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1

Evaluation of a psychiatric day hospital program for elderly patients with mood disorders  

Microsoft Academic Search

Background: Very little is known about the utility of psychiatric day hospitals for elderly adults with mood disorders. The objectives of this study were to evaluate a long-standing day-hospital program and to explore whether demographic and non-demographic patient characteristics were associated with treatment outcomes. Method: We used t-tests to compare retrospective admission and discharge data for 708 patients over a

Corey S. Mackenzie; Marsha Rosenberg; Melissa Major

2006-01-01

2

[Nursing work at a day hospital in João Pessoa-Paraíba from the perspective of the psychiatric reform].  

PubMed

This is the report of an investigation that was carried out in order to apprehend themes that explain nursing work at a day hospital in João Pessoa, State of Paraíba, in the perspective of the psychiatric reform. The authors used the referential of dialectical and historical materialism and work as an analytical category. The empirical material was analyzed through the technique of discourse analysis. The study revealed a coincident theme--to change the model of traditional psychiatric assistance--and, in this sense, the work of nursing incorporates, in addition to its formal, technically specialized quality, a political quality, thus indicating a new meaning to the nursing work process. PMID:16323602

Silva, Ana Tereza Medeiros C; Barros, Sônia

2005-09-01

3

[Treatment in psychiatric day hospital in comparison with inpatient wards in different European health care systems--objectives of EDEN project].  

PubMed

The paper presents the objectives and design of an ongoing multicenter randomized, controlled trial EDEN (European Day Hospital EvaluatioN). The EDEN-study aims to evaluate the efficacy of acute psychiatric treatment in a day hospital setting in five European centres: Dresden, London, Michalovce, Prague and Wroclaw. The main hypothesis is that day hospital treatment for acute psychiatric patients is as effective as conventional inpatient hospital care. The objectives of the study are to evaluate the viability and effectiveness of day hospitals for acute psychiatric treatment, to identify subgroups of patients with a more or less favourable outcome so that the treatment setting might be specifically applied and to ascertain the cost-effectiveness of day hospital treatment compared to conventional inpatient treatment. The study utilises a Randomised Controlled Trial (RCT) design with repeated measures at a maximum of six time points: at admission (t1), one week after admission (t2), four weeks after admission (t3), discharge (t4), three months after discharge (t5), and 12 months after discharge (t6). A combination of well-established standardised assessment instruments and open questions is used in 6 time periods. If the findings accept the main hypothesis of the study, some practical consequences could be inevitable: at a mental health policy level, these results could lead to an increase in the capacity of day hospitals; at the clinical level clinicians could redefine their concepts of care to consider the day hospital as an alternative to conventional inpatient treatment; from economic point of view could lead to reduction of treatment costs. PMID:12647460

Kiejna, Andrzej; Kallert, Thomas W; Rymaszewska, Joanna

2002-01-01

4

Antidepressant adherence after psychiatric hospitalization  

PubMed Central

Objective Depressed patients discharged from psychiatric hospitalizations face increased risks for adverse outcomes including suicide, yet antidepressant adherence rates during this high-risk period are unknown. Using Veterans Affairs (VA) data, we assessed antidepressant adherence and predictors of poor adherence among depressed veterans following psychiatric hospitalization. Method We identified VA patients nationwide with depressive disorders who had a psychiatric hospitalization between April 1, 1999 and September 30, 2003, received antidepressant medication, and had an outpatient appointment following discharge. We calculated medication possession ratios (MPRs), a measure of medication adherence, within three and six months following discharge. We assessed patient factors associated with having lower levels of adherence (MPRs <0.8) after discharge. Results 20,931 and 23,182 patients met criteria for three and six month MPRs. The mean three month MPR was 0.79 (s.d.=0.37). The mean six month MPR was 0.66 (s.d.=0.40). Patients with poorer adherence were male, younger, non-white, and had a substance abuse disorder, but were less likely to have PTSD or other anxiety disorders. Conclusion Poor antidepressant adherence is common among depressed patients after psychiatric hospitalization. Efforts to improve adherence at this time may be critical in improving the outcomes of these high-risk patients. PMID:19609666

Zivin, Kara; Ganoczy, Dara; Pfeiffer, Paul N.; Miller, Erin M.; Valenstein, Marcia

2010-01-01

5

Inpatient Suicide in a Chinese Psychiatric Hospital  

ERIC Educational Resources Information Center

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…

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

2008-01-01

6

Psychiatric Hospitalization after Deliberate Self-Poisoning  

ERIC Educational Resources Information Center

The decision for psychiatric hospitalization after deliberate self-poisoning (DSP) is not well understood. This study, a longitudinal cohort study of 3,148 consecutive DSP patients found 920 (29.2%) subjects were referred for psychiatric hospitalization, 576 (18.3%) on involuntary basis. A logistic regression analysis showed increased risk for:…

Carter, Gregory L.; Safranko, Ivan; Lewin, Terry J.; Whyte, Ian M.; Bryant, Jennifer L.

2006-01-01

7

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

Code of Federal Regulations, 2010 CFR

...from the 150 days (90 regular days plus 60 lifetime reserve days) which would otherwise be...the 90 benefit days, plus any remaining lifetime reserve days, subject to the 190 day lifetime limit on psychiatric hospital care,...

2010-10-01

8

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

Code of Federal Regulations, 2014 CFR

...Reduction of inpatient psychiatric benefit days available in the initial benefit period...Reduction of inpatient psychiatric benefit days available in the initial benefit period...inpatient in a psychiatric hospital on the first day of Medicare entitlement and for any...

2014-10-01

9

Comorbidity and Pattern of Substance Use in Hospitalized Psychiatric Patients  

PubMed Central

Background: Substance use in patients with psychiatric disorder is an every-day seen. Detection of this comorbidity can significantly affect the treatment of these disorders, as well as substance use. Objectives: This study has been conducted to determine the prevalence and pattern of substance use in hospitalized psychiatric patients. Patients and Methods: In this cross-sectional study, 210 hospitalized psychiatric patients were selected by simple randomization from all records of hospitalized patients. The instrument of gathering data was a demographic checklist including age, gender, marital status, education, type of disorder and substance abuse and duration of psychiatric disorder. Data were analyzed by SPSS version 16 using Fisher exact and Chi square tests. Results: The mean age of patients was 37.9 years. Most of the patients were male, married and unemployed. The Prevalence of substance use was 36.7%. The most prevalent pattern of substance use was opium, opioid, methamphetamines and other substances (poly substance). The prevalence of substance use in patients with mood disorders was more than the other disorders and the most prevalent substance use in these patients was opium and opioid. Poly substance use was the most prevalent pattern of use (80 %) in psychotic and mood disorders due to substance. Significant difference was seen between genders, marital status, occupation, duration of illness and frequency of substance use (P < 0.05 ), however no significant difference was seen between educational levels, age and substance use. Conclusions: The patients with mood disorders had the highest comorbidity with substance use and concurrent use of poly substance was the most prevalent pattern of use in these patients. Therefore, successful treatment of psychiatric disorders and substance use needs multimodal and more serious interventions. Regarding to the pattern of poly substance use in these patients, careful screening should be performed at admission. PMID:25389488

Sepehrmanesh, Zahra; Ahmadvand, Afshin; Moraveji, Alireza

2014-01-01

10

An Analysis of the Future Outlook of Hospitalized Psychiatric Patients  

ERIC Educational Resources Information Center

A schedule was developed for assessing the future outlook of hospitalized psychiatric patients and administered to samples of patients from two different hospitals. A factor analysis was done for each sample. (CK)

Gunn, Robert L.; Pearman, H. Egar

1970-01-01

11

Characteristics of violent behavior in a large state psychiatric hospital.  

PubMed

Violent behavior is a significant problem in psychiatric hospitals. The authors reviewed hospital incident reports to identify the characteristics of violent behavior in a large state psychiatric hospital. They found that a very small percentage of patients accounted for a majority of violent episodes, that rates of violent behavior varied among hospital units, that assaultive behavior was more common than self-harm in the long-term units, and that most commonly the assault victims were other patients. The data support earlier studies demonstrating that a small number of patients are responsible for a majority of violent episodes in a hospital setting. PMID:14762245

Kraus, John E; Sheitman, Brian B

2004-02-01

12

Improving Psychiatric Hospital Care for Pediatric Patients with Autism Spectrum Disorders and Intellectual Disabilities  

PubMed Central

Pediatric patients with autism spectrum disorders (ASD) and/or intellectual disabilities (ID) are at greater risk for psychiatric hospitalization compared to children with other disorders. However, general psychiatric hospital environments are not adapted for the unique learning styles, needs, and abilities of this population, and there are few specialized hospital-based psychiatric care programs in the United States. This paper compares patient outcomes from a specialized psychiatric hospital program developed for pediatric patients with an ASD and/or ID to prior outcomes of this patient population in a general psychiatric program at a children's hospital. Record review data indicate improved outcomes for patients in the specialized program of reduced recidivism rates (12% versus 33%) and decreased average lengths of inpatient stay (as short as 26 days versus 45 days). Available data from a subset of patients (n = 43) in the specialized program showed a decrease in irritability and hyperactivity behaviors from admission to discharge and that 35 previously undetected ASD diagnoses were made. Results from this preliminary study support specialized psychiatric care practices with this population to positively impact their health care outcomes. PMID:22934179

Gabriels, Robin L.; Agnew, John A.; Beresford, Carol; Morrow, Mary Ann; Mesibov, Gary; Wamboldt, Marianne

2012-01-01

13

Psychiatric Nurse Reports on the Quality of Psychiatric Care in General Hospitals  

PubMed Central

Although acute inpatient psychiatric care has changed dramatically over the past 2 decades, little is known about how these changes have affected the quality of care, psychiatric nurse staffing, or patient outcomes. The purpose of this report is to explore the quality of care, quality of the practice environment, and adverse events as assessed by psychiatric nurses in the general hospital setting. The study sample consisted of 456 registered nurses permanently assigned to psychiatric units, compared with a larger sample of 11 071 registered nurses who work permanently on medical, surgical, or medical-surgical units. Compared with nonpsychiatric nurses, psychiatric nurse characteristics reveal an older, more experienced workforce, with a higher proportion of male nurses. Nurses rated quality of patient care lower in the psychiatric specialty than in the medical-surgical specialty. Furthermore, psychiatric nurses reported significant concern about the readiness of patients for discharge and higher incidence of adverse events. They also experienced more verbal abuse, physical injuries, and complaints from patients and families. Collectively, the results from this study underscore the organizational problems and quality-of-care issues that cause psychiatric nurses in general hospital settings to evaluate their work environments negatively. PMID:18641503

Aiken, Linda H.

2008-01-01

14

Prevalence and Correlates of Autism in a State Psychiatric Hospital  

ERIC Educational Resources Information Center

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…

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

2012-01-01

15

[Changes in the provision of psychiatric services at a psychiatric district hospital].  

PubMed

Changes in the provision of psychiatric services within the last decennials are probably best understood if the impact of national socialism on clinical psychiatry is regarded. Many psychiatrists took part in the "Aktion T4" the organised killing of their patients, at least they did not resist campaigns directed to killing or sterilisation patients. After WW II, a period of silence and acceptance of inhuman circumstances in the large mental state hospitals appeared, when in the sixties a new generation of psychiatrists was no longer willing to continue the traditional system of mental health care delivery. The Expert Commission on Mental Health Care reported a comprehensive agenda on reformation of service delivery in 1975, which was influential in the development of alternative structures of psychiatric services. Most mental state hospitals reduced their capacities and parallel to this process smaller units, devoted to principles of community psychiatry, associated to general hospitals were created. Overall, the number of hospital driven beds decreased at about 33 %, but in the large hospitals at two thirds within the last 25 years in Baden-Wurttemberg. This process of deinstitutionalization was accompanied by the development of structures for community care, internal reorganization and modernization, and important steps in budget development, which lead to better treatment opportunities for all kinds of psychiatric institutions. The concrete and historical reality of these circumstances and changes, and possible future directions are exemplified for the psychiatric hospital in Weinsberg. PMID:15586320

Schaub, Rainer

2004-11-01

16

Sociodemographic and clinical characteristics of psychiatric re-hospitalizations.  

PubMed

Segregated individuals with mental disorders, families without support or guidance concerning disease and treatment, and unprepared professionals are some of the factors that can contribute to re-hospitalizations. This study identifies sociodemographic variables, clinical conditions, diagnoses and treatments in order to identify their relationship with psychiatric re-hospitalizations. This is an exploratory and descriptive study. A form was used to search data in patients' files from 2006 and 2007 in a regional psychiatric facility. A total of 681 re-hospitalizations were identified, the majority due to treatment abandonment. Length of hospitalization was higher for women between 40 and 49 years of age. Positive associations of sociodemographic data with previous hospitalizations were found, such as type of discharge, and physical and mental condition, which is in accordance with the literature. Readmissions are associated with sociodemographic and clinical indicators. These findings can guide care and public policies regarding mental health. PMID:20922329

de Castro, Sueli Aparecida; Furegato, Antonia Regina Ferreira; Santos, Jair Licio Ferreira

2010-01-01

17

Characteristics of psychiatric discharges from nonfederal, short-term specialty hospitals and general hospitals with and without psychiatric and chemical dependency units: the Hospital Discharge Survey data.  

PubMed Central

Hospitalization for mental disorders (Major Diagnostic Categories 19 and 20) was examined using the 1980 Hospital Discharge Survey (HDS) data. We added to the HDS data by noting whether each hospital had a specialized psychiatric and/or chemical dependency unit, especially noting short-term specialty psychiatric and chemical dependency hospitals. Of the approximately 1.7 million episodes with MDC-19 and -20 diagnoses in the nation's nonfederal short-term hospitals in 1980, 13.5 percent were in specialty hospitals. Of the remaining general hospital episodes: 31 percent occurred in hospitals with only psychiatric units, 5 percent in hospitals with only chemical dependency units, 31 percent in hospitals with both types of specialized treatment units, and 33 percent in hospitals with neither type of unit. The last figure is much less than previously thought. The five hospital types may be arrayed on a continuum of resource utilization and severity of cases treated, with general hospitals with no special units at one end, specialty hospitals at the other, and general hospitals with psychiatric or chemical dependency units intermediate. Presence or absence of a chemical dependency unit influences a hospital's profile in this regard, particularly for MDC-20. Future studies should take into account the presence of a chemical dependency unit. PMID:1846844

Kiesler, C A; Sibulkin, A E; Morton, T L; Simpkins, C G

1991-01-01

18

Case-based reimbursement for psychiatric hospital care.  

PubMed

A fixed-prepayment system (case-based reimbursement) for patients initially requiring hospital-level care was evaluated for one year through an arrangement between a private nonprofit psychiatric hospital and a self-insured company desiring to provide psychiatric services to its employees. This clinical and financial experiment offered a means of containing costs while monitoring quality of care. A two-group, case-control study was undertaken of treatment outcomes at discharge, patient satisfaction with hospital care, and service use and costs during the program's first year. Compared with costs for patients in the control group, costs for those in the program were lower per patient and per admission; cumulative costs for patients requiring rehospitalization were also lower. However, costs for outpatient services for patients in the program were not calculated. Treatment outcomes and patients' satisfaction with hospital care were comparable for the two groups. PMID:1490713

Sederer, L I; Eisen, S V; Dill, D; Grob, M C; Gougeon, M L; Mirin, S M

1992-11-01

19

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

Microsoft Academic Search

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

Naoki Hayashi; Miyabi Igarashi; Atsushi Imai; Yuka Osawa; Kaori Utsumi; Yoichi Ishikawa; Taro Tokunaga; Kayo Ishimoto; Hirohiko Harima; Yoshitaka Tatebayashi; Naoki Kumagai; Makoto Nozu; Hidetoki Ishii; Yuji Okazaki

2010-01-01

20

Deconstructing the language of psychiatric hospitalization.  

PubMed

The purpose of this study was to deconstruct the language of psychiatric nurses' documentation and charting. Employing concepts developed by post-modern theorists, everyday professional activities can be examined in unique ways that uncover how they conceal or skew rather than reveal and illumine patient conditions. The study design and sample was exploratory; content analysis with first and second level analyses. Nine major categories of charting entry were found. Deconstruction of the language and discourse of nursing through a Foucaultian lens goes beyond what is manifest to what is not said. Professional assumptions about patients and the social construction of patients and patient problems are exposed. PMID:10320487

Mohr, W K

1999-05-01

21

Children in Foster Care: Before, during, and after Psychiatric Hospitalization  

ERIC Educational Resources Information Center

Although it is generally accepted that foster children are at greater risk for mental health problems than are children in the general population, very little is known about the smaller group of foster children admitted to psychiatric hospitals. The present study sought to determine whether foster children admitted to inpatient care are a distinct…

Persi, Joe; Sisson, Megan

2008-01-01

22

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

PubMed

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

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

23

Architectural guidelines for state psychiatric hospitals.  

PubMed

Mental patients are a population who have special needs for which architectural interventions can be helpful. The physical settings in state hospitals often do not provide the proper environment for therapeutic progress, nor do they contribute to the implementation of new programs for care. The author presents seven guidelines related to specific elements of the physical setting, such as space differentiation, color, texture, and lighting, that administrators and staff can use in analyzing existing hospital settings and in discussing designs for renovations or new construction with architects. The application of such guidelines should help establish architecture as a valuable tool in the therapeutic process. PMID:1885179

Gulak, M B

1991-07-01

24

42 CFR 482.60 - Special provisions applying to psychiatric hospitals.  

Code of Federal Regulations, 2010 CFR

...provisions applying to psychiatric hospitals. 482.60 Section 482...MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...CONDITIONS OF PARTICIPATION FOR HOSPITALS Requirements for Specialty Hospitals § 482.60 Special...

2010-10-01

25

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

PubMed Central

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

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

2014-01-01

26

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

PubMed

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

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

1975-11-01

27

ASPECTS OF PSYCHIATRIC MORBIDITY IN THE OUT PATIENT POPULATION OF A GENERAL HOSPITAL IN SRI LANKA  

PubMed Central

SUMMARY A psychiatric morbidity study of a general hospital outpatient department population in Sri Lanka was done. A two stage sampling method was used. Questions which differentiated the psychiatrically morbid group were identified. The disease pattern was compared and contrasted with that presenting at psychiatric facilities in the area. Neurotic illness, the commonest being hypochondriasis was found to predominate in the general outpatient psychiatrically ill population in contrast to the population at in and out patient psychiatric facilities where schizophrenia was the major diagnostic category. PMID:22058542

Nikapota, A. D.; Patrick, V.; Fernando, L. H. S.

1981-01-01

28

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

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

2013-01-01

29

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

PubMed Central

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

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

30

Daily weather variables and affective disorder admissions to psychiatric hospitals  

NASA Astrophysics Data System (ADS)

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.

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

2014-12-01

31

Smoking bans in secure psychiatric hospitals and prisons.  

PubMed

The proposal of complete smoking bans in closed institutions, such as prisons and psychiatric hospitals, creates a tension between individual "rights" and the health of all members of that community. Smokers in closed institutions generally smoke more, suffer more health consequences and are less likely to quit than smokers in other settings. Complete smoking bans do not cause an increase in behavioural problems, nor do bans cause worsening of mental illness or quality of life. Although infrequently tested, the responsibility of public institutions to protect others from second-hand smoke has usually outweighed any individual "right to smoke" in legal judgments. A substantial cultural shift may be required from considering smoking a "rare pleasure" during detention to the realisation that smoking is the most significant reversible health risk factor for this population. The implementation of complete smoking bans in closed institutions is challenging and requires careful and proactive planning by staff. As complete smoking bans are being considered in many institutions and jurisdictions, this column presents a review of the evidence base and ethical issues involved. PMID:25341317

Sullivan, Danny H; Rees, Megan A

2014-09-01

32

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

ERIC Educational Resources Information Center

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…

Simon, Joan B.; Savina, Elena A.

2010-01-01

33

Psychiatric hospital treatment of children with autism and serious behavioral disturbance.  

PubMed

Children with autism spectrum disorder are psychiatrically hospitalized much more frequently than children in the general population. Hospitalization occurs primarily because of externalizing behaviors and is associated with behavioral disturbance, impaired emotion regulation, and psychiatric comorbidity. Additionally, a lack of practitioner and/or administrator training and experience with this population poses risks for denial of care by third-party payers or treatment facilities, inadequate treatment, extended lengths of stay, and poor outcomes. Evidence and best practices for the inpatient psychiatric care of this population are presented. Specialized treatment programs universally rely on multidisciplinary approaches, including behaviorally informed interventions. PMID:24231172

Siegel, Matthew; Gabriels, Robin L

2014-01-01

34

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

PubMed

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

Karlin, Bradley E; Zeiss, Robert A

2006-10-01

35

Adult General Psychiatric Patients Served in Nebraska's State Hospitals: Patient Characteristics and Needs.  

PubMed

This study identified the characteristics and needs of adults discharged from state psychiatric hospitals. A retrospective analysis of data on patients discharged from adult psychiatric units of three state psychiatric hospitals in Nebraska 2005-2008 was conducted. Diagnoses were classified into six groups, and Axis III data from the state psychiatric hospitals provided information about medical comorbidity. Only 12 % of admitted patients had private insurance or could pay for their own treatment. Almost all discharged patients (95 %) had a diagnosis of serious mental illness, and substance abuse (68 %) and personality disorder (68 %) were common, as were significant general health problems. Fourteen percent of patients used emergency services five or more times during the study period. Greater efforts must be made to diagnose, treat, and monitor major somatic illnesses and to better understand the factors that contribute to readmission and emergency service use in this population. PMID:24691573

Watanabe-Galloway, Shinobu; Watkins, Kate; Ryan, Steve; Harvey, Jim; Shaffer, Blaine

2015-02-01

36

The Use of Movies to Facilitate Family Engagement in Psychiatric Hospitalization  

ERIC Educational Resources Information Center

Studies indicate that the impact of family involvement may be the most important predictor of successful psychiatric hospitalization of adolescents. Yet the ability to engage both an adolescent and his or her family in family therapy in the context of what is often an involuntary hospitalization is a major challenge. A number of promising…

Garrison, David

2007-01-01

37

[Planning a day rehabilitation center at a psychiatric therapy departmental center].  

PubMed

The paper examines a ten-year project regarding chronic mental illness. The subject of rehabilitation is also discussed in the light of different theoretical models recently put forward in psychiatric literature. Lastly, the Authors illustrate their project for a Day Centre for psychiatric rehabilitation which would enable a fuller integration of pharmacological, psychological and social factors, thus representing a step forward in the care of mentally ill patients. PMID:2056892

Dosio, I; Gallino, G; Liffredo, F

1991-01-01

38

How to evacuate a psychiatric hospital: a Hurricane Katrina success story.  

PubMed

This article describes the successful evacuation of an entire psychiatric hospital from New Orleans, Louisiana, to Memphis, Tennessee, on a weekend night. The destination site was 400 miles away and buses were used for transport. The evacuation occurred shortly before Hurricane Katrina struck New Orleans and included 73 adult, adolescent, and child acute psychiatric patients. Thirty-five staff members also participated in the evacuation with their families and pets. This report is significant because little is known about how to implement a disaster plan that involves the transport of an entire psychiatric hospital-patients, nurses, physicians, staff, and family members--to another city. The knowledge gained can also benefit psychiatric nurses and their organizations when establishing or modifying their disaster plans. PMID:18251350

Thomas, Joan; Lackey, Nancy

2008-01-01

39

The impact of a geriatric assessment unit on a psychiatric consultation service in a general hospital.  

PubMed

The opening of a geriatric assessment unit (GAU) in a large general hospital has affected the number of elderly patients referred for psychiatric consultation, the type of psychopathology seen, and the training provided for psychiatric residents and interns on the consultation-liaison service. To examine these changes, the six months prior to the opening of the GAU are compared to the six months immediately following its opening. The number of patients age 65 or older referred and diagnoses made by the consulting psychiatrists were studied. The opening of the GAU significantly increased the number of elderly patients referred for psychiatric consultation. It was found that the GAU offered unique advantages in the assessment and treatment of elderly patients with certain psychiatric problems, and the advantages and limitations of different facilities within the general hospital for the psychiatric assessment and treatment of elderly patients are discussed. A case is presented which illustrates the interplay between the consultation-liaison psychiatrist and the geriatric service in the management of an elderly patient referred for consultation. The experience of this hospital in providing psychogeriatric training for residents and interns on the psychiatric consultation service is reviewed. PMID:10279533

Swenson, J R; Perez, E L

1986-01-01

40

Prospective study of psychiatric follow-up default and medication compliance after discharge at a psychiatric hospital in Nigeria.  

PubMed

We report a prospective follow-up of 81 patients recently discharged from the hospital. Their hospital attendance pattern, medication compliance, mental state and social functioning were measured. Defaulters were followed up in the community. At 3 months, 49.4% had defaulted, while 51.5% were medication noncompliant. Clinical outcome was best for the Non-Defaulter-Medication Compliant (ND-MC) group, worst for the Defaulter-Medication Non-Compliant (D-MNC) group. Reasons for default include feeling well, financial difficulty, medication side effects and stigma. Medication non-compliant patients were more likely to reside more than 20 km away from hospital. There is an urgent need to provide community psychiatric services to improve patients' access to services and medication compliance. PMID:18633705

Adeponle, A B; Baduku, A S; Adelekan, M L; Suleiman, G T; Adeyemi, S O

2009-02-01

41

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

PubMed Central

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

Ali, Akleema; Maharajh, Hari D.

2003-01-01

42

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

PubMed

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

Ali, Akleema; Maharajh, Hari D

2003-01-01

43

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

PubMed Central

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

2014-01-01

44

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

ERIC Educational Resources Information Center

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…

Linhorst, Donald M.; Scott, Lisa Parker

2004-01-01

45

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

ERIC Educational Resources Information Center

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…

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

2004-01-01

46

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

ERIC Educational Resources Information Center

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…

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

2005-01-01

47

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

ERIC Educational Resources Information Center

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…

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

2009-01-01

48

Money madness. Are private psychiatric hospitals resorting to kidnapping in their quest for paying patients?  

PubMed

In their zeal for lucrative insurance reimbursement, some private psychiatric hospitals seem to have gone over the edge themselves. A number of these institutions, critics charge, use outright coercion to commit and retain patients. Now some formerly abducted "recruits" are fighting back with lawsuits. PMID:10115962

Cowley, G; Carroll, G; Katel, P; Gordon, J; Edelson, J; Springen, K; Hager, M

1991-11-01

49

Comorbidity and Service Utilization Among Psychiatrically Hospitalized Adolescents with Posttraumatic Stress Disorder  

Microsoft Academic Search

Trauma exposure and posttraumatic stress disorder (PTSD) symptoms in youth have been associated with both internalizing and externalizing disorders. This study examined the prevalence of PTSD and comorbid disorders in a sample of 377 psychiatrically hospitalized adolescents. Adolescents diagnosed with PTSD had higher rates of comorbid major depressive disorder and conduct disorder as compared to adolescents without PTSD. In addition,

Maureen A. Allwood; Jennifer Dyl; Jeffrey I. Hunt; Anthony Spirito

2008-01-01

50

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

ERIC Educational Resources Information Center

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…

Kamis-Gould, Edna; And Others

1991-01-01

51

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

ERIC Educational Resources Information Center

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…

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

2006-01-01

52

Benzodiazepines — a necessary evil? A survey of prescribing at a specialist UK psychiatric hospital  

Microsoft Academic Search

Guidelines on the prescription of benzodiazepines recommend their use be limited to the short-term relief of severe anxiety or insomnia. However, clinical experience suggests that in psychiatry these drugs may be being prescribed more widely. The aim of this survey was to investigate benzodiazepine prescribing in a specialist UK psychiatric hospital using a structured interview with consultant psychiatrists. Prescribers were

Camilla Haw; Jean Stubbs

2007-01-01

53

Reducing Maladaptive Family Interaction by Involving Significant Others of Hospitalized Psychiatric Patients.  

ERIC Educational Resources Information Center

The program was set up to involve, on a continuing basis, the significant other of frequently-readmitted hospitalized psychiatric VA patients. The couples identified their characteristic strengths, and their maladaptive ways of functioning, and were expected to make use of alternative ways of behaving which were recommended by the staff. A…

Mabel, Sanford

54

The psychiatric screening clinic at a VA hospital: making it work.  

PubMed

A psychiatric crisis and screening clinic in a general medical and surgical hospital has expanded psychiatric treatment available to general medical patients and has eliminated overcrowding on the psychiatry service. The authors describe admissions procedures and problems that existed before the clinic was developed and ways clinic staff found to deal with the bureaucracy, which include promoting personal responsibility for patient care. The clinic has met its initial goal of decreasing the amount of time patients have to wait for their first contact with professional staff. Feedback from wards indicates that staff have been successful in making appropriate dispositions. PMID:649071

Sherman, J M; Stark, A L; Richman, B W

1978-06-01

55

Sexual Behavior of Psychiatric Inpatients: Hospital Responses and Policy Formulation  

Microsoft Academic Search

Historically, inpatient sexuality has been aneglected issue in hospital policy. Recent studies haveconfirmed sexual activity among individuals with mentalillness and have noted several areas of concern surrounding patient care and sexuality. Wesurveyed private mental health facilities within thestate of Ohio. Twenty-five percent of the respondinghospitals had a formal sexual policy and the majority (72%) said that sexual behavior was aninfrequent

Peter F. Buckley; Ilse R. Wiechers

1999-01-01

56

Maternal versus Paternal Suicide and Offspring Risk of Hospitalization for Psychiatric Disorders and Suicide Attempt  

PubMed Central

Objective We examined whether the risk for psychiatric morbidity requiring inpatient care was higher in offspring who experienced parental suicide compared to offspring who experienced parental fatal accidents, and if the association varied by the deceased parent’s gender. Subjects and Methods Children and adolescents (age 0-17 years) who experienced maternal (n=5,600) or paternal suicide (n=17,847) during 1973-2003 in Sweden were identified using national, longitudinal population-based registries. Cox regression modeling was used to compare psychiatric hospitalization risks among offspring of suicide decedents with propensity-matched offspring of accident decedents. Results Offspring of maternal suicide decedents had increased risk of hospitalization for suicide attempt after controlling for psychiatric hospitalization in decedents and surviving parents, compared to offspring of maternal accidental decedents. Offspring of paternal suicide decedents had similar risk of hospitalization for suicide attempt compared to offspring of accident decedents but had increased risk of hospitalization for depressive and anxiety disorders. The magnitude of risks for offspring hospitalization for suicide attempt was greater for those who experienced maternal versus paternal suicide, as compared to their respective controls (interaction p=0.05) [AHR (95%CI) = 1.80 (1.19-2.74) in offspring of maternal decedents vs. 1.14 (0.96-1.35) in offspring of paternal decedents]. Conclusions Maternal suicide is associated with increased risk of hospitalization for suicide attempt in offspring, beyond the risk associated with maternal accidental death. However, paternal suicide is not associated with hospitalization for suicide attempt. Future studies should examine factors that might differ between offspring who experience maternal versus paternal suicide, including genetic or early environmental determinants. PMID:20956422

Kuramoto, S. Janet; Stuart, Elizabeth A.; Runeson, Bo; Lichtenstein, Paul; Långström, Niklas; Wilcox, Holly C.

2013-01-01

57

Outpatient psychotherapy practice with adolescents following psychiatric hospitalization for suicide ideation or a suicide attempt.  

PubMed

Outpatient treatment is standard care for adolescents discharged following a psychiatric hospitalization. There is little research, however, on the amount and types of psychotherapy these clients receive in the community. We examined therapy attendance and therapist report of outpatient therapy practice with adolescents discharged from psychiatric hospitalization following either a suicide attempt or severe suicidal ideation in the Northeastern USA. Therapists (n = 84) completed a packet of self-report questionnaires regarding treatment of these adolescents in the first six months after discharge from the hospital. Information on number of sessions attended, primary presenting problem, therapist orientation, therapy techniques, and therapeutic relationship was collected. The findings indicated that therapists met their clients in both private and community outpatient settings. The most common modality of treatment was individual therapy, but almost all types of therapeutic techniques were endorsed. Adolescents attended an average of 8.1 therapy sessions (SD = 4.7), with 18% terminating treatment against therapist advice within the first three months. Psychologists, psychiatrists, and social workers used cognitive-behavioral, psychodynamic, and family system techniques about equally. Social workers used humanistic techniques more than their counterparts. The variability in number of therapy sessions attended suggests that many adolescents discharged after a psychiatric hospitalization will not receive adequate care. Short-term therapy protocols designed for community practice emphasizing cognitive techniques may be useful to test in future community-based research trials based on the high percentage of adolescents attending relatively few sessions. PMID:20404070

Spirito, Anthony; Simon, Valerie; Cancilliere, Mary Kathryn; Stein, Rachel; Norcott, Candace; Loranger, Katherine; Prinstein, Mitchell J

2011-01-01

58

Prevalence of Cigarette Smoking in Schizophrenic Patients Compared to Other Hospital Admitted Psychiatric Patients  

PubMed Central

Background: This study aimed to estimate the prevalence of cigarette smoking and some of the related factors among schizophrenic and other hospitalized psychiatric patients. Methods: This was a cross-sectional study on 120 patients hospitalized in Shahid Beheshti hospital in Kerman in 2005. Patients were equally devided in two groups of schizophrenia and other psychiatric disorders. Sampling was based on statistical census and data were collected using a questionnaire including 27 questions on demographic data, psychiatric disorder, smoking cigarettes and other substances, and Fagerstrom test. Data were analyzed by Chi-square and ANOVA tests using SPSS software. Findings: Prevalence and severity of cigarette smoking was 71.6% and 6.47% among schizophrenic and 51.6% and 6.40% among other psychiatric patients, respectively and the difference was not significant. History of withdrawal was 25.6% and 58.1% in the schizophrenia and other disorders respectively and the difference was significant (P?psychiatric patients is higher than normal population, but there is no significant difference between these two groups. Schizophrenic patients need persistent supportive and supervising programs for cigarette smoking abuse treatment because of their cognitive, motivate and social problems. PMID:24494081

Ziaaddini, Hassan; Kheradmand, Ali; Vahabi, Mostafa

2009-01-01

59

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

Microsoft Academic Search

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

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

2011-01-01

60

Working with families on an inpatient psychiatric unit for children: Hospital staff members are family therapists, too  

Microsoft Academic Search

Inpatient psychiatric units for children can be potent agents for family change. The activities of nursing, education, and activity therapy staff are an important addition to a program of formal family therapy in psychiatric hospitals. These modalities must be organized into a family framework so that insights and achievements from one arena may be generalized to another.

Paul A. Mansheim

1989-01-01

61

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

PubMed Central

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

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

62

[Discharge dynamics and related factors of newly-admitted patients in psychiatric hospitals].  

PubMed

The focus of psychiatric services in Japan is being shifted from hospitalization to community care, and the Ministry of Health, Labour and Welfare aims for the prompt discharge of newly-admitted patients. Correspondingly, it set a goal to lower the "mean residual rate (MRR)", which indicates the discharge dynamics of newly-admitted patients, to 24%. As a measure to achieve this goal, the present situation should be investigated in each homogeneous patient group. In this study, we conducted a survey of newly-admitted patients to investigate discharge dynamics and related factors by the diagnosis and type of hospitalization. Out of 1,459 psychiatric hospitals to which we sent questionnaires, 183 (12.5%) replied. Each hospital completed questionnaires regarding a maximum of 5 patients for each type of hospitalization (voluntary hospitalization [VH], hospitalization for medical care and protection [HMCP], and involuntary hospitalization ordered by the prefectural governor [IHOPG]) between October 2005 and January 2006. We weighted the obtained patient data in proportion to the estimated total number of patients, and analyzed valid data on 1,784 patients. The MRR for the whole sample was 29.4%. By diagnosis, dementia showed the highest MRR (45.6%), followed by schizophrenia (34.9%); depression, bipolar disorder, and alcoholism showed the lowest MRRs (20-21%). We calculated MRRs by the type of hospitalization for dementia and the other diagnoses separately, considering confounding effect between the diagnosis and type of hospitalization (markedly high proportion of HMCP observed in dementia). In dementia, HMCP showed a higher MRR (46.8%) than VH (43.7%). In the other diagnoses, IHOPG showed the highest MRR (43.7%), followed by HMCP (34.5%) and VH (25.6%). Dementia differed from the other diagnoses in the distribution of residential settings before admission, with a higher proportion of residential care facilities (25.5%) and hospitalization in other departments (19.3%). In dementia, the residential setting after discharge showed a similar distribution, and death was also frequent (6.6%). Multivariate analyses revealed that a long stay (one year or longer) was significantly associated with a residential setting before admission, the type of ward at admission, a founder (a private hospital or public/university hospital), and symptom severity at admission in schizophrenia; and with the type of ward at admission and hospital founder in dementia. In schizophrenia, the risk of a long stay was higher on hospitalization in other psychiatric hospitals (odds ratio [OR] : 28) and other departments (OR: 18), and living alone (OR: 2.1) than in living with the family by residential setting. The risk was also higher in psychiatric long-term care wards than in general psychiatric wards by the type of ward (OR: 3.0), and in private hospitals than in public/university hospitals by hospital founder (OR: 3.0). Additionally, the higher risk was associated with higher symptom severity assessed using a 6-point scale (OR: 1.3 per point). In dementia, the risk was higher in senile dementia wards than in general psychiatric wards by the type of ward (OR: 2.9), and in private hospitals than in public/university hospitals by hospital founder (OR: 6.8). The most frequently reported direct causes of a long stay were problems regarding a family's acceptance (51.5%), poor improvement of symptoms (48.8%), and poor recovery of daily living abilities (44.0%). In dementia, physical diseases (20.8%) and undecidedness of residence after discharge (29.2%) were also frequent. Considering the elapsed time after survey, the low response rate, and the data analyses with sampling bias adjustment, the results should be interpreted carefully. Nevertheless, the discharge dynamics and related factors in newly-admitted patients varied with the diagnosis and type of hospitalization. Particularly, schizophrenia and dementia, as well as IHOPG and HMCP, showed high MRRs and frequent long stays. Additionally, a long stay was related to patients' demographic and social c

Kono, Toshiaki; Shiraishi, Hiromi; Tachimori, Hisateru; Koyamas, Asuka; Naganuma, Yoichi; Takeshima, Tadashi

2012-01-01

63

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

PubMed Central

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

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

2014-01-01

64

Prediction of restraints among youth in a psychiatric hospital: Application of translational action research  

PubMed Central

This study extends a translational action research program by applying a theoretically based measure of risk in predicting incidents of restraint among children and adolescents in a secure psychiatric hospital. Youth inpatients (N=149, ages 5-17) were assessed at intake for the presence of selected individual and contextual risk factors, and their involvement in critical incidents was tracked (i.e., number of episodes in which restraint was applied) for the remainder of their hospitalization. Models including history of aggression or history of previous placements as well as a combined model including several individual and contextual factors significantly predicted the likelihood of a youth becoming involved in at least one restraint. Unique predictors of restraint involvement included history of aggression against adults and history of previous psychiatric hospitalizations. None of the variables assessed predicted the extent of a youth’s restraint involvement. The implications of these findings are discussed with respect to future research and empirically informed practice with high-risk youth. PMID:21254060

Tompsett, Carolyn J.; Domoff, Sarah; Boxer, Paul

2011-01-01

65

A Qualitative Analysis Exploring Explanatory Models of Aggression and Violence in a Small Cohort of Rural Psychiatrically Hospitalized Adolescents, Their Parents, and Selected Hospital Staff  

ERIC Educational Resources Information Center

The purpose of this study was to examine the etiology and cultural underpinnings of adolescent violence as collective case study analysis of three inter-related groups: psychiatrically hospitalized rural adolescents, their parent/guardian, and various hospital staff. Violence among adolescents is a serious societal issue that has had varying…

Johnson, Daniel C.

2010-01-01

66

Objective and subjective evaluation of a redesigned corridor environment in a psychiatric hospital.  

PubMed

This study examined the impact of redesigning a corridor space within a psychiatric hospital on the behaviour of patients with dementia. In addition, patient and staff perceptions of the redesigned corridor were assessed. Data were collected through an observational tool (behavioural mapping) and a specifically design questionnaire. The findings suggest a positive impact of the redesigned corridor on patient behaviour and that patients and staff perceived the change to the environment differentially. These results are discussed in relation to theoretical explanations of the importance of the health care environment and design for dementia. PMID:20394476

Edgerton, Edward; Ritchie, Louise; McKechnie, Jim

2010-05-01

67

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

PubMed Central

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

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

2015-01-01

68

The medication process in a psychiatric hospital: are errors a potential threat to patient safety?  

PubMed Central

Purpose To investigate the frequency, type, and potential severity of errors in several stages of the medication process in an inpatient psychiatric setting. Methods A cross-sectional study using three methods for detecting errors: (1) direct observation; (2) unannounced control visits in the wards collecting dispensed drugs; and (3) chart reviews. All errors, except errors in discharge summaries, were assessed for potential consequences by two clinical pharmacologists. Setting Three psychiatric wards with adult patients at Aalborg University Hospital, Denmark, from January 2010–April 2010. The observational unit The individual handling of medication (prescribing, dispensing, and administering). Results In total, 189 errors were detected in 1,082 opportunities for error (17%) of which 84/998 (8%) were assessed as potentially harmful. The frequency of errors was: prescribing, 10/189 (5%); dispensing, 18/189 (10%); administration, 142/189 (75%); and discharge summaries, 19/189 (10%). The most common errors were omission of pro re nata dosing regime in computerized physician order entry, omission of dose, lack of identity control, and omission of drug. Conclusion Errors throughout the medication process are common in psychiatric wards to an extent which resembles error rates in somatic care. Despite a substantial proportion of errors with potential to harm patients, very few errors were considered potentially fatal. Medical staff needs greater awareness of medication safety and guidelines related to the medication process. Many errors in this study might potentially be prevented by nursing staff when handling medication and observing patients for effect and side effects of medication. The nurses’ role in psychiatric medication safety should be further explored as nurses appear to be in the unique position to intercept errors before they reach the patient. PMID:24049464

Soerensen, Ann Lykkegaard; Lisby, Marianne; Nielsen, Lars Peter; Poulsen, Birgitte Klindt; Mainz, Jan

2013-01-01

69

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

Code of Federal Regulations, 2012 CFR

...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...

2012-10-01

70

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

Code of Federal Regulations, 2010 CFR

...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...

2010-10-01

71

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

Code of Federal Regulations, 2011 CFR

...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...

2011-10-01

72

42 CFR 409.62 - Lifetime maximum on inpatient psychiatric care.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 2010-10-01 false Lifetime maximum on inpatient psychiatric care...Hospital Insurance Benefits § 409.62 Lifetime maximum on inpatient psychiatric care. There is a lifetime maximum of 190 days on inpatient...

2010-10-01

73

Discharged from a mental health admission ward: is it safe to go home? A review on the negative outcomes of psychiatric hospitalization  

PubMed Central

Before psychiatry emerged as a medical discipline, hospitalizing individuals with mental disorders was more of a social stigmatizing act than a therapeutic act. After the birth of the mental health disciplines, psychiatric hospitalization was legitimized and has proven to be indispensable, preventing suicides and helping individuals in need. However, despite more than a century passing since this legitimization occurred, psychiatric hospitalization remains a controversial issue. There is the question of possible negative outcomes after a psychiatric admission ceases to take its protective effect, and even of whether the psychiatric admission itself is related to a negative setback after discharge. This review aims to summarize some of the most important negative outcomes after discharge from a psychiatric institution. These experiences were organized into two groups: those after a brief psychiatric hospitalization, and those after a long-stay admission. The author further suggests possible ways to minimize these adversities, emphasizing the need of awareness related to this important issue. PMID:24812527

Loch, Alexandre Andrade

2014-01-01

74

Factors influencing occupational engagement in day centers for people with psychiatric disabilities.  

PubMed

Occupational engagement is a vital factor in people's lives since it has been shown to be important for health and well-being. Community-based day centers (DCs), both meeting place-oriented and work-oriented ones, are common service alternatives in many western countries for enabling engagement in productive and leisure occupations among people with psychiatric disabilities. Little is, however, known about factors influencing occupational engagement in such settings. We aimed to investigate how factors pertaining to day center attendance, socio-demographics, motivation, clinical and self-related characteristics were related to how day center attendees rated their occupational engagement in productive occupations. These variables were assessed among day center attendees in meeting place-oriented (n = 39) and work-oriented (n = 54) DCs in Sweden through questionnaires and interviews. Logistic regression models showed that (1) less general psychopathology and more time spent on day center occupations were indicators of belonging to the group with a high level of occupational engagement according to a median cut; (2) higher perceived self-mastery was the only important factor with respect to ratings of occupational engagement above the third quartile. The models may be seen as creating a stepwise indication on which factors are important for reaching a medium level of occupational engagement (less severe general psychopathology and time spent at the day center) and for reaching a still higher level (a high level self-mastery), respectively, of occupational engagement. The findings may also be discussed in relation to different levels of engagement in a recovery process. PMID:25062905

Tjörnstrand, Carina; Bejerholm, Ulrika; Eklund, Mona

2015-01-01

75

Acute Interventions and Referral of Patients With Bipolar Disorder by the Psychiatric Consultation Liaison Service in a General Hospital in Germany: A Retrospective Analysis  

PubMed Central

Objective: To investigate the population of bipolar patients in a general hospital in Germany who required treatment by a consultant psychiatrist. Method: A retrospective analysis was conducted of the clinical records of 47 patients diagnosed with bipolar disorder (DSM-IV-TR criteria) who were treated by a consultant psychiatrist between 2009 and 2012 in one of the general hospitals of Charité Berlin, Campus Benjamin Franklin, Berlin, Germany. We investigated the sections of the hospital that requested psychiatric consultations for bipolar patients, the status of these patients, and their primary cause of treatment, as well as the intervention (including pharmacotherapy) recommended by the consultant psychiatrist. Results: For more than half of the patients, their psychiatric illness was either directly or indirectly the reason they presented to the hospital. The remaining bipolar patients were treated for various somatic illnesses unrelated to their bipolar disorder throughout the hospital, with a relative overrepresentation of patients in the neurology department. More than half of the patients were referred to a psychiatric hospital by the consultant psychiatrist. Benzodiazepines were the most commonly administered drugs for acute pharmacologic intervention. Conclusions: Psychiatric consultations are not frequently requested for bipolar patients compared to those with other psychiatric disorders. However, more than half of the bipolar patients needed further psychiatric treatment in a psychiatric hospital. This finding emphasizes the importance of psychiatric consultations in a general hospital for bipolar patients. The administration of benzodiazepines as an acute treatment seems to be the standard pharmacologic procedure, not a specific pharmacotherapy like mood stabilizers. PMID:25133062

Anderson, Christina

2014-01-01

76

Pathways to psychiatric care in urban north China: a general hospital based study  

PubMed Central

Background Pathway studies highlight the help-seeking behaviors of patients with physical and mental illnesses. A number of studies in this field have been completed in various parts of the world. The purpose of this study is to explore the characteristics of the help-seeking pathways of patients with mental illness from urban north China at Mental Health Professional (MHP). Methods The pathway diagrams, which accounted for more than five percent of patients, were documented for 441 subjects using the translated version of the World Health Organization (WHO) pathway encounter form. The patterns and durations of care-seeking were analyzed in different diagnostic groups. The ?2-test and the Mann-Whitney U test were employed, as needed. Results Respondents visited the MHP through a variety of pathways. Approximately three-quarters of the patients took an indirect pathway (74.8% vs 25.2%, ?2?=?108.8, p?hospitals (56.4% vs 4.1%, ?2?=?138.3, p?hospitals (24.8% vs 4.1%, ?2?=?40.96, p?psychiatric hospitals. Of the patients who first contacted with psychiatry hospital, 55.6% received a professional diagnosis and finally reached the MHP because of the poor treatment or high-cost medical care. Conclusions The majority of patients seek other pathways than to go to MHP directly and this may be due to stigma, and/or lack of knowledge. The study gives emphasis on the importance of improving skills and knowledge that will facilitate the recognition of psychiatric disorders in the community health centers, the general hospitals system and by private practitioners. The pathway described by this study may be helpful while preparing mental health programs in the future. PMID:24020825

2013-01-01

77

[Asylum: the Huge Psychiatric Hospital in the 19th century U.S].  

PubMed

The large-scale state psychiatric hospitals, referred to as "asylums," were built in the USA in the 19th century and generally have a bad reputation in Japan as institutions with an unpleasant environment for the patients. Asylums were not built for institutionalizing mental patients. The original meaning of the word asylum is a "retreat" or "sanctuary," and these institutions were originally built to act as sanctuaries for the protection of mental patients. The field of psychiatric medicine in western countries in the 19th century began to embrace the concept of "moral treatment" for mental patients, including no restraint of the patients and treating them in a more open environment. With this background, asylums were built according to the efforts of social activist Dorothea Dix with financial assistance from the Quakers. The psychiatrist Dr. Thomas Kirkbride had a large influence on asylum architecture, and believed that the hospital building and environment as well as location have healing effects on the patients, which he called the "therapeutic landscape". Kirkbridelater proposed an architectural plan that became the basis for subsequent mental hospital architecture, and many asylums were built according to this plan. As the architecture was considered part of the treatment, many leading architects and landscape architects at the time became involved in building asylums. In the later half of the 19th century, over 150 asylums were built across the USA. However, moral treatment fell out of favor toward the end of the 19th century, and the concept of therapeutic landscape was also neglected. The hospitals had many uncured patients, and caregivers became pessimistic about the efficacy of the treatments. Abuse and neglect of the patients were also common. The environment at the asylums deteriorated, which created the image of asylums that, we hold today. Many asylums have been demolished or abandoned. These early attempts at asylum failed due to insufficient treatment methods. However, the concept of the therapeutic landscape that comprehensively sees the architecture of the hospital building and landscape of the property as part of the treatment as well as the architectural beauty of asylum buildings may deserve reevaluation. PMID:23234200

Kazano, Haruki

2012-01-01

78

Risk Factors of Acute Behavioral Regression in Psychiatrically Hospitalized Adolescents with Autism  

PubMed Central

Aim: During adolescence, some individuals with autism engage in severe disruptive behaviors, such as violence, agitation, tantrums, or self-injurious behaviors. We aimed to assess risk factors associated with very acute states and regression in adolescents with autism in an inpatient population. Method: Between 2001 and 2005, we reviewed the charts of all adolescents with autism (N=29, mean age=14.8 years, 79% male) hospitalized for severe disruptive behaviors in a psychiatric intensive care unit. We systematically collected data describing socio-demographic characteristics, clinical variables (severity, presence of language, cognitive level), associated organic conditions, etiologic diagnosis of the episode, and treatments. Results: All patients exhibited severe autistic symptoms and intellectual disability, and two-thirds had no functional verbal language. Fifteen subjects exhibited epilepsy, including three cases in which epilepsy was unknown before the acute episode. For six (21%) of the subjects, uncontrolled seizures were considered the main cause of the disruptive behaviors. Other suspected risk factors associated with disruptive behavior disorders included adjustment disorder (N=7), lack of adequate therapeutic or educational management (N=6), depression (N=2), catatonia (N=2), and painful comorbid organic conditions (N=3). Conclusion: Disruptive behaviors among adolescents with autism may stem from diverse risk factors, including environmental problems, comorbid acute psychiatric conditions, or somatic diseases such as epilepsy. The management of these behavioral changes requires a multidisciplinary functional approach. PMID:20467546

Périsse, Didier; Amiet, Claire; Consoli, Angèle; Thorel, Marie-Vincente; Gourfinkel-An, Isabelle; Bodeau, Nicolas; Guinchat, Vincent; Barthélémy, Catherine; Cohen, David

2010-01-01

79

Family participation in treatment, post-discharge appointment and medication adherence at a Nigerian psychiatric hospital.  

PubMed

In low-income countries, clinicians must seek strategies to improve treatment adherence that are non-resource intensive and easily integrated into existing treatment structures. We conducted a prospective observational cohort study to investigate the relationship of family engagement in treatment during hospitalisation with post-discharge appointment and medication adherence in 81 patients from a Nigerian psychiatric hospital. After controlling for gender, diagnosis, mental state at discharge, and marital status, family involvement was significantly associated with appointment (P=0.047) but not medication adherence (P=0.590). Studies are needed to determine whether interventions based on engaging families in treatment can improve post-discharge adherence in this setting. PMID:19118334

Adeponle, Ademola B; Thombs, Brett D; Adelekan, Moruf L; Kirmayer, Laurence J

2009-01-01

80

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

NSDL National Science Digital Library

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.

2008-10-06

81

The Effect of Music Therapy on Hospitalized Psychiatric Patients’ Anxiety, Finger Temperature, and Electroencephalography: A Randomized Clinical Trial  

Microsoft Academic Search

Purpose: This study aimed to explore the effectiveness of music therapy in reducing anxiety in hospitalized psychiatric patients.Methodology: The authors used a randomized clinical trial design and randomly allocated the 24 enrolled participants to the experimental or the control group. Patients in the experimental group received music therapy in a therapy room at a set time for 30 min each

Chyn-Yng Yang; Chiung-Hua Chen; Hsin Chu; Wen-Chun Chen; Tso-Ying Lee; Shyi-Gen Chen; Kuei-Ru Chou

2012-01-01

82

Putting aggression into context: An investigation into contextual factors influencing the rate of aggressive incidents in a psychiatric hospital  

Microsoft Academic Search

The contribution of contextual factors to aggressive incidents in psychiatric hospitals has tended to be ignored. This study used a functional analysis framework to investigate 130 incidents. Staff interviews were used to identify antecedents and m anagem ent strategies em ployed. Reported aggression rates varied greatly between wards including those serving sim ilar functions. No difference was found between the

TONY LAVENDER

1999-01-01

83

The Contribution of Children's Temperamental Fear and Effortful Control to Restraint and Seclusion during Inpatient Treatment in a Psychiatric Hospital  

ERIC Educational Resources Information Center

The current study examined temperament characteristics as risk factors for restraint and seclusion (R/S) events in psychiatrically hospitalized youth, extending work that has sought to identify R/S risk factors and research examining temperament-behavior problem associations that has largely relied upon community samples. It was anticipated that…

Bridgett, David J.; Valentino, Kristin; Hayden, Lisa C.

2012-01-01

84

Determining the number of state psychiatric hospital beds by measuring quality of care with artificial neural networks.  

PubMed

This study uses a new paradigm to calculate the minimum and the optimum number of involuntary psychiatric beds at a state hospital in Maine with 5538 admissions over a 7-year period. The method measures quality of care (Q) based upon the accuracy of prediction of length-of-stay for the hospital, and of community length-of-stay for the community, each corrected for the severity of illness of the average patient. When Q in the hospital equals Q in the community, there is no net movement of patients from one phase of care to the other, analogous to a zero electromotive force, and the census at that point is the minimum number of beds (22 beds/100,000 population). When patients in the community were least ill, relative to the hospital then hospital bed census is at its optimum (31 beds/100,000) given current resources and technology. In studying specific diagnosis groups with the same methodology the authors found that patients with schizophrenia having the benefit of clozapine for most of the study period had a Q averaged over 7 years that was nearly equal in both hospital and community settings. This explains the perception that tertiary psychiatric hospitals comprised mostly of patients with schizophrenia can downsize significantly. However, affective disorders and "borderline" personality disorders clearly benefit from structured hospital care with specialized experienced staff. We make arguments for the role of the state hospital as a homeostat for the mental health care delivery system. PMID:9509590

Davis, G E; Lowell, W E; Davis, G L

1998-01-01

85

Intervention to reduce inpatient psychiatric admission in a metropolitan city.  

PubMed

When psychiatric hospitalization is over-used, it represents a financial drain and failure of care. We evaluated implementation and cessation of transporting people medically certified for psychiatric hospitalization to a central psychiatric emergency service for management and re-evaluation of hospitalization need. After implementation, the hospitalization rate declined 89 % for 346 transported patients; only four of the nonhospitalized patients presented in crisis again in the next 30 days. Following cessation, the hospitalization rate jumped 59 % compared to the preceding year. Costs declined 78.7 % per diverted patient. The findings indicate that it is possible to reduce hospitalization and costs, and maintain quality care. PMID:24817259

Amirsadri, Alireza; Mischel, Edward; Haddad, Luay; Tancer, Manuel; Arfken, Cynthia L

2015-02-01

86

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

PubMed

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

Creswell, Laryssa M

2014-04-01

87

The Effectiveness of an Individualized Form of Day Hospital Treatment.  

PubMed

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

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

2014-11-20

88

First psychiatric hospitalizations in the US military: the National Collaborative Study of Early Psychosis and Suicide (NCSEPS)  

PubMed Central

Background Military samples provide an excellent context to systematically ascertain hospitalization for severe psychiatric disorders. The National Collaborative Study of Early Psychosis and Suicide (NCSEPS), a collaborative study of psychiatric disorders in the US Armed Forces, estimated rates of first hospitalization in the military for three psychiatric disorders : bipolar disorder (BD), major depressive disorder (MDD) and schizophrenia. Method First hospitalizations for BD, MDD and schizophrenia were ascertained from military records for active duty personnel between 1992 and 1996. Rates were estimated as dynamic incidence (using all military personnel on active duty at the midpoint of each year as the denominator) and cohort incidence (using all military personnel aged 18–25 entering active duty between 1992 and 1996 to estimate person-years at risk). Results For all three disorders, 8723 hospitalizations were observed in 8 120 136 person-years for a rate of 10·7/10 000 [95% confidence interval (CI) 10·5–11·0]. The rate for BD was 2·0 (95% CI 1·9–2·1), for MDD, 7·2 (95% CI 7·0–7·3), and for schizophrenia, 1·6 (95% CI 1·5–1·7). Rates for BD and MDD were greater in females than in males [for BD, rate ratio (RR) 2·0, 95% CI 1·7–2·2; for MDD, RR 2·9, 95% CI 2·7–3·1], but no sex difference was found for schizophrenia. Blacks had lower rates than whites of BD (RR 0·8, 95% CI 0·7–0·9) and MDD (RR 0·8, 95% CI 0·8–0·9), but a higher rate of schizophrenia (RR 1·5, 95% CI 1·3–1·7). Conclusions This study underscores the human and financial burden that psychiatric disorders place on the US Armed Forces. PMID:16879759

HERRELL, RICHARD; HENTER, IOLINE D.; MOJTABAI, RAMIN; BARTKO, JOHN J.; VENABLE, DIANE; SUSSER, EZRA; MERIKANGAS, KATHLEEN R.; WYATT, RICHARD J.

2015-01-01

89

Prospective Study of Psychiatric Follow-up Default and Medication Compliance after Discharge at a Psychiatric Hospital in Nigeria  

Microsoft Academic Search

We report a prospective follow-up of 81 patients recently discharged from the hospital. Their hospital attendance pattern,\\u000a medication compliance, mental state and social functioning were measured. Defaulters were followed up in the community. At\\u000a 3 months, 49.4% had defaulted, while 51.5% were medication noncompliant. Clinical outcome was best for the Non-Defaulter-Medication\\u000a Compliant (ND-MC) group, worst for the Defaulter-Medication Non-Compliant (D-MNC) group.

A. B. Adeponle; A. S. Baduku; M. L. Adelekan; G. T. Suleiman; S. O. Adeyemi

2009-01-01

90

The Stability of Axis I Diagnoses in Youth across Multiple Psychiatric Hospitalizations  

ERIC Educational Resources Information Center

The literature has yet to reach a consensus as to the stability of severe psychiatric diagnoses in youth. Previous studies among youngsters tracked over set follow-up periods have reported diagnostic stability estimates that are similar to or slightly lower than those of adults. Less is known, however, about the stability of youth psychiatric

Pettit, Jeremy W.; Morgan, Sharon; Paukert, Amber L.

2005-01-01

91

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

PubMed Central

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

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

1999-01-01

92

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

PubMed

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

Moses, Tally

2014-05-01

93

A Geriatric Day Hospital: Who Improves the Most?  

ERIC Educational Resources Information Center

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…

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

2004-01-01

94

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

ERIC Educational Resources Information Center

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.…

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

2004-01-01

95

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

PubMed

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

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

2011-11-01

96

Hospital admissions from the Surgical Day Care Centre of Vancouver General Hospital 1977–1987  

Microsoft Academic Search

The admissions to Vancouver General Hospital from its Surgical Day Care Centre were reviewed for the period I977 to 1987.\\u000a The overall mean rate of admission for the period was 0.28 per cent, for surgically-related admissions 0.22 per cent and for\\u000a anaesthesia-related admissions 0.07 per cent. The principal reasons for surgery-related admissions were postoperative bleeding,\\u000a complications, the need for further

Peter F. Fancourt-Smith; Jeffrey Hornstein; Leonard C. Jenkins

1990-01-01

97

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

Medical Student Research Fellowship The Zucker Hillside Hospital is a 208-bed psychiatric facility located adjacent to the Long Island Jewish Medical Center on the border of Nassau County and Queens. The goal of the Zucker Hillside Hospital Medical Student Research Fellowship is to help fill the gap

Bushman, Frederic

98

[Patients with psychotic disorders in forensic psychiatric hospitals: are there consequences for general psychiatry?].  

PubMed

We assessed data concerning demographic, criminological and psychiatric characteristics of all patients with disorders of the schizophrenic spectrum, who were detained in the forensic psychiatric departments of Mecklenburg-West Pomerania, a federal state of Germany, in 2007. Of the 202 patients of both clinics, 45 suffer from a disorder of the schizophrenic spectrum assessed in ICD-10: F20-F29, which corresponds to 22%. This level is markedly lower than in other regions of Germany. But similarly to results assessed in other federal states of Germany and in Austria there is a high rate of pre-treatment in general psychiatric institutions. It remains a relevant task for general psychiatry to establish adequate interventions for hostile and violent psychotic patients, especially for those with a double diagnosis, history of delinquency and social decline. PMID:20076938

Habermeyer, E; Wolff, R; Gillner, M; Strohm, R; Kutscher, S

2010-09-01

99

Leisure Activity and Hospital Readmission of Short-Term Psychiatric Patients.  

ERIC Educational Resources Information Center

William Menninger (1948) reported research results indicating a significant relationship in a former patient's ability to stay well and his participation in recreation. J. Bates (1963) indicated one reason patients return to psychiatric facilities was the lack of skills that center around recreation. This study was conducted to investigate the…

McMinn, Sheri B.; Lay, C. Marvin

100

One gram of aspirin per day does not reduce risk of hospitalization for gallstone disease  

Microsoft Academic Search

Data from 4524 patients in a randomized, controlled trial of aspirin were analyzed to determine if aspirin reduced the risk for hospitalization for gallstone disease. Aspirin at a dose of 1000 mg\\/day did not reduce the risk of hospitalization for gallstones. Hospitalization rates for gallstone disease were consistent with national rates, and the data confirmed previous associations of gallstone disease

John H. Kurata; Jay Marks; David Abbey

1991-01-01

101

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

PubMed

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

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

2014-07-24

102

Validation of an individualised quality of life measure in older day hospital patients  

Microsoft Academic Search

BACKGROUND: To test the ease of use, reliability, responsiveness and construct validity of the Patient Generated Index, an individualised quality of life score, in older people attending a Medicine for Older People Day Hospital. METHODS: Prospective longitudinal study in patients attending a specialist Medicine for Older People Day Hospital in Scotland. The Patient Generated Index was administered at baseline, one

Miles D Witham; Roberta L Fulton; Lucy Wilson; Carolyn A Leslie; Marion ET McMurdo

2008-01-01

103

Impact of Partnership in Coping in mental health recovery: an experimental study at the Federal Neuro-Psychiatric Hospital, Kaduna.  

PubMed

Almost everyone, at some point in life, experiences emotional and behavioural problems or psychiatric symptoms, but mental health services reflect only an orthodox medical model which emphasizes cure to the detriment of humanistic focus. Partnership in Coping is an emerging concept, based on recovery alliance theory, which emphasizes partnership to overcome such problems and symptoms. It is a collaboratively-integrated system that provides opportunity for own problem solving, while one's coping strategies are being empowered. This study was designed to ascertain how Partnership in Coping impacts mental health recovery. It paves the way for remedying problems inherent in the orthodox medical model approach which provide pathological perspective to the detriment of humanistic focus. The participants were 56 service users at the Federal Neuro-Psychiatric Hospital, Kaduna. The Professional Quality of Life Scale helped in selecting research assistants, while the Mental Health Recovery Measure was used in assessing the post-treatment behaviour of participants. The experimental group had Partnership in Coping during a 3-month clinical intervention period, while the control group only had medical treatment. The finding revealed that F (1, 56)?= 2268.750, P < 001. Thus, partnership enhances complete recovery from mental illness. This reality changes perception and frees people from stigmatization and hopelessness, thereby influencing service systems. PMID:20887606

Gandi, Joshua C; Wai, Paul S

2010-10-01

104

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

PubMed

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

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

2013-10-01

105

Acute Psychiatric Hospital Admissions of Adults and Elderly Adults with Mental Retardation.  

ERIC Educational Resources Information Center

Examination of the records of 240 inpatients with mental retardation and 7 with autism discharged from a university hospital indicated that elderly adults had more medical problems than did adults, more elderly adults were transferred to a state hospital, and the most common diagnosis in both adults and elderly adults was chronic schizophrenia,…

Pary, Robert J.

1993-01-01

106

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

E-print Network

headings (MeSH) applied in the following fashion: (“Hospitalization”[Mesh] OR “Patient Admission”[Mesh] OR “Patient Readmission”[Mesh] OR “Length of Stay”[Mesh]) AND (“Depression”[Mesh] OR “Depressive Disorder”[Mesh] OR “Bipolar Disorder”[Mesh] OR “Mood... 2008;37:690–5. [38] Mendes-Chiloff CL, Ramos-Cerqueira AT, Lima MC, Torres AR. Depressive symptoms among elderly inpatients of a Brazilian university hospital: prevalence and associated factors. Int Psychogeriatr 2008;20:1028–40. [39] Saravay SM...

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

2014-11-08

107

Psychiatric Hospitalizations, Arrests, Emergency Room Visits, and Homelessness of Clients with Serious and Persistent Mental Illness: Findings from a Randomized Trial of Two ACT Programs vs. Usual Care  

Microsoft Academic Search

Objective: This investigation examined several adverse outcomes in clients with serious mental illness in a randomized trial of Assertive Community Treatment (ACT) versus usual care. Method: 163 subjects were randomized to one of two ACT experimental conditions (staffed by consumers or non-consumers) or usual community care. Conditions were compared on psychiatric hospitalization, emergency room visit, arrest, and homelessness, within the

Gregory N. Clarke; Heidi A. Herinckx; Ronald F. Kinney; Robert I. Paulson; David L. Cutler; Karen Lewis; Evie Oxman

2000-01-01

108

Valuation of hospital bed-days released by infection control programs: a comparison of methods.  

PubMed

We performed a contingent valuation survey to elicit the opportunity cost of bed-days consumed by healthcare-associated infections in 11 European hospitals. The opportunity cost of a bed-day was significantly lower than the accounting cost; median values were €72 and €929, respectively (P < .001). Accounting methods overestimate the opportunity cost of bed-days. PMID:25203185

Stewardson, Andrew J; Harbarth, Stephan; Graves, Nicholas

2014-10-01

109

Psychiatric morbidity in primary hyperparathyroidism  

Microsoft Academic Search

This report deals with the psychiatric symptomatology in patients with primary hyperparathyroidism (HPT). In a retrospective search of hospital records, psychiatric symptoms were found in 102 (23%) of 441 patients, 78 of whom had depressive and anxiety states. The presence of psychiatric symptoms was not related to the degree of hypercalcemia. Screening for HPT in 101 old patients hospitalized at

Charlotte Joborn; Jerker Hetta; Henry Johansson; Jonas Rastad; Hans Ågren; Göran Åkerström; Sverker Ljunghall

1988-01-01

110

First-Day Newborn Weight Loss Predicts In-Hospital Weight Nadir for Breastfeeding Infants  

PubMed Central

Abstract Background Exclusive breastfeeding reduces infant infectious disease. Losing ?10% birth weight may lead to formula use. The predictive value of first-day weight loss for subsequent weight loss has not been studied. The objective of the present study was to evaluate the relationship between weight loss at <24 hours and subsequent in-hospital weight loss ?10%. Methods For 1,049 infants, we extracted gestational age, gender, delivery method, feeding type, and weights from medical records. Weight nadir was defined as the lowest weight recorded during birth hospitalization. We used multivariate logistic regression to assess the effect of first-day weight loss on subsequent in-hospital weight loss. Results Mean in-hospital weight nadir was 6.0?±?2.6%, and mean age at in-hospital weight nadir was 38.7?±?18.5 hours. While in the hospital 6.4% of infants lost ?10% of birth weight. Infants losing ?4.5% birth weight at <24 hours had greater risk of eventual in-hospital weight loss ?10% (adjusted odds ratio 3.57 [1.75, 7.28]). In this cohort, 798 (76.1%) infants did not have documented weight gain while in the hospital. Conclusions Early weight loss predicts higher risk of ?10% in-hospital weight loss. Infants with high first-day weight loss could be targeted for further research into improved interventions to promote breastfeeding. PMID:20113202

Bokser, Seth; Newman, Thomas B.

2010-01-01

111

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

Code of Federal Regulations, 2014 CFR

...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...

2014-10-01

112

Factor structure of the Hospital Anxiety and Depression Scale in Japanese psychiatric outpatient and student populations  

Microsoft Academic Search

BACKGROUND: The Hospital Anxiety and Depression Scale (HADS) is a common screening instrument excluding somatic symptoms of depression and anxiety, but previous studies have reported inconsistencies of its factor structure. The construct validity of the Japanese version of the HADS has yet to be reported. To examine the factor structure of the HADS in a Japanese population is needed. METHODS:

Tomomi Matsudaira; Hiromi Igarashi; Hiroyoshi Kikuchi; Rikihachiro Kano; Hiroshi Mitoma; Kiyoshi Ohuchi; Toshinori Kitamura

2009-01-01

113

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

Code of Federal Regulations, 2013 CFR

...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...

2013-10-01

114

Cognitive and Social Factors Associated with NSSI and Suicide Attempts in Psychiatrically Hospitalized Adolescents  

PubMed Central

Although non-suicidal self-injury (NSSI) and suicide attempts (SA) frequently co-occur among youth, there is increasing evidence that both the risk factors and the phenomenology of the behaviors are distinct. This study examined how individuals who engage in NSSI only, individuals who attempt suicide only, and those who have histories of both NSSI and at least one suicide attempt may differ in terms of cognitions and perceived social support. Participants were 185 adolescents (78.1% female) between the ages of 13 and 18 recruited from a psychiatric inpatient facility in the northeastern United States. One hundred forty-eight teens were identified with a history of self-injurious behavior and divided into three groups: NSSI only (n=45), SA only (n=24) or both NSSI and SA (NSSI+SA; n=79). Analyses showed that the NSSI+SA group exhibited more cognitive errors, negative self-statements, and negative views of self, world, and future, as well as less perceived familial support than either the NSSI or SA only groups. There were no differences between groups on perceived support from teachers or peers. No significant demographic or diagnostic differences were found between the NSSI and SA groups. Limitations and clinical implications of the current research are discussed. PMID:23588400

Wolff, Jennifer; Frazier, Elisabeth A.; Esposito-Smythers, Christianne; Burke, Taylor; Sloan, Emma; Spirito, Anthony

2013-01-01

115

Integration of psychoanalytic concepts in the formulation and management of hospitalized psychiatric patients.  

PubMed

Although psychoanalysis and psychodynamic psychotherapy have flourished theoretically and in practice for an increasingly widespread population of patients, the mental health professions have in recent decades experienced a hegemony of managed care, a preoccupation with pharmacological approaches at the expense of psychological approaches, and a predilection for brief symptom-focused, more easily researchable manualized psychotherapies, in spite of literature demonstrating the effective contribution of psychoanalysis and psychodynamic thought to the practice of the mental health professions. In this article a psychiatric inpatient is considered from the point of view of what psychodynamic theory can offer practically to understanding and managing her. It is not suggested that this patient might necessarily benefit from formal psychodynamic psychotherapy, but rather that incorporation of a psychodynamic understanding of her can lead to a more effective management approach, especially regarding dealing with staff reactions to disturbing patients. Consideration of the patient's personality and recognition of the patient's having a comorbid personality disorder appeared important in her management, and have practical implications regarding staff members' understanding of the patient and the consequent identification and handling of transference and countertransference manifestations. Problems that are likely to occur as enactments on the inpatient unit can more readily be anticipated or identified earlier and a consistent staff approach prepared. A psychodynamically informed management approach on the inpatient unit can help to anticipate challenging interpersonal experiences such as enactments. Psychodynamic thought has developed in a manner so as to be applicable in an increasingly wide range of clinical situations, not only in terms of the varieties of patients who are deemed to be able to benefit from psychodynamic treatment per se, but also regarding the clinical venues in which psychodynamic concepts can be usefully applied. PMID:23428170

Steinberg, Paul Ian; Cochrane, David

2013-01-01

116

Gender Differences in the Relationship Between Physical Activity and Smoking Among Psychiatrically Hospitalized Adolescents  

PubMed Central

Physical activity has been identified as a protective factor with regard to tobacco use, such that physically active adolescents are less likely to initiate smoking, and smokers are less physically active than non-smokers. These findings, along with the well-documented benefits of exercise on mood and well-being in adults, have stimulated interest in exercise-based smoking cessation interventions. However, little research has explored the relationship between physical activity and smoking characteristics within adolescent smokers. Also, gender differences in adolescents’ motives for smoking and exercise may have implications for intervention development, especially in clinical populations. The current study explored the relationship between physical activity and smoking in a sample of adolescent smokers (N = 191) and non-smokers (N = 48) receiving inpatient psychiatric treatment (61% female, mean age 15.3 years). Results indicated that smokers were less likely to be physically active than non-smokers. Additionally, there was a consistent pattern of gender differences in the relationship between smoking and physical activity within smokers. Specifically, physically active male smokers were less nicotine dependent and less prone to withdrawal, and had a trend toward greater motivation to quit, than their non-active counterparts. In contrast, physically active female smokers did not differ in dependence or withdrawal and were less motivated to quit than non-active female smokers. Taken together, these results suggest that within clinical populations of adolescent females, smoking and exercise may be used jointly as weight control strategies. Exercise-based interventions for smoking cessation for adolescent females, especially clinical populations, should address weight and body image concerns. PMID:23459125

Bloom, Erika Litvin; Abrantes, Ana M.; Fokas, Kathryn F.; Ramsey, Susan E.; Brown, Richard A.

2012-01-01

117

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

Microsoft Academic Search

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 >

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

1997-01-01

118

THE EFFECT OF PERSON-ENVIRONMENT FIT ON THE PSYCHOLOGICAL WELL-BEING OF PSYCHIATRIC AIDES WORKING IN A STATE HOSPITAL (COPING RESOURCES, SOCIAL SUPPORT, OCCUPATIONAL STRESS, LOCUS-OF-CONTROL)  

Microsoft Academic Search

This study addressed two purposes: (1) to determine the effect of person-environment fit on the psychological well-being of psychiatric aides and (2) to determine what role the coping resources of social support and control have on the above relationship. Two hundred and ten psychiatric aides working in a state hospital in Texas responded to a questionnaire pertaining to these issues.^

BRENDA LYNN SOLOVITZ

1985-01-01

119

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

PubMed Central

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

Aoki, A; Aoki, Y; Harima, H

2012-01-01

120

Psychiatric rehabilitation.  

PubMed

The financial, personal, and societal costs of severe mental illness are extraordinarily high. Individuals suffering from schizophrenia occupy 25 percent of all hospital beds and account for 40 percent of all long-term care days. The rate of Supplemental Security income (SSI) and Social Security disability insurance (SSDI) beneficiaries who are disabled because of a mental disorder has increased more than 50 percent since 1986, and a total of more than 1.1 million individuals received benefits in 1991 because of their mental disorders. All of these costs have continued to rise despite the nearly ubiquitous administration of antipsychotic medication with its well-documented benefits. The most promising treatment to complement medication and produce better outcomes is psychiatric rehabilitation. It is based on the same rationale as rehabilitation for physically challenged individuals--illness produces impairments that make individuals less able to perform basic life skills that handicap them when they try to be students, workers, spouses, parents, etc. Rehabilitation teaches individuals to perform the basic skills using methods that compensate for the impairments, and modifying the environment so the new methods are successful or the skills are not required. Rehabilitation with severely mentally ill individuals is particularly challenging because of the extent of their impairments and disabilities. The impairments--flagrant symptoms that unpredictably wax, wane, and persist even with medication; reduced motivation to participate in community life; residual deficits in the most elemental cognitive processes of attention, memory, and abstraction--clearly limit individuals' abilities to perform life skills and function in major societal roles. Moreover, the challenge of successful rehabilitation is magnified by the individual-to-individual, time-to-time, and disorder-to-disorder variations in these impairments and disabilities. Given this challenge, how well does psychiatric rehabilitation work in practice? Two types of studies provide answers to this question; those that have focused exclusively on teaching skills to severely mentally ill individuals, and those that have focused on larger units of care, case management, and vocational rehabilitation, that typically include skills training as one of their services. The first type of study provides "pure" information but sacrifices, to some extent, clinical utility and immediate generality. The second provides information that can be transferred to clinical practice but sacrifices clarity about what is the effective ingredient in a set of intermingled services. The results of the first type have generally indicated, with some qualifications, that severely mentally ill individuals learn skills, use them in their own environments, and may receive other clinically meaningful benefits.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:8084983

Wallace, C J

1993-01-01

121

Thought and language disorder among sexually abused children in a psychiatric hospital.  

PubMed

The empirical literature offers evidence that childhood sexual abuse is a predictor of psychopathology in adults. However, the literature examining the relations between thought disorder and psychotic symptoms in children is sparse. Children with a history of childhood sexual abuse are expected to demonstrate more disturbances in thought relative to their peers with no childhood sexual abuse. Using the Thought and Language Index, Thematic Apperception Test (TAT) narratives for four commonly used TAT cards obtained from 39 closed charts of hospitalized children were analyzed. Narratives were assessed on seven dimensions including weakening of goals, perseveration, looseness, peculiar word usage, peculiar sentence construction, non-logical reasoning, and distractibility. Good inter-rater reliability was obtained. Sexually abused childrenhad higher aberrant scores on card number four compared to non-abused children. Sexual abuse history was a predictive factor for non-logical reasoning, with small effect size. Implications and suggestions for future research are discussed. PMID:23833866

Conway, Francine; McCarthy, James; Talreja, Priyam; Conway, Fiona

2013-04-01

122

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

PubMed

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

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

2014-01-01

123

Psychiatric diagnoses, trauma, and suicidiality  

Microsoft Academic Search

BACKGROUND: This study aimed to examine the associations between psychiatric diagnoses, trauma and suicidiality in psychiatric patients at intake. METHODS: During two months, all consecutive patients (n = 139) in a psychiatric hospital in Western Norway were interviewed (response rate 72%). RESULTS: Ninety-one percent had been exposed to at least one trauma; 69 percent had been repeatedly exposed to trauma

Silje K Floen; Ask Elklit

2007-01-01

124

[Why a gynecological consultation service in a hematology day hospital. Our experience].  

PubMed

The paper described the role of a gynaecological advisory service in an hematological day hospital. The main gynaecological problems which arose during anti-cancer and immunosuppressive therapy were classified according to patients' symptoms. The paper stresses the need for close collaboration between hematologists and gynaecologists and underlines the psychological importance of this aspect from the patient's point of view. PMID:1436606

Chiodi, S; Spinelli, S; Melica, F; Rossi, E; Damasio, E

1992-09-01

125

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

Microsoft Academic Search

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

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

2011-01-01

126

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

Microsoft Academic Search

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

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

2010-01-01

127

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

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

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

2013-01-01

128

Measuring the outcomes of day hospital attendance: a comparison of the Barthel Index and London Handicap Scale  

Microsoft Academic Search

Objective: To assess the ability of two scales to measure the effects of attendance at a geriatric day hospital.Design: ‘Before-and-after’ measurements. Setting: Day hospital serving a defined, urban, catchment area. Subjects: One hundred and three consecutive new patients over a three-month period.Intervention: Day hospital attendance for as long as the multidisciplinary team thought warranted.Outcome measures: Barthel Index and London Handicap

Rowan H Harwood; Shah Ebrahim

2000-01-01

129

Day-case laparoscopy in a Ghanaian teaching hospital: the patient's perspective.  

PubMed

A questioning survey was carried out to determine the acceptability to patients of various aspects of day-case laparoscopy in Korle-Bu Teaching Hospital. One hundred consecutive patients were interviewed within 2 weeks after operation. Sources of dissatisfaction include inadequate explanation about the operation and its aftermath, hospital reporting time, the waiting times at various stages of the process, the mechanism for sending patients from the ward to the theatre and the total length of time spent in hospital. Almost half the patients felt they were not well enough to be sent home at the time of discharge. More than half would have preferred overnight stay postoperatively. The main causes of morbidity were dizziness, abdominal pain, shoulder pain, nausea and vomiting. To make day-case laparoscopy more acceptable to patients a dedicated day care surgery unit with formal anaesthetic cover should be established. The operation and its aftermath should be fully explained to patients well before the day of operation. Stricter criteria should be established for patient discharge, and where appropriate, patients should be allowed the option of overnight stay post-operatively. PMID:8937226

Nkyekyer, K

1996-10-01

130

[Santa Tereza Windows: a study of the psycho-social rehabilitation process at the Psychiatric Hospital in Ribeirão Preto, São Paulo].  

PubMed

This is a case study of a psycho-social rehabilitation process taking place at Santa Tereza, a psychiatric hospital in Ribeirão Preto, whose objective is to understand possibilities and limitations implied in the rehabilitation process within Pensões Protegidas (Protected Homes) project. The basic strategies for the present study involved participative observation and interviews with individuals living in such homes as well as with the multi-professional staff working in the process. The results reveal a kind of orientation quite distant from the hospital-centered trend, since they reveal remarkable tendency towards deinstitutionalization. Finally, the author emphasizes the contribution of Pensões Protegidas Project at Santa Tereza for the better understanding of the so-called mentally ill. PMID:11789532

Guimarães, J; Saeki, T

2001-01-01

131

Psychological Stress and 30-Day All-Cause Hospital Readmission in Acute Coronary Syndrome Patients: An Observational Cohort Study  

PubMed Central

Background Many acute coronary syndrome (ACS; myocardial infarction and unstable angina) patients are rehospitalized within 30 days of discharge, and recent US health policy initiatives have tied hospital Medicare reimbursement to 30-day readmission rates. Patient-perceived psychological stress is thought to impact prognosis after ACS. A recently offered “posthospital syndrome” model of 30-day readmissions posits that the stress level at the time of the index hospitalization itself may increase 30-day risk for readmission in ACS patients. We tested whether self-reported stress in the days surrounding the ACS hospitalization was associated with increased risk for readmission within 30 days. Methods A mean of 8.5 days after discharge, 342 consecutively hospitalized ACS patients reported on how often they felt stress during the past two weeks. Readmission within 30 days of hospital discharge for any cause was determined by follow-up telephone calls to patients and confirmed by hospital records. Results Overall, 40 (11.7%) participants were readmitted within 30 days, and 22 (6.4%) reported high stress. Readmission within 30 days was more common in patients with high stress (5 admissions, 23%) than in patients with low stress (35 admissions, 11%). After adjustment for demographic and clinical factors, as well as depression, high stress was associated with a 3-fold increased risk of 30-day readmission (HR?=?3.21, 95% CI?=?1.13, 9.10). Conclusions Previous research has shown that stress in the days surrounding a hospitalization can mark long-term cardiovascular risk, but this is the first study to test a hypothesis of the posthospital syndrome model of early readmission. Further research is needed to confirm the association between stress and readmission risk, and to identify the processes of hospitalization that could be modified to both reduce the stress experienced and that would also be effective for reducing readmissions. PMID:24621575

Edmondson, Donald; Green, Philip; Ye, Siqin; Halazun, Hadi J.; Davidson, Karina W.

2014-01-01

132

Understanding psychiatric institutionalization: a conceptual review  

PubMed Central

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

2013-01-01

133

Accuracy of Referring Psychiatric Diagnosis  

PubMed Central

Background: The author examined the accuracy of the initial psychiatric diagnosis of primary medical providers requesting psychiatric consultation in a medical inpatient setting in a university hospital. Methods: A retrospective review of 217 consecutive psychiatric consultations was conducted in which the initial diagnostic impression of primary medical providers was compared with the final psychiatric diagnosis. Results: The accuracy of psychiatric diagnosis was the highest for cognitive disorders 60%, followed by depression 50% and anxiety disorders 46%, whereas the accuracy of diagnosing psychosis was 0%. Conclusion: Thus, the accuracy of initial diagnoses made by primary medical providers is quite variable. Factors affecting these results are discussed. PMID:21475469

Al-Huthail, Yaser R.

2008-01-01

134

PSYCHOLOGICAL CORRELATES OF SUBSTANCE ABUSE IN NON-PSYCHIATRIC AND PSYCHIATRIC POPULATION  

Microsoft Academic Search

The paper investigates psychological correlates of substance abuse among psychiatric patients . One Hundred and six (106) psychiatric patients from Uyo prisons and psychiatric hospital in Eket and 110 non-psychiatric others from Eket and Uyo served as participants. Their ages range from 16-65 years. The Eysenck Personality Questionnaire ( Neuroticism and Psychoticism scales) and the Psychological Correlates of Substance abuse

STELLA IDORENYIN ETIM; IBORO F. A. OTTU

135

Duration of Hospitalization and Post Discharge Suicide  

ERIC Educational Resources Information Center

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,…

Ho, Ting-Pong

2006-01-01

136

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

PubMed

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

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

2015-02-01

137

0 10 20 30 40 50 60 70 80 No MD visits within 7 days Pre-hospitalization  

E-print Network

before hospitalization" may be a useful quality indicator for some CSHCN. This may be particularly true an Outpatient Visit 28 Days Prior to Hospitalization March 2014, Issue 8 Quality of Care: Outpatient Care Before conditions (e.g., Diabetes, Inflammatory Bowel Disease, Sickle Cell Disease, Hemophilia) 1 #12;

Kay, Mark A.

138

Prevalence and socio-demographic risk factors associated with psychoactive substance use in psychiatric out-patients of a tertiary hospital in Nigeria  

PubMed Central

Background: The co-morbidity of psychoactive substance use and other mental disorders is a major challenge to the management of both conditions in several parts of the world. There is relative dearth of information on co-morbidity and its predictors in Nigeria. This study determined the prevalence and socio-demographic risk factors associated with psychoactive substance use in the psychiatric out-patients of a tertiary hospital in Nigeria. Study Design: A cross-sectional study. Materials and Methods: From routine clinic visits over a 4-month period, each consecutive 4th adult patients (>18 years) who had previously attended the clinic at least for 1 year, completed a socio-demographic and semi-structured drug use questionnaires and interview with the Schedule for Clinical Assessment in Neuropsychiatry (SCAN) to generate substance use diagnosis. Data was analysed using the statistical package for social sciences (SPSS), version 16. Level of significance was set at P < 0.05. Results: The lifetime prevalence for the use of substance was 29.3%, while that for multiple substances was 17.7%. The most commonly used substances were alcohol, cannabis and tobacco and they were also the ones mostly used in combination with one or the other. A total of 10.1% of the patients had a psychoactive substance use disorder. Being male, married with at least primary education and unemployed were significant risk factors for substance use. Conclusion: Psychoactive substance is common among the psychiatric outpatients of the hospital with males, those with formal education, the married and unemployed being at high risk of substance use. PMID:25538362

Okpataku, Christopher Izehinosen; Kwanashie, Helen Ochuko; Ejiofor, Janet Ifeakanwa; Olisah, Victor Obiajulu

2014-01-01

139

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

PubMed Central

‘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

Baur, Nicole

2013-01-01

140

Ambulatory laparoscopic cholecystectomy: An audit of day case vs overnight surgery at a community hospital in Japan  

PubMed Central

AIM: To evaluate the applicability and safety of ambulatory laparoscopic cholecystectomy (LC) and to compare day case and overnight stay LC. METHODS: Data were collected retrospectively and consecutively for day case and overnight stay LC patients from July 1, 2009 to April 30, 2011. Outcomes were analyzed for patient demographics, operation time, blood loss during operation and frequency and reasons for unexpected or prolonged hospitalization in each group. RESULTS: There was no hospital mortality and no patient was readmitted with serious morbidity after discharge. 50 patients received a day case LC and 19 had an overnight stay LC. There was a significant difference in age between both groups (P < 0.02). There were no significant differences between the day case LC performed (n = 41) and failed (n = 9) groups and between the day case LC performed and the one night stay LC (n = 12) groups. There was a significant difference in age between the one night stay and more nights stay LC groups (P < 0.05). Thus, elderly patients showed a tendency to like to stay in hospital rather than being a day case. The proportion of unexpected or prolonged hospitalization was not significantly different between the day case and overnight stay LC groups, when the patient’s request was excluded. CONCLUSION: Day case LC can be performed with a low rate of complications. In overnight stay patients, there are many who could be performed safely as a day case. Moreover, we need to take special care to treat elderly patients. PMID:23493831

Sato, Atsushi; Terashita, Yukio; Mori, Yoichiro; Okubo, Tomotaka

2012-01-01

141

Analysis of Time-of-Day Energy Demand and Supply in University and Hospital  

NASA Astrophysics Data System (ADS)

The aim of this study was to estimate the time-of-day energy demand in University of Yamanashi. Our University consisted of Kofu campus (Faculty of Education & Human Sciences and Faculty of Engineering) and Faculty of Medicine campus (Faculty of Medicine and University Hospital). The energy data of 4 facilities were classified into hot water, heating, cooling and electric power demands based on electric power consumptions, city gas and heavy oil from 1996 to 2005. For 10 years, primary energy increased 1.2 times in the whole of the university. The amount of electric power consumption was 63% in the fuel classification. The amount of electric power consumption of faculty reacted to the change in temperature greatly. In 2005, it was found that thermoelectric-ratios for 4 facilities, i.e. Education, Engineering, Medicine and Hospital were 2.3, 1.5, 2.0 and 2.7 respectively. These data are very useful for the energy saving and energy management of university.

Shimazaki, Yoichi

142

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

PubMed

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

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

2014-03-01

143

Digoxin Reduces 30-Day All-Cause Hospital Admission in Older Patients with Chronic Systolic Heart Failure  

PubMed Central

BACKGROUND Heart failure is a leading cause of hospital admission and readmission in older adults. The new United States healthcare reform law has created provisions for financial penalties for hospitals with higher-than-expected 30-day all-cause readmission rates for hospitalized Medicare beneficiaries ?65 years with heart failure. We examined the effect of digoxin on 30-day all-cause hospital admission in older patients with heart failure and reduced ejection fraction. METHODS In the main Digitalis Investigation Group (DIG) trial, 6800 ambulatory patients with chronic heart failure (ejection fraction ?45%) were randomly assigned to digoxin or placebo. Of these, 3405 were ?65 years (mean age, 72 years, 25% women, 11% non-whites). The main outcome in the current analysis was 30-day all-cause hospital admission. RESULTS In the first 30 days after randomization, all-cause hospitalization occurred in 5.4% (92/1693) and 8.1% (139/1712) of patients in the digoxin and placebo groups, respectively, (hazard ratio {HR} when digoxin was compared with placebo, 0.66; 95% confidence interval {CI}, 0.51–0.86; p=0.002). Digoxin also reduced both 30-day cardiovascular (3.5% vs. 6.5%; HR, 0.53; 95% CI, 0.38–0.72; p<0.001) and heart failure (1.7 vs. 4.2%; HR, 0.40; 95% CI, 0.26–0.62; p<0.001) hospitalizations, with similar trends for 30-day all-cause mortality (0.7% vs. 1.3%; HR, 0.55; 95% CI, 0.27–1.11; p=0.096). Younger patients were at lower risk of events but obtained similar benefits from digoxin. CONCLUSIONS Digoxin reduces 30-day all-cause hospital admission in ambulatory older patients with chronic systolic heart failure. Future studies need to examine its effect on 30-day all-cause hospital readmission in hospitalized patients with acute heart failure. PMID:23490060

Bourge, Robert C.; Fleg, Jerome L.; Fonarow, Gregg C.; Cleland, John G.F.; McMurray, John J.V.; van Veldhuisen, Dirk J.; Gheorghiade, Mihai; Patel, Kanan; Aban, Inmaculada B.; Allman, Richard M.; White-Williams, Connie; White, Michel; Filippatos, Gerasimos S.; Anker, Stefan D.; Ahmed, Ali

2013-01-01

144

Strategies to Reduce 30-Day Readmissions in Older Patients Hospitalized with Heart Failure and Acute Myocardial Infarction.  

PubMed

Readmission within 30 days after hospital discharge for common cardiovascular conditions such as heart failure and acute myocardial infarction is extremely common among older persons. To incentivize investment in reducing preventable rehospitalizations, the United States federal government has directed increasing financial penalties to hospitals with higher-than-expected 30-day readmission rates. Uncertainty exists, however, regarding the best approaches to reducing these adverse outcomes. In this review, we summarize the literature on predictors of 30-day readmission, the utility of risk prediction models, and strategies to reduce short-term readmission after hospitalization for heart failure and acute myocardial infarction. We report that few variables have been found to consistently predict the occurrence of 30-day readmission and that risk prediction models lack strong discriminative ability. We additionally report that the literature on interventions to reduce 30-day rehospitalization has significant limitations due to heterogeneity, susceptibility to bias, and lack of reporting on important contextual factors and details of program implementation. New information is characterizing the period after hospitalization as a time of high generalized risk, which has been termed the post-hospital syndrome. This framework for characterizing inherent post-discharge instability suggests new approaches to reducing readmissions. PMID:25431752

Dharmarajan, Kumar; Krumholz, Harlan M

2014-12-01

145

Hospital length of stay--does 1% TBSA really equal 1 day?  

PubMed

Length of stay (LOS) continues to be a standard variable when evaluating progress and outcomes in burn care. Common wisdom would dictate that this measure is linearly related to TBSA. Is this truly the case? A retrospective review of the National Burn Repository was conducted to evaluate factors that affect hospital LOS. The National Burn Repository data set was obtained from the American Burn Association. Data from the years 2002-2007 were extracted. Unique patients were identified by removing readmissions, outpatients, and patients not admitted. Patients whose "HOSPLOS" and/or "AREATOT" field was blank or 0 were excluded, as were nonthermally injured patients. Patients without an entry for age and dead patients were also excluded. This left a final data set of 52,712 patients for analysis. The data were then analyzed, with %TBSA burned as the independent variable. In patients who survived their entire LOS, the mean LOS increased linearly by decile. Females with a TBSA <40% have a trend toward increased LOS relative to their male counterparts of the same TBSA; however, this trend reverses for TBSA ?40%. Age alone is not a significant predictor of increasing LOS. The cause of burns was predominantly flame related across all deciles of TBSA, and most etiologies for burn demonstrate the predicted increase in LOS per %TBSA. LOS was not significantly affected by insurance type or whether the injury was work related or not. This analysis was confounded by the small numbers of patients with burns >60% and age older than 70 years. Anticipating hospital LOS is not a simple task. Using complex statistical analysis, a linear trend associated with %TBSA can be seen; however, other variables do contribute. Until the precise role of these variables can be elucidated, anticipating patient LOS to be 1 day for every %TBSA is still a useful exercise. PMID:21131842

Johnson, Laura S; Shupp, Jeffrey W; Pavlovich, Anna R; Pezzullo, John C; Jeng, James C; Jordan, Marion H

2011-01-01

146

"Dichos" therapy group: a therapeutic use of Spanish language proverbs with hospitalized Spanish-speaking psychiatric patients.  

PubMed

Physical, emotional, and cultural barriers have resulted in the underutilization of mental health services by Hispanic/Latino individuals. Described in this article is a culturally sensitive intervention that has been developed based on existing elements within Hispanic/Latino culture. The therapeutic uses of dichos--Spanish language proverbs and refranes (sayings)--are explored in the treatment of a regressed population of Hispanic/Latino psychiatric inpatients. The dichos therapy group described in this article utilizes dichos to draw patients into discussions about a wide range of issues, and is able to do so where other efforts fail because of their cultural and familial relevance, vivid imagry, and the flexibility with which they can be used. This intervention effectively facilitates building rapport, decreasing defensiveness, enhancing motivation and participation in therapy, improving self-esteem, focusing attention, stimulating emotional exploration and articulation of feelings, and development of insight, and assists in exploring cultural values and identity. Clinical examples are provided to exemplify these therapeutic effects. PMID:9225563

Aviera, A

1996-01-01

147

Negative cognitions as a moderator in the relationship between PTSD and substance use in a psychiatrically hospitalized adolescent sample.  

PubMed

Adolescents exposed to trauma are more likely to engage in alcohol and marijuana use compared to their nontrauma-exposed counterparts; however, little is known about factors that may moderate these associations. This study examined the potential moderating effect of cognitions relevant to exposure to trauma (i.e., negative view of self, world, and future) in the association between posttraumatic stress disorder (PTSD) diagnosis and substance use among a psychiatric inpatient sample of 188 adolescents. Findings were that PTSD diagnosis was not significantly associated with substance-use diagnoses, but was associated with substance-use symptoms, accounting for 2.9% and 9.6% of the variance in alcohol and marijuana symptoms, respectively. The association between PTSD diagnosis and substance use symptoms, however, was moderated by negative cognitions, with PTSD and high negative cognitions (but not low negative cognitions) being significantly positively associated with substance use symptoms. The relevant cognitions differed for alcohol symptoms and marijuana symptoms. Children and adolescents who experience trauma and PTSD may benefit from early interventions that focus on cognitive processes as one potential moderator in the development of posttrauma substance use. PMID:24659041

Allwood, Maureen A; Esposito-Smythers, Christianne; Swenson, Lance P; Spirito, Anthony

2014-04-01

148

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

PubMed Central

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

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

2014-01-01

149

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

NSDL National Science Digital Library

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 "ÃÂ" for death.

2008-10-06

150

The ambivalent chaplain: negotiating structural and ideological difference on the margins of modern-day hospital medicine.  

PubMed

The chaplain experience in modern-day hospital medicine is largely one of marginalization. It is not, however, an experience without agency. Working within the constraints of difference, chaplains learn how to negotiate on the margins of medicine. This starts with learning the language of hospital medicine, learning to skillfully see, speak, and move in ways that minimize difference. Successes in socialization and acclimation do not, however, guarantee the chaplain a place in the hospital, where chaplains encounter both structural marginalization (resulting from inequalities in power and hierarchy) and ideological marginalization (resulting from inequalities in accepted forms of knowledge and practice). Using the theories of Michel Foucault (1973) and Byron Good (1994), I examine how chaplains negotiate structural and ideological marginality, at times embracing their connection to medicine (downplaying their connection to the institution of religion) and at other times embracing their connection to religion and religious practices. The result is an ambivalent chaplain who strategically embraces one or the other paradigm in order to survive. Using data gathered during a 12-month ethnography of chaplain interns at a university teaching hospital, this article examines the structural and ideological differences between science and religion through the modern-day practice of hospital chaplains. It both introduces readers to the modern-day chaplain, a healer largely absent in ethnography, and adds a renewed perspective to a long-standing body of literature on the relationship between structure and agency, and science and religion. PMID:16546831

Norwood, Frances

2006-01-01

151

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

PubMed Central

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

Banerjee, Sohini

2013-01-01

152

The Validity of Goal Achievement as an Outcome Measure in Physical Rehabilitation Day Hospitals for Older People  

ERIC Educational Resources Information Center

Physical rehabilitation day hospitals are widely used community-based services designed to meet the medical and rehabilitation needs of older people. While there is evidence for the effectiveness of these services, concerns about the shortcomings of how this is measured have led to the recommendation that the achievement of individually tailored…

Kneebone, Ian I.; Hurn, Jane S.; Raisbeck, Elizabeth; Cropley, Mark; Khoshnaw, Hiro; Milton, Jane E.

2010-01-01

153

Bouncing-Back: Patterns and Predictors of Complicated Transitions Thirty Days after Hospitalization for Acute Ischemic Stroke  

PubMed Central

BACKGROUND Multiple complicated transitions or “bounce-backs” soon after hospital discharge may herald health system failure. Acute stroke patients often undergo transitions after hospital discharge, but little is known about complicated transitions in these patients. OBJECTIVE To identify predictors of complicated transitions within thirty days after hospital discharge for acute stroke. DESIGN Retrospective analysis of administrative data SETTING 422 hospitals, southern and eastern United States PARTICIPANTS 39,384 Medicare beneficiaries ?65 years discharged with acute ischemic stroke 1998–2000. MEASUREMENTS Complicated transition defined as movement from less to more intense care setting after hospital discharge, with hospital being most intense and home without home-health care being least intense. RESULTS 20% of patients experienced at least one complicated transition; 16% of those experienced more than one complicated transition. After adjustment using logistic regression, factors predicting any complicated transition included older age, African-American race, Medicaid enrollment, prior hospitalization, gastrostomy tube, chronic disease, length of stay and discharge site. When compared to patients with only one complicated transition, patients with multiple complicated transitions were more likely to be African-American [Odds Ratio=1.38, 95% Confidence Interval=1.13–1.68], be male [1.21, 1.04–1.40], have prior diagnosis of fluid and electrolyte disorder (e.g. dehydration) [1.23, 1.07–1.43], have a prior hospitalization [1.18, 1.01–1.36] and be initially discharged to skilled-nursing facility/long-term care [1.22, 1.04–1.44]. They were less likely to be initially discharged to a rehabilitation center [0.71, 0.57–0.89]. CONCLUSIONS Significant numbers of stroke patients experience complicated transitions soon after hospital discharge. Sociodemographic factors and initial discharge site distinguish patients with multiple complicated transitions. These factors may enable prospective identification and targeting of stroke patients at risk for “bouncing-back”. PMID:17341238

Kind, Amy J. H.; Smith, Maureen A.; Frytak, Jennifer R.; Finch, Michael D.

2008-01-01

154

Reducing seclusion and restraint use in inpatient settings: a phenomenological study of state psychiatric hospital leader and staff experiences.  

PubMed

The current study explored and described the experiences of individuals who either directed or participated in successfully reducing the use of restraint and seclusion (R/S) in two inpatient public mental health hospitals. A phenomenological methodology was used to capture the lived experiences of 21 study participants, including senior leaders, middle managers, and direct care staff, who were interviewed as key informants. Thirty-two themes were extracted and subsequently synthesized into five "meaning themes." The five meaning themes yielded six significant findings: (a) critical roles of leadership and staff in successful R/S reduction projects; (b) ability of leaders and staff to change their beliefs and behaviors; (c) ability of leaders and staff to build a shared vision that was critical to the reduction of R/S use in in-patient settings; (d) identification and resolution of key challenges staff and leaders experienced in reduction efforts; (e) use of a solid performance improvement lens to direct changes in practices; and (f) important lessons learned. PMID:25310675

Huckshorn, Kevin Ann

2014-11-01

155

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

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…

Silverman, Michael J.

2009-01-01

156

Digoxin Use and Lower 30-Day All-Cause Readmission for Medicare Beneficiaries Hospitalized for Heart Failure  

PubMed Central

BACKGROUND Heart failure is the leading cause for hospital readmission, the reduction of which is a priority under the Affordable Care Act. Digoxin reduces 30-day all-cause hospital admission in chronic systolic heart failure. Whether digoxin is effective in reducing readmission after hospitalization for acute decompensation remains unknown. METHODS Of the 5153 Medicare beneficiaries hospitalized for acute heart failure and not receiving digoxin, 1054 (20%) received new discharge prescriptions for digoxin. Propensity scores for digoxin use, estimated for each of the 5153 patients, were used to assemble a matched cohort of 1842 (921 pairs) patients (mean age, 76 years; 56% women; 25% African American) receiving and not receiving digoxin, who were balanced on 55 baseline characteristics. RESULTS 30-day all-cause readmission occurred in 17% and 22% of matched patients receiving and not receiving digoxin, respectively (hazard ratio {HR} for digoxin, 0.77; 95% confidence interval {CI}, 0.63–0.95). This beneficial association was observed only in those with ejection fraction <45% (HR, 0.63; 95% CI, 0.47–0.83), but not in those with ejection fraction ?45% (HR, 0.91; 95% CI, 0.60–1.37; p for interaction, 0.145), a difference that persisted throughout first 12-month post-discharge (p for interaction, 0.019). HRs (95% CIs) for 12-month heart failure readmission and all-cause mortality were 0.72 (0.61–0.86) and 0.83 (0.70–0.98), respectively. CONCLUSIONS In Medicare beneficiaries with systolic heart failure, a discharge prescription of digoxin was associated with lower 30-day all-cause hospital readmission, which was maintained at 12 months, and was not at the expense of higher mortality. Future randomized controlled trials are needed to confirm these findings. PMID:24257326

Ahmed, Ali; Bourge, Robert C.; Fonarow, Gregg C.; Patel, Kanan; Morgan, Charity J.; Fleg, Jerome L.; Aban, Inmaculada B.; Love, Thomas E.; Yancy, Clyde W.; Deedwania, Prakash; van Veldhuisen, Dirk J.; Filippatos, Gerasimos S.; Anker, Stefan D.; Allman, Richard M.

2013-01-01

157

Lunar phase and psychiatric illness in goa.  

PubMed

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

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

1999-01-01

158

Effects of pre-arrest comorbidities on 90-day survival of patients resuscitated from out-of-hospital cardiac arrest  

Microsoft Academic Search

BackgroundFactors that affect prognosis in successfully resuscitated out-of-hospital cardiopulmonary arrest (OHCA) patients in the intensive care unit (ICU) who survived the initial 24 h period of post-resuscitation have not been established. This study was conducted to evaluate the clinical prognostic factors associated with 90-day survival in patients who were successfully resuscitated from OHCA.MethodsThis study was conducted at a tertiary large

Chien-Chang Lee; Min-Shan Tsai; Cheng-Chung Fang; Yi-Jung Chen; Matthew Hui-Ming; Chien-Hwua Huang; Wen-Jone Chen; Shyr-Chyr Chen

2010-01-01

159

Stroke in Isfahan, Iran: Hospital Admission and 28Day Case Fatality Rate  

Microsoft Academic Search

Background: In Isfahan, a city in the middle of Iran, a community intervention trial has been started for cardiovascular disease prevention and control via reducing its risk factors and improvement of relevant healthy behavior. A surveillance system was needed to monitor vascular diseases, especially stroke, during and following this community intervention program. Methods: A prospective study on hospitalized stroke patients

Shahram Oveisgharan; Nizal Sarrafzadegan; Shahin Shirani; Shidokht Hosseini; Parisa Hasanzadeh; Alireza Khosravi

2007-01-01

160

Measurement of Adult Antimicrobial Drug Use in Tertiary Care Hospital Using Defined Daily Dose and Days of Therapy  

PubMed Central

Widespread overuse and inappropriate use of antimicrobial drugs continues to fuel an increase in antimicrobial resistance and leads to consequent treatment complications and increased healthcare costs. In the present study we aimed to describe antimicrobial drug consumption and predictors and to identify potential targets for antimicrobial stewardship. This was a prospective observational study conducted at adult medicine wards of tertiary care teaching hospital over the period of five months. Antimicrobial drug consumption was measured using days of therapy per 1000 patient days and defined daily dose per 1000 patient days. Additionally, predictors of multiple antimicrobial prescribing were also analyzed. Seven hundred thirty patients were screened and 550 enrolled, receiving 1,512 courses of antimicrobial therapy, mainly intravenously (66%). Most frequently prescribed agents were artesunate (13%), ceftriaxone (11%) and metronidazole (10.5%). Overall consumption was 1,533 days of therapy per 1000 patient days and was mainly attributed to antibiotics (98.3%) for empirical therapy (50%). Median days of antimicrobial drugs prescribing were 3 (inter quartile range 2-5). Most commonly consumed antimicrobials were ceftriaxone (31%, 248.8 g) and artesunate (26%, 29 g). Antimicrobials contributed to 72.5% expense of the total incurred. Multivariate analysis reveals that younger patients (?45 years) (odds ratio: 1.59, 95% CI 1.14-2.21) were more likely and absence of comorbidities (odds ratio: 0.58, 95% CI 0.42-0.79) and shorter hospital stay (?6 days)(odds ratio: 0.44, 95% CI 0.32-0.60) were associated with less likelihood of prescribing multiple antimicrobial drugs. Estimating antimicrobial drugs use by defined daily dose method will remain open to criticism because the prescribed dosage is not often in agreement with the “usual” daily dose, which depends on location of and susceptibility of pathogenic organisms and metabolic status of the patient. PMID:25035532

Bansal, Dipika; Mangla, S.; Undela, K.; Gudala, K.; D’Cruz, S.; Sachdev, A.; Tiwari, P.

2014-01-01

161

Measurement of adult antimicrobial drug use in tertiary care hospital using defined daily dose and days of therapy.  

PubMed

Widespread overuse and inappropriate use of antimicrobial drugs continues to fuel an increase in antimicrobial resistance and leads to consequent treatment complications and increased healthcare costs. In the present study we aimed to describe antimicrobial drug consumption and predictors and to identify potential targets for antimicrobial stewardship. This was a prospective observational study conducted at adult medicine wards of tertiary care teaching hospital over the period of five months. Antimicrobial drug consumption was measured using days of therapy per 1000 patient days and defined daily dose per 1000 patient days. Additionally, predictors of multiple antimicrobial prescribing were also analyzed. Seven hundred thirty patients were screened and 550 enrolled, receiving 1,512 courses of antimicrobial therapy, mainly intravenously (66%). Most frequently prescribed agents were artesunate (13%), ceftriaxone (11%) and metronidazole (10.5%). Overall consumption was 1,533 days of therapy per 1000 patient days and was mainly attributed to antibiotics (98.3%) for empirical therapy (50%). Median days of antimicrobial drugs prescribing were 3 (inter quartile range 2-5). Most commonly consumed antimicrobials were ceftriaxone (31%, 248.8 g) and artesunate (26%, 29 g). Antimicrobials contributed to 72.5% expense of the total incurred. Multivariate analysis reveals that younger patients (?45 years) (odds ratio: 1.59, 95% CI 1.14-2.21) were more likely and absence of comorbidities (odds ratio: 0.58, 95% CI 0.42-0.79) and shorter hospital stay (?6 days)(odds ratio: 0.44, 95% CI 0.32-0.60) were associated with less likelihood of prescribing multiple antimicrobial drugs. Estimating antimicrobial drugs use by defined daily dose method will remain open to criticism because the prescribed dosage is not often in agreement with the "usual" daily dose, which depends on location of and susceptibility of pathogenic organisms and metabolic status of the patient. PMID:25035532

Bansal, Dipika; Mangla, S; Undela, K; Gudala, K; D'Cruz, S; Sachdev, A; Tiwari, P

2014-05-01

162

Hospital length of stay in the first 100 days after allogeneic hematopoietic cell transplantation for acute leukemia in remission: comparison among alternative graft sources.  

PubMed

Several studies have shown comparable survival outcomes with different graft sources, but the relative resource needs of hematopoietic cell transplantation (HCT) by graft source have not been well studied. We compared total hospital length of stay in the first 100 days after HCT in 1577 patients with acute leukemia in remission who underwent HCT with an umbilical cord blood (UCB), matched unrelated donor (MUD), or mismatched unrelated donor (MMUD) graft between 2008 and 2011. To ensure a relatively homogenous study population, the analysis was limited to patients with acute myelogenous leukemia and acute lymphoblastic leukemia in first or second complete remission who underwent HCT in the United States. To account for early deaths, we compared the number of days alive and out of the hospital in the first 100 days post-transplantation. For children who received myeloablative conditioning, the median time alive and out of the hospital in the first 100 days was 50 days for single UCB recipients, 54 days for double UCB recipients, and 60 days for MUD bone marrow (BM) recipients. In multivariate analysis, use of UCB was significantly associated with fewer days alive and out of the hospital compared with MUD BM. For adults who received myeloablative conditioning, the median time alive and out of the hospital in first 100 days was 52 days for single UCB recipients, 55 days for double UCB recipients, 69 days for MUD BM recipients, 75 days for MUD peripheral blood stem cell (PBSC) recipients, 63 days for MMUD BM recipients, and 67 days for MMUD PBSC recipients. In multivariate analysis, UCB and MMUD BM recipients had fewer days alive and out of the hospital compared with recipients of other graft sources. For adults who received a reduced-intensity preparative regimen, the median time alive and out of the hospital during the first 100 days was 65 days for single UCB recipients, 63 days for double UCB recipients, 79 days for MUD PBSC recipients, and 79 days for MMUD PBSC recipients. Similar to the other 2 groups, receipt of UCB was associated with a fewer days alive and out of the hospital. In conclusion, length of stay in the first 100 days post-transplantation varies by graft source and is longer for UCB HCT recipients. These data provide insight into the resource needs of patients who undergo HCT with these various graft sources. PMID:25064747

Ballen, Karen K; Joffe, Steven; Brazauskas, Ruta; Wang, Zhiwei; Aljurf, Mahmoud D; Akpek, Görgün; Dandoy, Christopher; Frangoul, Haydar A; Freytes, César O; Khera, Nandita; Lazarus, Hillard M; LeMaistre, Charles F; Mehta, Paulette; Parsons, Susan K; Szwajcer, David; Ustun, Celalettin; Wood, William A; Majhail, Navneet S

2014-11-01

163

Psychiatric medication refill practices of juvenile detainees.  

PubMed

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

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

2013-12-01

164

Classifying emergency 30-day readmissions in England using routine hospital data 2004–2010: what is the scope for reduction?  

PubMed Central

Background Many health systems across the globe have introduced arrangements to deny payment for patients readmitted to hospital as an emergency. The purpose of this study was to develop an exploratory categorisation based on likely causes of readmission, and then to assess the prevalence of these different types. Methods Retrospective analysis of 82 million routinely collected National Health Service hospital records in England (2004–2010) was undertaken using anonymised linkage of records at person-level. Numbers of 30-day readmissions were calculated. Exploratory categorisation of readmissions was applied using simple rules relating to International Classification of Diseases (ICD) diagnostic codes for both admission and readmission. Results There were 5?804?472 emergency 30-day readmissions over a 6-year period, equivalent to 7.0% of hospital discharges. Readmissions were grouped into hierarchically exclusive categories: potentially preventable readmission (1?739?519 (30.0% of readmissions)); anticipated but unpredictable readmission (patients with chronic disease or likely to need long-term care; 1?141?987 (19.7%)); preference-related readmission (53?718 (0.9%)); artefact of data collection (16?062 (0.3%)); readmission as a result of accident, coincidence or related to a different body system (1?101?818 (19.0%)); broadly related readmission (readmission related to the same body system (1?751?368 (30.2%)). Conclusions In this exploratory categorisation, a large minority of emergency readmissions (eg, those that are potentially preventable or due to data artefacts) fell into groups potentially amenable to immediate reduction. For other categories, a hospital's ability to reduce emergency readmission is less clear. Reduction strategies and payment incentives must be carefully tailored to achieve stated aims. PMID:24668396

Blunt, Ian; Bardsley, Martin; Grove, Amy; Clarke, Aileen

2015-01-01

165

Associations Between the Subtypes of Aggression, Parenting Styles and Psychiatric Symptomatology in Children on a Psychiatric Inpatient Unit.  

E-print Network

??Childhood aggression often precedes more costly problem behavior that may result in psychiatric hospitalization. However, aggression is not a unidimensional construct, as there are subdimensions… (more)

Rathert, Jamie Lee

2013-01-01

166

[Experience in the ambulatory care of patients with hematologic diseases at the Hematology Day Hospital].  

PubMed

Upon establishing new out-patient services at the Clinical Centre, Clinic of Hematology has set up a new diagnostic and therapeutic department which is popularly named "Hematologic Daily Hospital". In way, the work at the Clinic of Hematology has been completely changed, since a new activity in the out-patient management of hematologic patients has been initiated. In the course of 8-hour working time numerous various diagnostic and therapeutic interventions are being performed in "Hematologic Daily Hospital", such as: a detailed survey of the patients, biologic material is taken and sent to various analyses, sternal and other functions are performed, cytologic analyses of punctates obtained, patients are referred to radiologic, ultrasonographic, CT and other surveys, administration of parenteral therapy of corresponding solution with or without cytostatics, blood and blood derivate transfusion as well as the application of various forms of apheresis. Data on the number and kinds of services applied are presented in this paper with the insight on the organization of work. Such an organization of work has made diagnostic of hematologic patients faster and has contributed to a simpler employment of therapy. PMID:2642202

Beli?, A; Kljaji?, D; Uzurov, V; Savi?, I

1989-01-01

167

Psychiatric symptoms in vertiginous patients.  

PubMed

Backgrounds: Psychiatric comorbidity is common in vertiginous patients. The risk of psychiatric disorder is increased in patients with previous mental problems, but earlier mentally healthy may develop symptoms as well. Especially in chronic phase of vertigo, psychological factors have a significant role in the morbidity. Aims: The aim of this study was to evaluate the prevalence of psychiatric problems in vertiginous patients in a community sample. Methods: A prospective evaluation of psychiatric symptoms based on self-rating scales [Beck Depression Inventory (BDI), Zung Anxiety Scale (SAS), DSM-IV and ICD-10 Personality Questionnaire (DIP-Q)] in a community sample of 100 vertiginous subjects in the Academic Tertiary Otolaryngology Department at the Helsinki University Hospital, Finland. Results: The prevalence of any psychiatric problem was 68% (68 patients); 19% had depressiveness and 12% symptoms of anxiety. Altogether 63 (63%) patients met the criteria of personality disorder. The most prevalent personality disorder was obsessive-compulsive (46 patients). Personality disorder alone seems not to affect functional capacity and is of importance only when comorbid with symptoms of anxiety and depression. The prevalence of psychiatric symptoms did not correlate with severity of vertigo symptoms or other co-occurring diseases. Conclusions: The prevalence of any psychiatric symptoms was high among vertiginous patients. In the chronic phase of vertigo, it seems that vertigo symptoms themselves do not influence on subjective feelings of debilitation. Psychiatric disorders worsen the clinical picture of vertigo along a more debilitating and disabling course. Psychiatric differential diagnoses should accompany the neuro-otology diagnostic procedure in patients with a chronic state of vertigo and greater disability. PMID:25394373

Ketola, Sirpa; Havia, Mari; Appelberg, Björn; Kentala, Erna

2014-11-14

168

Use of mobile assessment technologies in inpatient psychiatric settings.  

PubMed

Mobile electronic devices (i.e., PDAs, cellphones) have been used successfully as part of research studies of individuals with severe mental illness living in the community. More recently, efforts have been made to incorporate such technologies into outpatient treatments. However, few attempts have been made to date to employ such mobile devices among hospitalized psychiatric patients. In this article, we evaluate the potential use of such devices in inpatient psychiatric settings using 33 hospitalized patients with schizophrenia. Employing an Experience Sampling Method approach, we provide support for the feasibility of using such devices, along with examples of potentially clinically-relevant information that can be obtained using such technologies, including assessment of fluctuations in the severity of psychotic symptoms and negative mood in relation to social context, unit location, and time of day. Following these examples, we discuss issues related to the potential use of mobile electronic devices by patients hospitalized at inpatient psychiatric settings including issues related to patients' compliance, assessment schedules, questionnaire development, confidentiality issues, as well as selection of appropriate software/hardware. Finally, we delineate some issues and areas of inquiry requiring additional research and development. PMID:25042959

Kimhy, David; Vakhrusheva, Julia; Liu, Ying; Wang, Yuanjia

2014-08-01

169

Trends and Variations in the Rates of Hospital Complications, Failure-to-Rescue and 30-Day Mortality in Surgical Patients in New South Wales, Australia, 2002-2009  

PubMed Central

Background Despite the increased acceptance of failure-to-rescue (FTR) as an important patient safety indicator (defined as the percentage of deaths among surgical patients with treatable complications), there has not been any large epidemiological study reporting FTR in an Australian setting nor any evaluation on its suitability as a performance indicator. Methods We conducted a population-based study on elective surgical patients from 82 public acute hospitals in New South Wales, Australia between 2002 and 2009, exploring the trends and variations in rates of hospital complications, FTR and 30-day mortality. We used Poisson regression models to derive relative risk ratios (RRs) after adjusting for a range of patient and hospital characteristics. Results The average rates of complications, FTR and 30-day mortality were 13.8 per 1000 admissions, 14.1% and 6.1 per 1000 admission, respectively. The rates of complications and 30-day mortality were stable throughout the study period however there was a significant decrease in FTR rate after 2006, coinciding with the establishment of national and state-level peak patient safety agencies. There were marked variations in the three rates within the top 20% of hospitals (best) and bottom 20% of hospitals (worst) for each of the four peer-hospital groups. The group comprising the largest volume hospitals (principal referral/teaching hospitals) had a significantly higher rate of FTR in comparison to the other three groups of smaller-sized peer hospital groups (RR?=?0.78, 0.57, and 0.61, respectively). Adjusted rates of complications, FTR and 30-day mortality varied widely for individual surgical procedures between the best and worst quintile hospitals within the principal referral hospital group. Conclusions The decrease in FTR rate over the study period appears to be associated with a wide range of patient safety programs. The marked variations in the three rates between- and within- peer hospital groups highlight the potential for further quality improvement intervention opportunities. PMID:24788787

Ou, Lixin; Chen, Jack; Assareh, Hassan; Hollis, Stephanie J.; Hillman, Ken; Flabouris, Arthas

2014-01-01

170

Telavancin for Hospital-Acquired Pneumonia: Clinical Response and 28-Day Survival  

PubMed Central

U.S. Food and Drug Administration draft guidance for future antibiotic clinical trials of bacterial nosocomial pneumonia recommends the use of diagnostic criteria according to American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines and the use of a primary endpoint of 28-day all-cause mortality. The effect of applying these guidelines on outcomes of phase III nosocomial pneumonia studies of telavancin was evaluated in a post hoc analysis. ATS/IDSA criteria were applied in a blind fashion to the original all-treated (AT) group. Clinical cure rates at final follow-up were determined in the refined AT and clinically evaluable (CE) groups (ATS/IDSA-AT and ATS/IDSA-CE, respectively). The exploratory endpoint of 28-day survival was evaluated for the ATS/IDSA-AT group. Noninferiority of telavancin versus vancomycin was demonstrated, with similar cure rates in the ATS/IDSA-AT (59% versus 59%) and ATS/IDSA-CE (83% versus 80%) groups. Cure rates favored telavancin in ATS/IDSA-CE patients where Staphylococcus aureus was the sole pathogen (86% versus 75%). Overall, 28-day survival rates were similar in the telavancin (76%) and vancomycin (77%) groups but lower in telavancin-treated patients with preexisting moderate-to-severe renal impairment (creatinine clearance [CLCR] of <50 ml/min). Telavancin should be administered to patients with moderate-to-severe renal impairment only if treatment benefit outweighs the risk or if no suitable alternatives are available. PMID:24419353

Corey, G. Ralph; Kollef, Marin H.; Shorr, Andrew F.; Rubinstein, Ethan; Stryjewski, Martin E.; Hopkins, Alan

2014-01-01

171

Telavancin for hospital-acquired pneumonia: clinical response and 28-day survival.  

PubMed

U.S. Food and Drug Administration draft guidance for future antibiotic clinical trials of bacterial nosocomial pneumonia recommends the use of diagnostic criteria according to American Thoracic Society/Infectious Diseases Society of America (ATS/IDSA) guidelines and the use of a primary endpoint of 28-day all-cause mortality. The effect of applying these guidelines on outcomes of phase III nosocomial pneumonia studies of telavancin was evaluated in a post hoc analysis. ATS/IDSA criteria were applied in a blind fashion to the original all-treated (AT) group. Clinical cure rates at final follow-up were determined in the refined AT and clinically evaluable (CE) groups (ATS/IDSA-AT and ATS/IDSA-CE, respectively). The exploratory endpoint of 28-day survival was evaluated for the ATS/IDSA-AT group. Noninferiority of telavancin versus vancomycin was demonstrated, with similar cure rates in the ATS/IDSA-AT (59% versus 59%) and ATS/IDSA-CE (83% versus 80%) groups. Cure rates favored telavancin in ATS/IDSA-CE patients where Staphylococcus aureus was the sole pathogen (86% versus 75%). Overall, 28-day survival rates were similar in the telavancin (76%) and vancomycin (77%) groups but lower in telavancin-treated patients with preexisting moderate-to-severe renal impairment (creatinine clearance [CLCR] of <50 ml/min). Telavancin should be administered to patients with moderate-to-severe renal impairment only if treatment benefit outweighs the risk or if no suitable alternatives are available. PMID:24419353

Corey, G Ralph; Kollef, Marin H; Shorr, Andrew F; Rubinstein, Ethan; Stryjewski, Martin E; Hopkins, Alan; Barriere, Steven L

2014-01-01

172

Beneficial effects of psychiatric intervention on recovery after coronary artery bypass graft surgery.  

PubMed

The effects of perioperative psychiatric intervention were studied in 33 patients undergoing coronary artery bypass graft (CABG) surgery. All patients were evaluated preoperatively using the Mini-Mental State Exam and the Psychological Adjustment to Illness Scale-Self-Report. Participants in the study group (N = 16) had a structured psychiatric interview prior to surgery and were followed daily with supportive psychotherapy throughout their hospitalization. The number of medical complications was higher in the control group. No significant differences were found in neurologic or psychologic complications. The study group used significantly more oxycodone-acetaminophen (Percocet), but less morphine-sulfate or benzodiazepine on postoperative days 3, 4, and 6. The mean length of stay was 3 days shorter for patients in the study group. In the current era of escalating health care costs and high technology, clinical protocols and research studies that evaluate the cost effectiveness and efficacy of psychiatric intervention in medically ill patients should be pursued. PMID:2792747

Schindler, B A; Shook, J; Schwartz, G M

1989-09-01

173

Psychiatric manifestations in cerebrotendinous xanthomatosis  

PubMed Central

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

Fraidakis, M J

2013-01-01

174

42 CFR 456.170 - Medical, psychiatric, and social evaluations.  

Code of Federal Regulations, 2010 CFR

...UTILIZATION CONTROL Utilization Control: Mental Hospitals Medical, Psychiatric, and...evaluations. (a) Before admission to a mental hospital or before authorization...findings; (3) Medical history; (4) Mental and physical functional capacity;...

2010-10-01

175

42 CFR 456.170 - Medical, psychiatric, and social evaluations.  

Code of Federal Regulations, 2014 CFR

...UTILIZATION CONTROL Utilization Control: Mental Hospitals Medical, Psychiatric, and...evaluations. (a) Before admission to a mental hospital or before authorization...findings; (3) Medical history; (4) Mental and physical functional capacity;...

2014-10-01

176

42 CFR 456.170 - Medical, psychiatric, and social evaluations.  

Code of Federal Regulations, 2011 CFR

...UTILIZATION CONTROL Utilization Control: Mental Hospitals Medical, Psychiatric, and...evaluations. (a) Before admission to a mental hospital or before authorization...findings; (3) Medical history; (4) Mental and physical functional capacity;...

2011-10-01

177

42 CFR 456.170 - Medical, psychiatric, and social evaluations.  

Code of Federal Regulations, 2013 CFR

...UTILIZATION CONTROL Utilization Control: Mental Hospitals Medical, Psychiatric, and...evaluations. (a) Before admission to a mental hospital or before authorization...findings; (3) Medical history; (4) Mental and physical functional capacity;...

2013-10-01

178

42 CFR 456.170 - Medical, psychiatric, and social evaluations.  

Code of Federal Regulations, 2012 CFR

...UTILIZATION CONTROL Utilization Control: Mental Hospitals Medical, Psychiatric, and...evaluations. (a) Before admission to a mental hospital or before authorization...findings; (3) Medical history; (4) Mental and physical functional capacity;...

2012-10-01

179

[Hospital day-surgery: comparative evaluation of 3 general anesthesia techniques].  

PubMed

For the voluntary interruption of pregnancy, three anaesthetic techniques have been compared being a random assigned to three groups of 40 patients. Induction of anaesthesia was based on fentanyl 0.005 mg/kg+midazolam 0.2 mg/kg or fentanyl 0.005 mg/kg = propofol 2.5 mg/kg or ketamina 0.5 mg/kg+propofol 2.0 mg/kg. Anaesthesia was maintained delivering in spontaneous-assisted ventilation N2O 70% in O2. In addition to the intraoperative conditions, quality and rapidity of some neurofunctional aspects of the recovery have been evaluated using the Steward Score and the Coin Counting Test respectively. Our data suggest fentanyl-propofol association as the safest one as regards the needs of one-day surgery. PMID:8584192

Rossi, A E; Lo Sapio, D; Oliva, O; Vitale, O; Ebano, A

1995-06-01

180

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

PubMed

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

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

2014-05-01

181

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

PubMed Central

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

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

2014-01-01

182

Advance Directives (Psychiatric)  

MedlinePLUS

... to advocate for the use of "psychiatric living wills" as a mechanism for refusing psychiatric treatment. All of the state laws authorizing psychiatric advance directives except Maine specify that ...

183

[Reflections of a child psychiatrist on the diagnosis and hospitalization in psychiatry of adults: an experience of David Rosenhan].  

PubMed

In the 1970s, David Rosenhan and seven other persons were hospitalized in twelve different psychiatric hospitals, pretending having heard voices uttering such words as void, hollow, thud. They were immediately hospitalized with a diagnosis of schizophrenia and, for one of them, of bipolar condition. Right after entering hospital, they reversed to normal behavior. None of them had a psychiatric history. Nevertheless, they were released after a time lapse of 7 to 52 days with a mean of 19 days. Release diagnosis was the same as the admission with the adjunct "in remission". D. Rosenhan points out the contextual and incertain aspect of the diagnosis and underlines the fact that it is apparently impossible to consider as being normal a person who has been admitted to a psychiatric hospital. Psychiatric labels stick to the skin. D. Rosenhan describes the pervasive boredom in a psychiatric hospital and the general set which leads to de-personalization. C. Chiland gives some precisions on what lead D. Rosenhan to undertake such an "experiment". She analyzes the reactions of the American psychiatric community which felt attacked in it's knowledge to the point of entirely rejecting the message. Indeed the criticism concerned the contextual aspect of diagnosis in the framework of the Gestaltpsychology and called to a necessary awareness of what is experienced by a hospitalized patient. Instead of seeking solutions to ward off the negative effects of the psychiatric hospital, effects that are inherent to any total institution, the community has rejected Rosenhan's experiment as being based on faking. Should a child psychiatrist feel securely innocent? The danger of labelling does exist for the children and their parents. Although a one-way choice in the dynamic contradiction between segregation and integration is not possible, one nevertheless has to remain vigilant regarding the institutions, even in day-care ones, so as to avoid imprisoning the child in rejection or stagnation attitudes. PMID:1494600

Chiland, C

1992-01-01

184

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

PubMed Central

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

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

2014-01-01

185

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

PubMed Central

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

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

2011-01-01

186

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

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

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

2015-01-01

187

[Metabolic syndrome and cardiovascular risk patients under antiretrovirals in a hospital day at Bobo-Dioulasso (Burkina Faso)].  

PubMed

Highly active antiretroviral therapy (HAART) has reduced morbidity and mortality of HIV but has led to an increasing metabolic cardiovascular risk. A cross-sectional study was conducted from May to September 2011 in Day Care Hospital for HIV-Patients of Bobo-Dioulasso. We included in this study 400 patients infected by HIVon antiretroviral therapy ? 6 months selected by a random draw. Metabolic syndrome was assessed according to the definitions of the IDF and ATP-III. The high risk of cardiovascular disease in 10 years was defined by a Framingham score ? 20%. The average age of our patients was 41.4 years [20-76]. 17% received an IP. The average duration of PI exposure was 35.5 months and 50.1 months for NNRTI. The prevalence of diabetes was 1.3% (95% CI: 0.5-3) and that of hypertension of 12.0 % (95% CI: 9.3-16). The prevalence of metabolic syndrome according to IDF was 10% (95% CI: 7.3-13.5) and the metabolic syndrome according to ATP-III 12.3% (95% CI: 9.3-16). The body mass index was higher (BMI 25.2 vs. 22.5 kg/m(2), p <10(-3) with ATPIII and BMI 26.6 vs. 22.4 kg/m(2), p <10(-3) with IDF), and duration exposure to ARVs longer in patients with metabolic syndrome regardless of the definition used (58.6 months vs 27.9 months). High cardiovascular risk was present in 1.8% (95% CI: 0.8 to 3.7) of our patients, all male more than half (n=4/7) of them were smoking. The choice of antiretroviral therapy must take into account its potential long-term toxicity. It should also strengthen supervision. PMID:24953144

Sawadogo, A; Sanou, S; Hema, A; Kamboule, B E; Kabore, N F; Sore, I; Konate, A; Poda, G E A; Zoungrana, J; Sawadogo, A B

2014-08-01

188

Substance Use and Response to Psychiatric Treatment in Methadone-Treated Outpatients with Comorbid Psychiatric Disorder.  

PubMed

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

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

2014-11-01

189

Profiling psychiatric inpatient suicide attempts in Japan.  

PubMed

Suicide is an adverse event that can occur even when patient are hospitalized in psychiatric facilities. This study delineates the demographic characteristics of suicide attempts in mental hospitals and psychiatric wards of general hospitals in Japan, a country where the suicide rate is remarkably high. Analyses of incident reports on serious suicide attempts in psychiatric inpatients were performed using prefectural incident records between April 1, 2001, and December 31, 2012. Suicide reports were included for 35 incidents that occurred over 11 years, and demonstrated that 83% of patients (n = 29) committed suicide and 17% (n = 6) survived their attempt with serious aftereffects, such as cognitive impairment or persistent vegetative state. The male/female ratio of inpatient suicide was 1.5:1. The mean age of the attempters was 50.5 years (SD = 18.2). The most common psychiatric diagnoses for those with suicide incident reports were schizophrenia spectrum disorders (51.4%) and affective disorders (40%). Hanging (60%) was the most common method of suicide attempt, followed by jumping in front of moving objects (14.3%) and jumping from height (11.4%). Fifty-four percent of suicides (n = 19) occurred within hospital sites and the remainder (46%; n = 16) occurred outside hospital sites (e.g., on medical leave or elopement) while they were still inpatients. PMID:25345233

Ikeshita, Katsumi; Shimoda, Shigero; Norimoto, Kazunobu; Arita, Keisuke; Shimamoto, Takuya; Murata, Kiyoshi; Makinodan, Manabu; Kishimoto, Toshifumi

2014-01-01

190

PSYCHIATRIC MORBIDITY IN PATIENTS SUFFERING FROM MENSTRUAL DISTURBANCES  

PubMed Central

SUMMARY Sixty patients attending gynaecology O. P. D. of Smt. Sucheta Kripalani Hospital complaining of menstrual disturbances were compared with 30 controls, who were the relatives of the patients, on PGI- N2, neuroticism scale and Standardized Psychiatric Interivew Schedule. Psychiatric morbidity was found to be 51.7% and 26.6% in the studied sample and the controls respectively. PMID:21927378

Agarwal, Pradeep; Malik, S.C.; Padubidri, V.

1989-01-01

191

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

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

2011-01-01

192

Chromosomal abnormalities in a psychiatric population  

SciTech Connect

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.

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

1995-02-27

193

Correlation between psychometric and biological parameters in anorexic and bulimic patients during and after an intensive day hospital treatment.  

PubMed

This study describes: 1. The therapeutic effects on anorexia nervosa (AN) and bulimia nervosa (BN) patients of a psycho-nutritional intensive day-hospital program; 2. The possible correlation between the changes observed in the psychometric tests and the variations of a number of biological parameters. Forty-six female patients (24 AN and 22 BN) were assessed through a semi-structured clinical interview based on DSM-IV criteria for Eating Disorders (ED) and a number of psychometric tests (SCL-90R, BDI, EDI-2, EAT-40, BITE, BAT) at the beginning and at the end of treatment, and after a 6-month follow-up. At these three times, we also assessed the plasma level of leptin, cortisol, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and 17beta-estradiol together with body mass index (BMI) and menstrual cycle. From beginning to discharge, the scores on all psychometric tests improved in the whole sample, except for the Perfectionism subscale of EDI-2 in both groups (AN and BN), the Anger-Hostility, Phobic Anxiety and Paranoid Ideation subscales of SCL-90 and the Interpersonal Distrust subscale of EDI-2 in the BN group. At follow-up, there was a worsening of the BITE scores and of a number of EDI-2 subscales, especially in the AN subgroup - with these changes correlating with the trend of BMI. In AN patients, plasma leptin levels changed from the beginning to the end of treatment and at follow-up according to BMI changes. The mean plasma leptin level in the BN subgroup was higher than in the AN one. We found a statistically significant correlation with the scores of BDI, SCL-90R Depression and Ineffectiveness subscales, EAT-40, BITE-Symptom subscale and the trend of menses dividing these patients into two subgroups (according to the plasma leptin concentration, higher or lower than the top leptin level in the anorexics). These data seem to confirm that leptin secretion doesn't correlate univocally to BMI. PMID:16755167

Manara, F; Manara, A; Todisco, P

2005-12-01

194

Mental Health Professionals' Perceived Barriers and Benefits, and Personal Concerns in Relation to Psychiatric Research  

Microsoft Academic Search

Aim: Mental health professionals can contribute to generating a strong evidence base for policy and practice in psychiatry. An insight into their perception of psychiatric research is important for planning support strategies. This study explored healthcare professionals' perceptions of barriers, benefits and concerns about psychiatric research in a Singapore psychiatric hospital. Materials and Methods: Self-administered questionnaire was em- ployed to

Elaine Pek; Mythily Subramaniam; Janhavi Vaingankar; Yiong Huak Chan

195

Psychiatric emergencies: the check effect revisited.  

PubMed

Federal income support to persons with alcohol and drug related disabilities was ended in 1997. The argument for ending the programs was that recipients were using their benefits to purchase drugs and alcohol. This supposedly led to the "check effect," an increase in psychiatric emergencies in American communities in the days following the receipt of disability benefits. We test two hypotheses implied by this argument. The first is that psychiatric emergencies are elevated in the fourth through eighth day of the month. The second is that the excess of emergencies in these days was significantly reduced when benefits were ended. The tests are based on 35,500 psychiatric emergencies in San Francisco, California occurring over 1,551 days. Results support the first hypothesis but not the second. The implications are that there is a general check effect and that it was not reduced by ending benefits to persons with drug and alcohol related disabilities. PMID:10331323

Catalano, R; McConnell, W

1999-03-01

196

Psychiatric comorbidity in methamphetamine dependence.  

PubMed

The primary aim of the present study was to assess the prevalence of psychiatric comorbidity in a large sample of methamphetamine (MA)-dependent subjects using a validated structured clinical interview, without limitation to sexual orientation or participation in a treatment program. The secondary aim was to assess whether the prevalence of psychiatric comorbidities varied by gender. Structured clinical interviews (SCIDs) were administered to 189 MA-dependent subjects and lifetime prevalence of DSM-IV diagnoses was assessed. Across the sample, 28.6% had primary psychotic disorders, 23.8% of which were substance-induced; 13.2% had MA-induced delusional disorders and 11.1% had MA-induced hallucinations. A substantial number of lifetime mood disorders were identified that were not substance-induced (32.3%), whereas 14.8% had mood disorders induced by substances, and 10.6% had mood disorders induced by amphetamines. Of all participants, 26.5% had anxiety disorders and 3.7% had a substance-induced anxiety disorder, all of which were induced by MA. Male subjects reported a higher percentage of MA-induced delusions compared to female abusers. Given the impact of MA psychosis and other drug-induced symptoms on hospitals and mental health services, the description and characterization of comorbid psychiatric symptoms associated with MA use is of paramount importance. PMID:21055832

Salo, Ruth; Flower, Keith; Kielstein, Anousheh; Leamon, Martin H; Nordahl, Thomas E; Galloway, Gantt P

2011-04-30

197

Psychiatric comorbidity in methamphetamine dependence  

PubMed Central

The primary aim of the present study was to assess the prevalence of psychiatric comorbidity in a large sample of methamphetamine (MA) dependent subjects using a validated structured clinical interview, without limitation to sexual orientation or participation in a treatment program. The secondary aim was to assess whether the prevalence of psychiatric co-morbidities varied by gender. Structured Clinical Interviews (SCIDs) were administered to 189 MA-dependent subjects and lifetime prevalence of DSM-IV diagnoses was assessed. Across the sample, 28.6% had primary psychotic disorders, 23.8% of which were substance-induced; 13.2% had MA-induced delusional disorders and 11.1% had MA-induced hallucinations. A substantial number of lifetime mood disorders were identified that were not substance induced (32.3%), whereas 14.8% had mood disorders induced by substances, and 10.6% had mood disorders induced by amphetamines. Of all participants, 26.5% had anxiety disorders and 3.7% had a substance-induced anxiety disorder, all of which were induced by MA. Male subjects reported a higher percentage of MA-induced delusions compared to female abusers. Given the impact of MA psychosis and other drug-induced symptoms on hospitals and mental health services, the description and characterization of co-morbid psychiatric symptoms associated with MA use is of paramount importance. PMID:21055832

Salo, Ruth; Flower, Keith; Kielstein, Anousheh; Leamon, Martin H.; Nordahl, Thomas E.; Galloway, Gantt P.

2011-01-01

198

Psychiatric morbidity in prisoners  

PubMed Central

Context: The prevalence of psychiatric illness in correctional settings is significantly elevated, with higher than community rates reported for most mental disorders. Aims: (1) To examine the socio-demographic profile of convicted prisoners. (2) To evaluate the prevalence of psychiatric disorders in convicted prisoners. Materials and Methods: 500 convicts were assessed for psychiatric morbidity with the help of (a) Socio-demographic proforma, (b) Pareek Udai and Trivedi G's socio-economic status scale (rural) (household schedule), (c) Kuppuswamy's economic status scale (urban) and (d) Present State Examination (PSE). Results: 23.8% of the convicted prisoners were suffering from psychiatric illness excluding substance abuse. 56.4% of the prisoners had history of substance abuse / dependence prior to incarceration. Conclusions: The results suggest that a substantial burden of psychiatric morbidity exists in the prison population of India and the burden of psychiatric illness in this vulnerable and marginalized population poses a serious challenge to psychiatrists. PMID:22135446

Goyal, Sandeep Kumar; Singh, Paramjit; Gargi, Parshotam D.; Goyal, Samta; Garg, Aseem

2011-01-01

199

Postgraduate psychiatric training in Thailand.  

PubMed

In Thailand, after medical students graduated from medical schools, the general practitioners have to work for the government for at least three years. Then, they can enroll in postgraduate training program. Postgraduate training usually takes three to four years. All of the psychiatric training programs are supervised and monitored by the board of education of the Royal College of Psychiatrists of Thailand (RCPsychT). One of the missions of all training institutes is to prepare residents to be the high qualified psychiatrists to serve the mental well-being of Thai people. Additionally, they should teach the learners to be the leaders in academic and research fields in psychiatry. Currently, there are nine psychiatric training institutions in Thailand, most of which are running by university programs. The training program core curriculum composes of the compulsory rotations such as general psychiatry, child and adolescent psychiatry, neurology, consultation-liaison psychiatry, mental hospital psychiatry and addiction psychiatry. Moreover, the residents also have three months for elective in each program. The learning process includes practicing in an out-patient and in-patient unit under psychiatric staff supervision, individual and group supervision, case conference, journal club, book club and grand round etc. Research in field of psychiatry and social sciences is also compulsory for board examination. The RCPsychT approved two Certificate Diplomas including Diploma of Thai Board of Psychiatry, and Diploma of Thai Board of Child and Adolescent Psychiatry. There are only nine psychiatric training institutes and only thirty to forty residents enrolled in these programs in each year. The compact and collaboration of all training institutes bring about the benefits in efficiency programs management by regular meeting of representatives from each institute. They keep the standard of training program to progress in the same vision and direction. Furthermore, residents of each training programs can exchange and request for elective rotation at the other institutes. PMID:20058678

Ratta-Apha, Woraphat; Sitdhiraksa, Nantawat; Saisavoey, Nattha; Lortrakul, Manote; Udomratn, Pichet

2009-01-01

200

[The nurse's work in psychiatric emergencies].  

PubMed

Emergency psychiatric situations represent at least 10% of all admissions in general emergency departments in hospitals. The CPOA, the psychiatric orientation and consultation centre, is one of the main units in Paris which deals with crises. The specificities of its practice make it a benchmark centre both in terms of its clinical expertise as well as its care network. However, despite all the ensuing practices and knowledge, containing anxiety is not self-evident and requires readjustments and questioning to preserve the status of the person providing the care. PMID:24979918

Balanger, Vincent; Calas, Jean-François

2014-01-01

201

Multisystemic Therapy Effects on Attempted Suicide by Youths Presenting Psychiatric Emergencies  

ERIC Educational Resources Information Center

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,…

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

2004-01-01

202

Oral health and treatment needs of institutionalized chronic psychiatric patients in Israel  

Microsoft Academic Search

The aim of the study was to examine the oral health and treatment needs of chronically hospitalized psychiatric patients in Israel. Ten percent of the patients hospitalized for more than 2 years in the 18 psychiatric institutions in Israel were selected at random. The dental status (DMF-T index) was calculated, demographic and medical data were retrieved from the files. Of

T. Ramon; A. Grinshpoon; S. P. Zusman; A. Weizman

2003-01-01

203

Reducing the use of seclusion and restraint in psychiatric emergency and adult inpatient services- improving patient-centered care.  

PubMed

The reduction of seclusion and restraint (S/R) use has been given national priority by the US government, The Joint Commission, and patient advocacy groups. It is associated with high rates of patient and staff injuries and is a coercive and potentially traumatizing intervention. The New York City Health and Hospitals Corporation (HHC) is the largest municipal health care system in the country, with 11 HHC facilities operating psychiatric emergency services and inpatient psychiatric services. HHC operates 1117 adult inpatient psychiatric beds with an average length of stay of 22.2 days that generated over 19,000 discharges in 2009. In 2009, there were over 36,000 psychiatric emergency services visits. HHC's Office of Behavioral Health provides strategic leadership, planning, and support for the operations and quality objectives of these services. In January 2007, the corporate office initiated the Seclusion and Restraint Reduction Initiative, with a sequenced, intensive series of interventions and strategies to help focus the behavioral health leadership and staff on the need for continued culture change toward a more patient-centered and safe system of psychiatric emergency and adult inpatient care. From 2007 to 2009, there was a substantial decline in HHC's overall rate of S/R incidents in inpatient units. The more substantial impact was in the reduced overall time spent in S/R; the reduced frequency of use of S/R; and the reduced likelihood of patient injury from S/R use. PMID:21841927

Wale, Joyce B; Belkin, Gary S; Moon, Robert

2011-01-01

204

An Interprofessional Psychiatric Advanced Pharmacy Practice Experience  

PubMed Central

Objective. To create an interprofessional psychiatry advanced pharmacy practice experience (APPE) and assess the initial outcomes. Design. An elective psychiatry APPE was developed in a setting of interdisciplinary practice. Preceptor responsibilities were shared between a psychiatric pharmacist and an attending psychiatrist or psychiatric nurse practitioner. Students were also given the opportunity to shadow and work with other health care professionals such as nurses, social workers, therapists, family nurse practitioners, and utilization review staff members. Assessment. Midpoint and final evaluations demonstrated student advancement throughout the experience as well as the development of communication skills with patients and an increased ability to work collaboratively with other health care providers. Students rated this practice experience highly and their comments reflected achievement of the established learning objectives. Conclusion. An interdisciplinary elective practice experience in psychiatry at a local teaching hospital was effective in teaching psychiatric care and interprofessional interaction. This teaching model can be adapted for use in other practice settings or specialty areas. PMID:23966732

Cooley, Janet

2013-01-01

205

42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.  

Code of Federal Regulations, 2013 CFR

...requirements of this subpart, a national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health...

2013-10-01

206

42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.  

Code of Federal Regulations, 2010 CFR

...requirements of this subpart, a national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health...

2010-10-01

207

42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.  

Code of Federal Regulations, 2012 CFR

...requirements of this subpart, a national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health...

2012-10-01

208

42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.  

Code of Federal Regulations, 2014 CFR

...requirements of this subpart, a national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health...

2014-10-01

209

42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.  

Code of Federal Regulations, 2011 CFR

...requirements of this subpart, a national accreditation program for hospitals; psychiatric hospitals; transplant centers, except for kidney transplant centers; SNFs; HHAs; ASCs; RHCs; CORFs; hospices; religious nonmedical health...

2011-10-01

210

Pattern of Smoking and Nicotine Dependence in Patients with Psychiatric Disorders  

PubMed Central

Background Smoking prevalence is high among psychiatric patients. This study aimed to evaluate the prevalence of smoking, related factors and nicotine dependence in patients suffering from psychiatric disorders. Materials and Methods This analytical descriptive study was performed on patients who had been hospitalized for at least 2 days in Razi Hospital during 2010. Data were collected via an interview and the obtained information was recorded in a questionnaire. Fagerstrom test was also used. After determining the prevalence of smoking in these patients, the related factors and nicotine dependence were also evaluated using multiple logistic regression test and SPSS software. Results A total of 78.4% of men and 36.2% of women in this study were smokers and 64.4% had high nicotine dependence. Final logistic regression models showed that smoking was related with advanced age, male sexuality, hookah consumption, and depression. High nicotine dependence was correlated with hookah consumption and history of suicide attempt. Conclusion Prevalence of smoking is higher among psychiatric patients compared to the public. Adequate intervention and strategies are necessary in these patients to promote smoking cessation. PMID:25191402

Milani, Hooman Sharifi; Kharaghani, Roghieh; Samadi, Rajab; Farhadi, Mohammad Hassan; Ardakani, Mohammad Reza Khodaee; Hesami, Zahra; Masjedi, Mohammad Reza

2012-01-01

211

Association between cigarette smoking and suicide in psychiatric inpatients  

PubMed Central

Introduction Cigarette smoking is the single largest preventable cause of death and disability in the industrialized world and it causes at least 85% of lung cancers, chronic bronchitis and emphysema. In addition smokers are at a higher risk from psychiatric co-morbid illness such as depression and completed suicide. Methods We conducted a cross-sectional survey in which we targeted all patients with serious mental illness (SMI) who were admitted in Razi mental health Hospital in Tehran, Iran. We recruited 984 participants, who were receiving services from Razi mental health Hospital and hospitalized for at least two days between 21 July to 21 September, 2010. Nine hundred and fifty patients out of this figure were able to participate in our study. Results The final study sample (n = 950) consisted of 73.2% males and 26.8% females. The mean age was 45.31 (SD=13.7). A majority of participants (70%) was smoker. A history of never smoking was present for 25.2% of the study sample; while 4.8% qualified as former smokers and 70.0% as occasional or current smokers. Two hundred and nineteen participants had attempted suicide amongst them 102 (46.6%) once, 37 (16.9%) twice, and 80 (36.5%) attempted more than two times in their life time. In regression model, gender, age, and cigarette consumption were associated with previous suicide attempts and entered the model in this order as significant predictors. Conclusion There is an association of cigarette smoking and suicide attempt in psychiatric inpatients. Current smoking, a simple clinical assessment, should trigger greater attention by clinicians to potential suicidality and become part of a comprehensive assessment of suicide risk. PMID:23419005

2013-01-01

212

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.

213

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

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

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

2014-01-01

214

De-hospitalization of the pediatric day surgery by means of a freestanding surgery center: pilot study in the lazio region  

PubMed Central

Background Day surgery should take place in appropriate organizational settings. In the presence of high volumes, the organizational models of the Lazio Region are represented by either Day Surgery Units within continuous-cycle hospitals or day-cycle Day Surgery Centers. This pilot study presents the regional volumes provided in 2010 and the additional volumes that could be provided based on the best performance criterion with a view to suggesting the setting up of a regional Freestanding Center of Pediatric Day Surgery. Methods This is an observational retrospective study. The activity volumes have been assessed by means of a DRG (Diagnosis Related Group)-specific indicator that measures the ratio of outpatients to the total number of treated patients (freestanding indicator, FI). The included DRGs had an FI exceeding the 3rd quartile present in at least a health-care facility and a volume exceeding 0.5% of the total patients of the pediatric surgery and urology facilities of the Lazio Region. The relevant data have been provided by the Public Health Agency and relate to 2010. The best performance FI has been used to calculate the theoretical volume of transferability of the remaining facilities into freestanding surgery centers. Patients under six months of age and DRGs common to other disciplines have been excluded. The Chi Square test has been used to compare the FI of the health-care facilities and the FI of the places of origin of the patients. Results The DRG provided in 2010 amounted to a total of 5768 belonging to 121 types of procedures. The application of the criteria of inclusion have led to the selection of seven final DRG categories of minor surgery amounting to 3522 cases. Out of this total number, there were 2828 outpatients and 694 inpatients. The recourse of the best performance determines a potential transfer of 497 cases. The total outpatient volume is 57%. The Chi Square test has pointed to a statistically significant difference of the facilities and to a non-significant difference of inferiority of the regional places of origin with respect to the city of Rome. Conclusions The activity volumes would seem to support the setting up of a Freestanding Regional Center of Pediatric Day Surgery. This Center represents the healthcare facility that is most likely to allow a de-hospitalization process. Subsequent studies will be required to confirm the validity of this pilot study. PMID:22296851

2012-01-01

215

The relationships among work stress, resourcefulness, and depression level in psychiatric nurses.  

PubMed

Psychiatric nurses are exposed to highly stressful work environments that can lead to depression over time. This study aimed to explore the relationships among work stress, resourcefulness, and depression levels of psychiatric nurses. A cross-sectional design with randomized sampling was used; 154 psychiatric nurses were recruited from six medical centers in Taiwan. Psychiatric nurses' work stress was found positively correlated with their depression level, and negatively related to resourcefulness. Work stress significantly predicted depression level. These results suggest that the hospital administrative units may develop training courses about resourcefulness skills to reduce psychiatric nurses' work stress, and improve their mental health. PMID:25634877

Wang, Shu Mi; Lai, Chien Yu; Chang, Yong-Yuan; Huang, Chiung-Yu; Zauszniewski, Jaclene A; Yu, Ching-Yun

2015-02-01

216

Jail hospitalization of prearraignment patient arrestees with mental illness.  

PubMed

A growing number of individuals with mental illness are receiving psychiatric treatment in the criminal justice system. However, mental health problems facing individuals immediately after arrest and before arraignment have not been adequately studied. In New York City, prearraignment arrestees who require psychiatric hospitalization are temporarily transferred from police custody to correctional custody and admitted to the Bellevue Jail Psychiatry Service (BJPS) for treatment. The purpose of this study was to gain a better understanding of the impact of this jail hospitalization on the legal disposition of this vulnerable population. A retrospective chart review was conducted of 204 consecutively admitted male patient-arrestees on the BJPS. Results showed that admission to the BJPS delayed arraignment by an average of 8.03 days, with longer delays for individuals arrested outside of Manhattan. Although these delays are considered acceptable under legal precedent, concerns arise about the therapeutic impact of this practice on newly arrested individuals with severe mental illness. PMID:24618522

Gray, Susan M; Racine, Christopher W; Smith, Christopher W; Ford, Elizabeth B

2014-01-01

217

A Study on Psychiatric Comorbidity Among the Patients with Migraine  

Microsoft Academic Search

A cross-sectional retrospective study was done in the 'Headache clinic' of Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) comprising a sample of eighty patients with migraine. There were 64(80%), female and 16 male (20%). Among them 19(23.75%) had psychiatric disorder as co-morbidity. In accordance with DSM-IV, the commonest psychiatric illness was major depressive disorder (36.84%).

A A Mamun Hussain; M A Mohit; M A Ahad; M A Alim

2008-01-01

218

Psychiatric consequences of road traffic accidents  

Microsoft Academic Search

OBJECTIVE--To determine the psychiatric consequences of being a road traffic accident victim. DESIGN--Follow up study of road accident victims for up to one year. SETTING--Emergency department of the John Radcliffe Hospital, Oxford. SUBJECTS--188 consecutive road accident victims aged 18-70 with multiple injuries (motorcycle or car) or whiplash neck injury, who had not been unconscious for more than 15 minutes, and

R Mayou; B Bryant; R Duthie

1993-01-01

219

Neuroinflammation and psychiatric illness  

PubMed Central

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

2013-01-01

220

Psychiatric disorders and treatment among newly homeless young adults with histories of foster care  

PubMed Central

Objective While foster care placement is often preceded by stressful events such as childhood abuse, foster care itself often exposes children to additional severe stressors. A history of foster care, as well as the childhood abuse that often precedes it, is common among homeless young adults. However, whether a history of foster care elevates the likelihood of psychiatric disorders and treatment among homeless young adults, after adjustment for childhood abuse, is unknown. This study examined whether a history of foster care was associated with psychiatric disorders, prior psychiatric counseling, prescription of psychiatric medications, and prior psychiatric hospitalization among newly homeless young adults, controlling for childhood abuse and other covariates. Methods Among a consecutive sample of 424 newly homeless young adults (18 to 21 years) in a crisis shelter, logistic regression analyses determined the associations between foster care and any psychiatric disorder (affective, anxiety, personality, psychotic) and psychiatric treatment, adjusted for demographics, childhood abuse, substance abuse, prior arrest, unemployment, lack of high school diploma, and histories of psychiatric disorders and drug abuse among biological relatives. Results Homeless young adults with histories of foster care were 70% more likely to report any psychiatric disorder (AOR=1.70) and twice as likely to have received mental health counseling for a psychiatric disorder (AOR=2.17), been prescribed psychiatric medication (AOR=2.26), and been hospitalized for psychiatric problems (AOR=2.15) than those without such histories. Conclusions Histories of foster care should trigger screening for psychiatric disorders among homeless young adults to aid in the provision of treatment (counseling, medication, hospitalization) tailored to their psychiatric needs. PMID:22706986

Thompson, Ronald G.; Hasin, Deborah S.

2013-01-01

221

The Geriatric Population and Psychiatric Medication  

PubMed Central

With improvement in medical services in the last few years, there has been a constant rise in the geriatric population throughout the world, more so in the developing countries. The elderly are highly prone to develop psychiatric disorders, probably because of age related changes in the brain, concomitant physical disorders, as well as increased stress in later life. Psychiatric disorders in this population may have a different presentation than in other groups and some of psychopathologies might be mistaken for normal age related changes by an unwary clinician. Therefore the need of the day is to train psychiatrists and physicians to better recognize and manage mental disorders in this age group. PMID:21327169

Varma, Sannidhya; Sareen, Himanshu; Trivedi, J.K.

2010-01-01

222

Sickness absence for psychiatric illness: The Whitehall II study  

Microsoft Academic Search

Over the past 20 years, rates of sickness absence have increased and psychiatric disorders have become an important cause of sickness absence. The socio-demographic associations for psychiatric sickness absence are reported from the Whitehall II study, a longitudinal survey of 10,308 London-based male and female civil servants between 35–55 years. Short spells (? 7 days), long spells (> 7 days)

Stephen Stansfeld; Amanda Feeney; Jenny Head; Robert Canner; Fiona North; Michael Marmot

1995-01-01

223

Association of Family Background with Adolescent Smoking and Regular Use of Illicit Substances Among Underage Psychiatric In-Patients  

Microsoft Academic Search

This study investigated whether adolescent's family type was associated with regular smoking or the use of illicit substances (cannabis or hard drugs) among underage adolescent psychiatric in-patients. The sample consisted of 471 adolescents aged 12–17 years admitted to psychiatric hospital between April 2001 and March 2006 at Oulu University Hospital, Finland. The information on family factors and substance use was

Matti Laukkanen; Helinä Hakko; Kaisa Riala; Pirkko Räsänen

2008-01-01

224

Reinstitutionalization Following Psychiatric Discharge among VA Patients with Serious Mental Illness: A National Longitudinal Study  

Microsoft Academic Search

Patterns of reinstitutionalization following psychiatric hospitalization for individuals with serious mental illnesses (SMI)\\u000a vary by medical and psychiatric health care settings. This report presents rates of reinstitutionalization across care settings\\u000a for 35,527 patients following psychiatric discharge in the Department of Veterans Affairs (VA) health system, a national health\\u000a care system. Over a 7-year follow-up period, 30,417 patients (86%) were reinstitutionalized.

Cheryl Irmiter; John F. McCarthy; Kristen L. Barry; Soheil Soliman; Frederic C. Blow

2007-01-01

225

Psychiatric nurses' attitudes toward patients with borderline personality disorder experiencing deliberate self-harm.  

PubMed

The aim of this descriptive study was to explore the attitudes of psychiatric nurses toward patients with borderline personality disorder (BPD) experiencing deliberate self-harm. A convenience sample of psychiatric nurses (N = 83) working on the adult behavioral health units of three psychiatric hospitals in Pennsylvania were surveyed about their attitudes toward BPD inpatients experiencing deliberate self-harm using the Adapted Attitudes towards Deliberate Self-Harm Questionnaire. Psychiatric nurses had positive attitudes toward hospitalized BPD patients with deliberate self-harm issues. Psychiatric nurses with more years of nursing experience and self-reported need for further BPD continuing education had more positive attitudes toward hospitalized BPD patients with deliberate self-harm issues, findings that nurse educators need to consider when planning curricula. Future studies need to examine the longitudinal effect of continuing education on nurses' attitudes and outcomes for BPD patients with deliberate self-harm issues. PMID:23244348

Hauck, Judith L; Harrison, Barbara E; Montecalvo, Anthony L

2013-01-01

226

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

NASA Astrophysics Data System (ADS)

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.

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

1993-06-01

227

Alcohol and Other Psychiatric Disorders  

MedlinePLUS

... Disorders Underage Drinking College Drinking Women Older Adults Minority Health & Health Disparities Other Psychiatric Disorders Other Substance Abuse HIV/AIDS Other Psychiatric Disorders In the current Diagnostic and Statistical Manual of ...

228

Psychiatric Diagnoses as Contemporaneous Risk Factors for Suicide Attempts Among Adolescents and Young Adults: Developmental Changes  

Microsoft Academic Search

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

David B. Goldston; Stephanie Sergent Daniel; Alaattin Erkanli; Beth A. Reboussin; Andrew Mayfield; Patricia H. Frazier; Sarah L. Treadway

2009-01-01

229

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

ERIC Educational Resources Information Center

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

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

2010-01-01

230

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

ERIC Educational Resources Information Center

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…

Farooqi, Yasmin Nilofer

2006-01-01

231

Adult Partial Hospitalization JOHN DEMPSEY HOSPITAL  

E-print Network

." The Adult Partial Hospitalization Program is a day treatment program specifically designed for the diagnosisAdult Partial Hospitalization Program JOHN DEMPSEY HOSPITAL CONTACT US For further information.uchc.edu. The Adult Partial Hospitalization Program is available Monday through Friday from 9 a.m. to 2:05 p.m. OUR

Oliver, Douglas L.

232

Gender and Disorder Specific Criminal Career Profiles in Former Adolescent Psychiatric In-Patients.  

ERIC Educational Resources Information Center

A Norwegian nation-wide sample of 1087 former adolescent psychiatric in-patients, 584 males and 503 females, were followed up 15-33 years after first hospitalization. On the basis of detailed hospital records from index hospitalization all were rediagnosed according to DSM-IV. The patient list was linked to the national criminal register and the…

Kjelsberg, Ellen

2004-01-01

233

Underdiagnosis of alcohol dependence in psychiatric inpatients.  

PubMed

Alcoholism is prevalent among psychiatric inpatients, and accurately diagnosing alcohol problems is a critical step in treatment planning. The authors diagnosed alcohol dependence in 35 psychiatric inpatients by blind review of interview protocols and hospital records. They then examined the frequency with which admitting and attending clinicians diagnosed alcohol abuse and dependence in these patients. Alcoholism was underdiagnosed; 24% of the clinicians' diagnoses included no alcoholism diagnosis, 39% were alcohol abuse, and only 37% were alcohol dependence. Underdiagnosis was strongly associated with the presence of a comorbid psychosis, as well as with patients' denial of alcoholism and with less severe alcoholism. The authors discuss the patient and clinician variables which may contribute to underdiagnosing alcoholism and recommend educational and administrative measures to improve clinicians' diagnostic sensitivity. PMID:1746500

Woodward, B; Fortgang, J; Sullivan-Trainor, M; Stojanov, H; Mirin, S M

1991-01-01

234

Pathological Gambling: Psychiatric Models  

ERIC Educational Resources Information Center

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…

Westphal, James R.

2008-01-01

235

Osteomalacia and vitamin D deficiency in a psychiatric rehabilitation unit: case report and survey  

E-print Network

Abstract Background Vitamin D deficiency is common and predisposes to many serious diseases, yet often goes unrecognized. Findings We describe a case of severe vitamin D deficiency with osteomalacia in a patient resident in a psychiatric hospital...

Cardinal, Rudolf N; Gregory, Carol A

2009-05-09

236

Criterion-referenced evaluation of day one clinical competencies of veterinary students: VOLES-the VMTH (Veterinary Medicine Teaching Hospital) Online Evaluation System.  

PubMed

This article describes an extensive online criterion-referenced evaluation system for the assessment of veterinary students' achievement during their final year's Doctor of Veterinary Medicine (or equivalent) clinical education. Data are reported for the 2001 to 2009 University of California at Davis veterinary graduates, for a total of more than 1,100 students. These criterion-referenced evaluations extensively document the level of clinical skills attained and demonstrated during the individual clinical rotations that comprise the fourth-year curriculum. On average, in each of the 17,500 clinical rotations undertaken during this time period, student performance was assessed in at least 11 separate areas of skills, knowledge, and professional attributes. This provided more than 200,000 criterion-referenced judgments of the individual clinical attributes of graduates over nine years. The system is based on a previously detailed and validated definition of the skills, knowledge, and professional attributes that students should have demonstrated before graduation. The extensive database that this system has provided has established that this system, termed VOLES (VMTH [Veterinary Medicine Teaching Hospital] On-Line Evaluation System), is an effective tool to assess the clinical capabilities of veterinary students and their achievement of the "Day One" skills required for entering clinical practice. These expected proficiencies are balanced according to the differing expectations that each area of veterinary clinical practice demands. PMID:22430080

Zeck, Steven; Wall, Judy A; Smith, Bradford P; Wilson, W David; Walsh, Donal A

2012-01-01

237

Mapping Common Psychiatric Disorders  

PubMed Central

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

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

2013-01-01

238

Comorbidity of Psychiatric and Personality Disorders in First Suicide Attempters  

PubMed Central

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

Rao, K. Nagaraja; Kulkarni, Ranganath R.; Begum, Shamshad

2013-01-01

239

Comorbid Psychiatric and Alcohol Abuse\\/Dependence Disorders  

Microsoft Academic Search

Factors related to comorbid versus only substance disorders are essential to understanding and treating these complex problems. Medical records of sixty-nine inpatients at a private rehabilitation hospital in Southern California were reviewed to determine the associations between personal history factors and (1) comorbid psychiatric and substance abuse disorders and (2) participant's self-assessed progress in treatment. Results revealed significant differences between

Gina L. De Bernardo; Michael Newcomb; Amanda Toth; Gary Richey; Richard Mendoza

2002-01-01

240

Brief Report: Prevalence of Psychiatric Disorders in Pregnant Teenagers  

ERIC Educational Resources Information Center

Purpose: To evaluate the prevalence of ICD-10 psychiatric disorders in a population of pregnant teenage women from a Brazilian public hospital. Method: 1000 pregnant teenage women were evaluated using the Composite International Diagnostic Interview, a structured interview which establishes diagnoses according to the International Classification…

Mitsuhiro, Sandro Sendin; Chalem, Elisa; Barros, Marina Carvalho Moraes; Guinsburg, Ruth; Laranjeira, Ronaldo

2009-01-01

241

Burden and Stress among Psychiatry Residents and Psychiatric Healthcare Providers  

ERIC Educational Resources Information Center

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…

Zuardi, Antonio Waldo; Ishara, Sergio; Bandeira, Marina

2011-01-01

242

MENTAL HOSPITALS IN INDIA  

PubMed Central

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 status The 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

Krishnamurthy, K.; Venugopal, D.; Alimchandani, A.K.

2000-01-01

243

Culture and psychiatric diagnosis.  

PubMed

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

Lewis-Fernández, Roberto; Aggarwal, Neil Krishan

2013-01-01

244

A Tobacco Reconceptualization in Psychiatry (TRIP): Towards the Development of Tobacco-Free Psychiatric Facilities  

PubMed Central

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

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

245

Prevalence of Psychiatric Morbidities in Acute Coronary Heart Disease  

PubMed Central

Introduction. Psychiatric problems and stresses may deteriorate the prognosis of patients with IHD. So evaluating their frequency possibly will promote our perspective regarding their vital importance in the field of consultation-liaison psychiatry. Method and Materials. One hundred and one (101) patients with IHD were interviewed in CCU of a general hospital by a psychiatrist to find whether there was any relationship between cardiac events and psychiatric problems or stresses. Results. Cardiac events were significantly more prevalent among patients with both psychiatric problems and biological risk factors (P < 0.05). Also, the number of patients suffering from psychiatric problems was significantly more than cases without that (P < 0.05). There was a significant difference between male and female patients regarding the type of stress (P < 0.01). 79% of total stresses were experienced by patients who had as well psychiatric problems (P < 0.0001). In addition, there was significantly more dysthymic disorder in the acute group of patients in comparison with major or minor depressive disorder in the chronic group (P < 0.001). Conclusion. The high prevalence of psychiatric problems and psychosocial stresses among patients with IHD deserves sufficient attention by clinicians for detection, monitoring, and management of them. PMID:25140248

Shoja shafti, Saeed

2014-01-01

246

Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring  

PubMed Central

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

2012-01-01

247

Symptom networks and psychiatric categories.  

PubMed

The network approach to psychiatric phenomena has the potential to clarify and enhance psychiatric diagnosis and classification. However, its generally well-justified anti-essentialism views psychiatric disorders as invariably fuzzy and arbitrary, and overlooks the likelihood that the domain includes some latent categories. Network models misrepresent these categories, and fail to recognize that some comorbidity may represent valid co-occurrence of discrete conditions. PMID:20584376

Haslam, Nick

2010-06-01

248

Predictors of Psychiatric Boarding in the Emergency Department  

PubMed Central

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.

Misek, Ryan K.; DeBarba, Ashley E.; Brill, April

2015-01-01

249

[Psychiatric reform 25 years after the General Law of Health].  

PubMed

The paper analyzes the situation of the psychiatric reform 25 years of the General Health Law. The author wonders what has been done and what has been left undone, on the degree of implementation of the Community model that adopts the law and its future sustainability. It highlights, among the strengths, the loss of hegemony of the psychiatric hospital and the great development of alternative resources, and seeks to explain the reason for the inadequacies of care, policy and training, as well as threats: the changes in the management of social and health services, increased privatization of services, the theoretical impoverishment and changing demands of the population. PMID:22212830

Desviat, Manuel

2011-10-01

250

Factors Influencing the Choice of a Psychiatric Residency Program: A Survey of Applicants to the Johns Hopkins Residency Program in Psychiatry  

ERIC Educational Resources Information Center

Objective: The authors set out to determine what general factors are important in the selection of a psychiatric residency program, the views applicants have of several aspects of the Johns Hopkins Hospital Psychiatric Residency Program, and what relationships exist among these elements. Methods: A survey mailed to Johns Hopkins Hospital

Davydow, Dimitry; Bienvenu, Joseph; Lipsey, John; Swartz, Karen

2008-01-01

251

Musicians seeking psychiatric help: a preliminary study of psychiatric characteristics.  

PubMed

Musicians are at increased risk for mental disorders, in particular performance anxiety. Likely causes are high levels of occupational stress, special personality traits, and coping skills. In this cross-sectional study, routine outcome monitoring (ROM) data on clinical and psychosocial characteristics were collected from the first 50 musicians visiting our outpatient psychiatric clinic for performing artists and were compared to those of a large sample of psychiatric outpatients (n=1,498) and subjects from the general population. Of the musician outpatients, 82% (n=41) met the criteria of an Axis I psychiatric disorder. Performance anxiety could not be accurately diagnosed with the MINI-plus, and in a few cases it masked different psychiatric disorders. Musician outpatients scored significantly better on functional scales despite their Axis I disorder, with equal scores on scales measuring distress compared to general outpatients. Musicians displayed significantly higher mean scores on the DAPP-sf subscale measuring narcissistic personality traits than general outpatients and non-patient controls (p=0.001). Diagnostic challenges, in particular regarding performance anxiety, of musicians seeking psychiatric care are thoroughly discussed. Musicians with psychiatric disorders may constitute a group of patients with specific characteristics who may benefit from specialized psychiatric care, and health professionals should be aware of the high prevalence of psychiatric disorders in musicians. PMID:23462899

van Fenema, Esther; Julsing, Jolien E; Carlier, Ingrid V; van Noorden, Martijn S; Giltay, Erik J; van Wee, Nic J; Zitman, Frans G

2013-03-01

252

The certified psychiatric nurse practitioner: advanced practice psychiatric nursing reclaimed  

Microsoft Academic Search

During the decade of the 1990s, health care reform, market forces, population needs, new knowledge in neuroscience and changes in advanced practice regulation provided the impetus for the development of the role of the psychiatric nurse practitioner. Debate about issues of role, scope of practice, educational preparation, titling, and credentialing for the advanced practice psychiatric nurse (APPN) of the future

Pamela Bjorklund

2003-01-01

253

42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...  

Code of Federal Regulations, 2010 CFR

...payment system for inpatient hospital services of psychiatric...MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital Services of...

2010-10-01

254

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.

255

New Frontiers in Psychiatric Technology.  

ERIC Educational Resources Information Center

The second annual educational workshop concerned utilization of psychiatric technicians for technical service to allied professions. Manuscripts are included for the following presentations: (1) "Brief History of Colorado Psychiatric Technicians Association" by Francis L. Hedges, (2) "Hominology--The Approach to the Whole Man" by Theodore C. Kahn,…

Fuzessery, Zoltan, Ed.

256

The Psychiatric Disorders of Childhood.  

ERIC Educational Resources Information Center

A general textbook on the psychiatric disorders of childhood, the book is intended to be an introductory text for students and practitioners working with children (such as psychiatric and pediatric residents and psychologists, teachers, medical students). The genesis of mental illness is discussed in terms of the contributions of heredity and the…

Shaw, Charles R.; Lucas, Alexander R.

257

Psychiatric Emergencies In Family Medicine  

PubMed Central

The family physician is often called upon to deal with psychiatric emergencies. In order to deal with these situations expertly, he/she must be familiar with the techniques of psychiatric assessment and management. A knowledge of community resources is invaluable in treating such patients. PMID:20469247

Smith, V. A.; Goluboff, S.

1975-01-01

258

Biological measures and cellular immunological function in depressed psychiatric inpatients.  

PubMed

Thirty depressed psychiatric inpatients, including 18 with a diagnosis of major depression, and 25 hospital staff controls were compared with respect to cellular immune function--that is, mitogen responsiveness to concanavalin A (con A), phytohemagglutinin (PHA), and pokeweed mitogen (PWM); natural killer cell (NK) activity; and T cell subsets, including helper/inducer T cells (CD4) and suppressor/cytotoxic cells (CD8). Only physically healthy subjects, who had not used psychoactive medications (except for low dose benzodiazepines) or other medications known to affect the immune system for at least 14 days, were included. Paired comparisons of the immune measures of patients with a DSM-III diagnosis of major depression (n = 18) with their controls demonstrated a statistically significant reduction of the patients' con A response. In addition, the patients with major depression had significantly lower con A and PHA responses than the combined patients with other forms of depression (atypical, dysthymic, or atypical bipolar). There was no indication that severity of depression, dexamethasone suppression test status, benzodiazepine use, or age accounted for the differences in immune function. A possibly important, unexpected finding was that antihistamine use was associated with lower immune function. PMID:2017530

Levy, E M; Borrelli, D J; Mirin, S M; Salt, P; Knapp, P H; Peirce, C; Fox, B H; Black, P H

1991-02-01

259

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.

260

The Death of Esmin Green: Considering Ongoing Injustice in Psychiatric Institutions  

Microsoft Academic Search

:Esmin Green died in 2008, in the waiting room of Kings County Psychiatric Hospital in Brooklyn, New York, awaiting an involuntary stay. This case drew wide media attention because she died neglected and face-down on the floor, and her death was caught on video by the hospital's own cameras. I use this case as an example of how feminist bioethics

Sara M. Bergstresser

2011-01-01

261

The Death of Esmin Green: Considering Ongoing Injustice in Psychiatric Institutions  

Microsoft Academic Search

Esmin Green died in 2008, in the waiting room of Kings County Psychiatric Hospital in Brooklyn, New York, awaiting an involuntary stay. This case drew wide media attention because she died neglected and face-down on the floor, and her death was caught on video by the hospital's own cameras. I use this case as an example of how feminist bioethics

Sara M. Bergstresser

2011-01-01

262

Height, weight and body mass index (BMI) in psychiatrically ill US Armed Forces personnel  

PubMed Central

Background In both psychiatrically ill and psychiatrically healthy adults, the connection between health and individuals’ height and weight has long been examined. Specifically, research on the idea that individuals with certain body types were prone to particular psychiatric diseases has been explored sporadically for centuries. The hypothesis that psychiatrically ill individuals were shorter and weighed less than psychiatrically healthy counterparts would correspond with the neurodevelopmental model of psychiatric disease. Method To evaluate possible links between psychiatric illness and physique, the height, weight and BMI of 7514 patients and 85 940 controls were compared. All subjects were part of the National Collaborative Study of Early Psychosis and Suicide (NCSEPS). Patients were US military active duty personnel hospitalized for either bipolar disorder, major depressive disorder, or schizophrenia and controls were psychiatrically-healthy US military active duty personnel matched for date of entry into the service. Results No consistent differences in height, weight or BMI were found between patients and controls, or between patient groups. Some weak ANOVA differences were found between age at the time of entering active duty and weight, as well as BMI, but not height. Conclusions Unlike most previous studies that have looked at the links between height and psychiatric illness, this study of the NCSEPS cohort found that, at entry into the US Armed Forces, there were no consistent decreases in height for patients with bipolar disorder, major depressive disorder or schizophrenia compared with a large control group. Furthermore, there were no consistent differences for weight or BMI. PMID:12622316

WYATT, R. J.; HENTER, I. D.; MOJTABAI, R.; BARTKO, J. J.

2015-01-01

263

Influence of Arousal, Previous Experience, and Age on Surgery Preparation of Same Day of Surgery and In-Hospital Pediatric Patients.  

ERIC Educational Resources Information Center

Studied two pediatric surgery populations (N=66) to determine differences in retention of preparatory information. Results showed that children exposed to a hospital-relevant film retained more information than those children not prepared regardless of age, IQ, previous experience, sex, and time of film preparation. (LLL)

Faust, Jan; Melamed, Barbara G.

1984-01-01

264

The Hospital as Predictor of Children's and Adolescents' Length of Stay  

ERIC Educational Resources Information Center

Objective: To predict psychiatric hospital length of stay (LOS) for a sample of Illinois Department of Children and Family Services wards across 4 fiscal years. Method: A prospective design was implemented using the Children's Severity of Psychiatric Illness scale, a reliable and valid measure of psychiatric severity, risk factors, youth…

Leon, Scott C.; Snowden, Jessica; Bryant, Fred B.; Lyons, John S.

2006-01-01

265

Surgery for psychiatric disorders.  

PubMed

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

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

266

Exorcism: a psychiatric viewpoint.  

PubMed

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

Trethowan, W H

1976-09-01

267

Substance use disorders in an adolescent inpatient psychiatric population.  

PubMed Central

This study examined the comorbidity of substance use disorders and other psychiatric disorders in adolescent populations. The study population was comprised of 100 consecutive admissions, ages 13 to 17, to an acute care adolescent psychiatric inpatient unit for substance use disorders. Patients were assessed using the Personal Experience Screening Questionnaire (PESQ) and the substance-use disorder portion of the Structured Clinical Interview for DSM III-R (SCID-R). Thirty-three (33%) patients were identified as having a substance abuse or dependence diagnosis. There was no significant difference in the age between substance users and nonsubstance users. There were significantly more whites in the substance-using group. Sixty percent of all adolescents interviewed had histories of sexual or physical trauma, with trauma being significantly more common in the substance-using group. There were no significant differences in the number or type of other Axis I or Axis II diagnoses between the two groups. While substance users and nonsubstance users had no significant difference in the number of past psychiatric hospitalizations, nonsubstance users had significantly more past medical hospitalizations. These results indicate that high rates of comorbid substance abuse and psychiatric disorders exist in adolescents, and more in-depth study of comorbidity among adolescents is warranted. PMID:9581443

Deas-Nesmith, D.; Campbell, S.; Brady, K. T.

1998-01-01

268

Reinstitutionalization following psychiatric discharge among VA patients with serious mental illness: a national longitudinal study.  

PubMed

Patterns of reinstitutionalization following psychiatric hospitalization for individuals with serious mental illnesses (SMI) vary by medical and psychiatric health care settings. This report presents rates of reinstitutionalization across care settings for 35,527 patients following psychiatric discharge in the Department of Veterans Affairs (VA) health system, a national health care system. Over a 7-year follow-up period, 30,417 patients (86%) were reinstitutionalized. Among these patients, 73% were initially reinstitutionalized to inpatient psychiatric settings. Homelessness, medical morbidity, and substance use were associated with increased risks for reinstitutionalization. Despite the VA's increased emphasis on outpatient services delivery, the vast majority of patients experienced reinstitutionalization in the follow-up period. Study findings may inform efforts to refine psychiatric and medical assessment for service delivery for this vulnerable population. PMID:17763982

Irmiter, Cheryl; McCarthy, John F; Barry, Kristen L; Soliman, Soheil; Blow, Frederic C

2007-12-01

269

Time and the psychiatric interview: the negotiation of temporal criteria of the depressive disorder.  

PubMed

In this article, I am concerned with doctors' negotiations of the temporal dimension of the diagnostic criteria of depressive disorders during the first psychiatric interview. The data come from 16 initial psychiatric interviews recorded by doctors in three psychiatric hospitals in Poland. Taking a constructionist view of discourse and psychiatric practices, I shall argue that the discursive practice related to temporal information about patients' illnesses serves in gaining information, which is useful in the medical model of psychiatric diagnosis. The doctors positioned the patients' experiences on the timeline when the illness history was taken and temporal information authenticated the information. Conversely, the patients' current conditions were constructed in a limitless present, which allowed the psychiatrists to remove the relativity. PMID:23690146

Ziólkowska, Justyna

2014-03-01

270

[Psychiatric complications of cannabis use].  

PubMed

Cannabis is the most widely used illicit substance, especially among young people. Cannabis use is extremely commonplace and frequently comorbid with psychiatric disorders that raise questions about the etiology. The use of cannabis is an aggravating factor of all psychiatric disorders. Psychiatric complications are related to the age of onset, duration of exposure and individual risk factors of the individual (mental and social health). The panic attack is the most common complication. The link with psychosis is narrow that leads to increased prevention for vulnerable populations. Cannabis is also an indicator of increased depressive vulnerability and an aggravating factor for bipolar disorder. PMID:24579344

Coscas, Sarah; Benyamina, Amine; Reynaud, Michel; Karila, Laurent

2013-12-01

271

Psychiatric Consultation and Substance Use Disorders  

PubMed Central

Background A substantial number of patients in general hospitals will evince substance abuse problems but a majority is unlikely to be adequately identified in the referral-consultation process. This failure may preclude patients from receiving effective interventions for substance use disorders. Objectives 1. To evaluate all referred patients for possible substance use disorders. 2. To ascertain the degree of convergence between patients referred for chemical problems and the corresponding DSM diagnosis. 3. To compare demographic data for substance abusing patients and referrals not so classified. 4. To evaluate conditions concomitant with substance use disorders. Method Consecutive one-year referrals (524) to consultation-liaison psychiatric services were scrutinized for chemically-related problems by psychiatric consultants. Results Of the referrals, 176 met criteria for substance use disorders (SUD) (57% alcohol; 25% other drugs; 18% both alcohol and other drugs). Persons diagnosed with SUD tended to be younger, male, non-Caucasian, unmarried, and unemployed. They were more likely to be depressed, have liver and other gastrointestinal problems, and to have experienced traumatic events; they also tended to have current financial difficulties. Most were referred for SUD evaluation by personnel in general medicine and family practice. Following psychiatric consultation, SUD designated patients were referred mainly to substance abuse treatment programs. The only variable related to recommended inpatient versus outpatient services for individuals with SUD was the Global Assessment of Functioning Axis (GAF) with persons having lower estimated functioning more likely to be referred for inpatient interventions. Conclusions These data are similar to the results of past studies in this area. Unlike previous investigations in the domain of consultative-liaison psychiatry, financial stressors and specific consultant recommendations were included in data gathering. Although the results are encouraging in that individuals with SUD were identified and potentially sent for appropriate treatment, the likelihood is that many patients with SUD remain unrecognized and do not receive necessary consultative and treatment services. PMID:24357934

Specker, Sheila; Meller, William H.; Thurber, Steven

2009-01-01

272

Psychiatric morbidity and posttraumatic symptoms among earthquake victims in primary care clinics  

Microsoft Academic Search

Three months after the devastating Chi-Chi earthquake (magnitude of 7.3 on the Richter scale) struck the central area of Taiwan, 663 victims were screened for psychiatric morbidity at a local general hospital in a community mental health program. The rate of psychiatric morbidity as defined by the 12-item Chinese Health Questionnaire as greater than 4, was 24.5%. Posttraumatic symptoms were

Yen Kuang Yang; Tzung Lieh Yeh; Chwen Cheng Chen; M. R. C. Psycha; Chih Kuei Lee; I Hui Lee; Li-Ching Lee; Keith J. Jeffries

2003-01-01

273

Decision-making capacity for treatment in psychiatric and medical in-patients: cross-sectional, comparative study†  

PubMed Central

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

Owen, Gareth S.; Szmukler, George; Richardson, Genevra; David, Anthony S.; Raymont, Vanessa; Freyenhagen, Fabian; Martin, Wayne; Hotopf, Matthew

2013-01-01

274

Psychiatric and personality disorders in survivors following their first suicide attempt.  

PubMed

The aim of the study was to determine the prevalence of psychiatric and personality disorders in survivors following their first suicide attempt. Three hundred and fortyone survivors who received treatment from the various medical wards of a general hospital participated in the study. ICDIO psychiatric disorders were diagnosed in 47.2% of the cases. The most common diagnosis was depressive episode (31 %). Only 7 % qualified for a diagnosis of personality disorder. A significant proportion of patients (52..8%) did not suffer from any identifiable ICD- 10 psychiatric disorder. PMID:21206833

Chandrasekaran, R; Gnanaseelan, J; Sahai, Ajith; Swaminathan, R P; Perme, Bojir

2003-04-01

275

Understanding the management of people seeking voluntary psychiatric hospitalization who do not meet the criteria for inpatient admission: a qualitative study of mental health liaison nurses working in accident and emergency departments in the north of England.  

PubMed

Mental health liaison nurses assess people who self-present at accident and emergency departments seeking inpatient admission, however not all presentations meet the criteria for admission. Little is known about how liaison nurses manage this client group. This qualitative study explored how liaison nurses manage this client group. This study used the think aloud technique to recreate clinical scenarios of clients requesting admission who do not meet the criteria for such admission. Participants were then subsequently interviewed. Eighteen liaison nurses working in hospitals across the North of England participated. Data were analysed using framework analysis methods. Findings indicate that the liaison nurses use a variety of therapeutic skills and methods in managing this client group. Liaison nurses were found to 'sell' crisis and home-based treatment as an equivalent, or superior in quality, to hospital care. However, the existing evidence base does not fully support this assertion. Liaison nurses face numerous difficulties in this role. In the absence of any formalized training, liaison nurses rely on their own clinical knowledge and expertise. Implications for future service provision and further research are discussed. PMID:25634871

Hepworth, Iain; McGowan, Linda

2015-02-01

276

Psychiatric disorders in the elderly.  

PubMed

Recent research has shown that depression, anxiety disorders, and psychosis are more common than previously supposed in elderly populations without dementia. It is unclear whether the frequency of these disorders increases or decreases with age. Clinical expression of psychiatric disorders in old age may be different from that seen in younger age groups, with less and often milder symptoms. Concurrently, comorbidity between different psychiatric disorders is immense, as well as comorbidity with somatic disorders. Cognitive function is often decreased in people with depression, anxiety disorders, and psychosis, but whether these disorders are risk factors for dementia is unclear. Psychiatric disorders in the elderly are often related to cerebral neurodegeneration and cerebrovascular disease, although psychosocial risk factors are also important. Psychiatric disorders, common among the elderly, have consequences that include social deprivation, poor quality of life, cognitive decline, disability, increased risk for somatic disorders, suicide, and increased nonsuicidal mortality. PMID:21835102

Skoog, Ingmar

2011-07-01

277

Inappropriate admissions to psychiatric wards.  

PubMed

Our seven clinical vignettes illustrate different mechanisms of inappropriate admissions to psychiatric wards and the circumstances and outcome of such admissions, with emphasis on the shared responsibility of psychiatric and nonpsychiatric physicians, the financial consequences, and the implications of such admissions on the profession's public image. Inappropriate admissions create undue tensions and demands on an already overworked psychiatric staff, and raise legitimate issues of quality of care, the need for clinical and administrative guidelines for consultation and transfer, the degree of communication between psychiatry and other specialties, and a host of psychodynamic considerations, somehow overlooked in recent years. The main issue in most cases is the level of communication between the psychiatric and nonpsychiatric camps. Clinical, epidemiologic, and actuarial studies are needed in this area. PMID:4012380

Alarcon, R D; Walter-Ryan, W G; Shaw, L

1985-07-01

278

Substance use disorders in forensic psychiatric patients.  

PubMed

There is a lack of detailed information on the role of substance use disorders (SUD) as a substantial factor in offences and treatment in forensic psychiatric patients. The aim of this study was to get a better understanding of these specifics. Clinical records of 193 male patients admitted to a Dutch forensic psychiatric hospital were scrutinized on anamnestic, diagnostic and risk assessment data. One of the central findings was that the prevalence of SUDs was high. Patients with an SUD had a more extensive criminal history, unstable and deviant lifestyle and higher risk of violent behavior than patients without a substance use disorder. No differences were found in duration of treatment, aggressive incidents and leave. Another important finding was that a distinction could be made between patients with substance use as a primary criminogenic risk factor and patients with substance use as a secondary risk factor. Although substance use is identified as a general risk factor, this study supports the idea of sub categorization of patients with an SUD and emphasizes the need for a different treatment approach. Further study is needed to identify specific treatment approaches, based on more differentiated profiles of these patients. PMID:24268459

van der Kraan, Jolien; Verkes, Robbert Jan; Goethals, Kris; Vissers, Annelies; Brazil, Inti; Bulten, Erik

2014-01-01

279

Psychiatric aspects of Parkinson's disease.  

PubMed

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

Grover, Sandeep; Somaiya, Mansi; Kumar, Santhosh; Avasthi, Ajit

2015-01-01

280

Psychiatric aspects of Parkinson's disease  

PubMed Central

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

Grover, Sandeep; Somaiya, Mansi; Kumar, Santhosh; Avasthi, Ajit

2015-01-01

281

Road rage: a psychiatric phenomenon?  

Microsoft Academic Search

Background: Road rage is a concept recently popularised by the press. An association with psychiatric illness is implied from reports\\u000a of such drivers being “mad”. Previous literature has demonstrated a link between road traffic accidents and mental illness.\\u000a This study examines the relationship between road rage and psychiatric morbidity. It aims to estimate the prevalence of road\\u000a rage by self-report

G. Fong; D. Frost; S. Stansfeld

2001-01-01

282

Clinical characteristics of adolescents later hospitalized for schizophrenia.  

PubMed

Intellectual and behavioral abnormalities, non-psychotic psychiatric disorders, and drug abuse are sometimes present in adolescents who later develop schizophrenia. We followed a population-based cohort of adolescents with baseline assessments of intellectual and behavioral functioning, non-psychotic psychiatric disorders and drug abuse, and ascertained future hospitalization for schizophrenia. Results of the medical and mental health assessments on 16- to 17-year-old male adolescents screened by the Israeli Draft Board, were cross-linked with the National Psychiatric Hospitalization Case Registry, which contains data on all psychiatric hospitalizations in the country. Male adolescents who were later hospitalized for schizophrenia had significantly poorer test scores on all measures in comparison with adolescents not reported to the Psychiatric Registry, the magnitude of the differences was 0.3-0.5 standard deviation (SD). Adolescents (1.03%) of assigned a non-psychotic psychiatric diagnosis, compared to of the adolescents without any psychiatric diagnosis (0.23%), were later hospitalized for schizophrenia. Patients with schizophrenia (26.8%), compared to only 7.4% in the general population of adolescents, had been assigned a non-psychotic psychiatric diagnosis in adolescence (overall OR = 4.5, 95% CI = 3.6-5.6), ranging from OR = 21.5, (<2 >95% CI = 12.6-36.6) for schizophrenia-spectrum personality disorders to OR = 3.6 (<2 >95% CI = 2.1-6.2) for neurosis. The prevalence of self-reported drug abuse was higher in adolescents later hospitalized for schizophrenia (12.4%), compared to the prevalence of drug abuse in adolescents not later hospitalized (5.9%); adjusted RR = 2.033, 95% CI = 1.322-3.126. These results reflect the relatively common finding of impaired intellectual and behavioral functioning, the presence of non-psychotic psychiatric disorders, and drug abuse, in adolescents later hospitalized for schizophrenia, together with the relatively low power of these disorders in predicting schizophrenia. PMID:12457392

Weiser, Mark; Knobler, Haim Y; Noy, Shlomo; Kaplan, Zeev

2002-12-01

283

Implementing a smoking ban in an acute psychiatric admissions unit.  

PubMed

In contrast to general medical hospitals, psychiatric hospitals often allow patients to smoke cigarettes. In addition to obvious health concerns, smoking can also interfere with clinical assessments and therapeutic activities, Implementation of a smoking ban on an acute male admissions unit did not result in any increase in aggressive behaviors. In addition, staff attitudes following the ban improved, and most staff members believed the ban was both ethical and beneficial to patients. Our research indicates that banning smoking on an acute admissions unit is feasible and well tolerated by patients and staff, although it may require extra vigilance for smoking-related contraband. PMID:16350913

Matthews, Linda S; Diaz, Beth; Bird, Paula; Cook, Alan; Stephenson, Anne E; Kraus, John E; Sheitman, Brian B

2005-11-01

284

Psychiatric Symptoms in Patients with Shiga Toxin-Producing E. coli O104:H4 Induced Haemolytic-Uraemic Syndrome  

PubMed Central

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

Eberlein, Christian K.; Kielstein, Jan T.; Bleich, Stefan

2014-01-01

285

[Psychiatric case history of Vincent van Gogh].  

PubMed

Much has been written about Vincent van Gogh's pathological condition. Most authors base their various diagnoses on the symptoms he exhibited in the last years of his life. However, Van Gogh during a much longer part of his life displayed symptoms best consistent with a borderline (personality) disorder: impulsivity, variable moods, self-destructive behaviour, fear of abandonment, an unbalanced self-image, authority conflicts and other complicated relationships. The precipitating element disturbing Vincent's psychic balance--delicate in any case due to a positive family history, malnutrition, intoxication and exhaustion and the borderline disorder--may have been his being deserted by his friend Gauguin. He (also) developed an organic psychosyndrome with psychotic and epileptic elements. The stress (due to social isolation, by his being a psychiatric patient, and by poor prospects), the intoxication going on outside the hospitals and especially also the problems relating to his brother Theo caused a downward spiral culminating in suicide. PMID:11155509

van Meekeren, E

2000-12-23

286

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 ...

287

Hospital Charges of Potentially Preventable Pediatric Hospitalizations  

PubMed Central

Objectives Reducing the number of preventable hospitalizations represents a possible source of healthcare savings. However, the current literature lacks a description of the extent of potentially preventable pediatric hospitalizations. The study objectives are to (1) identify the charges and (2) demographic characteristics associated with potentially preventable pediatric hospitalizations. Methods Secondary analysis of the 2006 Kids’ Inpatient Database (weighted N=7,558,812). ICD-9-CM codes for 16 previously validated pediatric ambulatory care-sensitive (ACS) conditions identified potentially preventable hospitalizations; seven additional conditions reflected updated care guidelines. Outcome variables included number of admissions, hospitalization days, and hospital charges. Demographic and diagnostic variables associated with an ACS condition were compared with regression analyses using appropriate person-level weights. Results Pediatric ACS hospitalizations totaled $4.05B in charges and 1,087,570 hospitalization days in 2006. Two respiratory conditions—asthma and bacterial pneumonia—comprised 48.4% of ACS hospital charges and 46.7% of ACS hospitalization days. In multivariate analysis, variables associated with an ACS condition included: male gender (OR: 1.10; 95% CI: 1.07–1.13); race/ethnicity of black (OR: 1.22; 95% CI: 1.16–1.27) or Hispanic (OR: 1.12; 95% CI: 1.06–1.18); and emergency department (ED) as admission source (OR: 1.37; 95% CI: 1.27–1.48). Conclusions Respiratory conditions comprised the largest proportion of potentially preventable pediatric hospitalizations, totaling as much as $1.96B in hospital charges. Children hospitalized with an ACS condition tend to be male, non-white, and admitted through the ED. Future research to prevent pediatric hospitalizations should examine targeted interventions in the primary care setting, specifically around respiratory conditions and minority populations. PMID:22922047

Lu, Sam; Kuo, Dennis Z.

2014-01-01

288

Housing outcomes for hospitalized homeless veterans.  

PubMed

This study examines housing status at the time of hospital discharge in a national sample of 3,502 veterans who were homeless at admission to a Veterans Health Administration (VHA) medical center. A supplemental survey on homelessness was added to the annual VHA inpatient census over a 4-year period (1995 through 1998). Data from this survey were used to identify homeless veterans hospitalized on the final day of the fiscal year and to document their housing status at discharge. A signal detection technique, Receiver Operating Characteristic analysis, was used to identify predictors of housing status at discharge. At discharge, only 13% of the veterans in our analytic sample were literally homeless, 40% were doubled up, and 33% were transferred to another an institution; only 13% were living independently. Housing status at admission (specifically, staying with friends or family temporarily rather than literally homeless), treatment in a psychiatric or substance abuse program rather than a medical program, and a greater income level or access to VHA benefits were found to be associated with better housing outcomes. As one might expect, homelessness was infrequently resolved during an acute inpatient hospitalization, but few veterans returned to literal homelessness at the time of discharge. PMID:16702725

Greenberg, Greg A; Hoblyn, Jennifer; Seibyl, Catherine; Rosenheck, Robert A

2006-05-01

289

Adult Day Care Programs  

Microsoft Academic Search

Adult day care programs are rapidly becoming an alternative long term care service offered by nursing homes, community hospitals, and community agencies. For an adult day care program to be most effective a therapeutic triad needs to exist between formal caregivers, the elderly client and the informal family caregivers. The purpose of this descriptive study was to identify the profile

Joyce Hedenstrom; Sharon K. Ostwald

1988-01-01

290

Day to Day  

ERIC Educational Resources Information Center

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…

Jurecki, Dennis

2006-01-01

291

1. VIEW OF HOSPITAL COMPLEX FROM MOVIE THEATER, SHOWING SOUTHEAST ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. VIEW OF HOSPITAL COMPLEX FROM MOVIE THEATER, SHOWING SOUTHEAST SECTION OF COMPLEX - Fort Randall, Neuro-Psychiatric Ward, Northeast of intersection of California Boulevard & Nurse Drive, Cold Bay, Aleutian Islands, AK

292

Culturally competent psychiatric nursing care.  

PubMed

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

Wilson, D W

2010-10-01

293

Hospitality Management Hospitality Management  

E-print Network

of the global hospitality industry. Academic Offerings HOSPITALITY AND FOOD SERVICE MANAGEMENT MINOR HOSPITALITY AND FOOD SERVICE MANAGEMENT MINOR Students pursuing programs in other areas of study may choose a minor Service Operations 4 OR NSD 225 Nutrition in Health 3 12 credits needed: HPM 300 Selected Topics: Advanced

McConnell, Terry

294

[Catatonia de novo, report on a case: immediate vital prognosis and psychiatric prognosis in longer term].  

PubMed

We report on the case of a 20 year old woman with no previous psychiatric history, who displayed a first episode of catatonia with acute onset. Symptoms started plainly with sudden general impairment, intense asthenia, headache, abdominal pain and confusion. After 48 hours, the patient was first admitted to an emergency unit and transferred to an internal medicine ward afterwards. She kept confused. Her behaviour was bizarre with permanent swinging of pelvis, mannerism, answers off the point and increasingly poor. The general clinical examination was normal, except for the presence of a regular tachycardia (120 bpm). The paraclinical investigations also showed normal: biology, EEG, CT Scan, lumbar puncture. Confusion persisted. The patient remained stuporous, with fixed gazing and listening-like attitudes. She managed to eat and move with the help of nurses but remained bedridden. The neurological examination showed hypokinaesia, extended hypotonia, sweating, urinary incontinence, bilateral sharp reflexes with no Babinski's sign and an inexhaustible nasoorbicular reflex. The patient was mute and contrary, actively closed her eyes, but responded occasionally to simple instructions. For short moments, she suddenly engaged in inappropriate behaviors (wandering around) while connecting back to her environment answering the telephone and talking to her parents. The patient's temperature rose twice in the first days but with no specific etiology found. During the first 8 days of hospitalization, an antipsychotic treatment was administered: haloperidol 10 mg per os daily and cyamemazine 37.5 mg i.m. daily. Despite these medications, the patient worsened and was transferred to our psychiatric unit in order to manage this catatonic picture with rapid onset for which no organic etiology was found. On admission, the patient was stuporous, immobile, unresponsive to any instruction, with catalepsy, maintenance of postures, severe negativism and refusal to eat. A first treatment by benzodiazepine (clorazepate 20 mg i.v.) did not lead to any improvement. The organic investigations were completed with cerebral MRI and the ruling out of a Wilson's disease. Convulsive therapy was then decided. It proved dramatically effective from the first attempt; 4 shocks were carried out before the patient's relatives ask for her discharge from hospital. The patient revealed she had experienced low delirium during her catatonic state. The clinical picture that followed showed retardation with anxiety. She was scared with fear both for the other patients and the nursing team. She kept distant and expressed few affects. The treatment at the time of discharge was olanzapine 10 mg per os. She was discharged with a diagnosis of catatonia but with no specific psychiatric etiological diagnosis associated. She discontinued her follow-up a few weeks later. After one year, we had no information about her. Catatonia has now become rare but remains a problem for clinicians. We reviewed data concerning short term vital prognosis and psychiatric long term prognosis in catatonia. Lethal catatonia is associated with acute onset, both marked psychomotor and neurovegetative symptoms. In the light of literature, there is no proband clinical criterion during the episode that is of relevant diagnostic value to ascertain the psychiatric etiology. PMID:12640330

Patry, L; Guillem, E; Pontonnier, F; Ferreri, M

2003-01-01

295

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

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

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

296

Quinolones: review of psychiatric and neurological adverse reactions.  

PubMed

Quinolones are a class of antibacterial agents for the treatment of several infectious diseases (e.g. urinary and respiratory tract infections). They are used worldwide due to their broad spectrum of activity, high bioavailability and good safety profile. The safety profile varies from quinolone to quinolone. The aim of this article was to review the neurological and psychiatric adverse drug reaction (ADR) profile of quinolones, using a literature search strategy designed to identify case reports and case series. A literature search using PubMed/MEDLINE (from inception to 31 October 2010) was performed to identify case reports and case series related to quinolone-associated neurological and psychiatric ADRs. The search was conducted in two phases: the first phase was the literature search and in the second phase relevant articles were identified through review of the references of the selected articles. Relevant articles were defined as articles referring to adverse events/reactions associated with the use of any quinolone. Abstracts referring to animal studies, clinical trials and observational studies were excluded. Identified case reports were analysed by age group, sex, active substances, dosage, concomitant medication, ambulatory or hospital-based event and seriousness, after Medical Dictionary for Regulatory Activities (MedDRA®) coding. From a total of 828 articles, 83 were identified as referring to nervous system and/or psychiatric disorders induced by quinolones. 145 individual case reports were extracted from the 83 articles. 40.7% of the individual case reports belonged to psychiatric disorders only, whereas 46.9% related to neurological disorders only. Eight (5.5%) individual case reports presented both neurological and psychiatric ADRs. Ciprofloxacin, ofloxacin and pefloxacin were the quinolones with more neurological and psychiatric ADRs reported in the literature. Ciprofloxacin has been extensively used worldwide, which may explain the higher number of reports, while for ofloxacin and pefloxacin, the number of reports may be over-representative. A total of 232 ADRs were identified from the selected articles, with 206 of these related to psychiatric and/or neurological ADRs. The other 26 were related to other body systems but were reported together with the reactions of interest. Mania, insomnia, acute psychosis and delirium were the most frequently reported psychiatric adverse events; grand mal convulsion, confusional state, convulsions and myoclonus were the most frequently reported neurological adverse events. Several aspects should be taken into account in the development of CNS adverse effects, such as the pharmacokinetics of quinolones, chemical structure and quinolone uptake in the brain. These events may affect not only susceptible patients but also 'healthy' patients. PMID:21585220

Tomé, Ana M; Filipe, Augusto

2011-06-01

297

Risk of self-harm and suicide in people with specific psychiatric and physical disorders: comparisons between disorders using English national record linkage  

PubMed Central

Background Psychiatric illnesses are known risk factors for self-harm but associations between self-harm and physical illnesses are less well established. We aimed to stratify selected chronic physical and psychiatric illnesses according to their relative risk of self-harm. Design Retrospective cohort studies using a linked dataset of Hospital Episode Statistics (HES) for 1999–2011. Participants Individuals with selected psychiatric or physical conditions were compared with a reference cohort constructed from patients admitted for a variety of other conditions and procedures. Setting All admissions and day cases in National Health Service (NHS) hospitals in England. Main outcome measures Hospital episodes of self-harm. Rate ratios (RRs) were derived by comparing admission for self-harm between cohorts. Results The psychiatric illnesses studied (depression, bipolar disorder, alcohol abuse, anxiety disorders, eating disorders, schizophrenia and substance abuse) all had very high RRs (> 5) for self-harm. Of the physical illnesses studied, an increased risk of self-harm was associated with epilepsy (RR?=?2.9, 95% confidence interval [CI] 2.8–2.9), asthma (1.8, 1.8–1.9), migraine (1.8, 1.7–1.8), psoriasis (1.6, 1.5–1.7), diabetes mellitus (1.6, 1.5–1.6), eczema (1.4, 1.3–1.5) and inflammatory polyarthropathies (1.4, 1.3–1.4). RRs were significantly low for cancers (0.95, 0.93–0.97), congenital heart disease (0.9, 0.8–0.9), ulcerative colitis (0.8, 0.7–0.8), sickle cell anaemia (0.7, 0.6–0.8) and Down's syndrome (0.1, 0.1–0.2). Conclusions Psychiatric illnesses carry a greatly increased risk of self-harm as well as of suicide. Many chronic physical illnesses are also associated with an increased risk of both self-harm and suicide. Identifying those at risk will allow provision of appropriate monitoring and support. PMID:24526464

Singhal, Arvind; Ross, Jack; Seminog, Olena; Hawton, Keith

2014-01-01

298

Transorbital lobotomy at Eastern State Hospital (1951-1954).  

PubMed

1. Lobotomy was one of several somatic treatments for psychiatric illness developed in Europe during the 1930s, and was first performed in the United States in 1936. 2. Patients who underwent transorbital lobotomy at Eastern State Hospital were carefully chosen candidates who had exhausted psychiatric treatment options and for whom little else could be offered. 3. Transorbital lobotomy was displaced in 1955 by rauwolfia and chlorpromazine; no lobotomies were performed thereafter at Eastern State Hospital. PMID:8959585

Colaizzi, J

1996-12-01

299

[Movement disorders is psychiatric diseases].  

PubMed

Movement disorders are common in psychiatry. The movement disorder can either be the symptom of a psychiatric disorder, can share a common aetiological factor with it, or can be the consequence of psychopharmacological therapy. Most common features include tic, stereotipy, compulsion, akathisia, dyskinesias, tremor, hypokinesia and disturbances of posture and gait. We discuss characteristics and clinical importance of these features. Movement disorders are frequently present in mood disorders, anxiety disorders, schizophrenia, catatonia, Tourette-disorder and psychogenic movement disorder, leading to differential-diagnostic and therapeutical difficulties in everyday practice. Movement disorders due to psychopharmacotherapy can be classified as early-onset, late-onset and tardive. Frequent psychiatric comorbidity is found in primary movement disorders, such as Parkinson's disease, Wilson's disease, Huntington's disease, diffuse Lewy-body disorder. Complex neuropsychiatric approach is effective concerning overlapping clinical features and spectrums of disorders in terms of movement disorders and psychiatric diseases. PMID:25577484

Hidasi, Zoltan; Salacz, Pal; Csibri, Eva

2014-12-01

300

Psychiatric rehabilitation today: an overview  

PubMed Central

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

RÖSSLER, WULF

2006-01-01

301

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

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

Harris, Robert D; Parker, Gary

2015-02-01

302

The Correlation between Methadone Dosage and Comorbid Psychiatric Disorders in Patients on Methadone Maintenance Treatment  

PubMed Central

Background Methadone Maintenance Treatment is a useful method for opioid dependents, which results in harm reduction and increased quality of life in opioid dependents. The prevalence of psychiatric disorders in addicts is higher than in the general population which can interfere with the course and treatment of substance dependents and decrease the efficacy of treatment. Methods This descriptive, cross-sectional study was aimed to determine the correlation between psychiatric disorders and methadone dosage. It was performed on 154 patients of Kerman Shahid Beheshti Hospital’s Methadone Clinic during a six month period from Dec 2010 to Jul 2011. The study population was chosen by convenience sampling. The searching tools were Socio-Demographic Questionnaire, psychiatric structured interview based on DSM-IV-TR, Beck Depression Inventory, Young Mania Rating Scales, and Anxiety and Depression Rating Scales. Findings Significant correlations were observed between increased methadone dosage and antisocial personality disorder. In addition, significant positive correlations were observed between increased methadone dosage and Hamilton anxiety scores, Hamilton depression scores and Young Mania scores. Conclusion High methadone dosage may be a marker of coexisting psychiatric disorders in patients on methadone maintenance treatment which indicates the necessity of devoting further attention to this group. Psychiatric services should be open and accessible to the patients, especially those who seek treatment voluntarily. Early diagnosis and treatment of patients with coexisting psychiatric disorders may increase the efficacy of methadone maintenance treatment. PMID:24494130

Parvaresh, Nooshin; Masoudi, Arman; Majidi-Tabrizi, Shiva; Mazhari, Shahrzad

2012-01-01

303

Observed-predicted length of stay for an acute psychiatric department, as an indicator of inpatient care inefficiencies. Retrospective case-series study.  

PubMed Central

Background Length of stay (LOS) is an important indicator of efficiency for inpatient care but it does not achieve an adequate performance if it is not adjusted for the case mix of the patients hospitalized during the period considered. After two similar studies for Internal Medicine and Surgery respectively, the aims of the present study were to search for Length of Stay (LOS) predictors in an acute psychiatric department and to assess the performance of the difference: observed-predicted length of stay, as an indicator of inpatient care inefficiencies. Methods Retrospective case-series of patients discharged during 1999 from the Psychiatric Department from General Hospital "Hermanos Ameijeiras" in Havana, Cuba. The 374 eligible medical records were randomly split into two groups of 187 each. We derived the function for estimating the predicted LOS within the first group. Possible predictors were: age; sex; place of residence; diagnosis, use of electroconvulsive therapy; co morbidities; symptoms at admission, medications, marital status, and response to treatment. LOS was the dependent variable. A thorough exam of the patients' records was the basis to assess the capacity of the function for detecting inefficiency problems, within the second group. Results The function explained 37% of LOS variation. The strongest influence on LOS came from: age (p = 0.002), response to treatment (p < 0.0001), the dummy for personality disorders (p = 0.01), ECT therapy (p = 0.003), factor for sexual and/or eating symptoms (p = 0.003) and factor for psychotic symptoms (p = 0.025). Mean observed LOS is 2 days higher than predicted for the group of records with inefficient care, whereas for the group with acceptable efficiency, observed mean LOS was 4 days lower than predicted. The area under the ROC curve for detecting inefficiencies was 69% Conclusions This study demonstrates the importance of possible predictors of LOS, in an acute care Psychiatric department. The proposed indicator can be readily used to detect inefficiencies. PMID:15102334

Jiménez, Rosa E; Lam, Rosa M; Marot, Milagros; Delgado, Ariel

2004-01-01

304

Relationship between occupational stress and depression among psychiatric nurses in Japan.  

PubMed

Abstract Psychiatric nursing is a stressful area of nursing practice. The purpose of this study was to examine occupational stress among psychiatric nurses in Japan. In this cross-sectional study, 238 psychiatric nurses were recruited from 7 hospitals. Data regarding the Generic Job Stress Questionnaire (GJSQ), the Center for Epidemiologic Studies for Depression scale (CES-D), and the Health Practice Index (HPI) were obtained via self-report questionnaires. After adjusting for all the variables, CES-D scores were associated with job stress, but social support reduced the effect of stress on depression among psychiatric nurses. However, the interpretation of our results was hampered by the lack of data concerning important occupational factors, such as working position, personal income, and working hours. Further longitudinal investigation into the factors associated with depression may yield useful information for administrative and psychological interventions. PMID:25148581

Yoshizawa, Kaori; Sugawara, Norio; Yasui-Furukori, Norio; Danjo, Kazuma; Furukori, Hanako; Sato, Yasushi; Tomita, Tetsu; Fujii, Akira; Nakagam, Taku; Sasaki, Masahide; Nakamura, Kazuhiko

2014-08-22

305

[Applying the human dignity ideals of Confucianism and Kant to psychiatric nursing: from theory to practice].  

PubMed

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

Lee, Mei-Hsiu; Lee, Shui-Chuen; Lee, Shu-Chen

2012-04-01

306

Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus.  

PubMed

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

Oliveira, Matheus F; Oliveira, João R M; Rotta, José M; Pinto, Fernando C G

2014-06-01

307

Psychiatric disorders and traumatic brain injury  

PubMed Central

Psychiatric disorders after traumatic brain injury (TBI) are frequent. Researches in this area are important for the patients’ care and they may provide hints for the comprehension of primary psychiatric disorders. Here we approach epidemiology, diagnosis, associated factors and treatment of the main psychiatric disorders after TBI. Finally, the present situation of the knowledge in this field is discussed. PMID:19043523

Schwarzbold, Marcelo; Diaz, Alexandre; Martins, Evandro Tostes; Rufino, Armanda; Amante, Lúcia Nazareth; Thais, Maria Emília; Quevedo, João; Hohl, Alexandre; Linhares, Marcelo Neves; Walz, Roger

2008-01-01

308

Psychiatric Morbidity and Quality of Life in Vitiligo Patients  

PubMed Central

Background: Vitiligo has underlying mental illness but mostly not diagnosed and never used psychiatric medication. Hence, the problem persists affecting mostly the individual's quality of life. Aim: Assessing the quality of life, level of depression, and self-esteem of patients with vitiligo and give psychiatric medication for underlying mental illness. Materials and Methods: The study conducted at Owaisi Hospital Research Centre, Hyderabad. The patients registered for dermatologist consultation were also registered for consultation with psychiatrist to rule out any mental illness after detailed evaluation using standardized scales. Results: Patients suffering with vitiligo had depression and low self-esteem; their quality of life was disturbed. Conclusion: The findings provide the role of Mental Health Professionals involved in the field of dermatology for the patients suffering with vitiligo. PMID:25035556

Ramakrishna, Podaralla; Rajni, Tenali

2014-01-01

309

Psychiatric Morbidity and Referral on Two General Medical Wards  

Microsoft Academic Search

Psychiatric morbidity among 230 medical inpatients was determined by a two-stage screening procedure, using the General Health Questionnaire and Standardized Psychiatric Interview. Of these patients, 23% were considered psychiatrically ill, affective disorders being the commonest illnesses encountered; and 27 (12%) were psychiatrically referred. While referral was related to severity of psychiatric illness and previous psychiatric illness, the degree to which

G. P. Maguire; D. L. Julier; K. E. Hawton; J. H. J. Bancroft

1974-01-01

310

PSYCHIATRIC DISORDERS ASSOCIATED WITH FXTAS  

PubMed Central

Carriers of the FMR1 premutation (with 55-200 CGG repeats) may present with multiple medical and psychiatric disorders. Middle-aged carriers (males more often than females) may suffer from fragile X-associated tremor/ataxia syndrome (FXTAS). FXTAS is a newly discovered neurodegenerative disease characterized by intention tremor and ataxia, along with several other neurological features. Psychiatric manifestations are common in premutation carriers of both genders and include attention deficits, anxiety, depression, irritability, impulse dyscontrol, and substance abuse or dependence. Major depressive disorder, panic disorder with or without agoraphobia, generalized anxiety disorder, social phobia, and specific phobia are among the psychiatric diagnoses often encountered in premutation carriers, including those with FXTAS. Later in the course of the illness, cognitive deficits (including dementia) may occur. In this paper, we discuss common psychiatric phenotypes in FXTAS, based on a thorough review of the literature, as well as our own research experience. Symptomatic pharmacologic treatments are available, although disease modifying agents have not yet been developed.

Seritan, Andreea L.; Ortigas, Melina; Seritan, Stefan; Bourgeois, James A.; Hagerman, Randi J.

2015-01-01

311

Psychiatric complications of 'Ecstasy' use  

Microsoft Academic Search

Two case reports are presented of significant psychiatric disorders associated with ingestion of 'Ecstasy' (3,4-methylenedioxymethamphetamine), a recreational drug whose use appears to be increasing. In one case, the patient developed a brief paranoid psychosis which recurred and persisted for at least a month after he took a second dose of the drug. In the other, the patient experienced persistent symptoms

Sietske Boeles; Eluned Dorkins; Robert Peveler

1994-01-01

312

Psychiatric morbidity in asymptomatic human immunodeficiency virus patients  

PubMed Central

Background: Psychiatric morbidity in human immunodeficiency virus (HIV) patients is being studied all over the world. There is paucity of Indian literature particularly in asymptomatic HIV individuals. Aim: The aim of the following study is to establish the prevalence and the determinants of psychiatric morbidity in asymptomatic HIV patients. Materials and Methods: A cross-sectional study was undertaken to assess psychiatric morbidity as per ICD-10 dacryocystorhinostomy criteria in 100 consecutive asymptomatic seropositive HIV patients and an equal number of age, sex, education, economic and marital status matched HIV seronegative control. All subjects were assessed with the general health questionnaire (GHQ), mini mental status examination, hospital anxiety and depression scale (HADS) and sensation seeking scale (SSS) and the scores were analyzed statistically. Results: Asymptomatic HIV positive patients had significantly higher GHQ caseness and depression but not anxiety on HADS as compared to HIV seronegative controls. On SSS asymptomatic HIV seropositive subjects showed significant higher scores in thrill and adventure seeking, experience seeking and boredom susceptibility as compared to controls. HIV seropositive patients had significantly higher incidence of total psychiatric morbidity. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. Conclusion: Psychiatric morbidity is higher in asymptomatic HIV patients when compared to HIV seronegative controls. Among the individual disorders, alcohol dependence syndrome, sexual dysfunction and adjustment disorder were significantly increased compared with HIV seronegative controls. High sensation seeking and substance abuse found in HIV seropositive patients may play a vital role in engaging in high-risk behavior resulting in this dreaded illness. PMID:25013313

Chauhan, V. S.; Chaudhury, Suprakash; Sudarsanan, S.; Srivastava, Kalpana

2013-01-01

313

Acute behavioral crises in psychiatric inpatients with autism spectrum disorder (ASD): Recognition of concomitant medical or non-ASD psychiatric conditions predicts enhanced improvement.  

PubMed

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

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

314

Influence of aeroionotherapy on some psychiatric symptoms  

NASA Astrophysics Data System (ADS)

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.

Deleanu, M.; Stamatiu, C.

1985-03-01

315

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

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

2013-01-01

316

Neuroimaging Correlates of Novel Psychiatric Disorders after Pediatric Traumatic Brain Injury  

ERIC Educational Resources Information Center

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…

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

317

Emergency Psychiatric Service Use by Individuals with Intellectual Disabilities Living with Family  

ERIC Educational Resources Information Center

The purpose of this study was to describe the experiences of individuals with intellectual disabilities (ID) and their families in the emergency department (ED). Hospital chart audits were conducted on a sample of 20 individuals with ID living with family who had visited the ED for a psychiatric crisis. Individuals had a combined total of 44 ED…

Lunsky, Yona; Tint, Ami; Robinson, Suzanne; Khodaverdian, Alin; Jaskulski, Christine

2011-01-01

318

Designing a state-level prospective payment system for inpatient psychiatric services in medicaid  

Microsoft Academic Search

New Hampshire's new payment system for hospital psychiatric services is described. The system puts into practice arguments that incentives to reduce levels of care in a pure prospective payment system should be weakened and that “experience rating” should be used to ensure more fair payment to providers. This paper describes the system and summarizes the arguments.

Thomas G. McGuire; William S. Mosakowski; Linda S. Radigan

1990-01-01

319

Psychiatric Morbidity, Violent Crime, and Suicide among Children and Adolescents Exposed to Parental Death  

ERIC Educational Resources Information Center

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…

Wilcox, Holly C.; Kuramoto, Satoko J.; Lichtenstein, Paul; Langstrom, Niklas; Brent, David A.; Runeson, Bo

2010-01-01

320

Psychiatric outcome following paediatric intensive care unit (PICU) admission: a cohort study  

Microsoft Academic Search

Objective To determine whether paediatric intensive care unit (PICU) admission is associated with greater psychiatric morbidity in children and parents as compared with general paediatric ward admissions. Design Retrospective cohort study. Setting Paediatric intensive care unit and two general paediatric wards of a London teaching hospital. Participants Children aged 5–18 years discharged from PICU (exposed cohort) and general paediatric wards (unexposed

Gwyneth Rees; Julia Gledhill; M. Elena Garralda; Simon Nadel

2004-01-01

321

Symptom, Family, and Service Predictors of Children's Psychiatric Rehospitalization within One Year of Discharge.  

ERIC Educational Resources Information Center

Objective: To investigate predictors of readmission to inpatient psychiatric treatment for children aged 5 to 12 discharged from acute-care hospitalization. Method: One hundred nine children were followed for 1 year after discharge from inpatient care. Time to rehospitalization was the outcome of interest. Predictors of readmission, examined via…

Blader, Joseph C.

2004-01-01

322

A Study of Childhood Social Competence, Adult Premorbid Competence, and Psychiatric Outcome in Three Schizophrenic Subtypes  

ERIC Educational Resources Information Center

School and hospital records were used to examine childhood social competence, adult premorbid competence, and psychiatric outcome in adult schizoaffective, paranoid, and undifferentiated schizophrenics. A significant difference existed in childhood interpersonal competence and adult social competence among the subtypes. Results reflect…

Lewine, R. J.; And Others

1978-01-01

323

Examining the Impact of Psychiatric Diagnosis and Comorbidity on the Medical Lethality of Adolescent "Suicide Attempts"  

ERIC Educational Resources Information Center

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…

Mc Manama O'Brien, Kimberly H.; Berzin, Stephanie C.

2012-01-01

324

Psychiatric Diagnoses as Contemporaneous Risk Factors for Suicide Attempts among Adolescents and Young Adults: Developmental Changes  

ERIC Educational Resources Information Center

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…

Goldston, David B.; Daniel, Stephanie Sergent; Erkanli, Alaattin; Reboussin, Beth A.; Mayfield, Andrew; Frazier, Patricia H.; Treadway, Sarah L.

2009-01-01

325

Self-reported peer victimization and suicidal ideation in adolescent psychiatric inpatients: the mediating role of negative self-esteem.  

PubMed

The current study investigated relationships among self-reported peer victimization, suicidality, and depression in adolescent psychiatric inpatients. Sixty-seven adolescent psychiatric inpatients at a Midwestern children's hospital completed measures of bullying and peer victimization, suicidal ideation, and depression during their inpatient stay. Analyses indicated significant moderate correlations among victimization, suicidal ideation, and depression in adolescents. Results from mediational analyses found that negative self-esteem mediated the relationship between peer victimization and suicidal ideation. To date, this study is the first to directly examine the mechanisms underlying the relationship between peer victimization and suicidal ideation in adolescent psychiatric inpatients. PMID:23827938

Jones, Heather A; Bilge-Johnson, Sumru; Rabinovitch, Annie E; Fishel, Hazel

2014-10-01

326

Psychiatric Aspects of Organ Transplantation  

PubMed Central

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

Kalra, G.; Desousa, A.

2011-01-01

327

[Ketamine: psychiatric indications and misuses].  

PubMed

Ketamine or -ketamine hydrochloride- is used as an anesthesic and a painkiller. It may also, in some indications, be prescribed in psychiatry and addictology. A literature review was conducted from 2003 to 2013, in PubMed, Google Scholar, Embase, and Psyclnfo, using the following key words (alone or combined): "ketamine", "abuse", "addiction", "dependence" and "misuse". Various studies have shown the benefit of kétamine in some psychiatric conditions such as major depressive episodes and electroconvulsive therapy. Others have demonstrated beneficial effects in alcohol or opiate abstinence maintenance. Ketamine seems to be a promising molecule in psychiatry and in the treatment of addictions, despite the absence of marketing approval for those specific uses. Being a strong psycho-stimulant, ketamine can be the source of abuse and dependence with somatic, psychiatric and cognitive complications. PMID:25158385

Delimbeuf, N; Petit, A; Karila, L; Lejoyeux, M

2014-01-01

328

[Role of the psychiatric liaison nurse in suicide risk prevention].  

PubMed

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

Lemoine, Nathalie Cornet; Bossis, Marie Laure; Giffaud, Sandrine; Guitteny, Marie; Bulteau, Samuel; Vanelle, Jean-Marie; Sauvaget, Anne; Volkaert, Matthieu

2014-01-01

329

[Dermatitis artifacta--psychiatric causes].  

PubMed

Dermatitis artifacta is a psychodermatological condition in which skin lesions are produced or inflicted by the patient's own actions. Patients present with lesions of various forms and bizarre shapes, which are difficult to recognize. Lesions can mimic many different dermatological diseases, but they mostly resemble superficial erosion, hyperpigmented maculae, excoriation or ulcerations. Patients often deny responsibility, so the direct confrontation will mostly lead to withdrawal and seeking help somewhere else. An effective therapeutic relationship requires a nonjudgemental, empathic and supportive environment in order to encourage return to follow up, and eventually talk about the possible psychological basis of the disease. Dermatitis artifacta is difficult to diagnose and is rarely recognized, but it is estimated that 0.2%-0.5% of dermatological patients suffer from this disease. There is generally considered to be a female preponderance, but estimates vary from 1:3 to 1:20 male to female ratio. Most affected patients are in their teens or early adulthood. Many patients suffer from a psychiatric illness, mostly borderline personality disorder. Patients may suffer from anxiety, depression or somatoform disorders. There is strong association with eating disorders; it is estimated that dermatitis artifacta occurs in approximately one-third of patients with anorexia or bulimia. Patients may have subconscious compulsion based on psychological or emotional need to elicit care; the illness often serves as an extreme form of nonverbal communication. Dermatitis artifacta occurs in patients with poor coping skills and often represents a maladaptive response to psychological stressor. Treatment is very difficult and with variable outcomes. Dermatitis artifacta is a challenging condition that requires both dermatological and psychiatric expertise, but unfortunately psychiatric treatment is rarely conducted since patients deny their responsibility and refuse psychiatric help. PMID:23193836

Zivkovi?, Maja Vurnek; Situm, Mirna

2012-10-01

330

Psychiatric aspects of bariatric surgery  

PubMed Central

Purpose of review Bariatric surgery has been consistently shown to be effective in long-term marked weight loss and in bringing significant improvement to medical comorbidities such as metabolic syndrome. Empirical data suggest a high prevalence of psychiatric disorders among bariatric surgery candidates. In this review, we focus on the studies published recently with a high impact on our understanding of the role of psychiatry in bariatric surgery. Recent findings This article reviews the specific psychopathologies before surgery, changes in psychopathologies after surgery, suicide risk related to bariatric surgery, factors associated with weight loss, and recommendations for presurgical and postsurgical assessment and management. Research indicates a decrease in certain psychiatric symptoms after weight loss with bariatric surgery. However, the risk of suicide and unsuccessful weight loss in some bariatric surgery patients make monitoring following surgery as important as careful assessment and management before surgery. Specific considerations for youth and older populations and future potential research foci are discussed. Summary Recent publications suggest new directions for psychiatric evaluation and interventions for bariatric surgery patients. Future research on outcomes of specific populations, effectiveness of psychopharmacotherapy, and underlying pathophysiology are warranted for the advancement of treating bariatric surgery patients. PMID:25036421

Yen, Yung-Chieh; Huang, Chih-Kuan; Tai, Chi-Ming

2014-01-01

331

Psychiatric morbidities among mentally ill wives of Nepalese men working abroad  

PubMed Central

Introduction: Husband working abroad may have not only favorable outcomes for wives and other family members but also adverse consequences, including psychological problems. Present study intended to look into psychiatric morbidity profiles of the Nepalese female psychiatric patients and the stressors related with their husband working abroad. Materials and Methods: This is a hospital-based descriptive study with convenient sampling method. Hundred consecutive female psychiatric patients, with the particular stressor, coming into the contact of the investigating team were enrolled within the study period of 12 months. The psychiatric morbidities/diagnoses were sorted out according to the International classification of disease and infirmity, 10th edition (ICD-10) criteria. Results: Average age of the enrolled cases was 29 years. Nearly half of the women were illiterate or barely literate. Some other stressors, besides the one of husband working abroad were found to precipitate the illness in about 60%, main being relational and health problems. Common presenting complaints were mood, anxiety, and physical symptoms. Almost 30% of the subjects had some mental illness in their past too and similar proportion had in their blood relatives. About one-third admitted to use substances, mainly alcohol and cigarettes. The common psychiatric diagnoses were mood, anxiety, neurotic, and stress-related disorders. Nearly 10% had presented for suicide attempt. Conclusions: The status of husband working abroad may have adverse consequences in mental health of women. Mood affect, anxiety, and stress-related disorders are common psychiatric illness among them.

Shakya, Dhana Ratna

2014-01-01

332

Psychiatric disorders in individuals diagnosed with infantile autism as children: a case control study.  

PubMed

The objective of this study was to compare the prevalence and types of psychiatric disorders in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with psychiatric disorders in 336 matched controls from the general population using data from the nationwide Danish Psychiatric Central Register. The average observation time was 32.5 years, and mean age at follow-up was 40.6 years (range 25-55 years). Of the 118 individuals with IA, 57 (48.3%) had been in contact with psychiatric hospitals (inpatient hospitalization or outpatient visits) during the follow-up period, compared with 20/336 (6.0%) in the control group (p < 0.0001). This observation should alert general psychiatrists to the possibility of additional treatable psychiatric disorders occurring in individuals with IA. Of the 118 individuals in the IA group, 20 individuals (17%) had been given a comorbid psychiatric diagnosis during the observation period, compared with 9 individuals (2.7%) in the control group. Of the subjects with IA, 3.4% had received a diagnosis of schizophrenia (F20) at least once since the index admission in childhood, 0.8% had been diagnosed with delusional disorder (F22), 0.8% with acute psychotic disorder (F23), and 1.6% with unspecified non-organic psychosis (F29). In the control group, 0.9% had been diagnosed with schizophrenia (p = 0.08). In the group with IA, 3.4% had received a diagnosis in the broad category of affective disorders compared with 1.2% in the control group (p = 0.21). Issues associated with using registers in the ascertainment of co-occurring psychiatric disorders in IA are discussed. PMID:18212598

Mouridsen, Svend Erik; Rich, Bente; Isager, Torben; Nedergaard, Niels Jørgen

2008-01-01

333

Psychiatric disturbance and decision-making.  

PubMed

The relationship between psychiatric disorder (as measured by severity of psychoneurotic status and depression) and decision-making behaviour was examined in a sample of 39 hospitalised patients. Measures based on the conflict theory of decision-making of Janis and Mann (1977) and the expectancy-value theory of decision-making of Edwards (1961) were administered. Patients who scored highest on measures of psychoneurotic disorder--the Middlesex Hospital Questionnaire and the Beck Depression Inventory--were least confident about their decision-making. They also reported a high use of maladaptive decision-making coping patterns, in particular decision avoidance. Slightly over one-half of the patients demonstrated an ability to make rational decisions, while the remainder made either irrational decisions or avoided making any decision at all. Observation in the test session revealed that patients were strikingly slow in answering the questionnaires and often attempted to make no response. The importance of this area of research for patient assessment and treatment is discussed. PMID:3464265

Radford, M H; Mann, L; Kalucy, R S

1986-06-01

334

Hospital Waste Management in Nonteaching Hospitals of Lucknow City, India  

PubMed Central

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

Manar, Manish Kumar; Sahu, Krishna Kumar; Singh, Shivendra Kumar

2014-01-01

335

Methodological challenges in using the Finnish Hospital Discharge Register for studying fire-related injuries leading to inpatient care  

PubMed Central

Background The objective was to examine feasibility of using hospital discharge register data for studying fire-related injuries. Methods The Finnish National Hospital Discharge Register (FHDR) was the database used to select relevant hospital discharge data to study usability and data quality issues. Patterns of E-coding were assessed, as well as prominent challenges in defining the incidence of injuries. Additionally, the issue of defining the relevant amount of hospital days accounted for in injury care was considered. Results Directly after the introduction of the ICD-10 classification system, in 1996, the completeness of E-coding was found to be poor, but to have improved dramatically around 2000 and thereafter. The scale of the challenges to defining the incidence of injuries was found to be manageable. In counting the relevant hospital days, psychiatric and long-term care were found to be the obvious and possible sources of overestimation. Conclusions The FHDR was found to be a feasible data source for studying fire-related injuries so long as potential challenges are acknowledged and taken into account. Hospital discharge data can be a unique and powerful means for injury research as issues of representativeness and coverage of traditional probability samples can frequently be completely avoided. PMID:23496937

2013-01-01

336

Training Psychiatric Residents to Treat Blacks  

PubMed Central

As only 600 of the 30,000 psychiatrists in America are black, it is apparent that black psychiatrists in the United States will not be able to meet the needs of all the mentally ill blacks in this country. In view of this situation, the authors feel that psychiatric residency training programs should prepare psychiatric residents to treat black patients. This paper describes some of the knowledge base and experience that residents need to treat black psychiatric patients. PMID:3392750

Bell, Carl C.; Fayen, Maurine; Mattox, Gail

1988-01-01

337

The Correlation Between Psychiatric Disorders and Women’s Lives  

PubMed Central

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

Bursalioglu, Fusun Sevimli; Aydin, Nazan; Yazici, Esra; Yazici, Ahmet Bulent

2013-01-01

338

The impact of inpatient suicide on psychiatric nurses and their need for support  

Microsoft Academic Search

Background  The nurses working in psychiatric hospitals and wards are prone to encounter completed suicides. The research was conducted\\u000a to examine post-suicide stress in nurses and the availability of suicide-related mental health care services and education.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Experiences with inpatient suicide were investigated using an anonymous, self-reported questionnaire, which was, along with\\u000a the Impact of Event Scale-Revised, administered to 531 psychiatric nurses.

Chizuko Takahashi; Fuminori Chida; Hikaru Nakamura; Hiroshi Akasaka; Junko Yagi; Atsuhiko Koeda; Eri Takusari; Kotaro Otsuka; Akio Sakai

2011-01-01

339

ASD, a Psychiatric Disorder, or Both? Psychiatric Diagnoses in Adolescents with High-Functioning ASD  

ERIC Educational Resources Information Center

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…

Mazefsky, Carla A.; Oswald, Donald P.; Day, Taylor N.; Eack, Shaun M.; Minshew, Nancy J.; Lainhart, Janet E.

2012-01-01

340

Psychiatric Service Use and Psychiatric Disorders in Adults with Intellectual Disability  

ERIC Educational Resources Information Center

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

Bhaumik, S.; Tyrer, F. C.; McGrother, C.; Ganghadaran, S. K.

2008-01-01

341

Cultural relativism and psychiatric illness.  

PubMed

Psychiatry has had a long-standing association with sociology and, especially, cultural anthropology. These social sciences have been influential in developing the concept of cultural relativism and applying it to psychiatry, sometimes in a challenging way and with much detriment. The concept has been used by some antipsychiatrists in attempts to discredit psychiatric practice. Contemporary psychiatrists endorsing a form of biological determinism have tended to either disregard the concept or judge it as trivial if not nonsensical. This study describes the concept of cultural relativism, reviews its applications to illness, and analyzes its implications from a historical and theoretical point of view. Its varied aspects, power, and limitations are discussed. PMID:2664073

Fabrega, H

1989-07-01

342

Economic impact of psychiatric relapse and recidivism among adults with schizophrenia recently released from incarceration: a Markov model analysis.  

PubMed

Abstract Objectives: To develop an economic model that estimates the cost burden of psychiatric relapse and recidivism among patients with schizophrenia recently released from incarceration from a US state government perspective. Methods: A Markov state-transition model was developed to estimate the numbers of schizophrenia patients recently-released from incarceration who would experience psychiatric relapse and/or arrest and re-incarceration over a period of 3 years, along with corresponding costs. The model includes three health states: (1) in community, on therapy, (2) in community, off therapy, and (3) incarcerated. It is assumed that a patient's probability of psychiatric hospitalization increases with treatment discontinuation, and the probability of arrest increases with the occurrence of a prior psychiatric hospitalization. Data from the US Census and Bureau of Justice Statistics were used to estimate the model population. Published literature was used to estimate the risks of psychiatric relapse, arrest, and all cost inputs. State-specific incarceration rates and sentence length data (from the state of Florida) were applied. The impact on outcomes and costs was evaluated by varying the rates of anti-psychotic treatment following release from incarceration and the annual risk of medication discontinuation. Results: Among 34,500 persons released from incarceration in the state of Florida annually, 5307 were estimated to have schizophrenia. The cumulative 3-year costs to the state government were $21,146,000 and $25,616,000 for criminal justice and psychiatric hospitalization costs, respectively ($3984 per patient criminal justice; $4827 per patient hospitalization costs). A relative 20% increase in the proportion of patients receiving antipsychotic treatment following release from incarceration decreased total cumulative costs over 3 years by $1,871,100 ($353 per patient). Conclusions: The economic impact of psychiatric relapse and recidivism among patients with schizophrenia is substantial from the state government perspective. This general model can be made state-specific by utilizing local criminal justice data sources. PMID:25266814

Lin, Iris; Muser, Erik; Munsell, Michael; Benson, Carmela; Menzin, Joseph

2014-11-26

343

Physical, addictive, and psychiatric disorders among homeless veterans and nonveterans.  

PubMed Central

A cross-sectional survey of 1,431 homeless adults was conducted during the winter of 1989-90 at three shelters in Santa Clara County, CA, with a 98 percent response rate. Of the 1,008 U.S.-born men, 423, or 42 percent, were veterans, including 173 combat-exposed veterans and 250 noncombat-exposed veterans. There were 585 nonveterans. Both combat and noncombat-exposed veterans were significantly more likely to report excessive alcohol consumption before their initial loss of shelter than were nonveterans. Combat-exposed veterans had the highest prevalences of psychiatric hospitalizations and physical injuries before homelessness, 1.5 to 2 times higher than nonveterans and noncombat-exposed veterans. The length of time between military discharge and initial loss of shelter was longer than a decade for 76 percent of combat-exposed veterans and 50 percent of noncombat-exposed veterans. The extended time from discharge to homelessness suggests that higher prevalences of alcohol consumption, psychiatric hospitalization, and physical injury among veterans, especially those exposed to combat, may not have arisen from military service. It is possible, however, that such disorders may be considerably delayed before becoming serious enough to impact one's family, work, and the availability of shelter. PMID:8434094

Winkleby, M A; Fleshin, D

1993-01-01

344

42 CFR 456.482 - Medical, psychiatric, and social evaluations.  

Code of Federal Regulations, 2010 CFR

... false Medical, psychiatric, and social evaluations. 456.482 Section 456...456.482 Medical, psychiatric, and social evaluations. If a facility provides...age 21, the medical, psychiatric, and social evaluations required by §§...

2010-10-01

345

42 CFR 456.482 - Medical, psychiatric, and social evaluations.  

Code of Federal Regulations, 2011 CFR

... false Medical, psychiatric, and social evaluations. 456.482 Section 456...456.482 Medical, psychiatric, and social evaluations. If a facility provides...age 21, the medical, psychiatric, and social evaluations required by §§...

2011-10-01

346

28 CFR 549.42 - Use of psychiatric medications.  

Code of Federal Regulations, 2014 CFR

...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...

2014-07-01

347

28 CFR 549.42 - Use of psychiatric medications.  

Code of Federal Regulations, 2013 CFR

...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...

2013-07-01

348

28 CFR 549.42 - Use of psychiatric medications.  

Code of Federal Regulations, 2012 CFR

...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...

2012-07-01

349

Psychiatric resilience: longitudinal twin study  

PubMed Central

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

Amstadter, Ananda B.; Myers, John M.; Kendler, Kenneth S.

2014-01-01

350

Epigenetic signaling in psychiatric disorders.  

PubMed

Psychiatric disorders are complex multifactorial illnesses involving chronic alterations in neural circuit structure and function. While genetic factors are important in the etiology of disorders such as depression and addiction, relatively high rates of discordance among identical twins clearly indicate the importance of additional mechanisms. Environmental factors such as stress or prior drug exposure are known to play a role in the onset of these illnesses. Such exposure to environmental insults induces stable changes in gene expression, neural circuit function, and ultimately behavior, and these maladaptations appear distinct between developmental and adult exposures. Increasing evidence indicates that these sustained abnormalities are maintained by epigenetic modifications in specific brain regions. Indeed, transcriptional dysregulation and associated aberrant epigenetic regulation is a unifying theme in psychiatric disorders. Aspects of depression and addiction can be modeled in animals by inducing disease-like states through environmental manipulations (e.g., chronic stress, drug administration). Understanding how environmental factors recruit the epigenetic machinery in animal models reveals new insight into disease mechanisms in humans. PMID:24709417

Peña, Catherine J; Bagot, Rosemary C; Labonté, Benoit; Nestler, Eric J

2014-10-01

351

[A comparative clinico-economic study of 2 models of organizational forms of psychiatric care exemplified in schizophrenia].  

PubMed

The authors describe part of the results of a comparative clinico-economic analysis of the functioning of two models of organizational forms of psychiatric services with special reference to Moscow and Kaluga. The purpose of the given research fragment was to make a comparative analysis of expenditures on schizophrenic patients depending on the system of psychiatric services organization on the whole and between different types of services; to specify approaches to optimization of their functioning with the use of a clinico-economic approach. Based on a comparative investigation of the representative groups of schizophrenic patients (386 patients of a mental health center in Moscow and 531 patients of the Kaluga regional psychiatric hospital No. 1), it has been established that as a result of the proper organization and financing of psychiatric services in Kaluga, the "direct" expenditures on one schizophrenic patient per year could be 20% as reduced and the losses of the national income could be lowered more than 2-fold. It should necessarily be mentioned that the financing of extra hospital services in Kaluga exceeded that in Moscow more than 3-fold, reaching about 20.3% of all the expenditures on schizophrenic patients. Apparently, the organizational and financial experience gained in Kaluga with the design of the common complex and many-staged system of psychiatric services may turn fairly instrumental in elaborating approaches to optimization of the functioning of psychiatric services. PMID:1332339

Ushakov, Iu V; Bogdanova, E D; Shipin, S V; Mirzoian, M G

1992-01-01

352

Psychiatric Mental Health Nurse Practitioner Clinical Courses  

E-print Network

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

Cui, Yan

353

Ayahuasca in Adolescence: A Preliminary Psychiatric Assessment  

Microsoft Academic Search

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

Dartiu Xavier Da Silveira; Charles S. Grob; Marlene Dobkin de Rios; Enrique Lopez; Luisa K. Alonso; Cristiane Tacla; Evelyn Doering-Silveira

2005-01-01

354

Personal Digital Assistants in Psychiatric Education  

ERIC Educational Resources Information Center

Objective: This article describes the various administrative and clinical applications for PDA use in psychiatric care and review the process for implementation in an academic medical center. Method: The authors reviewed the psychiatric literature and tested various hardware and software products. Results: The literature describes various uses of…

Luo, John S.; Ton, Hendry

2006-01-01

355

Community Mental Health and the Psychiatric Foundation.  

ERIC Educational Resources Information Center

The National Association of Psychiatric Technology (NAPT), a non-profit organization, is the outgrowth of local and state organizations of psychiatric attendants, aides, and technicians who had banded together to improve their knowledge and skills and to demonstrate their competence to assume greater responsibilities in the care and treatment of…

National Association of Psychiatric Technology, Sacramento, CA.

356

The Role of The Psychiatric Nurse  

Microsoft Academic Search

Objective: To provide an overview of the interdisciplinary team from the perspective of a psychiatric nurse.Conclusion: Psychiatric nursing has undergone many changes over the years, including changes to the training and registration of nurses and the scope and location of their activities. Tensions within the interdisciplinary team may emerge from a lack of understanding of the skills and abilities of

Margaret Grigg

2001-01-01

357

Adults with Psychiatric Disabilities on Campus.  

ERIC Educational Resources Information Center

Individuals with mental illness and resulting psychiatric disabilities are entitled to the same rights as all other Americans, but services needed to integrate these people fully into the community are not yet in place, especially in the field of higher education. Postsecondary education is an opportunity for qualified students with psychiatric

Unger, Karen V.

358

Psychiatric Comorbidity in Migraine: A Review  

Microsoft Academic Search

Investigations of migraine comorbidity have confirmed its association with diverse psychiatric conditions. This association appears to be strongest for major depression and anxiety disorders (particularly panic and phobia), but increased comorbidity has also been reported with substance abuse and certain mood disorders. This literature also indicates that greater psychiatric comorbidity exists for migraine sufferers with aura than without. Some support

F Radat; J Swendsen

2005-01-01

359

Impulse control disorders in psychiatric inpatients  

Microsoft Academic Search

The aim of this study was to examine the prevalence of impulse control disorders (ICDs) in a European psychiatric inpatient sample. Two hundred thirty four consecutive psychiatric inpatients (62% female) were examined using a module of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) that has been developed for ICDs (SCID-ICD). In addition

Astrid Müller; Katharina Rein; Ines Kollei; Andrea Jacobi; Andrea Rotter; Patricia Schütz; Thomas Hillemacher; Martina de Zwaan

2011-01-01

360

Accommodating Faculty and Staff with Psychiatric Disabilities.  

ERIC Educational Resources Information Center

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…

Lee, Barbara A.; Ruger, Peter H.

361

Forensic psychiatric expert witnessing within the criminal justice system in Germany.  

PubMed

In recent years, the number of occupied beds in German forensic-psychiatric hospitals has continued to rise. Diversion refers to the removal of offenders from the criminal justice system at any stage of the procedure and court proceedings. There are no specific diversion programs in Germany but diversion does in fact happen via legal regulations that are based on the construct of legal responsibility. The assessments of responsibility as well as risk are the core tasks of forensic-psychiatric expert witnessing in Germany. Recommendations of an interdisciplinary working group serve as a guide to operationalize this forensic-psychiatric task. These recommendations list formal minimum requirements for expert reports on the question of criminal responsibility and risk assessment as well as minimum standards regarding content and in writing the report. PMID:24268458

Konrad, Norbert; Völlm, Birgit

2014-01-01

362

Job satisfaction and turnover intention among Jordanian nurses in psychiatric units.  

PubMed

Psychiatric nursing has been identified as a stressful occupation, and this stress could affect individuals' health, well-being, and job satisfaction. The stress of nurses might also affect the organization in terms of absenteeism and quality of care. The purpose of this study was to examine the relationship between job satisfaction and turnover intention among Jordanian nurses in the psychiatric units of the Jordanian National Mental Health Center. A descriptive, correlational, cross-sectional design was used. Nurses were asked to complete a demographic data sheet and questionnaires regarding job satisfaction and turnover intention. Of the 179 questionnaires distributed, 154 were completed, with an 86% response rate. The results revealed a statistically-significant negative relationship between job satisfaction and turnover intention. The findings of the study are consistent with previous research regarding the negative relationship between job satisfaction and turnover intention. The findings provide new information about Jordanian nurses who work in government hospital psychiatric services. PMID:24890435

Alsaraireh, Faris; Quinn Griffin, Mary T; Ziehm, Scott R; Fitzpatrick, Joyce J

2014-10-01

363

Quantitative proteomics for investigating psychiatric disorders.  

PubMed

The underlying pathophysiology of psychiatric disorders remains elusive. The use of quantitative proteomics to investigate disease-specific protein signatures holds great promise to improve the understanding of psychiatric disorders and identify relevant biomarkers. In this review, we discuss quantitative proteomic approaches for elucidating molecular mechanisms of psychiatric disorders, i.e. anxiety, schizophrenia, bipolar disorder and depression, by studying specimens from animal models and patients. We present gel-based, label-free and stable isotope-labeling methodologies and evaluate their strengths and limitations in the context of psychiatric research, with a focus on (15)N metabolic labeling of live animals due to its increased accuracy and potential for future applications. We also review biomarker candidate validation methods and present quantitative proteomic studies from the literature that aim to disentangle the molecular pathobiology of psychiatric disorders and identify candidate biomarkers. Finally, we explore the applicability of implementing proteomic methods as a routine diagnostic tool in the clinical laboratory. PMID:21280236

Filiou, Michaela D; Turck, Christoph W; Martins-de-Souza, Daniel

2011-02-01

364

Home based care and standard hospital care for patients with severe mental illness: a randomised controlled trial.  

PubMed Central

OBJECTIVE--To compare the efficacy of home based care with standard hospital care in treating serious mental illness. DESIGN--Randomised controlled trial. SETTING--South Southwark, London. PATIENTS--189 patients aged 18-64 living in catchment area. 92 were randomised to home based care (daily living programme) and 97 to standard hospital care. At three months' follow up 68 home care and 60 hospital patients were evaluated. MAIN OUTCOME MEASURES--Use of hospital beds, psychiatric diagnosis, social functioning, patients' and relatives' satisfaction, and activity of daily living programme staff. RESULTS--Home care reduced hospital stay by 80% (median stay six days in home care group, 53 days in hospital group) and did not increase the number of admissions compared with hospital care. On clinical and social outcome there was a non-significant trend in favour of home care, but both groups showed big improvements. On the global adjustment scale home care patients improved by 26.8 points and the hospital group by 21.6 points (difference 5.2; 95% confidence interval -1.5 to 12). Other rating scales showed similar trends. Home care patients required a wide range of support in areas such as housing, finance, and work. Only three patients dropped out from the programme. CONCLUSIONS--Home based care may offer some slight advantages over hospital based care for patients with serious mental illness and their relatives. The care is intensive, but the low drop out rate suggests appreciation. Changes to traditional training for mental health workers are required. PMID:1571681

Muijen, M.; Marks, I.; Connolly, J.; Audini, B.

1992-01-01

365

The impact of preadmission approval and continued stay review on hospital stay and outcome among children and adolescents.  

PubMed

Managed care has emerged as the centerpiece of the health care industry's efforts to control costs and ensure appropriate use of hospital services. This study assesses the impact of managed care by preadmission approval and/or continued stay review on length of psychiatric hospitalization and clinical outcome of children and adolescents. The sample included 277 cases hospitalized in nine psychiatric specialty hospitals in 1990. Demographic and clinical characteristics, hospital ownership type, and preadmission approval or continued stay review were used as independent variables in a multiple regression model to predict length of stay and clinical outcome. Results indicate that the model accounted for 27% of the variance in length of stay. Previous psychiatric hospitalization and for-profit hospital status predicted longer hospitalization. Clinical outcome was not significantly predicted by the model. Managed care did not predict either length of stay or clinical outcome. Implications for health care reform are discussed. PMID:10144461

Eisen, S V; Griffin, M; Sederer, L I; Dickey, B; Mirin, S M

1995-01-01

366

Indian Psychiatric Society-World Psychiatric Association - World Health Organization survey on usefulness of International Classification of Diseases-10  

PubMed Central

Background: World Health Organization (WHO) is in the process of revising the International Classification of Diseases 10 (ICD-10). For increasing the acceptability of the ICD-11, WHO along with World Psychiatric Association (WPA), conducted a survey of psychiatrists around the world, in which 386 psychiatrists from India participated. Aim: To present the findings of “WPA-WHO Global Survey of Psychiatrists’ Attitudes toward Mental Disorders Classification” for Indian psychiatrists who participated in the survey as members of Indian Psychiatric Society. Methodology: The online survey was sent to qualified psychiatrists who are members of Indian Psychiatric Society and are residing in India. Results: Of the 1702 members who were urged to participate in the survey, 386 (22.7%) participated. Most(79%) of the psychiatrists opined that they use formal classificatory systems in their day-to-day clinical practice. ICD-10 was the most commonly (71%) followed classificatory system. Nearly half (48%) felt the need for only 10–30 categories for use in clinical settings and another 44% opined that 31-100 categories are required for use. Most of the participants (85%) suggested that a modified/simpler classificatory system should be designed for primary care practitioners. Similarly, the same number of participants (89%) argued that for maximum utility of a nosological system diagnostic criteria should provide flexible guidance that allows cultural variation and clinical judgement. About 75% opined that the diagnostic system they were using was difficult to apply across cultures. Conclusion: Findings of the survey suggest that classificatory systems are routinely used in day-to-day practice by most of the participating psychiatrists in India and most expect that future classificatory system should provide flexible guidance that allows cultural variation and clinical judgement.

Avasthi, Ajit; Grover, Sandeep; Maj, Mario; Reed, Geoffrey; Thirunavukarasu, M.; Garg, Uttam Chand

2014-01-01

367

42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.  

Code of Federal Regulations, 2010 CFR

...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...

2010-10-01

368

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

369

Hospital utilization by health maintenance organizations. Separating apples from oranges.  

PubMed

The hospitalization rate of HMOs is reported to be 444 bed days per 1,000 enrollees per year. It is often forgotten that there is also out-of-plan utilization. A review of previous studies and a survey of reporting practices by three HMOs illustrate many problems with HMO utilization data. HMO rates, like those of other insurers, reflect only the hospital admissions that the plans know about and pay for, not the total hospital experience of their enrollees. While only a thorough tracking of subscriber utilization of all insurers and institutions will provide estimates of the magnitude of unreported admissions and their impact on utilization rates, this report enumerates the ways in which patients may receive inpatient care without the HMO having a record of the admissions and/or having to pay for them. It was found that admissions can be unreported when another insurer or institution pays (e.g., Medicare, No Fault, Workmen's Compensation, duplicate coverage, school health and liability insurance or VA, military, municipal, and state hospitals); when the HMO does not cover benefits (e.g., cosmetic and oral surgery, experimental procedures, long-term psychiatric, chronic, or rehabilitation stays); and when HMO coverage is denied for procedural reasons (e.g., catastrophic stays covered by reinsurance, newborns, voluntary "leakage," or improper following of HMO procedures). True HMO rates are unknown but are estimated by some authors to be 7-37% higher than the reported figure, depending on which types of unreported use are estimated. There is a need for future analyses to quantify true hospitalization rates of enrollees of HMOs and other insurers. PMID:3517513

Mott, P D

1986-05-01

370

New Methods of Psychiatric Treatment  

PubMed Central

There have recently been many innovations in the field of psychiatric therapy. Many of the new techniques challenge some of the underlying assumptions of conventional psychiatry. Some methods, such as reality therapy and behavior therapy, attack the symptom directly, rather than assuming there is an underlying disorder which must be treated. Another, crisis therapy, stresses brief intervention aimed at rapidly reestablishing previous levels of function, with relatively little concern for insight into developmental causes. Or, as in family therapy, the pattern of family interaction rather than the individual may be the primary object of study and treatment. Each of the new methods of treatment has certain advantages as well as disadvantages. They have stimulated psychiatry to explore innovative methods and should make it possible eventually to incorporate in the treatment of each individual those techniques which will most effectively meet his needs. PMID:5566347

Flinn, Don E.

1971-01-01

371

Technologic advances in psychiatric nursing.  

PubMed

This is an exciting time to be involved with the care of patients with mental illness. More and more information about what is happening in the brain when mental illness develops is becoming available. Even more important, however, clinicians need not be seduced by the secrets of the brain being discovered. Psychiatric nurses must remember that patients have real and frightening experiences. They alone must learn to adapt and function with their symptoms of mental illness. To the degree that clinicians become enamored of the science and technology, they may lose their empathy with the human experience of mental illness [11]. Nurses, who help people respond to their illnesses, must engage the science with curiosity and engage the person with empathy. PMID:12712664

Bostrom, Andrea C

2003-03-01

372

The future of (psychiatric) nursing.  

PubMed

The Institute of Medicine's (IOM) recent report, The Future of Nursing: Leading Change, Advancing Health, describes a number of problems in nursing practice, education, and leadership-as well as recommendations to address them. However, these problems are not really new; they were discussed in earlier publications and addressed in the 1970s by the National Joint Practice Commission (NJPC). In this article, I review these early publications and the work of the NJPC as background for the IOM report. I also outline each recommendation in the report, raising questions about the "how to" and sustainability of these suggestions. To move psychiatric-mental health nursing forward, the best first step would be to find out more about the specialty and the nurses who practice it, so the IOM recommendations can begin to be achieved. PMID:21766732

Smoyak, Shirley A

2011-08-01

373

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).

374

Dinosaur Day!  

ERIC Educational Resources Information Center

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…

Nakamura, Sandra; Baptiste, H. Prentice

2006-01-01

375

Psychiatric Severity and HIV-Risk Sexual Behaviors among Persons with Substance Use Disorders.  

PubMed

Abstract Objective: The relationship between mental illness and human-immunodeficiency virus (HIV)-risk sexual behavior among persons with substance use disorders is not well established because of differences in assessing psychiatric factors (types, symptoms, severity), substance use (diagnosis, survey responses, past substance use) and HIV-risk sexual behaviors (individual measures, combination of sex/drug use risk behaviors) across studies. This study utilized a more global and dimensional aspect of psychiatric issues (problem severity), to examine the relationship with HIV-risk sexual behaviors and substance use among persons with substance use disorders. Methods: Participants included 224 men and 46 women, with a mean age of 40.4 years (SD = 9.5). The most common substances were heroin/opiates, with 41.4% reporting use of these substances (n = 110, 110/266), while 27.8% reported using cocaine (n = 74, 74/266) and 12.8% reported using alcohol (n = 34, 34/266). Of all participants, 39 (14.4%) were identified as having high psychiatric severity (defined using the psychiatric severity score from the Addiction Severity Index), which was used as an indication of probable comorbid psychiatric and substance use disorders. Among these participants likely to have comorbid disorders, hierarchical linear regression was conducted to examine HIV-risk sexual behaviors (number of partners and unprotected sexual behaviors in the past 30 days) in relation to psychiatric severity, substance use, and gender. Results: Gender (women) and psychiatric severity (higher) were significantly related to greater HIV-risk sexual behaviors. After entering gender and substance use into the regression model, psychiatric severity accounted for another 21.9% of the variance in number of partners and 14.1% of the variance in unprotected sexual behaviors. Overall, the models accounted for 55.5% and 15.6% of the variance, respectively. A significant interaction was found for number of partners (but not frequency of unprotected behavior), such that those higher in psychiatric severity and higher in substance use had a greater number of sexual partners. The model including this interaction term accounted for 63.4% of the variance in number of partners. Conclusions: Findings suggest psychiatric severity is an underlying risk factor for HIV-risk sexual behavior among persons with substance use disorders who have various psychiatric comorbidities. PMID:25455334

Majer, John M; Komer, Anne C; Jason, Leonard A

2014-12-01

376

Rapid Follow-Up for Patients After Psychiatric Crisis.  

PubMed

Patients in psychiatric crisis often lack connection to community resources and present to emergency departments (EDs) for care. A transitional psychiatry clinic (TPC) bridged patients after ED visit. These retrospective chart review data of 390 patients were analyzed by ANOVA, logistic regression and survival analysis. Predictors of ED return included psychosis, personality disorder and increased number of prior ED visits. Longer wait for the TPC was associated strongly with non-attendance. TPC appointment within 3 days was associated with significantly longer time in the community without ED presentation. Rapid follow-up after ED visits increased attendance at aftercare and lengthens community tenure. PMID:25398419

McCullumsmith, Cheryl; Clark, Brendan; Blair, Courtney; Cropsey, Karen; Shelton, Richard

2014-11-15

377

A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients  

Microsoft Academic Search

A Swedish\\/Norwegian head and neck cancer study was designed to assess prospectively the levels of mental distress and psychiatric morbidity in a heterogeneous sample of newly diagnosed head and neck cancer patients. A total of 357 patients were included. The mean age was 63 years, and 72% were males. The patients were asked to answer the HAD scale (the Hospital

E Hammerlid; M Ahlner-Elmqvist; K Bjordal; A Biörklund; J Evensen; M Boysen; M Jannert; S Kaasa; M Sullivan; T Westin

1999-01-01

378

Registration of aggressive incidents in an adolescent forensic psychiatric unit and implications for further practice.  

PubMed

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

Tremmery, S; Danckaerts, M; Bruckers, L; Molenberghs, G; De Hert, M; Wampers, M; De Varé, J; de Decker, A

2014-09-01

379

Comorbid Psychiatric and Substance Abuse Disorders: Recent Treatment Research  

Microsoft Academic Search

Psychiatric comorbidity is defined as the co-occurrence of a psychiatric disorder in a patient with a substance use disorder. Psychiatric disorders in substance abuse patients can antedate the substance use disorder or be a consequence of the substance abuse. There is emerging evidence that drug use in adolescence may alter the onset of certain psychiatric disorders in vulnerable individuals. Patients

Paula Riggs; Frances Levin; Alan I. Green; Frank Vocci

2008-01-01

380

Training in Psychiatric Genomics during Residency: A New Challenge  

ERIC Educational Resources Information Center

Objective: The authors ascertained the amount of training in psychiatric genomics that is provided in North American psychiatric residency programs. Methods: A sample of 217 chief residents in psychiatric residency programs in the United States and Canada were identified by e-mail and surveyed to assess their training in psychiatric genetics and…

Winner, Joel G.; Goebert, Deborah; Matsu, Courtenay; Mrazek, David A.

2010-01-01

381

Is cannabis an anti-antipsychotic? The experience in psychiatric intensive care  

Microsoft Academic Search

Background Cannabis use is a major problem in inner cities and has been causally implicated in psychosis. Very few of the available hospital-based studies of the implications of cannabis usage have involved psychiatric intensive care units (PICU); but PICU receive many of the most challenging and resource-hungry—and incompletely understood—patients in the mental health system. Aims To study the clinical impact

Maria Isaac; Michael Isaac; Frank Holloway

2005-01-01

382

Should psychiatrists assist in the restraint of children and adolescents in psychiatric facilities?  

PubMed

Psychiatrists in psychiatric hospitals or residential facilities can find themselves involved in patient crises that precipitate a restraint or seclusion. The decision to become directly involved must be made quickly, with little time for administrative or legal consultation. The psychiatrist's decision to participate in physically restraining or secluding a patient, particularly a child or adolescent, may have long-lasting consequences. This Open Forum is offered to promote a discussion on this topic. PMID:23370623

James Masters, Kim; Nunno, Michael; Mooney, Andrea J

2013-02-01

383

Modeling Trajectory of Depressive Symptoms Among Psychiatric Inpatients: A Latent Growth Curve Approach  

PubMed Central

Objectives Changes in the parameters of inpatient psychiatric care have inspired a sizable literature exploring correlates of prolonged intervention as well as symptom change over varying lengths of hospitalization. However, existing data offer limited insight regarding the nature of symptom change over time. Objectives of this longitudinal research were to (a) model the trajectory of depressive symptoms within an inpatient psychiatric sample, (b) identify characteristics associated with unique patterns of change, and (c) evaluate the magnitude of expected gains using objective clinical benchmarks. Methods Participants included psychiatric inpatients treated between April 2008 and December 2010. Latent growth curve modeling was used to determine the trajectory of Beck Depression Inventory II depressive symptoms in response to treatment. Age, gender, trauma history, prior hospitalization, and DSM-IV diagnoses were examined as potential moderators of recovery. Results Results indicate a nonlinear model of recovery, with symptom reductions greatest following admission and slowing gradually over time. Female gender, probable trauma exposure, prior psychiatric hospitalization, and primary depressive diagnosis were associated with more severe trajectories. Diagnosis of alcohol/substance use, by contrast, was associated with more moderate trajectories. Objective benchmarks occurred relatively consistently across patient groups with clinically significant change occurring between 2–4 weeks post-admission. Conclusion The nonlinear trajectory of recovery observed in these data provides insight regarding the dynamics of inpatient recovery. Across all patient groups, symptom reduction was most dramatic in the initial week of hospitalization. However, notable improvement continued for several weeks post-admission. Results suggest timelines for adequate inpatient care are largely contingent on program-specific goals. PMID:23759452

Clapp, Joshua D.; Grubaugh, Anouk L.; Allen, Jon G.; Mahoney, Jane; Oldham, John M.; Fowler, J. Christopher; Ellis, Tom; Elhai, Jon D.; Frueh, B. Christopher

2014-01-01

384

Informing Best Practices for Children in Psychiatric Crises: Perspectives and Insights From Families  

E-print Network

system that includes secure transportation and access to "warm-line" services. To prevent or curtail hospitalization of children, families require assistance in outpatient medication management, especially timely access to psychiatric medication... and children needed more sustained supports including medical insurance, counseling, respite care, special education, and vocational training, all of which could help prevent crises situations. In turn, the absence or discontinuance of such ongoing services...

Walter, Uta M.; Petr, Christopher G.; Davis, Sharah A.

2006-01-01

385

Telemedicine Use and the Reduction of Psychiatric Admissions from a Long-Term Care Facility  

Microsoft Academic Search

Copper Ridge is a long-term care facility that provides care for persons with dementia and their families from early diagnosis to end of life. A low-cost videoconferencing system was employed in the development of a comprehensive, integrated continuum of care for Copper Ridge residents by bridging long-term care with inpatient psychiatric care at Johns Hopkins Hospital. In this article, we

Constantine G. Lyketsos; Carmel Roques; Linda Hovanec; Beverly N. Jones

2001-01-01

386

Psychiatric disorders (Axis I & II) and self-immolation: a case–control study from Iran  

Microsoft Academic Search

ObjectiveIn Iran, self-immolation is the third leading cause of years of life lost among women, after disasters and breast cancer. The objective of this study was to investigate pre-existing psychiatric disorders in self-immolation patients.MethodsIn a case–control study, 30 consecutive cases of deliberate self-inflicted burns admitted to the regional Burn centre (Imam Khomeini hospital in Kermanshah province, Iran) were compared with

A Ahmadi; R Mohammadi; D C Schwebel; N Yeganeh; S Hejazi-Bazargan

2010-01-01

387

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.

2007-04-19

388

[History of psychiatric legislation in Italy].  

PubMed

The different models of mental illness which have followed one another in Italian psychiatry have been linked to the history of psychiatric legislation and its various attempts at reform. The first law of the newly United State which unified legislations and former procedures, whose prevalent psychiatric theories were those that referred to degeneration, was the law 36/1904 that set up the asylums. Accordingly psychiatric praxis was focused on social protection and custody, given that the mentally ill was seen as incurable; Fascism added the inmate's obligation to be enrolled in the judicial register. Afterwards numerous attempts to reform the psychiatric legislation were made that eventually gave rise to law 431/1968 which paved the way to territorial psychiatry. Law 180/1978 changed the organization of Italian psychiatry abolishing asylums and the concept of dangerousness, including psychiatry in the National Health Service but adopting an idea of mental illness as simply social unease. PMID:21563394

Stocco, Ester; Dario, Claudia; Piazzi, Gioia; Fiori Nastro, Paolo

2009-01-01

389

The effectiveness of anticonvulsants in psychiatric disorders  

PubMed Central

Anticonvulsant drugs are widely used in psychiatric indications. These include mainly alcohol and benzodiazepine withdrawal syndromes, panic and anxiety disorders, dementia, schizophrenia, affective disorders, bipolar affective disorders in particular, and, to some extent, personality disorders, A further area in which neurology and psychiatry overlap is pain conditions, in which some anticonvulsants, and also typical psychiatric medications such as antidepressants, are helpful. From the beginning of their psychiatric use, anticonvulsants have also been used to ameliorate specific symptoms of psychiatric disorders independently of their causality and underlying illness, eg, aggression, and, more recently, cognitive impairment, as seen in affective disorders and schizophrenia. With new anticonvulsants currently under development, it is likely that their use in psychiatry will further increase, and that psychiatrists need to learn about their differential efficacy and safety profiles to the same extent as do neurologists. PMID:18472486

Grunze, Heinz C. R.

2008-01-01

390

Treatment of sleep dysfunction and psychiatric disorders  

Microsoft Academic Search

Opinion statement  Patients with neurologic disorders commonly experience sleep dysfunction and psychiatric disorders. The most common sleep\\u000a dysfunction is insomnia, which is a primary symptom in 30% to 90% of psychiatric disorders. Insomnia and fatigue are prominent\\u000a symptoms of anxiety disorders and major depression, including patients who are treated but have residual symptoms. Anxiety\\u000a and depressive disorders account for 40% to

Philip M. Becker

2006-01-01

391

Adults with learning disabilities and psychiatric problems  

Microsoft Academic Search

The co-occurrence of psychiatric illness with a learning disability has been well established, and people with learning disabilities are more likely to suffer from mental ill health (including behavioural disorders, personality disorders, autistic-spectrum disorders and attention-deficit hyperactivity disorder) (Deb et al, 2001b). The arrival of effective medical and psychosocial treatments for psychiatric disorders makes their diagnosis in those with learning

Mike Vanstraelen; Geraldine Holt; Nick Bouras

392

Psychiatric Profile in Rubinstein-Taybi Syndrome  

Microsoft Academic Search

Background:The diagnosis of Rubinstein-Taybi syndrome (RTS) is primarily clinical and based on the characteristic phenotype that is often combined with a variety of somatic anomalies and psychiatric disorders. Sampling and Methods:In this paper, a review is presented of the psychiatric and behavioural aspects of RTS. This is illustrated with a case report. Results:Behavioural aspects of about 150 patients are described,

W. M. A. Verhoeven; S. Tuinier; H. J. H. Kuijpers; J. I. M. Egger; H. G. Brunner

2010-01-01

393

Relationship between cerebrospinal fluid amine metabolites, neuroendocrine findings and personality dimensions (Marke-Nyman scale factors) in psychiatric patients.  

PubMed

5-Hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA) were measured in the spinal fluid of 45 women hospitalized in a psychiatric department for major depression (14 cases), schizophrenia (18 cases) and alcohol dependence (13 cases). Dexamethasone suppression tests were performed following CSF examinations in all patients, and TRH stimulation tests were also made in six subjects. All biological examinations were carried out in a drug-free state. The Marke-Nyman Temperament scale was administered to all patients as soon as severe psychotic disturbances subsided and sufficient cooperation was achieved, but no later than 10 days following biological examinations. The MNT was repeated after recovery to check reliability of the test results during an episode of a psychiatric disorder. CSF amine metabolite concentrations did not differ significantly in the three patient groups; postdexamethasone average cortisol levels were above the critical level (5 micrograms/dl) in each group, the highest values being found in major depression. One of the three MNT factors was inhomogeneous among diagnostic groups (validity: low in depression and alcoholism), but the other two also differed from a healthy control population. Correlation structure between biological and psychological variables was homogeneous throughout the diagnoses and a significant inverse correlation was found only between CSF 5-HIAA and the validity factor of MNT. Maximal TSH response to TRH stimulation correlated with both solidity and stability in the MNT scale. Since MNT results proved to be stable even during an illness episode, a possible link is suggested between personality traits and central serotonin metabolism. PMID:6190356

Banki, C M; Arató, M

1983-04-01

394

Subjectivity and Severe Psychiatric Disorders  

PubMed Central

To have a complete human science in the mental health field it is essential to give adequate attention to both the objective and the subjective data related to people with psychiatric disorders. The tendency in the past has been to ignore or discount one or the other of these data sources. Subjective data are particularly neglected, sometimes considered (only) part of the “art” of medicine since the usual methodologies of the physical sciences in themselves are not adequate to reflect the nature, elusiveness, and complexity of human subjective experience. The complete experience of hallucinated voices, for instance, often includes not only the voices themselves but also terrible anguish and terrifying inability to concentrate. But even such descriptors fall unnecessarily short of reflecting the data of the experience, thus leaving research, theory, and treatment with incomplete information. To represent adequately the subjective data it is essential to recognize that besides the usual discursive knowledge and methods of traditional physical science, a second kind of knowledge and method is required to reflect the depth of human experience. To accomplish this, we must employ approaches to narrative and the arts that are uniquely capable of capturing the nature of these experiences. Only by attending seriously in our research, training, theory, and practice to the unique nature of subjective data is it possible to have a true human science for our field. PMID:20961994

Strauss, John

2011-01-01

395

Seroepidemiology of Toxoplasma gondii infection in psychiatric inpatients in a northern Mexican city  

PubMed Central

Background Patients with psychiatric disorders were found to show a high seroprevalence of Toxoplasma gondii infection. There is scarce information about the epidemiology of T. gondii infection in psychiatric patients in Mexico. Therefore, we sought to determine the prevalence of T. gondii infection and associated socio-demographic, clinical and behavioural characteristics in a population of psychiatric patients in Durango City, Mexico. Seroprevalence in patients was compared with that obtained in a control population. Methods One hundred and thirty seven inpatients of a public psychiatric hospital and 180 controls were examined for the presence of IgG and IgM antibodies against T. gondii by enzyme-linked immunoassay (Diagnostic Automation Inc., Calabasas, CA, USA). The control population consisted of blood donors of a public blood bank and elderly persons attending a senior center in the same city. Age in controls (42 years +/- 20.2) was comparable with that of the psychiatric patients (43.7 years +/-13.8) (p = 0.42). Socio-demographic, clinical and behavioral characteristics from the patients were also obtained. Results Anti-T. gondii IgG antibodies indicating latent infection with T. gondii was found in 25 (18.2%) of 137 psychiatric inpatients and 16 (8.9%) of 180 controls (p = 0.02). Ten (26.3%) of 38 schizophrenic patients had latent infection and this prevalence was also significantly higher than that observed in controls (p = 0.005). Prevalence of anti-T. gondii IgM antibodies was comparable among patients and controls (4.4% vs 2.2%, respectively, p = 0.22). Multivariate analysis showed that T. gondii infection in inpatients was positively associated with sexual promiscuity (adjusted OR = 15.8; 95% CI: 3.8–64.8), unwashed raw fruit consumption (adjusted OR = 5.19; 95% CI: 2.3–11.3), and a history of surgery (adjusted OR = 6.5; 95% CI: 2.6–16), and negatively associated with lamb meat consumption (adjusted OR = 0.26; 95% CI: 0.10–0.63). Conclusion In the present study, psychiatric inpatients in Durango, Mexico, in general and schizophrenia inpatients in particular had a significantly higher prevalence of T. gondii infection than the control group. Results suggest that unwashed raw fruit consumption might be the most important route of T. gondii transmission in our psychiatric inpatients while lamb meat consumption the less important. Additional studies will have to elucidate the causative relation between infection with T. gondii and psychiatric disorders. PMID:17178002

Alvarado-Esquivel, Cosme; Alanis-Quiñones, Olga-Patricia; Arreola-Valenzuela, Miguel-Ángel; Rodríguez-Briones, Alfredo; Piedra-Nevarez, Luis-Jorge; Duran-Morales, Ehecatl; Estrada-Martínez, Sergio; Martínez-García, Sergio-Arturo; Liesenfeld, Oliver

2006-01-01

396

Dinosaur Day!  

NSDL National Science Digital Library

On Dinosaur Day, first-grade 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 manner. The event drew parents, teachers, and students together as they helped each other discuss, write, draw, measure, mix, and record at each learning station.

Baptiste, H. P.; Nakamura, Sandra

2006-01-01

397

Inspire Day  

ERIC Educational Resources Information Center

The authors collaborated on hosting a "Spring Inspire Day." planned and delivered by preservice elementary teachers as a social studies/science methods project. Projects that have authentic application opportunities can make learning meaningful for prospective teachers as well as elementary students. With the impetus for an integrated…

Bohach, Barbara M.; Meade, Birgitta

2014-01-01

398

Election Day  

NSDL National Science Digital Library

Election Day teaches how elections work in the United States. Players learn about political parties, public opinion, campaign financing, election law, political marketing, strategic planning, and the media. The game is well-suited for high-school and college students.

Washington, University O.

399

Pattern of psychiatric morbidity among the patients admitted in a private psychiatric clinic  

Microsoft Academic Search

Background: Mental health problem is a major public health issue in the world across the developed and developing countries. However, data in most of the developing countries including Bangladesh are scarce. In Bangladesh, socio-political situation is insecure and unstable with poverty and vulnerable to natural disaster which causes psychiatric morbidity. The pattern of psychiatric morbidity in private clinic is quite

A Fahmida; Wahab MA; Rahman MM

2009-01-01

400

Engram formation in psychiatric disorders  

PubMed Central

Environmental factors substantially influence beginning and progression of mental illness, reinforcing or reducing the consequences of genetic vulnerability. Often initiated by early traumatic events, “engrams” or memories are formed that may give rise to a slow and subtle progression of psychiatric disorders. The large delay between beginning and time of onset (diagnosis) may be explained by efficient compensatory mechanisms observed in brain metabolism that use optional pathways in highly redundant molecular interactions. To this end, research has to deal with mechanisms of learning and long-term memory formation, which involves (a) epigenetic changes, (b) altered neuronal activities, and (c) changes in neuron-glia communication. On the epigenetic level, apparently DNA-methylations are more stable than histone modifications, although both closely interact. Neuronal activities basically deliver digital information, which clearly can serve as basis for memory formation (LTP). However, research in this respect has long time neglected the importance of glia. They are more actively involved in the control of neuronal activities than thought before. They can both reinforce and inhibit neuronal activities by transducing neuronal information from frequency-encoded to amplitude and frequency-modulated calcium wave patterns spreading in the glial syncytium by use of gap junctions. In this way, they serve integrative functions. In conclusion, we are dealing with two concepts of encoding information that mutually control each other and synergize: a digital (neuronal) and a wave-like (glial) computing, forming neuron-glia functional units with inbuilt feedback loops to maintain balance of excitation and inhibition. To better understand mental illness, we have to gain more insight into the dynamics of adverse environmental impact on those cellular and molecular systems. This report summarizes existing knowledge and draws some outline about further research in molecular psychiatry. PMID:24904262

Gebicke-Haerter, Peter J.

2014-01-01

401

Tobacco use treatment in primary care patients with psychiatric illness  

PubMed Central

The prevalence of smoking is higher in patients with psychiatric illness compared to the general population. Smoking causes chronic illnesses which lead to premature mortality in those with psychiatric illness, is associated with greater burden of psychiatric symptoms, and contributes to the social isolation experienced by individuals with psychiatric disorders. Most patients with psychiatric illness present initially to primary care rather than specialty care settings, and some patients receive care exclusively in the primary care setting. Therefore, family physicians and other primary care clinicians have an important role in the recognition and treatment of tobacco use disorders in patients with psychiatric illnesses. In this article we review common myths associated with smoking and psychiatric illness, techniques in implementing evidence-based tobacco use treatments, the evidence base for tobacco use treatment for patients with specific psychiatric diagnoses, and factors to consider in treating tobacco use disorders in patients with psychiatric illness. PMID:24808119

Cerimele, Joseph M.; Halperin, Abigail C.; Saxon, Andrew J.

2014-01-01

402

Pattern of benzodiazepine use in psychiatric outpatients in Pakistan: a cross-sectional survey  

PubMed Central

Background Benzodiazepines (BDZ) are the largest-selling drug group in the world. The potential of dependence with BDZ has been known for almost three decades now. In countries like Pakistan where laws against unlicensed sale of BDZ are not implemented vigorously the risk of misuse of and dependence on these drugs is even higher. Previous studies have shown that BDZ prevalence among patients/visitors to general outpatient clinics in Pakistan may be as high as 30%. However, no research has been carried out on the prevalence of BDZ use in psychiatric patients in Pakistan. Methods We carried out a cross-sectional survey over 3 months in psychiatry outpatient clinics of two tertiary care hospitals in Karachi and Lahore. Besides basic socio-demographic data the participants were asked if they were taking a BDZ at present and if yes, the frequency, route and dosage of the drug, who had initiated the drug and why it had been prescribed. We used chi-square test and t-test to find out which socio-demographic or clinical factors were associated with an increased risk of BDZ use. We used Logistic Regression to find out which variable(s) best predicted the increased likelihood of BDZ use. Results Out of a total of 419 participants 187 (45%) of the participants had been currently using at least one BDZ. Seventy-three percent of the users had been using the drug for 4 weeks or longer and 87% were taking it every day. In 90% of cases the BDZ had been initiated by a doctor, who was a psychiatrist in 70% of the cases. Female gender, increasing age, living in Lahore, and having seen a psychiatrist before, were associated with an increased likelihood of using BDZ. Conclusion The study shows how high BDZ use is in psychiatric outpatients in Pakistan. Most of the users were taking it for a duration and with a frequency which puts them at risk of becoming dependent on BDZ. In most of the cases it had been initiated by a doctor. Both patients and doctors need to be made aware of the risk of dependence associated with the use of BDZ. PMID:19400933

2009-01-01

403

Expanding the scope of psychiatric nursing practice: devaluing the essence of psychiatric nursing?  

PubMed

Psychiatric Nurse Practitioners are quickly becoming sought after employees, especially in public mental health systems where a shrinking number of psychiatrists necessitate alternate access to prescribers. In addition, new guidelines necessitate greater attention to the follow up and monitoring of the medical problems of psychiatric patients. These events are occurring in the midst of declining reimbursement and rising litigation concerns in psychiatry. At the same time there is an increased focus on a recovery orientation to psychiatry alongside the primacy of psychotropic medicine as the most cost effective treatment, which can become competing aims for practitioners. It is important for psychiatric nurses and psychiatric nurse practitioners to consider how these opportunities might also have a negative impact on the core foundation of psychiatric nursing. PMID:23120800

Hogan, Beverly Kay

2012-09-01

404

CDRP - Funded Institutions - Rapid City Regional Hospital  

Cancer.gov

Rapid City Regional Hospital is a not-for-profit regional medical center operated in trust for the community and region by a 13-member Board of Trustees, who represents the local communities. It is licensed for 310 acute care and 56 psychiatric beds and is accredited by the Joint Commission on Accreditation of Health Care Organizations and the Commission for the Accreditation of Rehabilitation Facilities.

405

ASD, a Psychiatric Disorder, or Both? Psychiatric Diagnoses in Adolescents with High-Functioning ASD  

PubMed Central

Objective 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 in adolescents with high-functioning autism. Methods Participants included 35, predominantly Caucasian and male, verbal 10 – 17 year olds with a confirmed autism spectrum disorder and without intellectual disability. The average age of autism spectrum diagnosis was 11-years-old. Lifetime psychiatric diagnoses were established via the Autism Comorbidity Interview, developed to identify co-morbid conditions within the context of autism. Autism Comorbidity Interview results were compared to parent report of prior community psychiatric diagnoses. Results Approximately 60% of prior psychiatric diagnoses were not supported on the Autism Comorbidity Interview; the lowest diagnostic concordance was for prior bipolar disorder and obsessive-compulsive disorder diagnoses. While 51% of children met Autism Comorbidity Interview criteria for at least one psychiatric disorder, rates of prior diagnoses were much higher, with 77% having at least one prior psychiatric diagnosis and 60% having two or more. Conclusions Although many participants met criteria for comorbid psychiatric disorders, the majority of previous psychiatric diagnoses were not supported when autism-related manifestations were systematically taken into account. These findings require replication and may not generalize to lower-functioning and earlier diagnosed children with ASD. Results emphasize the importance of increasing awareness of the manifestations of high-functioning autism in order to improve accuracy of diagnosis and appropriateness of interventions. PMID:22642847

Mazefsky, Carla A.; Oswald, Donald P.; Day, Taylor N.; Minshew, Nancy J.; Eack, Shaun M.; Lainhart, Janet E.

2013-01-01

406

Hospital length of stay in individuals with schizophrenia with and without cocaine-positive urine drug screens at hospital admission.  

PubMed

Despite the high prevalence of cocaine use disorder (CUD) in individuals with schizophrenia, current understanding of the effect of cocaine on psychiatric hospital length of stay (LOS) in individuals with schizophrenia is limited. We therefore retrospectively examined the medical records of 5106 hospital admissions due to exacerbation of schizophrenia. Linear regression and t-test were used to compare LOS between individuals with schizophrenia with cocaine-positive urine drug test results and those with negative test results. Individuals with schizophrenia who were also positive for cocaine had shorter LOS from both unadjusted (geometric mean LOS, 8.07 ± 1.92 vs. 11.83 ± 1.83 days; p < 0.001) and adjusted (? = 0.69; confidence interval, 0.63-0.76; p < 0.001) analyses. Our results suggest that individuals with schizophrenia who also have comorbid CUD may require shorter inpatient treatment during periods of exacerbation of symptoms. Replication of this finding has relevance in treatment planning and resource allocation for the subpopulation of individuals with schizophrenia who also have stimulant use disorders. PMID:25489749

Wu, Hanjing Emily; Mohite, Satyajit; Ngana, Ikenna; Burns, Wilma; Shah, Nurun; Schneider, Laurie; Schmitz, Joy M; Lane, Scott D; Okusaga, Olaoluwa O

2015-01-01

407

Cognitive deficits in psychiatric disorders: Current status  

PubMed Central

Cognition denotes a relatively high level of processing of specific information including thinking, memory, perception, motivation, skilled movements and language. Cognitive psychology has become an important discipline in the research of a number of psychiatric disorders, ranging from severe psychotic illness such as schizophrenia to relatively benign, yet significantly disabling, non-psychotic illnesses such as somatoform disorder. Research in the area of neurocognition has started unlocking various secrets of psychiatric disorders, such as revealing the biological underpinnings, explaining the underlying psychopathology and issues related to course, outcome and treatment strategies. Such research has also attempted to uproot a number of previously held concepts, such as Kraepelin's dichotomy. Although the range of cognitive problems can be diverse, there are several cognitive domains, including executive function, attention and information processing, and working memory, which appear more frequently at risk. A broad range of impairment across and within the psychiatric disorders are highlighted in this oration. The oration summarizes the studies investigating cognitive processing in different psychiatric disorders. I will also discuss the findings of my own research on neurocognitive deficits in mood disorders, schizophrenia, obsessive–compulsive disorder, somatoform disorder, including studies on ‘high-risk’ individuals. Tracing the evaluation of neurocognitive science may provide new insights into the pathophysiology and treatment of psychiatric disorders. PMID:20703409

Trivedi, J.K.

2006-01-01

408

Current practices in managing acutely disturbed patients at three hospitals in Rio de Janeiro-Brazil: a prevalence study  

PubMed Central

Background The medical management of aggressive and violent behaviour is a critical situation for which there is little evidence. In order to prepare for a randomised trial, due to start in the psychiatric emergency rooms of Rio de Janeiro in 2001, a survey of current practice was necessary. Methods A seven day survey of pharmacological management of aggressive people with psychosis in the emergency rooms of all four public psychiatric hospitals in Rio de Janeiro, Brazil. Results In one hospital data were not available. Of the 764 people with psychosis attending these ERs, 74 were given IM medication for rapid tranquillisation (9.7%, 2.1/week/100,000). A haloperidol-promethazine mix (with or without other drugs) was used for the majority of patients (83%). Conclusion The haloperidol-promethazine mix, given intramuscularly for rapid tranquilization, is prevalent in Rio, where it is considered both safe and efficient. However, scientific evaluation of all pharmacological approaches to rapid tranquilization of psychotic people is inadequate or incomplete and a randomized trial of IM haloperidol-promethazine is overdue. PMID:11860610

Huf, Gisele; da Silva Freire Coutinho, Evandro; Fagundes, Hugo M; Oliveira, Edmar S; Lopez, Jose Ramon RA; Gewandszajder, Marcio; da Luz Carvalho, Andreia; Keusen, Alexandre; Adams, Clive E

2002-01-01

409

Seven Days  

NSDL National Science Digital Library

A SCEC-VDO movie showing two approx. magnitude 5 earthquakes that occurred within seven days in Southern California. The second earthquake is on or near the San Andreas fault and led to concern of a much larger earthquake (that did not happen). The Southern California Earthquake Center's Virtual Display of Objects (SCEC-VDO) is 3D visualization software that allows users to display, study and make movies of earthquakes as they occur globally. SCEC-VDO was developed by interns of SCEC Undergraduate Studies in Earthquake Information Technology (UseIT), under the supervision of Sue Perry and Tom Jordan.

Southern California Earthquake Center (SCEC)

410

The Meaning of Coping for Psychiatric Patients.  

PubMed

Contemporary psychiatric theory holds that a precipitant of major mental illness is the inability of some vulnerable individuals to cope with the difficulties of everyday life. Such mentally ill people are characterized as having deficient, dysfunctional, or absent coping skills. Recently, researchers have exerted considerable effort to distinguish between productive and nonproductive coping. In this article, we argue that not only are such conceptualizations reliant on reductive, circular logic, but they also miss the essentially rational, local, and individual nature of coping in psychiatric patients' lives. We used semistructured interviews and thematic analyses of psychiatric patients' descriptions of their coping. Patients reported that professional intervention reduced their ability to cope, that they distrusted the mental health system and its professionals, that coping mechanisms were misinterpreted, that situational crises modulated coping, and that sometimes coping was just "not coping." We argue for a more respectful, nuanced understanding of coping among mental health professionals. PMID:25013205

Ryan, Jacqueline; Rapley, Mark; Dziurawiec, Suzanne

2014-07-10

411

Childhood maltreatment, emotional dysregulation, and psychiatric comorbidities.  

PubMed

Affect dysregulation, defined as the impaired ability to regulate or tolerate negative emotional states, has been associated with interpersonal trauma and posttraumatic stress. Affect-regulation difficulties play a role in many psychiatric conditions, including anxiety and mood disorders, and especially major depression in youth and bipolar disorder throughout the life span. Exposure to traumatic events and interpersonal trauma in childhood is associated with wide-ranging psychosocial, developmental, and medical impairments in children, adolescents, and adults, with emotional dysregulation being a core feature that may help to account for this heightened risk. In order to understand how the developmental effects of childhood maltreatment contribute to emotional dysregulation and psychiatric sequelae, we review emotional regulation and its developmental neurobiology, and examine the research evidence of associations between childhood trauma, emotional dysregulation, and psychiatric comorbidities in children, adolescents, and adults. PMID:24704784

Dvir, Yael; Ford, Julian D; Hill, Michael; Frazier, Jean A

2014-01-01

412

Ayahuasca in adolescence: a preliminary psychiatric assessment.  

PubMed

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 for depression, anxiety, alcohol consumption patterns (abuse), attentional problems, and body dysmorphic disorders were used. It was found that, compared to controls, considerable lower frequencies of positive scoring for anxiety, body dismorphism, and attentional problems were detected among ayahuasca-using adolescents despite overall similar psychopathological profiles displayed by both study groups. Low frequencies of psychiatric symptoms detected among adolescents consuming ayahuasca within a religious context may reflect a protective effect due to their religious affiliation. However further studies on the possible interference of other variables in the outcome are necessary. PMID:16149324

Da Silveira, Dartiu Xavier; Grob, Charles S; de Rios, Marlene Dobkin; Lopez, Enrique; Alonso, Luisa K; Tacla, Cristiane; Doering-Silveira, Evelyn

2005-06-01

413

Indian – American contributions to psychiatric research  

PubMed Central

The Indian Diaspora, especially in North America, is a visible force in the field of psychiatric medicine. An estimated 5000 persons of Indian origin practice psychiatry in the USA and Canada, and an estimated 10% of these are in academic psychiatry. Wide ranging contributions, from molecular biology of psychiatric disorders to community and cultural psychiatry, are being made by this vibrant group of researchers. This article is a brief summary and work-in-progress report of the contributions by Indian – American psychiatric researchers. Although not exhaustive in coverage, it is meant to give the reader an overview of the contributions made by three waves of researchers over a span of 50 years. PMID:21836715

Pandurangi, Anand K.

2010-01-01

414

Sleep-disordered breathing and psychiatric disorders.  

PubMed

Sleep-disordered breathing, the commonest form of which is obstructive sleep apnoea (OSA) is increasingly recognised as a treatable cause of morbidity. It shares many risk factors with psychiatric disorders including behaviours such as smoking and physical comorbidity. Many symptoms of the two overlap, leaving OSA often undetected and undertreated. In the few studies that assess the two, OSA is commonly comorbid with depression (17-45%) and schizophrenia (up to 55%) and possibly bipolar. There is some limited evidence that treating OSA can ameliorate psychiatric symptoms. Some psychotropics, such as narcotics, cause sleep-disordered breathing (SDB), whilst weight-inducing neuroleptics may exacerbate it. An extreme form of SDB, sudden infant death syndrome (SIDS), is a risk in mothers with substance abuse. Being aware of these common comorbidities may help improve psychiatric patient's treatment and quality of life. PMID:25308389

Naqvi, Haider A; Wang, David; Glozier, Nicholas; Grunstein, Ronald R

2014-12-01

415

What kinds of things are psychiatric disorders?  

PubMed

This essay explores four answers to the question 'What kinds of things are psychiatric disorders?' Essentialist kinds are classes whose members share an essence from which their defining features arise. Although elegant and appropriate for some physical (e.g. atomic elements) and medical (e.g. Mendelian disorders) phenomena, this model is inappropriate for psychiatric disorders, which are multi-factorial and 'fuzzy'. Socially constructed kinds are classes whose members are defined by the cultural context in which they arise. This model excludes the importance of shared physiological mechanisms by which the same disorder could be identified across different cultures. Advocates of practical kinds put off metaphysical questions about 'reality' and focus on defining classes that are useful. Practical kinds models for psychiatric disorders, implicit in the DSM nosologies, do not require that diagnoses be grounded in shared causal processes. If psychiatry seeks to tie disorders to etiology and underlying mechanisms, a model first proposed for biological species, mechanistic property cluster (MPC) kinds, can provide a useful framework. MPC kinds are defined not in terms of essences but in terms of complex, mutually reinforcing networks of causal mechanisms. We argue that psychiatric disorders are objectively grounded features of the causal structure of the mind/brain. MPC kinds are fuzzy sets defined by mechanisms at multiple levels that act and interact to produce the key features of the kind. Like species, psychiatric disorders are populations with central paradigmatic and more marginal members. The MPC view is the best current answer to 'What kinds of things are psychiatric disorders?' PMID:20860872

Kendler, K S; Zachar, P; Craver, C

2011-06-01

416

Screening for Elder Abuse in Hospitalized Older Adults With Dementia  

Microsoft Academic Search

The prevention of elder abuse is important as current estimates show the world's population of adults over age 65 will triple with an associated rise in the number of older adults who are diagnosed with dementia. Many older adults with dementia are hospitalized for psychiatric treatment, thus presenting an opportunity for elder abuse screening. Which instrument is most suitable for

Leslie D. Pisani; Christine A. Walsh

2012-01-01

417

Sexual Education for Psychiatric Residents  

ERIC Educational Resources Information Center

Objective: The authors seek to promote sexuality curriculum development in departments of psychiatry. Methods: The authors first focus on educational philosophy about what residents can be taught about sexual topics and then provide numerical and narrative resident evaluation data following a 6-month, half day per week rotation in a sexuality…

Levine, Stephen B.; Scott, David L.

2010-01-01

418

The Characteristic Adult Education Problems and Needs of Seven Indiana State Mental Hospitals: A Diagnostic Study.  

ERIC Educational Resources Information Center

This study examined characteristic adult educational problems and needs concerning employee employer, employee patient, and employee public relationships as perceived by key personnel in seven state hospitals for adult psychiatric patients. A special three part rating schedule was administered to 11 key personnel in each hospital. Data from Parts…

Grubb, Allen William

419

TwelveMonth Outcome After a First Hospitalization for Affective Psychosis  

Microsoft Academic Search

Background: We studied the 12-month course of ill- ness after a first hospitalization for affective psychosis to identify potential outcome predictors in this rarely stud- ied patient population. Methods: For this study, 109 patients consecutively ad- mitted for their first psychiatric hospitalization for treat- ment of affective psychosis were recruited. Diagnostic, symptomatic, and functional evaluations were obtained at the index

Stephen M. Strakowski; Paul E. Keck; Susan L. McElroy; Scott A. West; Kenji W. Sax; John M. Hawkins; Geri F. Kmetz; Vidya H. Upadhyaya; Karen C. Tugrul; Michelle L. Bourne

1998-01-01

420

The discriminating characteristics of for-profit versus not-for-profit freestanding psychiatric inpatient facilities.  

PubMed Central

This study examines the characteristics that discriminate between ownership types among private, freestanding psychiatric inpatient facilities in the United States. Use of data from the Inventory of Mental Health Organizations (National Institute of Mental Health 1983, 1986), revealed that not-for-profits provide more services and serve more of the underinsured, while for-profits serve the better insured, concentrate primarily on inpatient services, and serve more children, adolescents, and substance abusers. A surplus bed capacity among for-profit psychiatric hospitals is presumed to contribute to lower occupancy rates and less turnover in the for-profit sector. Not-for-profit psychiatric facilities are also found to be more involved in professional training and to be more accessible through emergency services. However, the misclassification test in the discriminant procedure reveals that a significant group of not-for-profit facilities looks more like its for-profit counterpart group than like other not-for-profits. Study findings are interpreted both in terms of debates over the tax-exempt status of not-for-profit hospitals and the potential negative service effects of proprietization. PMID:1592604

Culhane, D P; Hadley, T R

1992-01-01

421

Psychiatric and Cognitive Functioning in Adolescent Inpatients with Histories of Dating Violence Victimization  

PubMed Central

The presence of dating violence victimization as well as its relation to psychiatric diagnosis and cognitive processes was examined in a sample of 155 adolescents hospitalized in a psychiatric facility. Participants and their parents completed semi-structured diagnostic interviews. Participants also completed self-report measures of dating violence victimization and cognitive functioning. Seventy-seven percent of adolescents who had initiated dating reported psychological, physical, and/or sexual abuse by a dating partner over the past year. Victims of psychological abuse alone as well as physical and/or sexual violence endorsed higher rates of major depressive disorder compared to non-victims. Physical/sexual dating violence victims also endorsed significantly higher rates of PTSD and alcohol use disorders, more frequent co-occurrence of externalizing and internalizing disorders, and more frequent negative cognitive biases, relative to non-victimized adolescents. Findings suggest that psychiatrically hospitalized adolescents with dating violence histories represent a subgroup of adolescent inpatients with a particularly serious clinical picture. PMID:20824193

Rizzo, Christie J.; Esposito-Smythers, Christianne; Spirito, Anthony; Thompson, Ariel

2010-01-01

422

Predicting violence: nursing diagnosis versus psychiatric diagnosis.  

PubMed

Predicting violent behavior is a major concern for nurses as well as other mental health professionals. Two diagnostic assessment systems (Nursing Diagnosis-NANDA and Psychiatric Diagnosis-DSM III-R) were compared in their ability to predict assaultive behavior. The nursing diagnosis potential for violence suggested a difference (p = .07) between the assaultive and control subjects. No differences were found between assaultive and control subjects on psychiatric diagnoses. Nursing diagnosis is based upon measurable behaviors and is time specific. Clinical implications and further research endeavors in this area are suggested. PMID:7826718

Lanza, M L; Kayne, H L; Pattison, I; Hicks, C; Islam, S

1994-01-01

423

New approaches to psychiatric diagnostic classification.  

PubMed

Recent findings in psychiatric genetics have crystallized concerns that diagnostic categories used in the clinic map poorly onto the underlying biology. If we are to harness developments in genetics and neuroscience to understand disease mechanisms and develop new treatments, we need new approaches to patient stratification that recognize the complexity and continuous nature of psychiatric traits and that are not constrained by current categorical approaches. Recognizing this, the National Institute for Mental Health (NIMH) has developed a novel framework to encourage more research of this kind. The implications of these recent findings and funding policy developments for neuroscience research are considerable. PMID:25442935

Owen, Michael J

2014-11-01

424

Comorbidity of fibromyalgia and psychiatric disorders.  

PubMed

There are mounting data supporting comorbidity of fibromyalgia syndrome (FMS) and psychiatric conditions. These include depression, panic disorders, anxiety, and post-traumatic stress disorder (PTSD). The nature of the relationship between depression and FMS is not fully understood, and it was hypothesized that chronic pain causes depression, or vice versa, and that chronic pain syndromes are variants of depression. A link between PTSD symptoms and FMS has been reported, and both conditions share similar symptomatology and pathogenetic mechanisms. Assessment of comorbid psychiatric disorders in FMS patients has clinical implications because treatment in these patients should focus both on physical and emotional dimensions of dysfunction. PMID:17894922

Buskila, Dan; Cohen, Hagit

2007-10-01

425

Tourette Syndrome: A Training Day for Teachers.  

ERIC Educational Resources Information Center

This article describes a Tourette syndrome training day for teachers facilitated by members of the Tic Disorders Clinic at Great Ormond Street Hospital in England. The day provided a mix of information giving and discussion of current practice. Outcomes of the day are related to professional knowledge and experience. (Contains references.) (CR)

Chowdhury, Uttom; Christie, Deborah

2002-01-01

426

Predicting unplanned readmission after myocardial infarction from routinely collected administrative hospital data.  

PubMed

Objective Readmission rates are high following acute myocardial infarction (AMI), but risk stratification has proved difficult because known risk factors are only weakly predictive. In the present study, we applied hospital data to identify the risk of unplanned admission following AMI hospitalisations. Methods The study included 1660 consecutive AMI admissions. Predictive models were derived from 1107 randomly selected records and tested on the remaining 553 records. The electronic medical record (EMR) model was compared with a seven-factor predictive score known as the HOSPITAL score and a model derived from Elixhauser comorbidities. All models were evaluated for the ability to identify patients at high risk of 30-day ischaemic heart disease readmission and those at risk of all-cause readmission within 12 months following the initial AMI hospitalisation. Results The EMR model has higher discrimination than other models in predicting ischaemic heart disease readmissions (area under the curve (AUC) 0.78; 95% confidence interval (CI) 0.71-0.85 for 30-day readmission). The positive predictive value was significantly higher with the EMR model, which identifies cohorts that were up to threefold more likely to be readmitted. Factors associated with readmission included emergency department attendances, cardiac diagnoses and procedures, renal impairment and electrolyte disturbances. The EMR model also performed better than other models (AUC 0.72; 95% CI 0.66-0.78), and with greater positive predictive value, in identifying 12-month risk of all-cause readmission. Conclusions Routine hospital data can help identify patients at high risk of readmission following AMI. This could lead to decreased readmission rates by identifying patients suitable for targeted clinical interventions. What is known about the topic? Many clinical and demographic risk factors are known for hospital readmissions following acute myocardial infarction, including multivessel disease, high baseline heart rate, hypertension, diabetes, obesity, chronic obstructive pulmonary disease and psychiatric morbidity. However, combining these risk factors into indices for predicting readmission had limited success. A recent study reported a C-statistic of 0.73 for predicting 30-day readmissions. In a recent American study, a simple seven-factor score was shown to predict hospital readmissions among medical patients. What does this paper add? This paper presents a way to predict readmissions following myocardial infarction using routinely collected administrative data. The model performed better than the recently described HOSPITAL score and a model derived from Elixhauser comorbidities. Moreover, the model uses only data generally available in most hospitals. What are the implications for practitioners? Routine hospital data available at discharges can be used to tailor preventative care for AMI patients, to improve institutional performance and to decrease the cost burden associated with AMI. PMID:25001433

Rana, Santu; Tran, Truyen; Luo, Wei; Phung, Dinh; Kennedy, Richard L; Venkatesh, Svetha

2014-09-01

427

3. PSYCHIATRIC WARD IN 24' X 60' QUONSET HUT, VIEW ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. PSYCHIATRIC WARD IN 24' X 60' QUONSET HUT, VIEW OF SOUTH FACE - Fort Randall, Neuro-Psychiatric Ward, Northeast of intersection of California Boulevard & Nurse Drive, Cold Bay, Aleutian Islands, AK

428

4. FIRE BREAK BETWEEN PSYCHIATRIC WARD AND NEXT WARD TO ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. FIRE BREAK BETWEEN PSYCHIATRIC WARD AND NEXT WARD TO THE SOUTH - Fort Randall, Neuro-Psychiatric Ward, Northeast of intersection of California Boulevard & Nurse Drive, Cold Bay, Aleutian Islands, AK

429

46 CFR 108.209 - Hospital spaces.  

Code of Federal Regulations, 2012 CFR

...more persons on a voyage of more than three days must have a hospital space. (b) Each hospital space must be suitably separated from other spaces. (c) No hospital space may be used for any other purpose, when used for care of the...

2012-10-01

430

46 CFR 108.209 - Hospital spaces.  

Code of Federal Regulations, 2014 CFR

...more persons on a voyage of more than three days must have a hospital space. (b) Each hospital space must be suitably separated from other spaces. (c) No hospital space may be used for any other purpose, when used for care of the...

2014-10-01

431

46 CFR 108.209 - Hospital spaces.  

Code of Federal Regulations, 2013 CFR

...more persons on a voyage of more than three days must have a hospital space. (b) Each hospital space must be suitably separated from other spaces. (c) No hospital space may be used for any other purpose, when used for care of the...

2013-10-01

432

46 CFR 108.209 - Hospital spaces.  

Code of Federal Regulations, 2011 CFR

...more persons on a voyage of more than three days must have a hospital space. (b) Each hospital