service Access upon Discharge from Hospital

    ERIC Educational Resources Information Center

    Burra, Tara A.; Hwang, Stephen W.; Rourke, Sean B.; Stergiopoulos, Vicky

    2012-01-01

    This study examines differences in services available at the time of discharge for homeless and housed psychiatric inpatients. Participants diagnosed with schizophrenia or schizoaffective disorder were recruited from a general hospital psychiatric inpatient unit. Thirty homeless individuals and 21 housed controls (matched for diagnosis, gender,…

  9. Psychiatric stigma in correctional facilities.

    PubMed

    Miller, R D; Metzner, J L

    1994-01-01

    While legislatively sanctioned discrimination against the mentally ill in general society has largely disappeared, it persists in correctional systems where inmates are denied earn-time reductions in sentences, parole opportunities, placement in less restrictive facilities, and opportunities to participate in sentence-reducing programs because of their status as psychiatric patients or their need for psychotropic medications. The authors discuss the prevalence of such problems from detailed examinations of several correctional systems and from the results of a national survey of correctional medical directors. PMID:7718934

  10. White Day

    E-print Network

    Hacker, Randi

    2010-05-05

    but also to their male co-workers. Men have White Day a month later on March 14th. Created by a sweets manufacturer in 1980 to boost sales, White Day is more of a marketing ploy than a holiday. On White Day, you will see men scurrying about purchasing giri...

  11. Predictors of Time to Discharge in Patients Hospitalized for Behavioral and Psychological Symptoms of Dementia

    PubMed Central

    Kitamura, Tatsuru; Kitamura, Maki; Hino, Shoryoku; Kurata, Koichi

    2013-01-01

    Background/Aims In Japan, more than 50,000 patients with dementia are housed in psychiatric facilities, a trend precipitated by prolonged hospitalizations. This study aimed to determine predictors for the time to discharge in patients hospitalized for behavioral and psychological symptoms of dementia (BPSD). Methods Medical charts of patients admitted to an acute psychogeriatric ward for treatment of BPSD were reviewed. Cox's proportional hazards model was used to evaluate relationships between active behavioral problems and/or demographics at the time of admission, and the time until favorable discharge (FD), defined as discharge to the patient's own home or a care facility. Results For the 402 study patients included in this study, median time to FD was 101 days. In addition to family and residential factors, multivariate analysis identified higher Mini-Mental State Examination scores as independent clinical predictors for a shorter hospital stay, whereas male gender and combative behavior as the primary reason for hospital admission were predictors for a longer hospital stay. Conclusion Clinical characteristics can be predictive of the time to discharge for patients with BPSD. Earlier interventions and enhanced care strategies may be needed for patients with a lower likelihood of FD. PMID:23637701

  12. ‘Often there is a Good Deal to be Done, But Socially Rather Than Medically’: The Psychiatric Social Worker as Social Therapist, 1945–70

    PubMed Central

    LONG, VICKY

    2011-01-01

    Seeking to align psychiatric practice with general medicine following the inauguration of the National Health Service, psychiatric hospitals in post-war Britain deployed new treatments designed to induce somatic change, such as ECT, leucotomy and sedatives. Advocates of these treatments, often grouped together under the term ‘physical therapies’, expressed relief that the social problems encountered by patients could now be interpreted as symptomatic of underlying biological malfunction rather than as a cause of disorder that required treatment. Drawing on the British Journal of Psychiatric Social Work, this article analyses the critique articulated by psychiatric social workers based within hospitals who sought to facilitate the social reintegration of patients following treatment. It explores the development of ‘psychiatric social treatment’, an approach devised by psychiatric social workers to meet the needs of people with enduring mental health problems in hospital and community settings that sought to alleviate distress and improve social functioning by changing an individual’s social environment and interpersonal relationships. ‘Physical’ and ‘social’ models of psychiatric treatment, this article argues, contested not only the aetiology of mental illness but also the nature of care, treatment and cure. PMID:21461311

  13. 28 CFR 549.43 - Involuntary psychiatric treatment and medication.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...2011-07-01 false Involuntary psychiatric treatment and medication. 549.43 Section...Administrative Safeguards for Psychiatric Treatment and Medication § 549.43 Involuntary psychiatric treatment and medication. Title 18...

  14. 28 CFR 549.42 - Use of psychiatric medications.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...42 Use of psychiatric medications. Psychiatric medications will be used only for treatment of diagnosable mental illnesses and disorders, and their symptoms, for which such medication is accepted treatment. Psychiatric medication will...

  15. 28 CFR 549.42 - Use of psychiatric medications.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...42 Use of psychiatric medications. Psychiatric medications will be used only for treatment of diagnosable mental illnesses and disorders, and their symptoms, for which such medication is accepted treatment. Psychiatric medication will...

  16. 28 CFR 549.42 - Use of psychiatric medications.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...42 Use of psychiatric medications. Psychiatric medications will be used only for treatment of diagnosable mental illnesses and disorders, and their symptoms, for which such medication is accepted treatment. Psychiatric medication will...

  17. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...CONTROL Inpatient Psychiatric Services for Individuals Under Age 21: Admission and Plan of Care Requirements § 456...provides inpatient psychiatric services to a beneficiary under age 21, the medical, psychiatric, and social...

  18. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...CONTROL Inpatient Psychiatric Services for Individuals Under Age 21: Admission and Plan of Care Requirements § 456...provides inpatient psychiatric services to a recipient under age 21, the medical, psychiatric, and social...

  19. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...CONTROL Inpatient Psychiatric Services for Individuals Under Age 21: Admission and Plan of Care Requirements § 456...provides inpatient psychiatric services to a recipient under age 21, the medical, psychiatric, and social...

  20. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...CONTROL Inpatient Psychiatric Services for Individuals Under Age 21: Admission and Plan of Care Requirements § 456...provides inpatient psychiatric services to a beneficiary under age 21, the medical, psychiatric, and social...

  1. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...CONTROL Inpatient Psychiatric Services for Individuals Under Age 21: Admission and Plan of Care Requirements § 456...provides inpatient psychiatric services to a beneficiary under age 21, the medical, psychiatric, and social...

  2. Psychiatric disorders in asthmatic outpatients.

    PubMed

    Nascimento, Isabella; Nardi, Antonio Egidio; Valença, Alexandre M; Lopes, Fabiana L; Mezzasalma, Marco A; Nascentes, Ronaldo; Zin, Walter A

    2002-05-15

    It has been reported that the lifetime prevalence of panic disorder in patients with pulmonary disease is higher than epidemiologic estimates of population prevalence. We evaluated the frequency of anxiety disorders in 86 subjects from the Outpatient Asthma Clinic. Psychiatric diagnoses were assessed with the Mini-International Neuropsychiatric Interview 4.4 Version (MINI). Forty-five asthmatic patients (52.3%) reported at least one current anxiety disorder. The frequency of panic disorder with or without agoraphobia was 13.9% (n=12) and that of agoraphobia without panic disorder was 26.8% (n=23). Social anxiety and generalized anxiety disorders occurred in 9.3% (n=8) and 24.4% (n=21) of the sample, respectively. Twenty-nine patients (33.7%) reported a major depressive episode. The psychiatric morbidity of the sample was 61.6% (n=53). Our results tend to support the high morbidity of anxiety disorders, particularly panic/agoraphobic spectrum disorders, in asthmatic outpatients. PMID:12007595

  3. Psychiatric resilience: longitudinal twin study

    PubMed Central

    Amstadter, Ananda B.; Myers, John M.; Kendler, Kenneth S.

    2014-01-01

    Objective There is great variability in response to stressful life events (SLEs), with some individuals demonstrating substantial psychiatric symptoms while others remain largely asymptomatic. The source of this variability is poorly understood. The present study aimed to examine the genetic and environmental underpinning of resilience, defined as the difference between the twins’ total score on a broad measure of internalizing symptoms and their predicted score based on their cumulative exposure to SLEs. Method SLE exposure and internalizing symptoms were assessed at two time points in 7,500 adult twins. Using the residual between actual and predicted internalizing symptom total score, twin modeling was conducted for each wave separately, as well as longitudinally. Quantitative and qualitative sex effects were also tested. Results Resilience was found to have a mild to moderate genetic heritability at each individual wave (~31%). Additionally, qualitative sex effects were found. Incorporating error of measurement into the model increased the estimated heritability for the latent construct of resilience (~50%). Unconfounded by measurement error and occasion specific effects, environmental influences contributed roughly equally to determining the individual level of resilience. Conclusions Genetic factors influence the level of psychiatric resilience, and are largely stable over time. The genes that impact on resilience are not entirely the same in males and females, although the degree of heritability is equal across the sexes. Environmental influences can also have an enduring effect on resilience. The present findings of the genetic and environmental influences on adaptation to SLEs clarify the sources of individual variation to environmental stressors. PMID:24723629

  4. Value-sensitive psychiatric rehabilitation.

    PubMed

    Greenberg, David; Kalian, Moshe; Witztum, Eliezer

    2010-09-01

    Psychiatric rehabilitation contains value-laden concepts that may be unacceptable to certain cultures and many individuals. The concepts of independence and work are examined in a clash between mental health professionals in charge of national policies in psychiatric rehabilitation in Israel and a rehabilitation center for the severely mentally ill within the ultra-orthodox Jewish community. The government professionals considered that having the living quarters and work site in the same building deemed it unsuitable for rehabilitation, and too few progressed to independent living and working. As such, they ordered the center to be closed. Clients' families turned to the Supreme Court and the claims and counter claims reveal value-laden positions. The bases for misunderstanding and lack of cooperation between the government professionals and the rehabilitation center are explained in the context of everyday life and values in the ultra-orthodox Jewish community and attitudes in the general population. Fruitful cooperation is based on appreciating core values, identifying and working with the community's figures of authority, and accepting that the role of the mental health professional is to advise the community, within which the professional has no status. PMID:20940272

  5. Do hospitals cross-subsidize?

    PubMed

    David, Guy; Lindrooth, Richard C; Helmchen, Lorens A; Burns, Lawton R

    2014-09-01

    Despite its salience as a regulatory tool to ensure the delivery of unprofitable medical services, cross-subsidization of services within hospital systems has been notoriously difficult to detect and quantify. We use repeated shocks to a profitable service in the market for hospital-based medical care to test for cross-subsidization of unprofitable services. Using patient-level data from general short-term hospitals in Arizona and Colorado before and after entry by cardiac specialty hospitals, we study how incumbent hospitals adjusted their provision of three uncontested services that are widely considered to be unprofitable. We estimate that the hospitals most exposed to entry reduced their provision of psychiatric, substance-abuse, and trauma care services at a rate of about one uncontested-service admission for every four cardiac admissions they stood to lose. Although entry by single-specialty hospitals may adversely affect the provision of unprofitable uncontested services, these findings warrant further evaluation of service-line cross-subsidization as a means to finance them. PMID:25062300

  6. Mental health of doctors in a tertiary hospital in Nigeria

    PubMed Central

    Issa, Baba Awoye; Yussuf, Abdullah Dasliva; Olanrewaju, Ganiyu Toyin; Abiodun, Olatunji Alao

    2014-01-01

    Introduction Doctors are vulnerable to psychiatric morbidity as a result of their busy schedules and multiple role obligations. Yet, they often don't admit they have mental health problems nor are they readily subjected to mental health evaluation by their colleagues due to fear of labeling and general stigma. Methods A cross-sectional survey of doctors in the service of University of Ilorin Teaching Hospital, Ilorin, Nigeria was done using a socio-demographic questionnaire and the twelve items General Health Questionnaire (GHQ-12) using a cut-off point of 3 to indicate possibility of psychiatric disorder (GHQ-12 positive). Non-parametric analysis and regression test of factors associated with psychiatric morbidity was done using SPSS. Level of significance was set at 0.05 p-value. Results Two hundred and forty one doctors representing 68.9% of the doctors participated in the survey. The point prevalence of psychiatric morbidity among the doctors using the GHQ-12 was 14.9%. Being married, non-participation in social activities and perception of work load as being “heavy” were significantly associated with psychiatric morbidity (p-value < 0.05). Conclusion The prevalence of psychiatric morbidity among doctors at the University of Ilorin Teaching Hospital was higher than the general population prevalence. Measures to lessen the negative effect of marriage and the perceived heavy work load on mental health of doctors, such as provision of recreational facilities within the hospital and encouragement of doctors’ participation in social activities are advanced.

  7. Accommodating Faculty and Staff with Psychiatric Disabilities.

    ERIC Educational Resources Information Center

    Lee, Barbara A.; Ruger, Peter H.

    This pamphlet discusses the legal protections for employees with psychiatric disabilities, and analyzes the decisions of federal and state courts in cases where employees who claimed a psychiatric disorder challenged an employment decision under the Americans with Disabilities Act of 1990 (ADA), the Rehabilitation Act of 1973, or state law. It…

  8. Pregnancy Pointers for Women with Psychiatric History

    MedlinePLUS

    National Alliance on Mental Illness page printed from http://www2.nami.org/ (800) 950-NAMI; info@nami.org ©2015 Pregnancy Pointers for Women with Psychiatric History Women with a psychiatric history may wonder about the risks associated with pregnancy and parenthood. A safe pregnancy for ...

  9. Psychiatric Residents' Experience Conducting Disability Evaluations

    ERIC Educational Resources Information Center

    Christopher, Paul P.; Boland, Robert J.; Recupero, Patricia R.; Phillips, Katharine A.

    2010-01-01

    Objective: The increasing frequency and societal cost of psychiatric disability underscore the need for accuracy in evaluating patients who seek disability benefits. The authors investigated senior psychiatric residents' experiences performing disability evaluations, their self-assessment of competence for this task, and whether they perceived a…

  10. Psychiatric Restraint and Seclusion: Resisting Legislative Solution

    Microsoft Academic Search

    Stacey A. Tovino

    2007-01-01

    The use of restraint and seclusion in the American psychiatric setting has a rich history—rich in medical, ethical, legal, and social controversy. For centuries, mental health care providers used movement restrictions and solitary confinement to manage psychiatric patients. Superintendents of eighteenth and early nineteenth century insane asylums and other institutions of confinement believed that strait-waistcoats, “tranquilizer chairs,” “maniac beds,” chains,

  11. Psychiatric Mental Health Nurse Practitioner Clinical Courses

    E-print Network

    Cui, Yan

    0 Psychiatric Mental Health Nurse Practitioner Clinical Courses Student Preceptor Guide Revised 1..............................................................................................................................................28 #12;2 TO: Psychiatric Mental Nurse Practitioner (PMH) Students, Preceptors, and Clinical Faculty Concentration Coordinator, Department of Advanced Practice & Doctoral Studies The University of Tennessee Health

  12. Ayahuasca in Adolescence: A Preliminary Psychiatric Assessment

    Microsoft Academic Search

    Dartiu Xavier Da Silveira; Charles S. Grob; Marlene Dobkin de Rios; Enrique Lopez; Luisa K. Alonso; Cristiane Tacla; Evelyn Doering-Silveira

    2005-01-01

    Ayahuasca is believed to be harmless for those (including adolescents) drinking it within a religious setting. Nevertheless controlled studies on the mental\\/ psychiatric status of ritual hallucinogenic ayahuasca concoction consumers are still lacking. In this study, 40 adolescents from a Brazilian ayahuasca sect were compared with 40 controls matched on sex, age, and educational background for psychiatric symptomatology. Screening scales

  13. Psychiatric comorbidity in gender identity disorder

    Microsoft Academic Search

    U. Hepp; B. Kraemer; U. Schnyder; N. Miller; A. Delsignore

    2005-01-01

    ObjectiveDespite being recognized as an important prognostic factor for the outcome in gender identity disorder (GID), psychiatric comorbidity has rarely been assessed by means of standardized diagnostic instruments. The aim of this study was to assess current and lifetime psychiatric comorbidity in patients with GID.

  14. Hospital mission and cost differences.

    PubMed

    Sorrentino, E A

    1989-01-01

    The results show no significant differences on average length of stay, cost per patient day, or cost per admission among non-profit, government, and for-profit hospitals when controlling for bed capacities, occupancy rates, number of Medicare/Medicaid days, and hospitals without nurseries. For-profit hospital manhours per patient day were significantly lower than non-profit and government hospitals. This is an important finding because patient-care delivery is labor-intensive. A majority of for-profit hospitals do not have nurseries, which means that they should have more manhours per patient day. As indicated earlier, the manhours for hospitals with nurseries are higher than those for hospitals without nurseries. This indicates cost-cutting behavior on the part of a majority of for-profit hospitals. This method of limiting expenditures by decreasing labor costs associated with certain services is consistent with profit-maximization. The findings of this study with regard to cost differences among non-profit and for-profit hospitals contradict previous research. However, a recent study by Kralewski, Gifford and Porter (1988) noted that whereas ownership, when considered alone, differentiates hospitals, when evaluated within each community, most of the investor-owned and non-for-profit hospital differences disappear. Similar questions have been raised as to whether non-profit hospitals truly differ from for-profit hospitals (Pauly 1987). Caution needs to be exercised in attempting to extrapolate the findings of this study, because of the dynamic health care environment. Hospital ownership changes over time, reimbursement rules affect behavior, and internal factors in organizational operation affect outcomes. These should be considered in future studies exploring organizational mission and cost differences. PMID:10293600

  15. Psychiatric diagnosis: the indispensability of ambivalence

    PubMed Central

    Callard, Felicity

    2014-01-01

    The author analyses how debate over the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has tended to privilege certain conceptions of psychiatric diagnosis over others, as well as to polarise positions regarding psychiatric diagnosis. The article aims to muddy the black and white tenor of many discussions regarding psychiatric diagnosis by moving away from the preoccupation with diagnosis as classification and refocusing attention on diagnosis as a temporally and spatially complex, as well as highly mediated process. The article draws on historical, sociological and first-person perspectives regarding psychiatric diagnosis in order to emphasise the conceptual—and potentially ethical—benefits of ambivalence vis-à-vis the achievements and problems of psychiatric diagnosis. PMID:24515564

  16. Comorbid disorders in hospitalized bipolar adolescents compared with unipolar depressed adolescents

    Microsoft Academic Search

    Carrie M. Borchardt; Gail A. Bernstein

    1995-01-01

    This study examined comorbid psychiatric disorders in adolescents with bipolar disorder. Hospitalized bipolar adolescents\\u000a (N=10) were compared to hospitalized adolescents with unipolar depression (N=33), and to adolescents with nonaffective psychiatric\\u000a disorders (N=11). Results showed conduct disorder, attention-deficit hyperactivity disorder, psychosis, and having any DSM-III-R\\u000a psychoactive substance use disorder were all significantly more common in the bipolar group than the unipolar

  17. Independent influence of negative blood cultures and bloodstream infections on in-hospital mortality

    PubMed Central

    2014-01-01

    Background The independent influence of blood culture testing and bloodstream infection (BSI) on hospital mortality is unclear. Methods We included all adults treated in non-psychiatric services at our hospital between 2004 and 2011. We identified all blood cultures and their results to determine the independent association of blood culture testing and BSI on death in hospital using proportional hazards modeling that adjusted for important covariates. Results Of 297 070 hospitalizations, 48 423 had negative blood cultures and 5274 had BSI. 12 529 (4.2%) died in hospital. Compared to those without blood cultures, culture-negative patients and those with BSI were sicker. Culture-negative patients had a significantly increased risk of death in hospital (adjusted hazard ratio [HR] ranging between 3.1 and 4.4 depending on admission urgency, extent of comorbidities, and whether the blood culture was taken in the intensive care unit). Patients with BSI had a significantly increased risk of death (adj-HR ranging between 3.8 and 24.3] that was significantly higher when BSI was: diagnosed within the first hospital day; polymicrobial; in patients who were exposed to immunosuppressants or were neutropenic; or due to Clostridial and Candidal organisms. Death risk in culture negative and bloodstream infection patients decreased significantly with time. Conclusions Risk of death in hospital is independently increased both in patients with negative blood cultures and further in those with bloodstream infection. Death risk associated with bloodstream infections varied by the patient’s immune status and the causative microorganism. PMID:24444097

  18. Earth Day

    NSDL National Science Digital Library

    On April 22, 2005, people around the world will celebrate the 35th anniversary of Earth Day. This Topic in Depth focuses on the past and present of this significant day. From the Wisconsin Historical Society, the first two sites contain historical documents pertaining to Earth Day. The first (1) document features a May 1970 issue of The Gaylord Nelson Newsletter reporting on the first Earth Day. The second (2) document is a speech by Nelson entitled "An Environmental Agenda for the 70's." Housed in the archives of the US Environmental Protection Agency (EPA) website, the next two sites also contain historical documents. The first (3) site contains an article written by Nelson for the EPA Journal in April of 1980, entitled "Earth Day '70: What It Meant." The second (4) site contains an article written by John C. Whitaker (former Interior undersecretary in the Nixon administration) for the EPA Journal in the summer of 1998. The article is entitled "Earth Day Recollections: What It Was Like When the Movement Took Off." The (5) Earth Day Network (first mentioned in the April 4, 2003, Scout Report for Life Sciences) works "to broaden the environmental movement worldwide and to educate and mobilize people, governments, and corporations to take responsibility for a clean and healthy environment." In addition to information sections about Ongoing Programs, Current Campaigns, and News, the Earth Day Network website contains Earth Day 2005 Materials for organizers. From EarthDay.gov, Take Action In Your Classroom (6) offers links to a variety of environmental education resources. The next website, from the U.S. Army Environmental Center, presents (7) Army Earth Day; and links to information about the Army's environmental activities. The final (8) site is an Earth Day-inspired educational website (first reported on in the April 14, 1999 Scout Report for Science & Engineering) from the Wilderness Society. The site offers a collection of environmental education resources for teachers and students. [NL

  19. National survey of hospital patients.

    PubMed Central

    Bruster, S.; Jarman, B.; Bosanquet, N.; Weston, D.; Erens, R.; Delbanco, T. L.

    1994-01-01

    OBJECTIVE--To survey patients' opinions of their experiences in hospital in order to produce data that can help managers and doctors to identify and solve problems. DESIGN--Random sample of 36 NHS hospitals, stratified by size of hospital (number of beds), area (north, midlands, south east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of discharge two to four weeks after discharge by means of a structured questionnaire about their treatment in hospital. SUBJECTS--5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Subjects had been patients on medical and surgical wards apart from paediatric, maternity, psychiatric, and geriatric wards. MAIN OUTCOME MEASURES--Patients' responses to direct questions about preadmission procedures, admission, communication with staff, physical care, tests and operations, help from staff, pain management, and discharge planning. Patients' responses to general questions about their degree of satisfaction in hospitals. RESULTS--Problems were reported by patients, particularly with regard to communication with staff (56% (2824/5020) had not been given written or printed information); pain management (33% (1042/3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/5124) had not been told about warning signs and 62% (3177/5119) had not been told when to resume normal activities). Hospitals failed to reach the standards of the Patient's Charter--for example, in explaining the treatment proposed and giving patients the option of not taking part in student training. Answers to questions about patient satisfaction were, however, highly positive but of little use to managers. CONCLUSIONS--This survey has highlighted several problems with treatment in NHS hospitals. Asking patients direct questions about what happened rather than how satisfied they were with treatment can elucidate the problems that exist and so enable them to be solved. PMID:7819893

  20. Space Day

    NSDL National Science Digital Library

    Space Day '98, to be held on May 21, 1998, celebrates and honors the people who have made space exploration possible. The highlight of the Space Day homepage, maintained by Lockheed Martin Corporation, will be a live interactive webcast all day on May 21. Features of the webcast include experts in the fields of space discussing issues ranging from global collaboration to mysteries that remain. In addition to the webcast, the Space Day '98 home page provides resources for teachers and the curious alike. Mission: Fun allows visitors to test their space knowledge through interactive Shockwave games and quizzes while Teachers' Space provides educators with downloadable lesson plans (Adobe Acrobat [.pdf] format).

  1. Epidemiology of psychiatric disorders in very young children in a Romanian pediatric setting.

    PubMed

    Gleason, Mary Margaret; Zamfirescu, Andrei; Egger, Helen L; Nelson, Charles A; Fox, Nathan A; Zeanah, Charles H

    2011-10-01

    A growing literature demonstrates that early clinical intervention can reduce risks of adverse psychosocial outcomes. A first step necessary for developing early intervention services is to know the prevalence of clinical disorders, especially in systems that are rebuilding, such as Romania, where the mental health system was dismantled under Ceausescu. No epidemiologic studies have examined prevalence of psychiatric disorders in young children in Romania. The objective of this study was to determine the prevalence of psychiatric disorders in Romanian children 18-60 months in pediatric settings. Parents of 1,003 children 18-60 months in pediatric waiting rooms of two pediatric hospitals completed background information, the Child Behavior Checklist (CBCL). A subgroup over-sampled for high mental health problems were invited to participate in the Preschool Age Psychiatric Assessment. Rates of mental health problems were similar to the US norms on the CBCL. The weighted prevalence of psychiatric disorders in these children was 8.8%, with 5.4% with emotional disorders and 1.4% with behavioral disorders. Comorbidity occurred in nearly one-fourth of the children with a psychiatric disorder and children who met diagnostic criteria had more functional impairment than those without. Of children who met criteria for a psychiatric disorder, 10% of parents were concerned about their child's emotional or behavioral health. This study provides prevalence rates of psychiatric disorders in young Romanian children, clinical characteristic of the children and families that can guide developing system of care. Cultural differences in parental report of emotional and behavioral problems warrant further examination. PMID:21866415

  2. Epidemiology of psychiatric disorders in very young children in a Romanian pediatric setting

    PubMed Central

    Gleason, Mary Margaret; Zamfirescu, Andrei; Egger, Helen L.; Nelson, Charles A.; Fox, Nathan A.; Zeanah, Charles H.

    2014-01-01

    Background A growing literature demonstrates that early clinical intervention can reduce risks of adverse psychosocial outcomes. A first step necessary for developing early intervention services is to know the prevalence of clinical disorders, especially in systems that are rebuilding, such as Romania, where the mental health system was dismantled under Ceaucescu. No epidemiologic studies have examined prevalence of psychiatric disorders in young children in Romania. Objective To determine the prevalence of psychiatric disorders in Romanian children 18-60 months in pediatric settings. Methods Parents of 1003 children 18-60 months in pediatric waiting rooms of two pediatric hospitals completed background information, the Child Behavior Checklist (CBCL). A subgroup over-sampled for high mental health problems were invited to participate in the Preschool Age Psychiatric Assessment. Results Rates of mental health problems were similar to the U.S. norms on the CBCL. The weighted prevalence of psychiatric disorders in these children was 8.8%, with 5.4% with emotional disorders and 1.4% with behavioral disorders. Co-morbidity occurred in nearly one fourth of the children with a psychiatric disorder and children who met diagnostic criteria had more functional impairment than those without. Of children who met criteria for a psychiatric disorder, 10% of parents were concerned about their child’s emotional or behavioral health. Conclusions This study provides prevalence rates of psychiatric disorders in young Romanian children, clinical characteristic of the children and families that can guide developing system of care. Cultural differences in parental report of emotional and behavioral problems warrant further examination. PMID:21866415

  3. Hospital Hints

    MedlinePLUS

    ... hospital. You will need: Bathrobe and slippers (put your name on each item); most hospitals provide special bed ... medicines , including prescription and over-the-counter drugs Your allergies Names and telephone numbers (home and business) to contact ...

  4. Norovirus - hospital

    MedlinePLUS

    ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ... to understand an outbreak, such as in a hospital setting. This test is done by collecting a ...

  5. Computer Consultation for Psychiatric Diagnosis

    PubMed Central

    Erdman, Harold P.; Jefferson, James W.; Greist, John H.; Olson, Warren; Klein, Marjorie H.; Salinger, Robert

    1980-01-01

    Psychiatric diagnosis has traditionally been unreliable. A new classification system (DSM-III) has been introduced, but its increased complexity places a greater burden on the clinician. We argue that computer diagnostic programs can be useful training and consultative tools, since computers can apply diagnostic logic consistently and demonstrate diagnostic principles in regard to a particular patient. A program that collects information from clinicians to make DSM-III diagnoses is described. It also performs several teaching functions, e.g. explaining branching logic during data collection, indicating criteria necessary to make any specific diagnosis, and indicating which were not met if the diagnosis was not made. Preliminary data are reported on agreement between computer and clinician diagnosis.

  6. Data mining in psychiatric research.

    PubMed

    Tovar, Diego; Cornejo, Eduardo; Xanthopoulos, Petros; Guarracino, Mario R; Pardalos, Panos M

    2012-01-01

    Mathematical sciences and computational methods have found new applications in fields like medicine over the last few decades. Modern data acquisition and data analysis protocols have been of great assistance to medical researchers and clinical scientists. Especially in psychiatry, technology and science have made new computational methods available to assist the development of predictive modeling and to identify diseases more accurately. Data mining (or knowledge discovery) aims to extract information from large datasets and solve challenging tasks, like patient assessment, early mental disease diagnosis, and drug efficacy assessment. Accurate and fast data analysis methods are very important, especially when dealing with severe psychiatric diseases like schizophrenia. In this paper, we focus on computational methods related to data analysis and more specifically to data mining. Then, we discuss some related research in the field of psychiatry. PMID:22231840

  7. Psychiatric Diagnoses as Contemporaneous Risk Factors for Suicide Attempts Among Adolescents and Young Adults: Developmental Changes

    PubMed Central

    Goldston, David B.; Daniel, Stephanie Sergent; Erkanli, Alaattin; Reboussin, Beth A.; Mayfield, Andrew; Frazier, Patricia H.; Treadway, Sarah L.

    2010-01-01

    The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12-19 years of age at hospitalization, repeatedly assessed for up to 13 years (n = 1,825 assessments). Semistructured psychiatric diagnostic instruments were administered at repeated assessments to assess psychiatric disorders and suicide attempts. After controlling for demographic variables and prehospitalization suicide attempts, most contemporaneous psychiatric disorders (major depressive disorder [MDD], dysthymic disorder, generalized anxiety disorder [GAD], panic disorder, attention-deficit/hyperactivity disorder [AD/HD], conduct disorder, and substance use disorder [SUD]) were related to increased risk of attempts. The relationship between suicide attempts and MDD, GAD, AD/HD, and SUD strengthened as participants got older. MDD, dysthymic disorder, GAD, and panic disorder were more commonly associated with repeat than 1st-time suicide attempts. In sum, most major psychiatric disorders are associated with increased risk for suicide attempts, but the strength of the relationships between these disorders and attempts changes over the course of development. PMID:19309187

  8. Validity and reliability study of the Turkish psychiatric nurses of job motivation scale.

    PubMed

    Engin, E; Cam, O

    2009-06-01

    This methodological study was planned to explore the validity and reliability of the evaluation scale for measuring the job motivation of nurses who work in psychiatric clinics. The sample was composed of 378 nurses who work in all psychiatric units or psychiatric hospitals located in Turkey's four large cities - Ankara, Istanbul, Izmir and Manisa. For testing reliability of 'job motivation scale', the internal consistency tests were executed with split scale analysis, Cronbach's alpha coefficient and item-total score correlation. For construct validity, factor analysis was used. For the first part of scale, Cronbach's alpha was determined to be 0.79. For the second part, Cronbach's alpha was 0.72. Factor analysis was performed in an attempt to establish validity and underlying associations between items in the scale. The first analysis produced nine eigenvalues (>1) and nine factors were extracted. The scree test indicated that a two-factor model would be suitable. The factor structure of the tool for measuring the job motivation of nurses who work in psychiatric clinics was parallel with motivation concepts. Validity and reliability levels of the scale for measuring the job motivation of nurses who work in psychiatric clinics were found to be sufficient in the Turkish population. PMID:19538603

  9. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...requirements for psychiatric residential treatment facilities. 483.354 Section 483...or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric...requirements for psychiatric residential treatment facilities. A psychiatric...

  10. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...requirements for psychiatric residential treatment facilities. 483.354 Section 483...or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric...requirements for psychiatric residential treatment facilities. A psychiatric...

  11. Dinosaur Day!

    ERIC Educational Resources Information Center

    Nakamura, Sandra; Baptiste, H. Prentice

    2006-01-01

    In this article, the authors describe how they capitalized on their first-grade students' love of dinosaurs by hosting a fun-filled Dinosaur Day in their classroom. On Dinosaur Day, students rotated through four dinosaur-related learning stations that integrated science content with art, language arts, math, and history in a fun and time-efficient…

  12. 34 CFR 300.11 - Day; business day; school day.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...Day; business day; school day. 300.11 ...DISABILITIES General Definitions Used in This Part ...Day; business day; school day. (a) Day ...that children are in attendance at school for instructional...

  13. The mortality of young offenders sentenced to prison and its association with psychiatric disorders: a register study

    Microsoft Academic Search

    Eila S. Sailas; Benjamin Feodoroff; Nina C. Lindberg; Matti E. Virkkunen; Reijo Sund; Kristian Wahlbeck

    2005-01-01

    Background: We studied the nationwide mortality in Finland of young offenders sentenced to prison, with the advantage of a long-term follow-up in an unselected population. In addition, we aimed to clarify the relationship between psychiatric disorders requiring hospital treatment and early death in young offenders sentenced to prison. Methods: All offenders sentenced to prison between 1984 and 2000 in Finland

  14. Specificity of psychiatric manifestations in relation to neurotoxic chemicals.

    PubMed

    Ross, W D; Sholiton, M C

    1983-01-01

    Previous impressions of specificity of psychiatric manifestations in relation to particular chemical intoxications have been confirmed by comparisons of the symptoms and signs of two groups of individuals. Nine persons exposed to inorganic mercury had "erethism" and xenophobia in addition to non-specific features of central nervous system poisoning. Twelve men with heavy exposure to organotins, in contrast to ten men with light or no exposure, more frequently presented an unique alternation between outbursts of range and deep depression, the later lasting from a few hours to a few days. The more heavily exposed men also had a greater number of nonspecific symptoms from neurotoxins. PMID:6575580

  15. Registration of aggressive incidents in an adolescent forensic psychiatric unit and implications for further practice.

    PubMed

    Tremmery, S; Danckaerts, M; Bruckers, L; Molenberghs, G; De Hert, M; Wampers, M; De Varé, J; de Decker, A

    2014-09-01

    Although aggression is part of daily life in psychiatric units for adolescents, empirical data on its prevalence are sparse. Only few studies have described prevalence of aggressive incidents in adolescent psychiatric wards, and data in forensic psychiatric care are even more limited. Available studies reported high prevalence rates of aggression, ranging from 0.4 to 2.4 incidents of aggression per day across (forensic) child and adolescent psychiatric units. Between 27 and 78 % of all admitted youth committed an aggressive act. In this study, we collected systematically registered data of all aggressive incidents from the first 2 years (2010-2012) on a newly established forensic adolescent psychiatric unit, which used a formal aggression management program embedded in the social competence model, which is based on early intervention in the 'chain of behavior' to prevent any further escalation. The inclusion of also minor aggressive incidents is unique in the literature and the clinical relevance is highlighted. A mean of one incident a day took place, with each adolescent involved in at least one incident. Notably, 1.7 aggressive incidents per month made seclusion of restraint use necessary. Based on the social competence theory, the aggression management model suggests intervening early in the cascade of aggression, in order to prevent further escalation and reduce the need for intrusive interventions. Evidence supported that aggression is a contextual event, as external factors clearly influence the incidence of aggression. Aggression management should be built on both relational and structural security. PMID:24682593

  16. Earth Day

    NSDL National Science Digital Library

    The State University of New York at Buffalo presents this History of Earth Day website. The goal of the site is that teachers and students can better understand the development and purpose of Earth Day. In addition to the history, SUNY-Buffalo has compiled a series of websites complete with projects associated with Earth Day, appropriate for children, high school students, and college undergrads. Furthermore, the legal aspect of Earth Day - environmental legislation, EPA standards, and Global Climate Change legislation - are also discussed on the site. A list of further sites is also provided if users want more information on this national effort to help solve environmental issues such as pollution, overpopulation, and global warming. Teachers will find this website both informative and helpful in developing appropriate teaching curricula connected to this holiday, while students can have fun learning and creating projects of their own that contribute to preserving the environment.

  17. Assessment of quality in psychiatric nursing documentation – a clinical audit

    PubMed Central

    2014-01-01

    Background Quality in nursing documentation facilitates continuity of care and patient safety. Lack of communication between healthcare providers is associated with errors and adverse events. Shortcomings are identified in nursing documentation in several clinical specialties, but very little is known about the quality of how nurses document in the field of psychiatry. Therefore, the aim of this study was to assess the quality of the written nursing documentation in a psychiatric hospital. Method A cross-sectional, retrospective patient record review was conducted using the N-Catch audit instrument. In 2011 the nursing documentation from 21 persons admitted to a psychiatric department from September to December 2010 was assessed. The N-Catch instrument was used to audit the record structure, admission notes, nursing care plans, progress and outcome reports, discharge notes and information about the patients’ personal details. The items of N-Catch were scored for quantity and/or quality (0–3 points). Results The item ‘quantity of progress and evaluation notes’ had the lowest score: in 86% of the records progress and outcome were evaluated only sporadically. The items ‘the patients’ personal details’ and ‘quantity of record structure’ had the highest scores: respectively 100% and 71% of the records achieved the highest score of these items. Conclusions Deficiencies in nursing documentation identified in other clinical specialties also apply to the clinical field of psychiatry. The quality of electronic written nursing documentation in psychiatric nursing needs improvements to ensure continuity and patient safety. This study shows the importance of the existence of a validated tool, readily available to assess local levels of nursing documentation quality. PMID:25349532

  18. Rorschach and TAT Responses of Negro, Mexican-American, and Anglo Psychiatric Patients

    Microsoft Academic Search

    Dale L. Johnson; Melvin P. Sikes

    1965-01-01

    The Rorschach and Thematic Apperception Projective Test responses of 75 Anglos, Negroes, and Mexican-American patients on the psychiatric unit of a Veterans Administration General Medical and Surgical Hospital were compared. The subjects were a random sample of non-psychotic male veterans whose ages, educational backgrounds and occupational levels were quite similar.A number of statistically significant differences were found between the groups,

  19. Predictors of shelter use among low-income families: psychiatric history, substance abuse, and victimization.

    PubMed Central

    Weitzman, B C; Knickman, J R; Shinn, M

    1992-01-01

    For poor housed and homeless families in New York City, NY, we examined the degree to which psychiatric and substance-abuse problems and victimization placed the families at elevated risk of requiring emergency housing, and we documented the prevalence of such problems. These problems were infrequently reported by both groups. However, past mental hospitalization, treatment in a detoxification center, childhood sexual abuse, and adult physical abuse were associated with increased risk of homelessness. PMID:1443308

  20. Factors Associated With Frequent Admissions to an Acute Geriatric Psychiatric Inpatient Unit

    Microsoft Academic Search

    Benjamin K. P. Woo; Shahrokh Golshan; Edward C. Allen; John W. Daly; Dilip V. Jeste; Daniel D. Sewell

    2006-01-01

    As a first step toward developing strategies to reduce the frequency of psychiatric hospitalizations, the authors retrospectively collected and analyzed demographic and clinical variables from 424 consecutive admissions to a university-based geriatric psychiatry inpatient unit over a 20-month period. The study sample was dichotomized into patients who were admitted more than one time (35.6%) versus those with a single admission.