Sample records for psychiatric day hospital

  1. Day hospital versus admission for acute psychiatric disorders

    PubMed Central

    Marshall, Max; Crowther, Ruth; Sledge, William Hurt; Rathbone, John; Soares-Weiser, Karla

    2014-01-01

    Background Inpatient treatment is an expensive way of caring for people with acute psychiatric disorders. It has been proposed that many of those currently treated as inpatients could be cared for in acute psychiatric day hospitals. Objectives To assess the effects of day hospital versus inpatient care for people with acute psychiatric disorders. Search methods We searched the Cochrane Schizophrenia Group Trials Register (June 2010) which is based on regular searches of MEDLINE, EMBASE, CINAHL and PsycINFO. We approached trialists to identify unpublished studies. Selection criteria Randomised controlled trials of day hospital versus inpatient care, for people with acute psychiatric disorders. Studies were ineligible if a majority of participants were under 18 or over 65, or had a primary diagnosis of substance abuse or organic brain disorder. Data collection and analysis Two review authors independently extracted and cross-checked data. We calculated risk ratios (RR) and 95% confidence intervals (CI) for dichotomous data. We calculated weighted or standardised means for continuous data. Day hospital trials tend to present similar outcomes in slightly different formats, making it difficult to synthesise data. We therefore sought individual patient data so that we could re-analyse outcomes in a common format. Main results Ten trials (involving 2685 people) met the inclusion criteria. We obtained individual patient data for four trials (involving 646 people). We found no difference in the number lost to follow-up by one year between day hospital care and inpatient care (5 RCTs, n = 1694, RR 0.94 CI 0.82 to 1.08). There is moderate evidence that the duration of index admission is longer for patients in day hospital care than inpatient care (4 RCTs, n = 1582, WMD 27.47 CI 3.96 to 50.98). There is very low evidence that the duration of day patient care (adjusted days/month) is longer for patients in day hospital care than inpatient care (3 RCTs, n = 265, WMD 2.34 days/month CI 1.97 to 2.70). There is no difference between day hospital care and inpatient care for the being readmitted to in/day patient care after discharge (5 RCTs, n = 667, RR 0.91 CI 0.72 to 1.15). It is likely that there is no difference between day hospital care and inpatient care for being unemployed at the end of the study (1 RCT, n = 179, RR 0.88 CI 0.66 to 1.19), for quality of life (1 RCT, n = 1117, MD 0.01 CI ?0.13 to 0.15) or for treatment satisfaction (1 RCT, n = 1117, MD 0.06 CI ?0.18 to 0.30). Authors’ conclusions Caring for people in acute day hospitals is as effective as inpatient care in treating acutely ill psychiatric patients. However, further data are still needed on the cost effectiveness of day hospitals. PMID:22161384

  2. The school behaviors of children in three psychiatric treatment settings: An outpatient clinic, a day hospital, and an inpatient hospital

    Microsoft Academic Search

    Sara Goodman Zimet; Gordon K. Farley; Gregory D. Zimet

    1994-01-01

    Compares teachers' ratings of the school behaviors of children entering an outpatient clinic, a day psychiatric program, and\\u000a an inpatient psychiatric hospital. Many of the ratings did not discriminate among the three groups. Children starting outpatient\\u000a versus day treatment were rated as higher in aggression, anxiety, and hostile withdrawal, and children beginning outpatient\\u000a and day treatment versus inpatient treatment, were

  3. Revisiting the Psychiatric Day Hospital Experience 6 Months After Discharge: How Was the Transition and What Have Clients Retained?

    Microsoft Academic Search

    Nadine Larivière; Johanne Desrosiers; Michel Tousignant; Richard Boyer

    2010-01-01

    Psychiatric day hospitals offer intensive short-term multidisciplinary treatment. No study has examined in more depth the\\u000a impact of this therapeutic experience in the life of participants and what they retained from their participation after discharge.\\u000a A qualitative design using semi-structured individual interviews was completed with 18 participants of different gender, age\\u000a and diagnosis, treated in a day hospital, 6 months after

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

    PubMed

    Silva, Ana Tereza Medeiros C; Barros, Sônia

    2005-09-01

    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

  5. Antidepressant adherence after psychiatric hospitalization

    PubMed Central

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

    2010-01-01

    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

  6. Psychiatric Hospitalization after Deliberate Self-Poisoning

    ERIC Educational Resources Information Center

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

    2006-01-01

    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:…

  7. [Computer application in special psychiatric hospital].

    PubMed

    Popovi?, V; Toncev, I; Vuki?, D; Popovi?, R

    1995-09-01

    After beginning to work in May 1st, 1927. under the title State Mental Hospital in Gornja Toponica, Special Psychiatric Hospital has undergone many transformations during 67 years of its existence. In this critical socioeconomic moment, using the advantages of "informatic revolution", Special Psychiatric Hospital is striving for complete automatization of all relevant functions, showing the tendency to ling with referential scientific centers all over the world. Basic assumption of the project, structure of computer network and the way of the whole system functioning are exposed in the paper. By producing software which is in many respects adusted to specific needs of Special Psychiatric Hospital all functions related to admission and dismissal of hospitalized patients are completely automatized. This paper describes in detail the way of automatization for protocol of hospitalization, for case history and record book as well as for other functions from the hospital sphere of activity. PMID:18193793

  8. Changes in psychiatric inpatient treatment of children and youth in general hospitals: 1980-1985.

    PubMed

    Kiesler, C A; Simpkins, C

    1991-06-01

    Changes in the prevalence of inpatient psychiatric treatment of children and youth in short-term general hospitals between 1980 and 1985 were investigated. During that period, the locus of treatment of mental illness among children and youth shifted dramatically away from specialized facilities to general hospitals without psychiatric units. Among general hospitals without psychiatric units, the number of inpatient psychiatric episodes treated increased dramatically, patients' average length of stay almost doubled, and the total days of care provided more than tripled. The increased care was paid for primarily by Medicaid and commercial insurance. Total days of care for drug and alcohol problems among children and youth in general hospitals decreased substantially. The results suggest that general hospitals may be relying on psychiatric treatment to supplement revenues that were limited by Medicare's prospective payment system, which became effective during the period under study. PMID:1907594

  9. Profiling the Hospital-Based Psychiatric Registered Nurse Workforce

    Microsoft Academic Search

    Nancy P. Hanrahan; Angela M. Gerolamo

    2004-01-01

    BACKGROUND:Registered nursing is a core profession staffing psychiatric hospitals. However, strategic planning to address a critical national workforce shortage of registered nurses has not included psychiatric registered nurses. The lack of information thwarts policy decisions to adequately staff registered nurses for safe and effective psychiatric inpatient environments.OBJECTIVE:This study describes and compares demographic, educational, and employment characteristics of hospital-based psychiatric nurses

  10. 42 CFR 409.63 - Reduction of inpatient psychiatric benefit days available in the initial benefit period.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... false Reduction of inpatient psychiatric benefit days available in the initial benefit period. 409.63 Section 409.63 Public...SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits §...

  11. 42 CFR 409.63 - Reduction of inpatient psychiatric benefit days available in the initial benefit period.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... false Reduction of inpatient psychiatric benefit days available in the initial benefit period. 409.63 Section 409.63 Public...SERVICES MEDICARE PROGRAM HOSPITAL INSURANCE BENEFITS Scope of Hospital Insurance Benefits §...

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

    PubMed

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

    1991-06-01

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

  13. [The psychiatric hospital circuit: the trajectories of young people prior to psychiatric hospitalization].

    PubMed

    Scisleski, Andrea Cristina Coelho; Maraschin, Cleci; Silva, Rosane Neves da

    2008-02-01

    This article analyzes psychiatric hospitalization of young patients from a contemporary social-subjective (rather than a psychopathological) perspective, following the trajectory of these youth prior to their admission. The study was conducted at the Center for Comprehensive Psychosocial Care for Children and Adolescents, São Pedro Psychiatric Hospital, in the city of Porto Alegre, Rio Grande do Sul State, Brazil. Recurrent traits in the trajectory of these youth expressed how the health care network functioned with them prior to their hospitalization, with a consistent pattern of socioeconomic deprivation, low schooling, and drug use. Another key aspect was the role of the court system in referring them for hospitalization, adhering to a kind of logic that punished both the youth and the services and paradoxically formed a strategy for access to health services. PMID:18278281

  14. [An existential health care approach in hospital psychiatric nursing].

    PubMed

    Furlan, Marcela Martins; Ribeiro, Cléa Regina de Oliveira

    2011-04-01

    The focus of Mental Health Care in Brazil has been on community psychiatric care services that replace the asylum model. However, individuals with mental disorders continue to shift between community services and psychiatric hospitals, besides becoming a target of the disciplinarization and violence that question the quality of the nursing care being delivered. The objective of this study is to understand the ontology of nursing care in psychiatric hospitalization. Participants were four individuals with mental disorders who attended a center for psychosocial care, who agreed to talk about their psychiatric hospitalization experience by means of a semi-directed interview. The subjects remembered about their psychiatric hospitalization and assigned meanings to it. Heidegger's Existential Analysis was used, and thus generated the Meaning Unit: Being-in-the-world cared with impersonality; which allowed to unveil the phenomenon through Dasein's structure, and thus made it possible to outline the ontological care in nursing in psychiatric hospitals. PMID:21655789

  15. Closing forensic psychiatric hospitals in Italy: a new revolution begins?

    PubMed

    Barbui, Corrado; Saraceno, Benedetto

    2015-06-01

    On 30 May 2014 the Italian Parliament approved a new law regarding forensic psychiatric hospitals. Forensic psychiatric hospitals are facilities that admit individuals who have committed a criminal offence but lack criminal responsibility because of a mental disorder and are deemed as dangerous to public safety. Here we report the key aspects of the new legislation together with some critical considerations. PMID:26034177

  16. 28 CFR 549.45 - Involuntary hospitalization in a suitable facility for psychiatric care or treatment.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

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

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

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

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  19. Psychiatric diagnoses after hospitalization with work-related burn injuries in Washington State.

    PubMed

    Anderson, Naomi J; Bonauto, David K; Adams, Darrin

    2011-01-01

    This study aims to describe workers who were hospitalized with work-related burn injuries and their psychiatric sequelae in Washington State. Psychiatric sequelae of interest were depression, posttraumatic stress disorder, and other anxiety disorders. Workers' compensation claims meeting a definition for a hospitalized burn patient from Washington State from January 2001 through April 2008 were analyzed. The resulting claims were searched for the presence of certain psychiatric diagnoses or treatment codes, and descriptive analyses performed. In Washington State during the time period, the prevalence of claims with psychiatric diagnoses after hospitalization with burn injury was 19%. Claims with psychiatric diagnoses had higher medical costs and more days of time loss than those without these diagnoses. Workers with electrical burns in the construction industry and in construction and extraction occupations had a higher proportion of psychiatric sequelae. Burns are devastating yet preventable injuries. Workers who were hospitalized with work-related burn injuries, particularly those in certain industries and occupations and those with electrical burns, are at high risk for developing serious psychiatric sequelae with major costs to both the individual and the society. PMID:21552064

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  1. OVERSEER: An Expert System Monitor for the Psychiatric Hospital

    PubMed Central

    Bronzino, Joseph D.; Morelli, Ralph A.; Goethe, John W.

    1988-01-01

    In order to improve patient care, comply with regulatory guidelines and decrease potential liability, psychiatric hospitals and clinics have been searching for computer systems to monitor the management and treatment of patients. This paper describes OVERSEER: a knowledge based system that monitors the treatment of psychiatric patients in real time. Based on procedures and protocols developed in the psychiatric setting, OVERSEER monitors the clinical database and issues alerts when standard clinical practices are not followed or when laboratory results or other clinical indicators are abnormal. Written in PROLOG, OVERSEER is designed to interface directly with the hospital's database, and, thereby utilizes all available pharmacy and laboratory data. Moreover, unlike the interactive expert systems developed for the psychiatric clinic, OVERSEER does not require extensive data entry by the clinician. Consequently, the chief benefit of OVERSEER's monitoring approach is the unobtrusive manner in which it evaluates treatment and patient responses and provides information regarding patient management.

  2. 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

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

    1991-02-01

    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

  3. 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

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

    1991-01-01

    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

  4. Psychiatric Day Treatment Clerkship for Undergraduate Pharmacy Students.

    ERIC Educational Resources Information Center

    Cardoni, Alex A.; Gunning, Jacqueline

    1981-01-01

    A psychiatric day treatment clerkship for undergraduate pharmacy students at the University of Connecticut is described. Students participate in client interviewing, medication history taking, client medication counseling, medication counseling, medication clinic, medication group, and health care group. Evaluation of performance is based on both…

  5. Psychiatric disorder in hospital and general practice

    Microsoft Academic Search

    Brian Cooper

    1966-01-01

    Accepted clinical notions in psychiatry have been derived largely from the study of mental hospital case-material which, however, may be unrepresentative because of the selective factors influencing hospital admission. To obviate bias, it will be necessary to study cases identified in the community.

  6. Acceptability and impact of a partial smoking ban in a psychiatric hospital

    Microsoft Academic Search

    Manuela Etter; Jean-François Etter

    2007-01-01

    Objective.The acceptability and impact of partial smoking bans in psychiatric hospitals are not well documented. We assessed the impact of a partial smoking ban in a psychiatric hospital in Switzerland.

  7. Deconstructing the language of psychiatric hospitalization.

    PubMed

    Mohr, W K

    1999-05-01

    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

  8. Events precipitating psychiatric hospitalization of children.

    PubMed

    Williams, R A; Crabb, H; Batts, P; Hollis, H M; Feibelman, N D

    1990-01-01

    The precipitating events that preceded the admission of 50 children to an inpatient psychiatric program were studies and defined. These events, while varying in their particulars, could be grouped into three broad conceptual categories: 1) emotionally related events; 2) severe-conduct events; and 3) school-related events. The emotionally related events were the most numerous: suicide threats or attempts preceded the admission of 22% of the sample. The study findings are discussed in terms of their developmental, treatment, and preventive significance and are compared with the findings obtained from a previous study with adolescent patients. PMID:10112795

  9. Violence, Burnout and Minor Psychiatric Disorders in Hospital Work.

    PubMed

    Pai, Daiane Dal; Lautert, Liana; Souza, Sônia Beatriz Cocaro de; Marziale, Maria Helena Palucci; Tavares, Juliana Petri

    2015-01-01

    OBJECTIVE Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. METHODS Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. RESULTS Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001), among nursing auxiliaries/technicians (p=0.014) and was associated with minor psychiatric disorders (p<0.05), as exposure to different forms of violence increased the chances of these disorders by 60% (CI 95%: 1.2-2.1). The three Burnout dimensions were also associated to violence at work (p<0.05). CONCLUSION Health workers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders. PMID:26107707

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

    Code of Federal Regulations, 2014 CFR

    2014-07-01

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

  11. 28 CFR 549.44 - Voluntary hospitalization in a suitable facility for psychiatric care or treatment, and voluntary...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

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

  12. 28 CFR 549.44 - Voluntary hospitalization in a suitable facility for psychiatric care or treatment, and voluntary...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

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

  13. Psychiatric hospitalization of children in Florida. Legal aspects.

    PubMed

    Mutch, S A; Myers, W C

    1994-07-01

    The hospitalization of children in psychiatric hospitals and their associated rights or lack thereof remains an important issue. Much attention has been focused on children's rights in Florida, most recently with the cases of Gregory K. and Kimberly Mays. On a national level, Hillary Rodham Clinton has drawn attention to children's rights through her advocacy for children. The commitment of children to mental health facilities in Florida deserves examination. This is an important issue, not only to the psychiatrist who tests youths, but also to the family practitioner, internist, or any other referring physician who is involved in the case of the child and the family. It is imperative that the primary care physician as well as the psychiatrist know and understand the limitations and requirements for civil commitment of a child in a psychiatric setting. PMID:7964573

  14. Predicting service utilization after psychiatric hospitalization.

    PubMed

    Goethe, J W; Dornelas, E A; Gruman, C

    1999-01-01

    The purposes of this study were to determine (1) the extent of service utilization in the posthospitalization period and (2) the probability of specified service utilization outcomes for patients with given characteristics, using ordered logit models. The sample consisted of former inpatients who were evaluated for 6 months and responded to a mailed questionnaire or telephone interview at both the 3- and 6-month follow-up points. Significant independent predictors of service utilization at 6 months were the diagnosis, length of hospital stay, history of suicide attempts, perceived stress, and medication compliance at 3 months. High service utilization was evident in a sizable proportion of the sample and could be predicted using this model. PMID:10360613

  15. Changes in general hospital psychiatric care, 1980-1985.

    PubMed

    Kiesler, C A

    1991-04-01

    More than 60% of all inpatient psychiatric episodes occur in general hospitals. The need for psychologists' involvement in this important area is discussed. Changes in general hospital inpatient care from 1980 to 1985 are described. These include important and controversial changes in public policy, most notably Medicare's prospective payment system. Substantial changes in the de facto system occurred in patterns of diagnosis, sites of care, and the role of third-party payers. Implications for public policy and future investigations are drawn. PMID:2048799

  16. Effects of Home Visit Intervention on Re-hospitalization Rates in Psychiatric Patients.

    PubMed

    Chang, Yun-Chang; Chou, Frank Huang-Chih

    2015-07-01

    To examine the home visit intervention (HoVI) effects on the re-hospitalization rate and medical costs in patients with schizophrenia or other psychiatric disorders. The subjects who received more than 3 HoVIs were defined as the HoVI group, whereas the subjects who received equal to or less than 3 HoVIs were defined as the HoVI < 4 group; the subjects who had never received an HoVI were defined as the non-HoVI group. Differences in the re-hospitalization rates and National Health Insurance (NHI) costs among the three groups were examined. The re-hospitalization rate of the HoVI group was significantly lower than that of the non-HoVI group. The hospitalization days and the NHI costs of the HoVI group were also lower than those of the non-HoVI group. However, the HoVI < 4 group was not different than the non-HoVI group regarding the re-hospitalization rate or the hospitalization days. The re-hospitalization rate was significantly higher before compared with after the HoVIs. The NHI costs were significantly higher before compared with after the HoVIs. HoVIs (More than 3 HoVIs) produced a lower re-hospitalization rate, number of hospitalization days, and NHI costs in patients who received care through the Home Visit. Project to strengthen the Community Rehabilitation Program. PMID:25563484

  17. Predicting length of hospital stay for psychiatric inpatients.

    PubMed

    Kiesler, C A; Simpkins, C; Morton, T

    1990-02-01

    Medicare's use of diagnosis-related groups and the frequent acceptance of length of stay as an indicator of resource utilization has caused a surge of interest in the predictability of length of hospital stay for psychiatric inpatients. By constructing a weighted least squares regression model using data from the 1980 Hospital Discharge Survey, the authors were able to account for an increased amount of variance in length of stay for the major diagnostic categories of mental disorder and substance abuse for Medicare and Blue Cross/Blue Shield patients. The enhanced ability to predict length of stay is attributed to a carefully constructed data base and an increased number of predictor variables, particularly comorbidity. Knowledge of the presence or absence of a chemical dependency unit in the hospitals from which patients were discharged substantially increased the proportion of variance accounted for in the analysis. PMID:2105904

  18. The emergence of psychiatric departments as quasi-units in general hospitals.

    PubMed

    Kiesler, C A; Simpkins, C

    1991-12-01

    The organization of inpatient psychiatric treatment in general hospitals was investigated using data from the Hospital Discharge Surveys for 1980 and 1985 and definitions of psychiatric services used by the American Hospital Association and the National Institute of Mental Health. The definitions differ in that psychiatric services meeting the AHA definition are formally organized and physically separate units, while those meeting the NIMH definition may have a less formal structure. The number of psychiatric inpatient episodes in psychiatric departments as defined by NIMH increased sixfold between 1980 and 1985, while those in formal psychiatric units as defined by AHA decreased by 16 percent. The increase was completely accounted for by episodes of mental disorders; episodes of alcohol and drug disorders decreased in both settings. The implications of the psychiatric department as an entrepreneurial newcomer in the competitive general hospital market are discussed. PMID:1810859

  19. Bedding, not boarding. Psychiatric patients boarded in hospital EDs create crisis for patient care and hospital finances.

    PubMed

    Kutscher, Beth

    2013-11-18

    As the supply of psychiatric beds dwindles, hospitals are devising innovative ways handle psych patients who come through the emergency department. Some collaborate with other hospitals, use separate pysch EDs or refer patients to residential treatment centers. PMID:24396888

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

    PubMed Central

    2010-01-01

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

  1. Psychiatric Hospitalization and School and Community Adjustment of Children and Adolescents with Acquired Brain Injury

    Microsoft Academic Search

    James K. Luiselli; Denise Dion; Erin Hammil; Andrea Potoczny-Gray; Ronald C. Savage; Donald L. Sherak

    2000-01-01

    There is a high prevalence of psychiatric disorders in children and adolescents who have acquired brain injury (ABI). We examined the records of 82 students with ABI who were admitted to a community-based school for education and neurorehabilitation over a three-year period to determine how many experienced one or more psychiatric hospitalizations before admission, and whether hospitalization status was related

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

    PubMed

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

    1975-11-01

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

  3. Hospitalized psychiatric patients view the World Trade Center disaster

    Microsoft Academic Search

    Lynn E. DeLisi; Tiffany H. Cohen; Andrea M. Maurizio

    2004-01-01

    There is conflicting literature describing how psychiatric patients, particularly those with schizophrenia, respond to overwhelming environmental disasters, with some reports describing marked improvement in their symptoms. This view is contrary to the notion that those individuals who are most vulnerable (i.e. people with serious psychiatric illness) are at high risk for further increase in psychiatric symptoms subsequent to stressful events.

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

    Microsoft Academic Search

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

    2007-01-01

    BACKGROUND: 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

  5. Recruitment and Retention of African American Patients for Clinical Research: An Exploration of Response Rates in an Urban Psychiatric Hospital

    Microsoft Academic Search

    Estina E. Thompson; Cheryl Munday; James S. Jackson

    2002-01-01

    The issues related to recruiting African American psychiatric inpatients are discussed in the context of a study on the influence of ethnicity on psychiatric diagnosis. Ethnically diverse psychiatric residents interviewed 960 Black and White inpatients in 2 urban psychiatric hospitals. Despite the obstacles cited in the literature about recruiting and retaining African Americans into research, 78% of this sample were

  6. Recruitment and Retention of African American Patients for Clinical Research: An Exploration of Response Rates in an Urban Psychiatric Hospital

    Microsoft Academic Search

    Estina E. Thompson; Harold W. Neighbors; Cheryl Munday; James S. Jackson

    1996-01-01

    The issues related to recruiting African American psychiatric inpatients are discussed in the context of a study on the influence of ethnicity on psychiatric diagnosis. Ethnically diverse psychiatric residents interviewed 960 Black and White inpatients in 2 urban psychiatric hospitals. Despite the obstacles cited in the literature about recruiting and retaining African Americans into research, 78% of this sample were

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

    PubMed

    Shor, Ron; Shalev, Anat

    2015-03-01

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

  8. Implementing an ecological approach to violence reduction at a forensic psychiatric hospital: approaches and lessons learned.

    PubMed

    Bader, Shannon M; Evans, Sean E

    2015-06-01

    Existing literature on aggression within psychiatric hospitals suggests that treating an aggressive patient's symptoms could be complemented by (a) milieu environments that mitigate violence and (b) hospital-wide policies and procedures that focus on creating a safe environment. Described as an ecological approach, examples of how this broader, situational approach can reduce inpatient violence in psychiatric settings are provided throughout. The authors identify potential barriers to focusing on wards and institutional rules as well as patient treatment. Last, details of how this ecological approach has been implemented at one state hospital in California are provided. PMID:25882371

  9. Diagnosis-related frequency of compulsory measures in 10 German psychiatric hospitals and correlates with hospital characteristics

    Microsoft Academic Search

    Tilman Steinert; Veronika Martin; Manfred Baur; Ulrich Bohnet; Rita Goebel; Gottfried Hermelink; Rita Kronstorfer; Wolfgang Kuster; Beate Martinez-Funk; Martin Roser; Albrecht Schwink; Wolfram Voigtländer

    2007-01-01

    Objective  To investigate the incidence of coercive measures in standard psychiatric care in different psychiatric hospitals.\\u000a \\u000a \\u000a \\u000a Methods  We developed a common documentation of mechanical restraint, seclusion, and medication by coercion, and introduced it in 10\\u000a participating hospitals. We developed software able to process the data and to calculate four key indicators for routine clinical\\u000a use.\\u000a \\u000a \\u000a \\u000a Results  9.5% of 36,690 cases treated in 2004

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

    PubMed

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

    2013-01-01

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

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  12. Psychiatric morbidity of overseas patients in inner London: A hospital based study

    PubMed Central

    Carranza, Fredy J; Parshall, Alice M

    2005-01-01

    Background Evaluation of the referral, admission, treatment, and outcome of overseas patients admitted to a psychiatric hospital in central London. Ethical, legal and economic implications, and the involvement of consulates in the admission process, are discussed. Method Assessment and review of overseas patients admitted between 1 January 1999 and 31 December 1999. Non-parametric statistical tests were used, and relevant outcomes described. Results 19% of admissions were overseas patients. Mean age was 38 years. 90% were unattached; 84% were white, 71% from European countries. 45% spoke fluent English. Differences in socio-economic status between home country and England were found. 74% were unwell on arrival; 65% travelled to England as tourists. 65% of admissions came via the police. 32% had been ill for more than one year before admission; 68% had psychiatric history. 77% were admitted and 48% discharged under section of the Mental Health Act. 74% had psychotic disorders, all of them with positive symptoms. 55% showed little to moderate improvement in mental state; 10% were on Enhanced Care Programme Approach. Relatives of 48% of patients were contacted. The Hospital repatriated 52% of patients; the Mental Health Team followed up 13% of those discharged. The average length of admission was 43.4 days (range 1–365). Total cost of admissions was GBP350, 600 ($577, 490); average individual cost was GBP11, 116 (range GBP200-81, 000). Conclusions Mentally ill overseas individuals are a vulnerable group that need recognition by health organisations to adapt current practice to better serve their needs. The involvement of consulates needs further evaluation. PMID:15845140

  13. User participation when using milieu therapy in a psychiatric hospital in Norway: a mission impossible?

    PubMed

    Oeye, Christine; Bjelland, Anne Karen; Skorpen, Aina; Anderssen, Norman

    2009-12-01

    In the past decade, the Norwegian government has emphasized user participation as an important goal in the care of mentally ill patients, through governmental strategic plans. At the same time, the governmental documents request normalization of psychiatric patients, including the re-socialization of psychiatric patients back into society outside the psychiatric hospital. Milieu therapy is a therapeutic tool to ensure user participation and re-socialization. Based on an ethnographic study in a long-term psychiatric ward in a psychiatric hospital, we identified how staff tried to implement user participation in their milieu-oriented therapy work. We have identified three major tensions and challenges in implementing user participation in milieu-therapeutic work. First, it is difficult to implement individual-based user participation and at the same time take collective house rules and codes of conduct into consideration. Second, user participation proved a difficulty when patients' viewpoints challenged staff judgements on proper conduct and goals for which patients might aim. Third, user participation becomes a challenge when trying to establish relationships based on equality when using milieu therapy in a biomedical hierarchical hospital structure. These tensions and challenges are seen in light of paradoxical political frames and demands on one side, and milieu therapy as a complex tradition anchored in different ideologies on the other. PMID:19906279

  14. Crisis visits and psychiatric hospitalizations among patients attending a community clinic in rural Southern California.

    PubMed

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

    2012-04-01

    Ethnic minorities from disadvantaged socioeconomic backgrounds report increased utilization of mental health emergency services; however findings have been inconsistent across ethnic/racial groups. In this study we describe patients who present to a rural crisis unit in Southern California, examine rates of psychiatric hospitalizations across ethnic/racial groups, and investigate factors that are associated with increased psychiatric hospitalizations in this sample. This is a retrospective study of 451 racially and ethnically diverse patients attending a crisis unit in Imperial County, California. Chart review and data abstraction methods were used to characterize the sample and identify factors associated with psychiatric crises and subsequent hospitalizations. The sample was predominantly Latino/Hispanic (58.5%). Based on chart review, common psychosocial stressors which prompted a crisis center visit were: (a) financial problems; (b) homelessness; (c) partner or family conflict; (d) physical and health problems; (e) problems at school/work; (f) medication compliance; (g) aggressive behavior; (h) delusional behavior; (i) addiction and (j) anxiety/depression. Bivariate analyses revealed that Hispanics had a disproportionately lower rate of psychiatric hospitalizations while African Americans had a higher rate. Multivariate analyses which included demographic, clinical and psychosocial stressor variables revealed that being African American, having a psychotic disorder, and presenting as gravely disabled were associated with a higher likelihood of hospitalization while partner/family conflict was associated with a lesser likelihood in this rural community. These data elucidate the need for longitudinal studies to understand the interactions between psychosocial stressors, ethnicity and social support as determinants of psychiatric hospitalizations. PMID:20924788

  15. Somatic, cognitive and emotional characteristics of abused children in a psychiatric hospital

    Microsoft Academic Search

    Avi Sadeh; Robert M. Hayden; James P. D. McGuire; Henry Sachs; Roberta Civita

    1994-01-01

    A systematic review of medical records of one hundred consecutive admissions to a children's psychiatric inpatient unit was\\u000a conducted to assess specific somatic, cognitive and emotional characteristics that distinguish sexually abused children from\\u000a other hospitalized children. Sexually abused children were characterized by: a lower performance IQ, higher incidence of parasomnia\\u000a prior to admission, longer length of hospital stay, and comparatively

  16. Outpatient mental health service use by older adults after acute psychiatric hospitalization

    Microsoft Academic Search

    Hong Li; Enola Proctor; Nancy Morrow-Howell

    2005-01-01

    This study described outpatient mental health service used by elderly patients discharged from acute inpatient psychiatric treatment for depression, assessed services barriers, and identified factors related to the use of outpatient mental health services. The sample consisted of 199 elderly patients discharged home from a geropsychiatric unit of an urban midwestern hospital. Multivariate logistic regression was used to identify factors

  17. THE PRIVATE PSYCHIATRIC HOSPITAL AS A CRUCIBLE FOR INNOVATIVE MODELS OF PROFESSIONAL PRACTICE

    Microsoft Academic Search

    A. Steven Frankel

    1988-01-01

    The article discusses the development of an interdisciplinary vehicle for the delivery of mental health services that is based in a private psychiatric hospital. One of many possible models, it offers an example of ways psychologists can develop innovative service programs that 1) preserve a \\

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

    ERIC Educational Resources Information Center

    Linhorst, Donald M.; Scott, Lisa Parker

    2004-01-01

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

  19. [Security rules in acute inpatient wards in psychiatric hospitals in the greater area of Athens].

    PubMed

    Koukia, E; Giannouli, E; Gonis, N; Douzenis, A

    2009-04-01

    This research concerns the recording of safety measures in acute mental health wards of psychiatric hospitals in the greater area of Athens. The practices of control and testing on patients performed by nurses are also reported. The total sample consists of 14 acute inpatient psychiatric wards. The results indicated that important differences were noticed in the controls and prohibitions. Moreover, the main characteristic was the lack of protocols and measures of safety, a situation that burdened nursing practice. The lack of rules and strategies that would promote the safety of patient, professionals and therapeutic milieu, were brought into light by nurses' quotes. PMID:22218133

  20. Outcome and length of stay in psychiatric hospitalization, the experience of the University Clinic of Turin

    Microsoft Academic Search

    Paola Rocca; C. Mingrone; T. Mongini; C. Montemagni; L. Pulvirenti; G. Rocca; F. Bogetto

    2010-01-01

    Background  Given the current tendency to shorten psychiatric hospitalization and change its organization, an issue could be raised regarding\\u000a its outcomes.\\u000a \\u000a \\u000a \\u000a \\u000a Purpose  To analyze features related to length of stay in a short-term inpatient treatment, to study outcomes and to evaluate the diagnosis-specific\\u000a effects of hospitalization.\\u000a \\u000a \\u000a \\u000a \\u000a Method  A sample of 310 consecutive hospitalized patients, with psychotic disorder, depressive disorder and bipolar disorder (DSM

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

    ERIC Educational Resources Information Center

    Elbaz-Haddad, Merav; Savaya, Riki

    2011-01-01

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

  2. Changes in diagnostic case mix in psychiatric care in general hospitals, 1980-85.

    PubMed

    Kiesler, C A; Simpkins, C

    1992-05-01

    The Hospital Discharge Survey of 1980 and 1985 was used to assess changes in diagnostic case mix of psychiatric inpatient care in short-term, nonfederal general hospitals. Information regarding presence of psychiatric and chemical dependency units was added to both surveys, and information regarding exemption from Medicare's PPS system was noted for 1985. The largest increase was in ICD-9 code 296 (affective disorder), which more than doubled in frequency, along with a similar decrease in Diagnosis-Related Group 426, depressive neurosis. One explanation for this sizable shift was "gaming the system." One cannot conclusively, however, distinguish between gaming the system and the effects of changing professional views of depression during this time period. Other variables potentially contributing to the effect are described as well. PMID:1601291

  3. [A social psychiatric study on foreign-born inpatients at Tokyo Metropolitan Matsuzawa hospital].

    PubMed

    Igarashi, Y; Hayashi, N; Ebata, K; Kaneko, T

    1994-01-01

    The authors carried out a chart review study of 293 foreign-born patients who were admitted to Tokyo Metropolitan Matsuzawa Hospital from January 1986 to December 1992. We divided the subjects into three groups according to their living status in Japan, Immigrant group: 66 long-term residents, Resident group: 188 short-term residents with purposes of work or study, and Visitor group: 39 temporary visitors for sightseeing or business. The subjects came from 43 countries in the world, 70.3% (206/293) of whom were those from Asian countries. The subjects grew in number every year and the noticeable feature was a drastic increase in the number of Resident group (e.g. 6 patients in 1986, 63 in 1992). The mean duration (SD) of hospitalization for Immigrant group was the longest among the groups (Immigrant group: 58.7 (55.0) days, Resident group: 31.9 (35.0) days, Visitor group: 19.0 (16.3) days). The frequent diagnoses at discharge based on ICD-9, were schizophrenia (59.7%) and reactive psychosis (19.1%). The significantly larger proportion of Visitor group had previous psychiatric histories in their homeland than other groups (Visitor group: 56.4%, Immigrant group: 24.2%, Resident group: 23.9%). 70.0% (205/293) of the subjects could not use Japanese in usual settings and the number of them had been increasing every year. This communication difficulty had caused serious inconvenience in the treatment. All of Visitor group, and 71.8% (135/188) of Resident group could not receive social securities, and there were difficulties for them to raise money for their medical treatment and living expenses. 92.3% among Visitor group, 91.0% of Resident group and 21.2% of Immigrant group returned to their homeland after inpatient treatment. The result indicated that we must immediately establish the interpreter dispatch system for foreign-born patients and that of the social securities guaranteeing their medical care and living expenses. PMID:7938313

  4. Staff representations and tobacco-related practices in a psychiatric hospital with an indoor smoking ban.

    PubMed

    Keizer, Ineke; Gex-Fabry, Marianne; Bruegger, Aurélia; Croquette, Patrice; Khan, Aqal Nawaz

    2014-04-01

    The present study describes representations about smoking and practices related to patient smoking among staff of a large public psychiatric hospital. A survey was performed using a specially designed questionnaire. The return rate was 72.4% (n = 155). A large proportion of staff recognized the importance of both smoking status and mental health for patient's well-being (46.9%), and believed that smoking cessation was possible for psychiatric patients (58.6%). However, the role of the psychiatric hospital was perceived as providing information (85.3%) and helping to diminish cigarette consumption (51%), rather than proposing smoking cessation (29.5%). Staff daily practice included reminding patients of smoking restrictions (43.9%), managing cigarettes (46.5%), and nicotine replacement therapy (24.3%). A principal component analysis of tobacco-related practices revealed two main factors (59.8% of variance): basic hospital actions (factor 1) and more specialized interventions (factor 2), which were significantly associated with higher worries about personally developing smoke-related illnesses (Spearman r = 0.38, P < 0.0001). Compared with non-smokers, smokers reported higher perceived vulnerability to develop an illness due to tobacco and a higher level of worry about this. The discussion highlights the need to redefine roles and expectancies of mental health staff, and improve training and collaboration with experts, in order to improve efficiency concerning tobacco issues. PMID:23773346

  5. A low-cost evaluation of alcoholism treatment in a private psychiatric hospital program.

    PubMed

    Saxon, J J; Nace, E P; Cammarota, C

    1983-01-01

    The authors designed a low-cost evaluation study to examine outcome on an alcoholism specialty unit of a private psychiatric hospital as well as to look at the effects of several post-treatment therapies. Using conservative criteria for good outcome, and accounting for the expected poorer outcome of non-respondents, they found that the program achieved a 58 percent success rate. Use of Alcoholics Anonymous and a covert sensitization exercise developed especially for the program were associated with better outcome in terms of drinking behavior post-hospitalization. It should not be difficult to conduct a similar study in other treatment settings with a low research budget. PMID:10259671

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

    ERIC Educational Resources Information Center

    Kozyrskyj, Anita; Black, Charlyn; Chateau, Dan; Steinbach, Carmen

    2005-01-01

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

  7. The Psychiatric Hospital Adolescent Experience: Toward Greater School/Hospital Understanding and Communication.

    ERIC Educational Resources Information Center

    Goldfarb, Pnina

    1992-01-01

    Trends toward increased hospitalization of children and youth in facilities for the mentally ill and emotionally disturbed suggest the need for educators to better understand these institutions. This discussion considers hospital characteristics, hospital/school program specifics, and aids to communication between hospitals and schools. (DB)

  8. The psychiatric inpatient treatment of children and youth in general hospitals.

    PubMed

    Kiesler, C A; Simpkins, C; Morton, T

    1989-12-01

    National attention has recently focused on the mental health needs and services of children and youth. The lack of outpatient services and their coordination has been noted, as well as the consequent press towards inpatient care. We describe the inpatient treatment of children and adolescents (ages 0-18) in short-term, non-Federal general hospitals in 1980. Nationally, 128,300 children were treated for mental disorders in general hospitals at an estimated cost of over $1.5 billion. Compared to adults, children were more likely to be treated in scatter beds (vs. specialty units); have a diagnosis of mental disorder (vs. alcohol/drug disorder); stay much longer; and pay with commercial insurance. Previous work focusing on psychiatric units of general hospitals identified less than 40% of the total episodes, a figure very similar to that for adults. The majority of psychiatric inpatient episodes for children and youth in the United States takes place in short-term general hospitals. Community psychologists need to be aware of national trends in inpatient care and be involved in the development and promulgation of alternative models of care. PMID:2636541

  9. [Outcome of a substitution therapy program in an outpatient treatment setting of a psychiatric hospital].

    PubMed

    Unglaub, Willi; Loncarek, Ema; Wismath, Martin; Johann, Monika; Wodarz, Norbert; Klein, Helmfried

    2004-11-01

    We look at 42 opiate addicts being in substitution therapy at a certain date (24.9.2003) in an outpatient treatment setting of a psychiatric hospital. Treatment outcome is described with amount of take home, reduced delinquency, increased social reintegration as well as pharmacological treatment. 25 men and 17 women, age from 20 to 49 (29) have been in our treatment between 1 to 52 months (29). 20 of them (48 %) got an additional psychiatric medication, mostly antidepressants (42 %) but also neuroleptics (9,5 %). 21 patients had a drug free urine test (including cannabis) during the last month and could take their opiate medication at home. Necessity of support by social security declines from 25 % before to 16 % in substitution treatment. Also the need of unemployment benefit could be reduced from 36 % before to 26 % in treatment. Full time jobs increase from 31 % to 48 %, part time jobs from 3 % to 7 % in treatment. PMID:15570492

  10. The Association of Ward Atmosphere with Burnout and Attitudes of Treatment Team Members in a State Psychiatric Hospital

    Microsoft Academic Search

    Barbara A. Caldwell; Kenneth J. Gill; Elaine Fitzgerald; Michael Sclafani; Peg Grandison

    2006-01-01

    As part of a Clinical Affiliation Agreement between a major state psychiatric facility and a state university, it was agreed that the hospital's staff would be assessed in terms of: burnout, nursing functioning, and ward atmosphere. The assessment data would be used to examine hospital characteristics as they relate to the strategies necessary to transform an approach of custodial care

  11. Health literacy and 30-day postdischarge hospital utilization.

    PubMed

    Mitchell, Suzanne E; Sadikova, Ekaterina; Jack, Brian W; Paasche-Orlow, Michael K

    2012-01-01

    Low health literacy is associated with higher mortality, higher rates of hospitalization, and poor self-management skills for chronic disease. Early, unplanned hospital reutilization after discharge is a common and costly occurrence in U.S. hospitals. Still, few studies have examined the relation between health literacy and 30-day hospital reutilization rates. The authors examined the association between health literacy and 30-day reutilization of hospital services (readmission or return to the emergency department) in an urban safety net hospital, and conducted a secondary analysis of data from the control arm subjects of the Project RED and the RED-LIT trials. Health literacy was measured using the REALM tool. The primary outcome was rate of 30-day reutilization. The authors used multivariate Poisson regression analysis to control for potential confounding. Of the 703 subjects, 20% had low health literacy, 29% had marginal health literacy, and 51% had adequate health literacy. Sixty-two percent of subjects had a 12th-grade education or less. Subjects with low health literacy were more likely to be insured by Medicaid (p < .001); Black non-Hispanic (p < .001); unemployed, disabled, or retired (p < .001); low income (p < .001); and less educated (high school education or less, p < .001). The fully adjusted incidence rate ratio for low health literacy compared with adequate health literacy was 1.46 (CI [1.04, 2.05]). Low health literacy is a significant, independent, and modifiable risk factor for 30-day hospital reutilization after discharge. Interventions designed to reduce early, unplanned, hospital utilization after discharge should include activities to mitigate the effect of patients' low health literacy. PMID:23030580

  12. 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

    Johnson, Daniel C.

    2010-01-01

    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…

  13. Longitudinal Assessment of Parental Satisfaction with Children’s Psychiatric Hospitalization

    Microsoft Academic Search

    Joseph C. Blader

    2007-01-01

    Objective  To examine trends over time in parents’ satisfaction with their children’s prior psychiatric hospitalization and whether such\\u000a trends are related to postdischarge outcomes.\\u000a \\u000a \\u000a \\u000a Study Design\\/Data Collection  Parents of 107 child inpatients completed a satisfaction survey at discharge. Satisfaction with the same inpatient stay was\\u000a re-assessed 3, 6, and 12 months after discharge. Parents also provided ratings of behavioral symptoms at admission, discharge,

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

    Microsoft Academic Search

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

    2007-01-01

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

  15. Validity of a brief measure of post-hospital adjustment for psychiatric patients.

    PubMed

    Dornelas, E A; Botticello, A L; Goethe, J W; Fischer, E H

    2001-01-01

    This study examined the psychometric properties of a 14-item self-administered outcome measure of post-hospital adjustment for former psychiatric inpatients. Such scales are frequently used in follow-up assessment, often without knowledge of scale reliability or validity. Responses to the scale items were factor analyzed for two samples, former patients and their therapists, each group rating the patient's post-hospital adjustment. Two strong factors emerged and were consistent across both samples: an anxiety-depression (intrapsychic) dimension and a functioning/productivity (external adjustment) dimension. Both scales showed good convergent validity with longer, standardized measures. Agreement between patients and therapists was adequate for anxiety-depression, indicating good consensual validity, but poor for functional adjustment. For the expatients, discriminant validity was not evident. PMID:11559868

  16. The effects of the Medicare PPS on vulnerable subgroups of psychiatric patients treated in short-term general hospitals.

    PubMed

    DesHarnais, S I; Schumacher, D

    1991-08-01

    Changes in care in short-term general hospitals were monitored for three vulnerable subgroups of Medicare psychiatric patients: (1) those more than 75 years old, (2) those with comorbidities, and (3) those with one or more secondary diagnoses of psychiatric or substance abuse problems. Patterns of care studied for changes following institution of the Medicare Prospective Payment System (PPS) were volume of cases, average length of stay, discharge locations, and readmission rates. Results indicate that the changes occurring for the three subgroups were similar to the changes occurring for all Medicare psychiatric patients. After PPS was introduced in 1983, the average length of stay decreased, and a greater proportion of patients were discharged to other hospitals or home health care providers; however, rates of readmission to the same hospital did not increase. PMID:1945351

  17. Evaluation of tobacco use on Chinese population through ATTOC model: a cross-sectional survey on hospitalized psychiatric patients

    PubMed Central

    Wang, Xue; Peng, Zugui; Ziedonis, Douglas M; Wang, Chaomin; Yu, Bo; Li, Tao

    2015-01-01

    Objectives: To evaluate the feasibility of Addressing Tobaccos through Organizational Change (ATTOC) intervention to Chinese psychiatric patients, and to better address tobacco use through the ATTOC intervention model in the context of China. Methods: The study was conducted in Mental Health Center of West China Hospital in 2010. A total of 100 hospitalized psychiatric patients were recruited to carry out ATTOC intervention. Subjects suffers from mental illness were diagnosed by professional psychiatrists according to the International Statistical Classification of Diseases (ICD-10) criteria. Results: The prevalence of tobacco use in hospitalized psychiatric patients were closely correlated with the type of mental illness, family smoking history, sex, age, marital status, education status, etc. However, most psychiatric patients knew little about these, and tended to ignore the importance of smoking cessation. Conclusions: The ATTOC intervention program of the U.S. may be suitable for hospitalized Chinese psychiatric patients, and it could be applied for the tobacco smoking treatment in China. However, the health effects of tobacco use still did not draw amount attentions from both the clinicians and general public. It is urgently needed to raise people’s awareness and carry out ATTOC intervention to control tobacco use, and ultimately terminate tobacco use.

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

    PubMed Central

    2013-01-01

    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

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

    NSDL National Science Digital Library

    2008-10-06

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

  20. STUDY OF DROPOUTS FROM A PSYCHIATRIC CLINIC OF A GENERAL HOSPITAL

    PubMed Central

    Gill, H.P.S.; Singh, Gurmeet; Sharma, Kuldip C.

    1990-01-01

    SUMMARY During the study period of three months, out of 425 patients attending the psychiatric clinic of a general hospital, for the first time, 165 (38.8%) did not complete the treatment as prescribed by the doctors and were considered as dropouts. They were contacted at their homes to find out the reasons of the dropping out, were compared with patients, who completed the treatment fully on socio-demographic variables and attitude towards treatment. Dropouts significantly differed from treatment acceptors regarding their income, place of domicile and occupation. Maximum number of patients (59.9%) dropped out after the first visit. Dropouts were the maximum among epileptics, and minimum among the mentally retarded patients. Dropouts were dissatisfied with their experience at the clinic as treatment advised was not of their choice, and they feared bad side effects from ECT and drugs. Long distance of residence from clinic was an important reason for dropping out, besides social and economic reasons. PMID:21927444

  1. Predicting discharge in forensic psychiatry: the legal and psychosocial factors associated with long and short stays in forensic psychiatric hospitals.

    PubMed

    Ross, Thomas; Querengässer, Jan; Fontao, María Isabel; Hoffmann, Klaus

    2012-01-01

    In Germany, both the number of patients treated in forensic psychiatric hospitals and the average inpatient treatment period have been increasing for over thirty years. Biographical and clinical factors, e.g., the number of prior offences, type of offence, and psychiatric diagnosis, count among the factors that influence the treatment duration and the likelihood of discharge. The aims of the current study were threefold: (1) to provide an estimate of the German forensic psychiatric patient population with a low likelihood of discharge, (2) to replicate a set of personal variables that predict a relatively high, as opposed to a low, likelihood of discharge from forensic psychiatric hospitals, and (3) to describe a group of other factors that are likely to add to the existing body of knowledge. Based on a sample of 899 patients, we applied a battery of primarily biographical and other personal variables to two subgroups of patients. The first subgroup of patients had been treated in a forensic psychiatric hospital according to section 63 of the German legal code for at least ten years (long-stay patients, n=137), whereas the second subgroup had been released after a maximum treatment period of four years (short-stay patients, n=67). The resulting logistic regression model had a high goodness of fit, with more than 85% of the patients correctly classified into the groups. In accordance with earlier studies, we found a series of personal variables, including age at first admission and type of offence, to be predictive of a short or long-stay. Other findings, such as the high number of immigrants among the short-stay patients and the significance of a patient's work time before admission to a forensic psychiatric hospital, are more clearly represented than has been observed in previous research. PMID:22417759

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

    Microsoft Academic Search

    TONY LAVENDER

    1999-01-01

    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

  3. Trends, victims, and injuries in injurious patient assaults on adult, geriatric, and child/adolescent psychiatric units in US hospitals, 2007-2013.

    PubMed

    Staggs, Vincent S

    2015-04-01

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

  4. An analysis of the costs and benefits of two strategies to decrease length of stay in children's psychiatric hospitals.

    PubMed Central

    Margolis, L H; Petti, R D

    1994-01-01

    OBJECTIVE. We analyze the costs and benefits of two strategies-intensive home-based services and increased remuneration for providers of community-based placements--to decrease excessive length of stay in a children's psychiatric hospital. DATA SOURCES AND STUDY SETTING. Clinical, demographic, and financial data were collected retrospectively on all children discharged during 1987 through 1989 from the state children's psychiatric hospital that serves Wayne County, Michigan. Characteristics of the discharged children were similar to those reported in other studies of intensive home-based services. STUDY DESIGN. A sample of 22 children was used for a simulation analysis. Excessive length of stay was defined as the duration of hospitalization after readiness for discharge and associated planning were indicated in the record. For the simulated analysis of the intensive home-based program, costs included estimated charges for the program and charges for the children hospitalized due to failure of the intervention. For analysis of the increased remuneration strategy, costs included charges for the out-of-home placement and charges for hospitalization. For both strategies benefits were defined as averted hospitalization charges. DATA COLLECTION/EXTRACTION METHODS. Charts of the discharged children were reviewed and 21 clinical, demographic, and financial variables were extracted. PRINCIPAL FINDINGS. Analysis of costs and benefits of intensive home-based services produced a favorable cost-benefit ratio of .47. Analysis of the strategy to increase remuneration for providers of community-based placements resulted in a cost-benefit ratio of 1, indicating no financial savings. CONCLUSIONS. Intensive home-based services represent an efficient strategy to decrease excessive length of stay for children in psychiatric hospitals by averting hospitalization altogether. Although increased remuneration to providers of community-based placements in order to increase the supply of placements as a means to hasten discharge from the hospital has a neutral cost-benefit ratio, the opportunity to provide care in the "least restrictive" environment argues in its favor as well. PMID:8005787

  5. Posttraumatic stress disorder in women--experiences form the Psychiatric Clinic, University Hospital Center Zagreb, Croatia.

    PubMed

    Jovanovi?, Nikolina; Kuzman, Martina Rojni?; Medved, Vesna; Saboli?, Andelina Boki?; Grubisin, Jasmina; Hotujac, Ljubomir

    2009-03-01

    Posttraumatic stress disorder (PTSD) is an anxiety disorder that develops after a severe traumatic event or experience. Lifetime prevalence rate in the European population is 1.9 % and it is higher for women (2.9%) then for men (0.9 %). The aim of this study was to examine rates and sociodemographic and clinical characteristics of women with PTSD who were hospitalized at the Psychiatric clinic of University Hospital Center in Croatia over the years 1990-2007. Data were gathered retrospectively from the medical charts. We found that 67 women were diagnosed with PTSD which is 0.58% of all admissions over these years. Majority suffered from comorbid depression (N = 51) and various somatic conditions, especially malignant gynecological tumors (N = 23). No significant differences were found in distribution of PTSD symptoms in relation to the combat vs. civilian trauma. We found that patients with combat trauma often suffer from comorbid depression, while those with civilian traumas more often reported somatic conditions, especially malignant gynecological tumors. Our institution is a speciality clinic at a tertiary care medical center which tends to accumulate patients with serious forms of the disorder, and therefore our results can not be generalized to other settings involved in working with women with PTSD. Our results indicate that psychiatrists' assessment of female patients should inevitably include lifetime traumatic experiences, and among those with PTSD, special attention should be paid to comorbid depression and malignant tumors. PMID:19408636

  6. Assessment of Psychiatric Outcomes in Japan Based on Diagnostic Procedure Combination Information

    Microsoft Academic Search

    Takeru Abe; Koji Ikeda; Kenji Kuroda; Akihito Hagihara

    2011-01-01

    We evaluated psychiatric care in terms of relationships between patient characteristics and a comprehensive measurement of\\u000a psychiatric outcomes among inpatients with lengths of stay (LOSs) of 90 days or fewer in a psychiatric hospital in Japan.\\u000a The sample consisted of inpatients discharged from an acute care psychiatric hospital between September 1 and December 31,\\u000a 2007. Multivariate analyses were performed to identify

  7. [Long-Term Tendencies in the Use of Seclusion and Restraint in Five Psychiatric Hospitals in Germany.

    PubMed

    Steinert, Tilman; Zinkler, Martin; Elsässer-Gaißmaier, Hans-Peter; Starrach, Axel; Hoppstock, Sandra; Flammer, Erich

    2014-07-28

    Objective: To evaluate multiple efforts of the last decade to reduce the use of coercive measures in psychiatric hospitals. Method: A working group for the prevention of violence and coercion in psychiatric hospitals has compared several outcome indicators since the year 2000 and repeatedly has provided evidence-based recommendations for clinical practice. We present data from those 5 hospitals with complete data sets recorded by an identical method over 9 years. Results: The percentage of admissions exposed to any kind of coercive measure decreased from 8.2?% in 2004 to 6.2?% in 2012. The standard deviation of outcomes between hospitals decreased by 20?%. Changes in the duration of measures were mostly insignificant. Conclusions: Measures to reduce the use of coercion are effective in clinical practice, but to less extent than in clinical studies. A ban on all forced and non-consensual medical interventions, as being stipulated by the UN Special Rapporteur on Torture, has so far not materialized in the participating psychiatric institutions. PMID:25068687

  8. Psychotic Illness in First-Time Mothers with No Previous Psychiatric Hospitalizations: A Population-Based Study

    PubMed Central

    Valdimarsdóttir, Unnur; Hultman, Christina M; Harlow, Bernard; Cnattingius, Sven; Sparén, Pär

    2009-01-01

    Background Psychotic illness following childbirth is a relatively rare but severe condition with unexplained etiology. The aim of this study was to investigate the impact of maternal background characteristics and obstetric factors on the risk of postpartum psychosis, specifically among mothers with no previous psychiatric hospitalizations. Methods and Findings We investigated incidence rates and potential maternal and obstetric risk factors of psychoses after childbirth in a national cohort of women who were first-time mothers from 1983 through 2000 (n = 745,596). Proportional hazard regression models were used to estimate relative risks of psychoses during and after the first 90 d postpartum, among mothers without any previous psychiatric hospitalization and among all mothers. Within 90 d after delivery, 892 women (1.2 per 1,000 births; 4.84 per 1,000 person-years) were hospitalized due to psychoses and 436 of these (0.6 per 1,000 births; 2.38 per 1,000 person-years) had not previously been hospitalized for any psychiatric disorder. During follow-up after the 90 d postpartum period, the corresponding incidence rates per 1,000 person-years were reduced to 0.65 for all women and 0.49 for women not previously hospitalized. During (but not after) the first 90 d postpartum the risk of psychoses among women without any previous psychiatric hospitalization was independently affected by: maternal age (35 y or older versus 19 y or younger; hazard ratio 2.4, 95% confidence interval [CI] 1.2 to 4.7); high birth weight (? 4,500 g; hazard ratio 0.3, 95% CI 0.1 to 1.0); and diabetes (hazard ratio 0). Conclusions The incidence of psychotic illness peaks immediately following a first childbirth, and almost 50% of the cases are women without any previous psychiatric hospitalization. High maternal age increases the risk while diabetes and high birth weight are associated with reduced risk of first-onset psychoses, distinctly during the postpartum period. PMID:19209952

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2010-01-01

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

  11. A Language/Action Model of Human-Computer Communication in a Psychiatric Hospital

    PubMed Central

    Morelli, R. A.; Goethe, J. W.; Bronzino, J. D.

    1990-01-01

    When a staff physician says to an intern he is supervising “I think you should try medication X,” this statement may differ in meaning from the same string of words spoken between colleagues. In the first case, the statement may have the force of an order (“Do this!”), while in the latter it is merely a suggestion. In either case, the utterance sets up important expectations which constrain the future actions of the parties involved. This paper lays out an analytic framework, based on speech act theory, for representing such “conversations for action” so that they may be used to inform the design of human-computer interaction. The language/action design perspective views the information system -- in this case an expert system that monitors drug treatment -- as one of many “agents” within a broad communicative network. Speech act theory is used to model a typical psychiatric hospital unit as a system of communicative action. In addition to identifying and characterizing the primary communicative agents and speech acts, the model presents a taxonomy of key conversational patterns and shows how they may be applied to the design of a clinical monitoring system. In the final section, the advantages and implications of this design approach are discussed.

  12. A Follow-Up Study of Psychiatric Consultations in the General Hospital: What Happens to Patients after Discharge?

    Microsoft Academic Search

    M. Rigatelli; L. Casolari; I. Massari; S. Ferrari

    2001-01-01

    Background: An appropriate follow-up is considered essential in the consultation-liaison psychiatry setting, but it is often neglected. This study evaluated the effectiveness of the psychiatric consultation process in the general hospital, by investigating what occurred to patients 3–5 months after discharge. Methods: We used a three-part questionnaire: (1) the results of the consultation process; (2) a telephone interview with patients,

  13. Facets of anger, childhood sexual victimization, and gender as predictors of suicide attempts by psychiatric patients after hospital discharge.

    PubMed

    Sadeh, Naomi; McNiel, Dale E

    2013-08-01

    Models of suicidal behavior that assess the interplay of multiple risk factors are needed to better identify at-risk individuals during periods of elevated risk, including following psychiatric hospitalization. This study investigated contributions of facets of anger, gender, and sexual victimization to risk for suicide attempts after hospital discharge. Psychiatric patients (N = 748; ages 18-40; 44% female) recruited from 3 inpatient facilities were assessed during hospitalization and every 10 weeks during the year following discharge as part of the MacArthur Violence Risk Assessment Study. Multiple logistic regression models with facets of anger (disposition toward physiological arousal, hostile cognitions, and angry behavior) from the Novaco Anger Scale (Novaco, 1994), gender, and childhood sexual victimization history were used to predict suicide attempts in the year following hospital discharge. Facets of anger differentially predicted suicide attempts as a function of gender and sexual victimization history, over and above the variance accounted for by symptoms of depression, anxiety, and recent suicide attempts. In men, greater disposition toward angry behavior predicted an overall greater likelihood of a suicide attempt in the year following hospital discharge, particularly among men with childhood sexual victimization. In women with a history of childhood sexual victimization, physiological arousal predicted suicide attempts. Results indicate that facets of anger are relevant predictors of suicide attempts following hospital discharge for psychiatric patients with a history of childhood sexual victimization. Further, results suggest that incorporating gender and victimization history into models of risk for suicide can help clarify relationships between anger and self-directed violence. PMID:23834063

  14. The relationship of hospital ownership and teaching status to 30- and 180-day adjusted mortality rates.

    PubMed

    Kuhn, E M; Hartz, A J; Krakauer, H; Bailey, R C; Rimm, A A

    1994-11-01

    Hospital characteristics have been shown previously to be associated with variations in the probability of death within 30 days of admission. In the current study, the authors extend the examination of the relationship between hospital type to both short-term and long-term adjusted mortality. Observed and predicted 1988 hospital mortality rates were obtained from the Health Care Financing Administration (HCFA). A total of 3,782 acute care hospitals were divided into six mutually exclusive groups on the basis of their status as osteopathic, private for-profit, public teaching, public nonteaching, private teaching, and private nonteaching hospitals. After adjusting for the HCFA predicted mortality, Medicaid admissions, and emergency visits, 30-day and 30-to-180-day patient mortality rates were compared for these hospital types. Separate comparisons also were performed after stratifying hospitals into three groups defined by community size. The risk-adjusted 30-day mortality per 1,000 patients was 91.5, ranging from 85.4 for private teaching hospitals to 95.3 for nonteaching public hospitals, and 97.4 for osteopathic hospitals. The adjusted 30-to-180-day mortality was 84.7, ranging from 82.6 for nonteaching public hospitals to 87.4 and 88.2, respectively for public teaching and osteopathic hospitals. Differences among hospital types were minimal for small communities and increased with community size. In the large communities, the types of hospitals with high 30-day mortality also had higher mortality after 30 days. There was a strong association of hospital type with adjusted 30-day mortality, which should depend on the quality of hospital care, and a much weaker association with post-30-day mortality, which may be more dependent on patient risk. There was no evidence that types of hospitals with low 30-day mortality were postponing rather than preventing mortality. PMID:7967851

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

    PubMed Central

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

    1999-01-01

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

  16. Case Management in a Psychiatric Hospital: Review of Outcomes and Resource Utilisation

    Microsoft Academic Search

    R Mahendran; M Hendriks; V Thambyrajah; T Vellayan

    Objective: Case management is a heterogeneous concept used in psychiatry and other health, welfare, and service sectors. The several models of case management in psychiatry can be viewed as arising from task areas of psychiatric care, namely medical, rehabilitation, social control, growth, and development. This study investigated the development of the brokerage model of case management in acute psychiatric care

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

    PubMed

    Moses, Tally

    2014-05-01

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

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    PubMed

    Dinakaran, P; Mehrotra, Seema; Bharath, Srikala

    2014-12-01

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

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

    PubMed Central

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

    2014-01-01

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

  1. [Patients with schizophrenia in forensic-psychiatric hospitals (section 63 German Penal Code) in North Rhine-Westphalia].

    PubMed

    Kutscher, S; Schiffer, B; Seifert, D

    2009-02-01

    The aim of our study was to determine the development of the number of patients with schizophrenia in detention (section 63 German Penal Code) in North Rhine-Westphalia and the characterization of these patients. Patients with schizophrenia are examined, by using a standardized questionnaire answered by the attending psychiatrist or psychologist (n = 531). During the last 12 years the number of patients with schizophrenia in forensic-psychiatric hospitals has increased three times, whereas the number of patients with other diagnoses heightened only twofold. The patients with schizophrenia showed high rates of psychiatric comorbidities (substance disorders 73.9 %, personality disorders 17.2 %), previous inpatient treatments (78.3 % with a mean of 7.5 stays) and previous convictions (63.4 %). Almost half of these convictions (46.6 %) were violent offences (e. g. assault, homicide). Possible explanations for this development are discussed. PMID:19221971

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

    PubMed

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

    2014-06-01

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

  3. Helpseeking of Immigrant and Native Born Parents: A Qualitative Study from a Montreal Child Day Hospital

    PubMed Central

    Guzder, Jaswant; Yohannes, Sennait; Zelkowitz, Phyllis

    2013-01-01

    Objectives: This qualitative study of the perceptions of native-born Canadian and immigrant parents whose children attended a psychiatric day hospital for significant behavior impairment, focused on parental helpseeking pathways, explanatory models of mental health, and referral or access experiences. Methods: A sample of ten immigrant and ten native born parents were recruited for semi-structured interviews analyzed thematically to discern similarities and differences between the two groups. Results: The immigrant group more frequently reported barriers and delays in accessing mental health services. They often reported lack of primary care physicians and language barriers. They were less likely to have a biomedical perspective or to use specialized resources for their children prior to admission. Both groups reported apprehension about medication trials, though the immigrant parents were less likely to agree to psychopharmacological treatment. None of the professionals treating parents for mental health problems initiated referral of their impaired children. Conclusions: Based on the qualitative analysis of this sample, native born single parents and immigrant parents may feel especially vulnerable to lack of social support. Adjustments of primary care, schools and community resources, as well as promoting best practices of culturally competent child mental health care, may increase access and willingness to pursue treatment in both groups. PMID:24223046

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    PubMed Central

    2012-01-01

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

  6. Why are some patients admitted to psychiatric hospital while others are not? A study assessing risk during the admission interview and relationship to outcome.

    PubMed

    Hunt, Glenn E; O'Hara-Aarons, Maureen; O'Connor, Nick; Cleary, Michelle

    2012-04-01

    The aim of this study was to determine what patient characteristics are used to decide whether a patient is or is not admitted to a psychiatric hospital, and what happens to those not admitted. A further aim was to determine if high levels of risk on admission predict seclusions, length of stay, or readmission within 28?days. Data were collected prospectively on consecutive presentations to an admission office via case notes and electronic databases. Eighty percent (100/127) of the adults presenting to the admission office over a typical month were admitted to hospital. Patients were more likely to be admitted if they were experiencing psychosis or exacerbation of schizophrenia, referred by other doctors or mental health teams, had a legal reason for referral, or if they were homeless. There was no association between risk for violence or suicide and seclusion rates, length of stay, or being readmitted within 28?days. It was reassuring to find that 85% of those not admitted were referred to other mental health providers, and none required admission over the following month. This study found high rates of seclusion and readmissions within 1?year, which requires further study to find strategies to reduce these rates. PMID:22039923

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

    Microsoft Academic Search

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

    2000-01-01

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

  8. 'Therapeutic landscapes' and the importance of nostalgia, solastalgia, salvage and abandonment for psychiatric hospital design.

    PubMed

    Wood, Victoria J; Gesler, Wil; Curtis, Sarah E; Spencer, Ian H; Close, Helen J; Mason, James; Reilly, Joe G

    2015-05-01

    We examine emotional reactions to changes to medical spaces of care, linked with past experiences. In this paper we draw on findings from a qualitative study of the transfer of psychiatric inpatient care from an old to a newly built facility. We show how the meanings attributed to 'therapeutic landscapes' from one?s past can evoke emotions and memories, manifesting in ideas about nostalgia, solastalgia, salvage and abandonment, which can impinge on one?s present therapeutic experience. We reflect on how consideration of these ideas might contribute to better future design of psychiatric inpatient facilities and the wellbeing of those using them. PMID:25796009

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

  10. Suggested Posthypnotic Amnesia in Four Diagnostic Groups of Hospitalized Psychiatric Patients

    Microsoft Academic Search

    Frederick J. Evans; Julia M. Staats

    1989-01-01

    We studied the parameters of suggested posthypnotic amnesia (initial deficit in recall, reversibility, and temporal disorganization of the initial material partially recalled during amnesia) in 132 psychiatric inpatients with DSM-III diagnoses of schizophrenia (N = 25), eating disorders (N = 77), alcoholism (N = 12), and major affective disorder (depression) (N = 18). We compared the findings on these patients

  11. Profiling hospitals for length of stay for treatment of psychiatric disorders

    Microsoft Academic Search

    Jeffrey S. Harman; Brian J. Cuffel; Kelly J. Kelleher

    2004-01-01

    Managed behavioral health care organizations (MBHOs) often profile hospitals on length of stay (LOS) and other performance measures. However, previous research has suggested that most of the variation in utilization for general medical conditions is attributable to case-mix indicators and random sources rather than individual providers. Hospital discharge data are used to estimate hierarchical linear models, where hospitals and physicians

  12. Relation between bed use, social deprivation, and overall bed availability in acute adult psychiatric units, and alternative residential options: a cross sectional survey, one day census data, and staff interviews.

    PubMed Central

    Shepherd, G.; Beadsmoore, A.; Moore, C.; Hardy, P.; Muijen, M.

    1997-01-01

    OBJECTIVES: To examine the relation between bed use, social deprivation, and overall bed availability in acute adult psychiatric units and to explore the range of alternative residential options. DESIGN: Cross sectional survey, combined with one day census data; ratings by and interviews with staff; examination of routine data sources. SETTINGS: Nationally representative sample of acute psychiatric units. SUBJECTS: 2236 patients who were inpatients on census day. MAIN OUTCOME MEASURES: Bed occupancy levels, judged need for continuing inpatient care, reasons preventing discharge, scores on the Health of the Nation outcome scales. RESULTS: Bed occupancy was related to social deprivation and total availability of acute beds (r = 0.66, 95% confidence interval 0.19 to 0.88, F = 8.72, df = 2.23; P = 0.002). However, 27% (603/2215) of current inpatients (61% (90/148) of those with stays of > 6 months) were judged not to need continuing admission. The major reasons preventing discharge were lack of suitable accommodation (37% (176/482) of patients in hospital < 6 months v 36% (31/86) of those in hospital > 6 months); inadequate domiciliary based community support (23% (113) v 9% (8)); and lack of long term rehabilitation places (21% (100) v 47% (40)). Scores on the Health of the Nation outcome scale were generally consistent with these staff judgments. CONCLUSIONS: The shortage of beds in acute psychiatric units is related to both social deprivation and the overall availability of acute beds. Patients currently inappropriately placed on acute admission wards should be relocated into more suitable accommodation, either in hospital or in the community. A range of provisions is required; simply providing more acute beds is not the answer. PMID:9022489

  13. Relationship between mean daily ambient temperature range and hospital admissions for schizophrenia: Results from a national cohort of psychiatric inpatients.

    PubMed

    Sung, Tzu-I; Chen, Mu-Jean; Lin, Chuan-Yao; Lung, Shih-Chun; Su, Huey-Jen

    2011-12-01

    Environmental temperature is known to correlate with schizophrenia, but little is known about the association with changes in temperature. This 12-year study aimed to evaluate the relationship between the mean daily range of ambient temperature and schizophrenia admissions in a national cohort of psychiatric inpatients in Taiwan. Meteorological data provided by the Central Weather Bureau of Taiwan were interpolated to create representative estimates. Psychiatric inpatient admissions in all hospitals with medical services enrolled in the current health care insurance system were retrieved from the 1996-2007 Psychiatric Inpatient Medical Claim dataset of the National Health Insurance Research Database. Generalized linear models with Poisson distributions were used to analyze the impact of mean diurnal change of temperature on schizophrenia admissions, controlling for internal correlations and demographic covariates. The daily temperature range varied between 1.7°C and 12.1°C (1st to 99th percentile). The relative risk of schizophrenia admission was significantly increased at a temperature range of 3.2°C (10th percentile), and the maximum was at 12.1°C (99th percentile); however, no such association was found with schizoaffective disorder. When restricted to the capital and largest city, the effects of temperature range were prominent and may correlate with temperature itself. The joint effect of temperature and temperature range was associated with elevated risk, particularly at cooler temperatures. A positive correlation was found between increasing temperature range and schizophrenia admissions. The increase in morbidity at high percentiles suggests that the increasing dynamics of temperature range are a valid reflection of risk, highlighting the need for precautionary action. PMID:22018962

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

    PubMed

    2015-03-01

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

  15. SOCIALIZATION OF THE YOUNGER PSYCHIATRIC PATIENT--THE COMMUNITY AND THE HOSPITAL-A DUAL RESPONSIBILITY.

    ERIC Educational Resources Information Center

    GIORDANO, JOSEPH; AND OTHERS

    TO ASSIST YOUNG, MENTAL PATIENTS IN OVERCOMING SOME OF THEIR SOCIAL DEFICITS, TWO RESOCIALIZATION PROJECTS (PRE- AND POST-DISCHARGE) WERE INITIATED TO MOVE THE PATIENT FROM A MENTAL HOSPITAL SETTING INTO THE LARGER COMMUNITY, WITH A COMMUNITY CENTER AS THE LEARNING GROUND. CAREFULLY SELECTED PATIENTS FROM THE HOSPITAL WERE GIVEN THE OPPORTUNITY TO…

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

    PubMed

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

    2014-09-01

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

  17. Psychiatric case notes: symptoms of mental illness and their attribution at the Maudsley Hospital, 1924-35.

    PubMed

    Jones, Edgar; Rahman, Shahina; Everitt, Brian

    2012-06-01

    Case notes of patients treated at the Maudsley Hospital during the interwar period provided data about diagnosis, symptoms and beliefs about mental illness. In the absence of effective treatments, patients were investigated in detail in the hope that connections between disease processes might be revealed. We analysed a randomly-selected sample of 700 patients taken equally from 1924, 1928, 1931 and 1935. Eight groups (three representing psychosis and five indicating psychological disorders) were identified on the basis of symptom clusters. Formal diagnosis did not correlate with clusters. Although there was a measure of agreement between patients and doctors about the cause of mental illness, stigma may have inhibited discussion of some themes. Psychiatric diagnosis was informed by symptoms but not determined by them. In an era before classification systems were tested for reliability, diagnosis was fluid, reflecting changing hypotheses about causation, pathology and treatment. Attributions were associated with diagnosis rather than symptoms. PMID:23057225

  18. Mediation analysis of critical time intervention for persons living with serious mental illnesses: Assessing the role of family relations in reducing psychiatric re-hospitalization

    PubMed Central

    Tomita, Andrew; Lukens, Ellen P.; Herman, Daniel B.

    2013-01-01

    Objective Critical Time Intervention (CTI) is a time-limited care coordination intervention designed to reduce homelessness and other adverse outcomes for persons living with serious mental illness during the transition period between institutions and community living. This study assesses whether CTI improves the quality of family relationships between family members and individuals living with serious mental illness, and examines whether changes in quality of family relationship mediated the association between the intervention and psychiatric re-hospitalization outcomes. Method This study utilizes data from a randomized controlled trial that assessed the effect of CTI in preventing homelessness. Following discharge from inpatient psychiatric treatment in New York City, 150 previously homeless persons living with serious mental illness were randomly assigned to receive usual services only or nine months of CTI in addition to usual services. Results Findings from mixed-effects regression models indicated that those assigned to the CTI group reported greater frequency of family contact and greater improvement in satisfaction with family relations than the comparison group during the 18 month follow-up period. Mediation analysis revealed that greater improvement in satisfaction with family relations mediated the effect of CTI on psychiatric re-hospitalization outcome but only at a modest level. Conclusion and Implications for Practice These findings suggest that a relatively brief but targeted intervention delivered at the point of hospital discharge may contribute to strengthening family relations and that improvement in perceived family relationship quality can contribute to a reduction in psychiatric re-hospitalization. PMID:24219767

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

    PubMed

    Bernstein, Kunsook Song; Saladino, Joseph P

    2007-10-01

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

  20. The outcome and cost of alcohol and drug treatment in an HMO: day hospital versus traditional outpatient regimens.

    PubMed Central

    Weisner, C; Mertens, J; Parthasarathy, S; Moore, C; Hunkeler, E M; Hu, T; Selby, J V

    2000-01-01

    OBJECTIVE: To compare outcome and cost-effectiveness of the two primary addiction treatment options, day hospitals (DH) and traditional outpatient programs (OP) in a managed care organization, in a population large enough to examine patient subgroups. DATA SOURCES: Interviews with new admissions to a large HMO's chemical dependency program in Sacramento, California between April 1994 and April 1996, with follow-up interviews eight months later. Computerized utilization and cost data were collected from 1993 to 1997. STUDY DESIGN: Design was a randomized control trial of adult patients entering the HMO's alcohol and drug treatment program (N = 668). To examine the generalizability of findings as well as self-selection factors, we also studied patients presenting during the same period who were unable or unwilling to be randomized (N = 405). Baseline interviews characterized type of substance use, addiction severity, psychiatric status, and motivation. Follow-up interviews were conducted at eight months following intake. Breathanalysis and urinalysis were conducted. Program costs were calculated. DATA COLLECTION: Interview data were merged with computerized utilization and cost data. PRINCIPAL FINDINGS: Among randomized subjects, both study arms showed significant improvement in all drug and alcohol measures. There were no differences overall in outcomes between DH and OP, but DH subjects with midlevel psychiatric severity had significantly better outcomes, particularly in regard to alcohol abstinence (OR = 2.4; 95% CI = 1.2, 4.9). The average treatment costs were $1,640 and $895 for DH and OP programs, respectively. In the midlevel psychiatric severity group, the cost of obtaining an additional person abstinent from alcohol in the DH cohort was approximately $5,464. Among the 405 self-selected subjects, DH was related to abstinence (OR = 2.1; 95% CI = 1.3, 3.5). CONCLUSIONS: Although significant benefits of the DH program were not found in the randomized study, DH treatment was associated with better outcomes in the self-selected group. However, for subjects with mid-level psychiatric severity in both the randomized and self-selected samples, the DH program produced higher rates of abstention and was more cost-effective. Self-selection in studies that randomize patients to services requiring very different levels of commitment may be important in interpreting findings for clinical practice. PMID:11055449

  1. Diagnosis and Treatment of Sleep Disordered Breathing in Hospitalized Cardiac Patients: A Reduction in 30-Day Hospital Readmission Rates

    PubMed Central

    Kauta, Shilpa R.; Keenan, Brendan T.; Goldberg, Lee; Schwab, Richard J.

    2014-01-01

    Background: Sleep disordered breathing (SDB) is associated with significant cardiovascular sequelae and positive airway pressure (PAP) has been shown to improve heart failure and prevent the recurrence of atrial fibrillation in cardiac patients with sleep apnea. Patients who are hospitalized with cardiac conditions frequently have witnessed symptoms of SDB but often do not have a diagnosis of sleep apnea. We implemented a clinical paradigm to perform unattended sleep studies and initiate treatment with PAP in hospitalized cardiac patients with symptoms consistent with SDB. We hypothesized that PAP adherence in cardiac patients with SDB would reduce readmission rates 30 days after discharge. Methods: 106 consecutive cardiac patients hospitalized for heart failure, arrhythmias, and myocardial infarction and who reported symptoms of SDB were evaluated. Patients underwent a type III portable sleep study and those patients diagnosed with sleep apnea were started on PAP. Demographic data, SDB type, PAP adherence, and data regarding 30-day hospital readmission/ED visits were collected. Results: Of 106 patients, 104 had conclusive diagnostic studies using portable monitoring systems. Seventy-eight percent of patients (81/104) had SDB (AHI ? 5 events/h). Eighty percent (65/81) had predominantly obstructive sleep apnea, and 20% (16/81) had predominantly central sleep apnea. None of 19 patients (0%) with adequate PAP adherence, 6 of 20 (30%) with partial PAP use, and 5 of 17 (29%) of patients who did not use PAP were readmitted to the hospital or visited the emergency department (ED) for a cardiac issue within 30 days from discharge (p = 0.025). Conclusions: Performing diagnostic unattended sleep studies and initiating PAP treatment in hospitalized cardiac patients was feasible and provided important clinical information. Our data indicate that hospital readmission and ED visits 30 days after discharge were significantly lower in patients with cardiac disease and SDB who adhered to PAP treatment than those who were not adherent. Commentary: A commentary on this article appears in this issue on page 1067. Citation: Kauta SR, Keenan BT, Goldberg L, Schwab RJ. Diagnosis and treatment of sleep disordered breathing in hospitalized cardiac patients: a reduction in 30-day hospital readmission rates. J Clin Sleep Med 2014;10(10):1051-1059. PMID:25317084

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

    NASA Astrophysics Data System (ADS)

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

    2013-07-01

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

  3. The psychiatric hospital and its place in a mental health service

    PubMed Central

    Tooth, Geoffrey

    1958-01-01

    Modern methods of treatment of mental disease enable the average length of stay in hospital to be drastically reduced. The former overcrowding is therefore disappearing; in fact, it should be possible to contemplate a reduction in the size of the hospitals, particularly if new admissions are kept to a minimum by the provision of efficient out-patient clinics and of adequate geriatric and domiciliary nursing services. Taking recent trends in England and Wales as his starting point, the author outlines ways in which a modern mental health service might be built up around existing facilities under a variety of conditions. He advocates that, as far as possible, the treatment of mental disease should be integrated into general medicine, and emphasises the need for close co-operation between psychiatrists, family doctors, and the staff of general hospitals. PMID:13585081

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

    PubMed Central

    2013-01-01

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

  5. Outcome of Occupational Therapy in a Psychiatric Day Care Unit for Long-Term Mentally Ill Patients

    Microsoft Academic Search

    Mona Eklund

    1999-01-01

    Twenty patients, receiving group based psychiatric outpatient occupational therapy, were assessed at admission and discharge regarding psychiatric symptoms (SCL-90-R), global mental health (HSRS), quality of life (SQoL), and occupational performance (AOF). The patients were in treatment from 4 to 30 months. There were statistically significant improvements from admission to discharge on all variables except quality of life. Thirteen of the

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

    Microsoft Academic Search

    Valerie Klinge; James Culbert; Leonard R. Piggott

    1982-01-01

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

  7. The Disability Profile of Patients with Schizophrenia in Psychiatric Hospital and Community Settings in Singapore

    Microsoft Academic Search

    P W Eu; C Lee; G Parker; J Loh

    The disability profile of persons with schizophrenia in Singapore and how disability levels vary in patients cared for in the community and in the long-stay wards of a state mental hospital were studied using the Life Skills Profile (LSP). The inter-rater reliability of the LSP assessed by the intraclass correlation coefficient (ICC), was lower than in the Australian studies. The

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

    PubMed Central

    Laskin, Benjamin; Furth, Susan

    2014-01-01

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

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

    E-print Network

    Velasquez, John Martin

    1992-01-01

    . Sociodemographic Data: Treatment Sample 4. Sociodemographic Data: Comparisons Between Treatment and Control Groups Page 14 15 16 17 5. Sociodemographic Data: Chi-Square Test of Independence Across Groups for Marital Status of Sub)ects 6. Sociodemographic... to minimize or avoid these or other future stresses. In general, the evidence indicates that these cognitive-behavioral interventions have a significant effect on reducing post-hospitalization distress among both the patient and his or her family members...

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

    PubMed

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

    2015-07-01

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

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

    ERIC Educational Resources Information Center

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

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

  12. THIRTY-DAY HOSPITAL READMISSION RATE AMONG ADULTS LIVING WITH HIV

    PubMed Central

    BERRY, Stephen A.; FLEISHMAN, John A.; YEHIA, Baligh R.; KORTHUIS, P. Todd; AGWU, Allison L.; MOORE, Richard D.; GEBO, Kelly A.

    2013-01-01

    Objective Thirty-day hospital readmission rate is receiving increasing attention as a quality of care indicator. The objective of this study was to determine readmission rates and to identify factors associated with readmission among persons living with HIV. Design Prospective multicenter observational cohort. Setting Nine U.S. HIV clinics affiliated through the HIV Research Network. Subjects Patients engaged in HIV care during 2005–2010. Main outcome measure(s) Readmission rate was defined as the proportion of hospitalizations followed by a readmission within 30 days. Factors in multivariate analyses included diagnostic categories, patient demographic and clinical characteristics, and having an outpatient follow-up visit. Results Among 11,651 total index hospitalizations, the 30-day readmission rate was 19.3%. AIDS defining illnesses (ADI, 9.6% of index hospitalizations) and non-AIDS defining infections (26.4% of index hospitalizations) had readmission rates of 26.2% and 16.6%, respectively. Factors independently associated with readmission included lower CD4 count (AOR 1.80 [1.53, 2.11] for CD4 <50 vs. ?351 cells/?l), longer length of stay (1.77 [1.53, 2.04] for ?9 days vs. 1–3 days), and several diagnostic categories including ADI. Having an outpatient follow-up clinic visit was not associated with lower readmission risk (AHR 0.98 [0.88, 1.08]). Conclusions The 19.3% readmission rate exceeds the 13.2% rate reported for the general population of 18–64 year-olds. HIV providers may use the 19.3% rate as a basis of comparison. Policymakers may consider the impact of HIV when estimating expected readmissions for a hospital or region. Preventing or recovering from severe immune dysfunction may be the most important factor to reducing readmissions. PMID:23612008

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

    PubMed Central

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

    2015-01-01

    Background: Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated. Aims: The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients. Settings and Design: This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India. Materials and Methods: One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1st November 2013 to 30th April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination. Statistical analysis used: The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P <0.05 was considered to be statistically significant. Results: The commonest dental illness was dental caries (22%). More than two-third of the patients had psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%). Conclusions: This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists. PMID:25767358

  14. [The role of the nurse and child health nurse in a haematology day hospital].

    PubMed

    Perray, Stéphanie; Costes, Élodie; Héritier, Sébastien

    2015-01-01

    The paediatric haemato-oncology nurse and the child health nurse in a day hospital have specific technical skills and in-depth knowledge in order to be able to provide global care for children with leukaemia. Close collaboration between the different professionals working in this care unit is essential. PMID:26183096

  15. Smoking-attributable morbidity: acute care hospital diagnoses and days of treatment in Canada, 2002

    Microsoft Academic Search

    Dolly Baliunas; Jayadeep Patra; Jürgen Rehm; Svetlana Popova; Benjamin Taylor

    2007-01-01

    BACKGROUND: Smoking is one of the most important risk factors for burden of disease. Our objective was to estimate the number of hospital diagnoses and days of treatment attributable to smoking for Canada, 2002. METHODS: Distribution of exposure was taken from a major national survey of Canada, the Canadian Community Health Survey. For chronic diseases, risk relations were taken from

  16. Clinical and Socio-Demographic Profile of Women with Post-Partum Psychiatric Conditions at a Federal Neuropsychiatric Hospital in Southeast Nigeria between 2009 and 2011

    PubMed Central

    Ndukuba, AC; Odinka, PC; Muomah, RC; Nwoha, SO

    2015-01-01

    Background: Pregnancy and labor in areas with high maternal morbidities as in Nigeria could be sufficiently stressful to precipitate mental disorders in women after delivery, which may be a new or a relapse of previously existing one, or an exacerbation of an attenuated mental illness in the nursing mother. Mental illness in a nursing mother, if not treated may result in impaired mother-infant relationship. Aim: To determine the clinical and socio-demographic characteristics of women diagnosed with postpartum psychiatric conditions in a tertiary mental health facility of a developing country. Subjects and Methods: A retrospective case note reviews of 76 women diagnosed with postpartum psychiatric conditions for the first time in the Federal Neuropsychiatric Hospital Enugu between January 2009 and December 2011. Results: The mean age of the women was 27.76 years, with 63% (48/76) of them coming from the rural areas. 93% (71/76) of them had at least a secondary education and 78% (59/76) of the women had a family history of psychiatric disorders. Schizophrenia was commonest, 48.7% (37/76) followed by depression, 22% (17/76) and mania, 15% (11/76). Those presenting with schizophrenia were younger when compared with other diagnostic groups, had a lower level of education and presented earlier for treatment. The husbands were the primary caregivers in 48% of them. Conclusion: With 63% (48/76) of them being rural dwellers, policy changes become imperative that would encourage establishment of psychiatric services in rural areas to ensure early detection and prompt treatment of postpartum women with a need for psychiatric services.

  17. The Day-Hospital of the University Hospital, Bobo Dioulasso: An Example of Optimized HIV Management in Southern Burkina Faso

    PubMed Central

    Chas, Julie; Hema, Arsène; Slama, Laurence; Kabore, Nongondo Firmin; Lescure, François-Xavier; Fontaine, Camille; Pialoux, Gilles; Sawadogo, Adrien

    2015-01-01

    Objectives To evaluate the epidemiological evolution of patients with HIV (PtHIV), between 2002 and 2012, in a day-hospital that became an HIV reference centre for south-west Burkina Faso. Materials and Methods This was a retrospective study of PtHIV followed in the Bobo Dioulasso university hospital since 2002. The study was based on clinical data recorded using ESOPE software and analysed using Excel and SAS. Results A total of 7320 patients have been treated at the centre since 2002; the active file of patients increased from 147 in 2002 to 3684 patients in 2012. Mean age was stable at 38.4 years and the majority were female (71%). The delay to initiation of antiretroviral (ARV) treatment after HIV diagnosis decreased from 12.9 months in 2002 to 7.2 months in 2012. The percentage of PtHIV lost to follow-up, untreated for HIV and deaths all decreased after 2005. Voluntary anonymous screening and/or an evocative clinical picture were the main reasons for HIV diagnosis, usually at a late stage (41.1% at WHO stage 3). Virological success increased due to a decrease in time to initiation of ARV treatment and an increase in percentage of patients treated (90.5% in 2012, mainly with 1st line drugs). However, there was also a slight increase in the rate of therapeutic failures and the percentage of patients who progressed to 2nd or 3rd line-ARVs. Conclusion Our day-hospital is a good example of the implementation of a specialist centre for the management of PtHIV in a resource-limited country (Burkina Faso). PMID:25970181

  18. 12-step involvement and peer helping in day hospital and residential programs.

    PubMed

    Zemore, Sarah E; Kaskutas, Lee Ann

    2008-01-01

    This study compares peer helping and 12-step involvement among participants receiving chemical dependency treatment at day hospital (N = 503) and residential (N = 230) programs, and examines relationships between both variables and outcomes. Findings show that residential (vs. day hospital) participants reported significantly more peer helping and 12-step involvement during treatment, and marginally more 12-step involvement at 6 months. Both peer helping and 12-step involvement predicted higher odds of sobriety across follow-ups; helping showed an indirect effect on sobriety via 12-step involvement. Results contribute to the 12-step facilitation literature; confirm prior results regarding benefits of mutual aid; and highlight methodological issues in helping research. The study's limitations are noted. PMID:19016170

  19. PS1-42: In-hospital Severity and 30-day Readmission

    PubMed Central

    Leader, Joseph; Kirchner, H Lester

    2014-01-01

    Background/Aims Identifying and preventing 30-day readmissions has become a national focus. There have been attempts at developing all-cause predictive models to identify ‘high risk’ readmission patients such as LACE. Historically, in-hospital severity predictive models have been developed for various services and disease states. Some of the most widely used severity measures are the Modified Early Warning Score (MEWS), Glasgow Coma Score (GCS), Acute Physiology, and the American Society of Anesthesiologists (ASA) Score. We wish to compare in-hospital severity scores to predict 30 day readmission. Methods A retrospective a cohort of patients was assembled who were admitted to two Geisinger hospitals during calendar year 2012. Admissions related to a child’s birth, unknown acuity, and in-hospital deaths. Data was obtained during the year preceding the admission and outcomes were assessed up to 30 days post-discharge. Additional data including initial laboratory results, comorbidities, length of stay, and discharge disposition was obtained. For severity scores measured longitudinally during the admission, we selected the initial, last, and worse. A base model of known readmission predictors was built using logistic regression with a flexible specification of continuous measures, and the severity scores were considered individually by forcing them into the model. The net reclassification index (NRI) was used to quantify improvement in prediction. Results A total of 41,413 admissions met cohort entry criteria (mean age 58.5 y, 45% (18,628) male). Readmissions within 30 days occurred 13.3% (5,502) during 2012 with another 2.9% (1,217) that died without a readmission. The base model consisting of demographics, comorbidities, discharge disposition, and utilization in past year resulted in an area under the ROC curve (AUC) of 0.710. LACE significantly contributed to the model (AUC = 0.715, NRI = 2.0%, OR = 1.12 [1.10, 1.13], P <0.001). The last reported GCS was significantly associated with 30-day readmission (OR = 1.05 [1.02, 1.09]), however there was no increase in the AUC and the NRI was non-significant. The MEWS was not significantly associated with readmission. Conclusions The usefulness of in-hospital severity scores was not consistent in their association with readmission. Additional research is needed to understand performance in subgroups and to utilize serial measurements when available.

  20. Health literacy and 30-day hospital readmission after acute myocardial infarction

    PubMed Central

    Bailey, Stacy Cooper; Fang, Gang; Annis, Izabela E; O'Conor, Rachel; Paasche-Orlow, Michael K; Wolf, Michael S

    2015-01-01

    Objective To assess the validity of a predictive model of health literacy, and to examine the relationship between derived health literacy estimates and 30-day hospital readmissions for acute myocardial infarction (AMI). Design Retrospective cohort study. Setting and participants A National Institute of Aging (NIA) study cohort of 696 adult, English-speaking primary care patients, aged 55–74?years, was used to assess the validity of derived health literacy estimates. Claims from 7733 Medicare beneficiaries hospitalised for AMI in 2008 in North Carolina and Illinois were used to investigate the association between health literacy estimates and 30-day hospital readmissions. Measures The NIA cohort was administered 3 common health literacy assessments (Newest Vital Sign, Test of Functional Health Literacy in Adults, and Rapid Estimate of Adult Literacy in Medicine). Health literacy estimates at the census block group level were derived via a predictive model. 30-day readmissions were measured from Medicare claims data using a validated algorithm. Results Fair agreement was found between derived estimates and in-person literacy assessments (Pearson Correlation coefficients: 0.38–0.51; ? scores: 0.38–0.40). Medicare enrollees with above basic literacy according to derived health literacy estimates had an 18% lower risk of a 30-day readmission (RR=0.82, 95% CI 0.73 to 0.92) and 21% lower incidence rate of 30-day readmission (IRR=0.79, 95% CI 0.68 to 0.87) than patients with basic or below basic literacy. After adjusting for demographic and clinical characteristics, the risk of 30-day readmission was 12% lower (p=0.03), and the incidence rate 16% lower (p<0.01) for patients with above basic literacy. Conclusions Health literacy, as measured by a predictive model, was found to be a significant, independent predictor of 30-day readmissions. As a modifiable risk factor with evidence-based solutions, health literacy should be considered in readmission reduction efforts. PMID:26068508

  1. Eating Disorders in Individuals with Type 1 Diabetes: Case Series and day Hospital Treatment Outcome.

    PubMed

    Colton, Patricia Anne; Olmsted, Marion Patricia; Wong, Harmonie; Rodin, Gary Michael

    2015-07-01

    Women with type 1 diabetes are at high risk for eating disorders (ED), a combination that can increase medical complications and mortality. As little is known about treatment response in this population, clinical presentation and treatment outcome in an extended case series were assessed. A chart review at the Eating Disorders Day Hospital Program at Toronto General Hospital identified a total of 100 individuals with type 1 diabetes assessed 1990-2012. Of 37 who attended day hospital, most experienced improvement in ED symptoms, but only 18.8% had a good immediate treatment outcome, while 43.8% had an intermediate outcome and 37.5% had a poor outcome (meeting diagnostic criteria at discharge). This is poorer than program outcomes in individuals without diabetes (?(2) ?=?12.2, df?=?2; p?=?0.002). Factors influencing treatment engagement and outcome must be further studied and used to improve treatment results in this high-risk group. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. PMID:25988537

  2. Impact of frontloading of skilled nursing visits on the incidence of 30-day hospital readmission.

    PubMed

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

    2014-01-01

    Hospitalization among older adults receiving skilled home health services continues to be prevalent. Frontloading of skilled nursing visits, defined as providing 60% of the planned skilled nursing visits within the first two weeks of home health episode, is one way home health agencies have attempted to reduce the need for readmission among this chronically ill population. This was a retrospective observational study using data from five Medicare-owned, national assessment and claim databases from 2009. An independent randomized sample of 4500 Medicare-reimbursed home health beneficiaries was included in the analyses. Propensity score analysis was used to reduce known confounding among covariates prior to the application of logistic analysis. Although whether skilled nursing visits were frontloaded or not was not a significant predictor of 30-day hospital readmission (p = 0.977), additional research is needed to refine frontloading and determine the type of patients who are most likely to benefit from it. PMID:24702719

  3. Understanding psychiatric institutionalization: a conceptual review

    PubMed Central

    2013-01-01

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

  4. Diagnoses and Timing of 30-Day Readmissions after Hospitalization For Heart Failure, Acute Myocardial Infarction, or Pneumonia

    PubMed Central

    Dharmarajan, Kumar; Hsieh, Angela F.; Lin, Zhenqiu; Bueno, Héctor; Ross, Joseph S.; Horwitz, Leora I.; Barreto-Filho, José Augusto; Kim, Nancy; Bernheim, Susannah M.; Suter, Lisa G.; Drye, Elizabeth E.; Krumholz, Harlan M.

    2013-01-01

    Context To better guide strategies intended to reduce high rates of 30-day readmission after hospitalization for heart failure, acute myocardial infarction, or pneumonia, further information is needed about readmission diagnoses, readmission timing, and the relationship of both to patient age, sex, and race. Objective To examine readmission diagnoses and timing among Medicare beneficiaries readmitted within 30 days after hospitalization for heart failure, acute myocardial infarction, or pneumonia. Design, Setting, and Patients We analyzed 2007 to 2009 Medicare Fee-For-Service claims data to identify patterns of 30-day readmission by patient demographic characteristics and time after hospitalization for heart failure, acute myocardial infarction, or pneumonia. Readmission diagnoses were categorized using an aggregated version of the Centers for Medicare & Medicaid Services’ Condition Categories. Readmission timing was determined by day after discharge. Main Outcomes Measures We examined (1) the percentage of 30-day readmissions occurring on each day (0–30) after discharge; (2) the most common readmission diagnoses occurring during cumulative time periods (days 0–3, 0–7, 0–15, and 0–30) and consecutive time periods (days 0–3, 4–7, 8–15, and 16–30) after hospitalization; (3) median time to readmission for common readmission diagnoses; and (4) the relationship between patient demographic characteristics and readmission diagnoses and timing. Results From 2007 to 2009, we identified 329,308 30-day readmissions after 1,330,157 heart failure hospitalizations (24.8% readmitted), 108,992 30-day readmissions after 548,834 acute myocardial infarction hospitalizations (19.9% readmitted), and 214,239 30-day readmissions after 1,168,624 pneumonia hospitalizations (18.3% readmitted). The proportion of patients readmitted for the same condition was 35.2% after index heart failure hospitalization, 10.0% after index acute myocardial infarction hospitalization, and 22.4% after index pneumonia hospitalization. Of all readmissions within 30 days, 61.0%, 67.6%, and 62.6% occurred with 15 days of discharge after hospitalization for heart failure, acute myocardial infarction, or pneumonia, respectively. The diverse spectrum of readmission diagnoses was largely similar in both cumulative (days 0–3, 0–7, 0–15, and 0–30) and consecutive (days 0–3, 4–7, 8–15, and 16–30) time periods after discharge. Median time to 30-day readmission was 12 days, 10 days, and 12 days for patients initially hospitalized with heart failure, acute myocardial infarction, or pneumonia, respectively, and was comparable across common readmission diagnoses. Neither readmission diagnoses nor timing substantively varied by age, sex, or race. Conclusions Among Medicare Fee-for-Service beneficiaries hospitalized for heart failure, acute myocardial infarction, or pneumonia, 30-day readmissions are frequent throughout the month following hospitalization and result from a similar spectrum of readmission diagnoses regardless of age, sex, race, or time after discharge. PMID:23340637

  5. Infrarenal aortic surgery with a 3-day hospital stay: A report on success with a clinical pathway

    Microsoft Academic Search

    Peter C. Podore; Erik B. Throop

    1999-01-01

    Purpose: This paper reports on an experience with a clinical pathway for elective infrarenal aortic surgery (AS) that targeted hospital discharge on postoperative day (POD) 3. The pathway incorporated early feeding, early ambulation, and selective use of the intensive care unit (ICU). Methods: A review of 50 consecutive hospital discharges after AS (aneurysm repair and aortofemoral bypass grafting) by a

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

    PubMed

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

    2015-02-01

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

  7. Narratives of change and reform processes: global and local transactions in French psychiatric hospital reform after the Second World War.

    PubMed

    Henckes, Nicolas

    2009-02-01

    As with the rest of biomedicine, psychiatry has, since the Second World War, developed under the strong influence of the transnational accumulation of a whole series of practices and knowledge. Anthropology has taught us to pay attention to the transactions between local-level actors and those operating at the global level in the construction of this new world of medicine. This article examines the role played by the recommendations of the WHO Expert Committee of Mental Health in the reform of the French mental health system during the 1950s. Rooted in the experience of practitioners and administrators participating in the process of reforming local psychiatric systems, the recommendations of the WHO Expert Committee developed a new vision of regulating psychiatry, based on professionalism and an idea of a normativity of the doctor-patient relation. This article shows how, by mobilizing the WHO reports' recommendations, French administrators and doctors succeeded in creating a typically French object: "the psychiatric sector", founded on elaborating a new mandate for the psychiatric profession. The article thus questions the deinstitutionalization model as an explanation of transformations of the structure of the French psychiatry system in the post-war period. PMID:19041168

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

    ERIC Educational Resources Information Center

    Francis, Greta; Radka, Dale F.

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

  9. [Place of psychoanalysis in a day hospital for psychotic little children].

    PubMed

    Klein, F; Boucharlat, R; Cartier-Bresson, M; Graveleau, M T; Ribas, D

    1983-12-15

    The authors try to draw conclusions from Winnicot's articles on the discontinous nature of emotional development. They try to understand how autism may originate in disruptions of self-non-self" attachments. However, they admit that the child's personality may develop even within such disruptions. In an experiment of intensive care in a day-hospital for autistic or psychotic children they have tried to restore these attachments in the hospital itself, through continuous care by each member of the staff, regardless of qualification or training. This continuity provides a basis for relationships which may be voiced and interpreted during the children's therapy as they share this reference experience. Its continuity makes life in the institution therapeutic in itself, even without psychoanalytic interpretations. The lack of spoken language gives rise to communication difficulties and use of an educated self is a current project. Two clinical observations exemplify the parallel work of parents and children and their reciprocal interactions. As the origin and future of these psychoses are still open questions, the possible responsibility of predisposing or initial fragilizing factors which facilitate this lasting personality organization is to be considered. PMID:6320417

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

    PubMed Central

    Baur, Nicole

    2013-01-01

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

  11. Proportion of inpatient days for mental disorders: 1969-1978.

    PubMed

    Kiesler, C A; Sibulkin, A E

    1983-07-01

    Mental hospitalization is an important part of the national picture of hospitalization. Total inpatient days for mental disorders, and their proportion of total hospital days for all disorders, is a statistic of considerable national import, yet there has never been a complete description of total inpatient days for mental disorders. The authors present data from the National Center for Health Statistics for nine years (data for only two years had been published previously), and correct them, and national totals, for the previous exclusion of data from residential treatment centers and community mental health centers. From 1969 through 1978, inpatient days for mental disorders fell from 168 million to 95 million. This decrease was more than accounted for by decreased psychiatric inpatient days at two sites: state mental hospitals and Veterans Administration psychiatric hospitals. The number of psychiatric inpatient days at all other sites increased during this time period. The authors also note a decrease in total inpatient days for all disorders over the decade. However, 85 percent of the total national decrease was accounted for by the decrease in psychiatric inpatient days. The authors stress the implications for public policy and the need for a more adequate national data base. PMID:6885014

  12. [Description of patients diagnosed with "alcohol dependence syndrome" and "alcohol abuse" according to the C.I.E.-9a criteria of the W.H.O. at a psychiatric hospitalization service].

    PubMed

    Conde López, V; Pacheco Yáñez, L; Pérez Puente, C

    1990-01-01

    The authors make an introduction where they describe several problems found in the alcoholic diseases researches. The most important of them are related to the "alcoholic case" concept. After this the authors report several epidemiological facts about the alcoholic diseases and disorders in Castilla-León and Madrid. Then a retrospective analysis of inpatients psychiatric records from the Psychiatry Department of Valladolid's University Hospital between 1980 to 1984 (N = 1.259) is made. 252 (20.01%) of them suffered an alcoholic disorders, following the I.C.D.-9th criteria psychoses alcoholic were 102 (8.10%) and they were excluded. However "Alcohol dependence" with 128 cases (10.17%) and "Alcohol Abuse Syndromes" with 22 cases (1.75%) were studied deeply, being 150 cases--120 males (80%) and 30 females (20%)--evaluated. Every diagnostic group was analysed in a distinct way through 41 epidemiological, clinical, diagnostic and medical care variables. These two groups and their differences and similarities between them are reported. The main profile is a male patient, 43 years old, married, urban life, blue collar worker, unskilled work, primary studies, bad economic level, marriage and working maladapted, clinical admitted through the Emergency Service, with an alcoholism 24 years old and intake of 234 grs. alcohol/day, with former treatment of minor tranquilizers (B.D.Z.) and at last is readmitted by alcoholic disease of disorder or a different psychiatric disease or disorders (I.C.D.-9.a or D.S.M.-III) in a 37.5% and 16.41% respectively. PMID:2220440

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

    PubMed

    Dharmarajan, Kumar; Krumholz, Harlan M

    2014-12-01

    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

  14. Residents examine factors associated with 30-day, same-cause hospital readmissions on an internal medicine service.

    PubMed

    Moran, Jennifer; Colbert, Colleen Y; Song, Juhee; Hull, Joshua; Rajan, Sabitha; Varghees, Sunita; Arroliga, Alejandro C; Reddy, Santosh P

    2013-01-01

    In recent years, there has been increased interest in stemming the tide of hospital readmissions in an attempt to improve quality of care. This study presents the Phase I results of a resident-led quality improvement initiative to determine the percentage of and risk factors for same-cause readmissions (SCRs; defined as hospital readmission within 30 days of hospital discharge for treatment of the same condition) to the internal medicine service of a multispecialty teaching hospital in central Texas. Results indicate that patients diagnosed with chronic obstructive pulmonary disease/asthma or anemia may be at increased risk for SCRs. Those patients who are insured by Medicaid and those who require assistance from social services also demonstrated an increased risk for SCRs. This study appears to be the first resident-led initiative in the field to examine 30-day SCRs to an internal medicine service for demographic and clinical risk factors. PMID:23550215

  15. Dissection of the prongs of ALI. A retrospective assessment of criminal responsibility by the psychiatric staff of the Clifton T. Perkins Hospital Center.

    PubMed

    Silver, S B; Spodak, M K

    1983-01-01

    The staff of the Clifton T. Perkins Hospital Center has systematically reassessed the impact of the proposed modification of the ALI test removing the second prong. Findings of this retrospective survey reveal few changes in the composite staff opinions reported by the hospital but many variations in the opinions of individual psychiatrists when rating the prongs independently. The effect of these changes in Maryland (while difficult to anticipate) might be an increase in litigation. The resulting fiscal impact, therefore, not only could affect the Division of Corrections but also could increase court costs. The data suggest that rather than limiting psychiatric testimony and ensuring that only the sickest patients are exculpated, the proposed truncation of ALI may have paradoxical consequences. There may be more frequent battles of the experts based on less rigorous science and potential exclusion of affective psychosis from appropriate access to the defense of insanity. While the study methods and sample size prohibit reliable conclusions concerning the likelihood of these consequences in vivo, the issues raised strongly support a need for further investigation before a relatively well-functioning legal framework is changed in favor of the untested rubric of the proposed modifications of ALI. PMID:6661569

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

    PubMed

    Norwood, Frances

    2006-01-01

    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

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

    NSDL National Science Digital Library

    2008-10-06

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

  18. [University professors in the Soviet Occupation Zone and the German Democratic Republic up to 1961 : Academic alternation of generations at university psychiatric hospitals].

    PubMed

    Kumbier, E; Haack, K

    2015-05-01

    After WWII a politically guided staffing policy foresaw an exchange program for professors from the Soviet Occupation Zone and the German Democratic Republic (GDR). In the field of medicine this initiative was not successful. With respect to university psychiatric/neurological hospitals this experiment failed as a result of a shortage of personnel due to the consequences of war, denazification and people migrating into western occupation zones. Criteria for politically selecting promising young talent which had been propagated by the Socialist Unity Party of Germany (Sozialistische Einheitspartei Deutschlands, SED) were thus not relevant in academic medicine until 1961; however, the communist rulers had great interest in bringing professional and academic resources up to date. Politically implicated representatives in the field were also included in this process. At the forefront was the interest in functioning medical care and education in order to be able to train much needed health professionals. At the end of the 1950s a new generation of professors was established at the university hospitals. This generation rotation demonstrated the politically intended replacement of the "old" professor generation and the transition to a new GDR generation that had been trained after 1945. This second generation of professors inherited vacant professorships and defined and shaped research and academia until the end of the GDR much more than the previous generation had and also more than the one that followed. The generation of professors continued to feel a strong affiliation with their academic teachers and consequently continued their tradition in the sense of a school, for the most part independent of political circumstances. PMID:25604837

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

    ERIC Educational Resources Information Center

    CRAWFORD, ANNIE L.

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

  20. Establishing an empirically based psychiatric nursing practice in a rapidly changing health care environment

    Microsoft Academic Search

    Sharon Tucker; Susan Brust

    2000-01-01

    Psychiatric services have shifted dramatically in the past decade, largely in response to economic survival. Services once delivered solely on an inpatient basis are now delivered through partial hospitalization and day treatment programs, intensive outpatient programs, and community-based centers. Few of these program changes, however, are developed on the basis of research or outcomes data, despite the embraced expectation for

  1. Risk factors associated with psychiatric readmission.

    PubMed

    Lorine, Kim; Goenjian, Haig; Kim, Soeun; Steinberg, Alan M; Schmidt, Kendall; Goenjian, Armen K

    2015-06-01

    The present study focused on identifying risk factors for early readmission of patients discharged from an urban community hospital. Retrospective chart reviews were conducted on 207 consecutive inpatient psychiatric admissions that included patients who were readmitted within 15 days, within 3 to 6 months, and not admitted for at least 12 months post-discharge. Findings indicated that a diagnosis of schizophrenia/schizoaffective disorder (OR = 18; 95% CI 2.70-117.7; p < 0.05), history of alcohol abuse (OR = 9; 95% CI 1.80-40.60; p < 0.05), number of previous psychiatric hospitalizations (OR = 2; 95% CI 1.28-3.73; p < 0.05), and type of residence at initial admission (e.g., homeless, OR = 29; 95% CI 3.99-217; p < 0.05) were significant risk factors for early readmission, where OR compares readmission group 1 versus group 3 in the multinomial logistic regression. Initial positive urine drug screen, history of drug abuse or incarceration, and legal status at initial admission did not predict early readmission. Reducing the risk factors associated with psychiatric readmissions has the potential to lead to the identification and development of preventative intervention strategies that can significantly improve patient safety, quality of care, well-being, and contain health care expenditures. PMID:25974053

  2. What are the Costs and Benefits of Providing Comprehensive Seven-day Services for Emergency Hospital Admissions?

    PubMed

    Meacock, Rachel; Doran, Tim; Sutton, Matt

    2015-08-01

    The English National Health Service is moving towards providing comprehensive 7-day hospital services in response to higher death rates for emergency weekend admissions. Using Hospital Episode Statistics between 1st April 2010 and 31st March 2011 linked to all-cause mortality within 30 days of admission, we estimate the number of excess deaths and the loss in quality-adjusted life years associated with emergency weekend admissions. The crude 30-day mortality rate was 3.70% for weekday admissions and 4.05% for weekend admissions. The excess weekend death rate equates to 4355 (risk adjusted 5353) additional deaths each year. The health gain of avoiding these deaths would be 29 727-36 539 quality-adjusted life years per year. The estimated cost of implementing 7-day services is £1.07-£1.43 bn, which exceeds by £339-£831 m the maximum spend based on the National Institute for Health and Care Excellence threshold of £595 m-£731 m. There is as yet no clear evidence that 7-day services will reduce weekend deaths or can be achieved without increasing weekday deaths. The planned cost of implementing 7-day services greatly exceeds the maximum amount that the National Health Service should spend on eradicating the weekend effect based on current evidence. Policy makers and service providers should focus on identifying specific service extensions for which cost-effectiveness can be demonstrated. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26010243

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

    PubMed Central

    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

    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

  4. Diversity and adaptation of human respiratory syncytial virus genotypes circulating in two distinct communities: public hospital and day care center.

    PubMed

    Gardinassi, Luiz Gustavo Araujo; Simas, Paulo Vitor Marques; Gomes, Deriane Elias; do Bonfim, Caroline Measso; Nogueira, Felipe Cavassan; Garcia, Gustavo Rocha; Carareto, Claudia Márcia Aparecida; Rahal, Paula; de Souza, Fátima Pereira

    2012-11-01

    HRSV is one of the most important pathogens causing acute respiratory tract diseases as bronchiolitis and pneumonia among infants. HRSV was isolated from two distinct communities, a public day care center and a public hospital in São José do Rio Preto - SP, Brazil. We obtained partial sequences from G gene that were used on phylogenetic and selection pressure analysis. HRSV accounted for 29% of respiratory infections in hospitalized children and 7.7% in day care center children. On phylogenetic analysis of 60 HRSV strains, 48 (80%) clustered within or adjacent to the GA1 genotype; GA5, NA1, NA2, BA-IV and SAB1 were also observed. SJRP GA1 strains presented variations among deduced amino acids composition and lost the potential O-glycosilation site at amino acid position 295, nevertheless this resulted in an insertion of two potential O-glycosilation sites at positions 296 and 297. Furthermore, a potential O-glycosilation site insertion, at position 293, was only observed for hospital strains. Using SLAC and MEME methods, only amino acid 274 was identified to be under positive selection. This is the first report on HRSV circulation and genotypes classification derived from a day care center community in Brazil. PMID:23202489

  5. LUNAR PHASE AND PSYCHIATRIC ILLNESS IN GOA

    PubMed Central

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

    1999-01-01

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

  6. Lunar phase and psychiatric illness in goa.

    PubMed

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

    1999-01-01

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

  7. Early In-Hospital Mortality following Trainee Doctors' First Day at Work

    PubMed Central

    Jen, Min Hua; Bottle, Alex; Majeed, Azeem; Bell, Derek; Aylin, Paul

    2009-01-01

    Background There is a commonly held assumption that early August is an unsafe period to be admitted to hospital in England, as newly qualified doctors start work in NHS hospitals on the first Wednesday of August. We investigate whether in-hospital mortality is higher in the week following the first Wednesday in August than in the previous week. Methodology A retrospective study in England using administrative hospital admissions data. Two retrospective cohorts of all emergency patients admitted on the last Wednesday in July and the first Wednesday in August for 2000 to 2008, each followed up for one week. Principal Findings The odds of death for patients admitted on the first Wednesday in August was 6% higher (OR 1.06, 95% CI 1.00 to 1.15, p?=?0.05) after controlling for year, gender, age, socio-economic deprivation and co-morbidity. When subdivided into medical, surgical and neoplasm admissions, medical admissions admitted on the first Wednesday in August had an 8% (OR 1.08, 95% CI 1.01 to 1.16, p?=?0.03) higher odds of death. In 2007 and 2008, when the system for junior doctors' job applications changed, patients admitted on Wednesday August 1st had 8% higher adjusted odds of death than those admitted the previous Wednesday, but this was not statistically significant (OR 1.08, 95% CI 0.95 to 1.23, p?=?0.24). Conclusions We found evidence that patients admitted on the first Wednesday in August have a higher early death rate in English hospitals compared with patients admitted on the previous Wednesday. This was higher for patients admitted with a medical primary diagnosis. PMID:19774078

  8. 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

    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

    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

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

    Microsoft Academic Search

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

    2006-01-01

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

  10. Psychiatric illness in patients with end-stage renal disease

    Microsoft Academic Search

    Paul L Kimmel; Mae Thamer; Christian M Richard; Nancy F Ray

    1998-01-01

    Purpose: We sought to determine the prevalence of psychiatric illness in hospitalized patients with end-stage renal disease. We also examined the association between end-stage renal disease treatment modality and risk of hospitalization with a diagnosis of a mental disorder, and compared rates of hospitalization with a diagnosis of psychiatric illness in renal failure patients to patients with other chronic medical

  11. Reasons for 30-day postoperative readmissions for Medicare patients at a community-based teaching hospital.

    PubMed

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

    2015-04-01

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

  12. Evaluation of a Discharge Medication Service on an Acute Psychiatric Unit

    PubMed Central

    Ahmed, Nadeem; Mukherjee, Koushik; Roma, Rebecca S.; DiLucente, Donna; Orchowski, Karen

    2013-01-01

    Background: Nonadherence with medication is a major factor that influences acute psychiatric hospital readmission. Pharmacists can positively influence rapid psychiatric readmission due to nonadherence by counseling patients and providing filled prescriptions on discharge. Objective: This study is a retrospective evaluation of a pharmacist-driven discharge medication service for hospitalized psychiatric patients. Measured outcomes include a comparison of rapid readmissions pre and post implementation. Rapid readmissions between the concurrent study group and excluded group were also compared. Methods: From October 2010 to November 2011, home-destined subjects being discharged from the hospital’s behavioral health unit were provided filled psychiatric prescriptions for self-administration upon discharge, coupled with medication counseling. A series of statistical comparisons were made between the 2 prior years' overall rapid readmissions. This was subsequently compared with the overall rapid readmission rate during the study year. The study group’s rapid readmissions were then compared to the overall rapid readmission rate of the study year as well as to the concurrent excluded group. Results: Thirty-day hospital readmissions were found to be significantly decreased in studied subjects compared to total rapid readmissions during the previous year (P = .004) and to the excluded group (P = .020). Conclusion: Immediate availability of prescriptions upon discharge, coupled with development of therapeutic alliances with patients, removes some of the barriers to patient medication adherence in the discharged, acute psychiatric patient. The program provided positive outcomes with regard to decreased frequent, rapid readmission to the acute care psychiatric unit due to medication nonadherence. PMID:24421481

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

    PubMed Central

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

    2014-01-01

    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

  14. Problems in private psychiatric insurance.

    PubMed

    Sodaro, E R; Carone, P A

    1983-01-01

    Insurance coverage for hospitalization in a freestanding psychiatric facility faces challenging, but not insurmountable, difficulties currently and in the immediate future. Relevant issues include: possible reductions in health insurance tax deductibility, so-called "consumer choice" and "pro-competition" options, prospective financing, and cost shifting from government insurance onto private patients. Some problems more specific to private psychiatric hospitals include: misuse of insurance coverage for dubious "therapies," the effects of declining coverage, the "dental versus mental" conflict, the effect of non-physicians entering the provider pool, poor coverage for liaison and consultation psychiatry, inappropriate usage, and confidentiality concerns. Positive future possibilities include: implementation of government insurance programs through private sector contracts, continuing improvement in psychiatric scientific technology, increased accountability efforts, public education, and improvements in psychiatry's relationships with labor and management. PMID:10298940

  15. A Psychiatric Home Care Program

    PubMed Central

    Langevin, Hebert; Fortin, Jean-N; Leonard, Fernand; Menard, Bernard-S

    1966-01-01

    The activities covering a three-year period of a psychiatric home care treatment program attached to a psychiatric unit of a general hospital are described. A detailed account of its operation and the roles played by each member of the team is given. This service frequently provides a substitute for hospitalization in the management of both acute and chronic psychiatric states and thereby constitutes an important preventive measure in the field of public health. Even if the initial attitude of the patient is negative it is possible to gain the co-operation of the family who become a useful ally in the treatment. The co-operation of the patient is not as essential as has been thought. The traditional role of the psychiatrist is reversed by virtue of his attending the patient at home. The active participation of social agencies is an integral part of the treatment. PMID:5907947

  16. Thirty-Day Hospital Readmission following Discharge from Post-acute Rehabilitation in Fee-for-Service Medicare Patients

    PubMed Central

    Ottenbacher, Kenneth J.; Karmarkar, Amol; Graham, James E.; Kuo, Yong-Fang; Deutsch, Anne; Reistetter, Timothy; Snih, Soham Al; Granger, Carl V.

    2014-01-01

    Importance The Centers for Medicare and Medicaid Services (CMS) recently identified 30-day readmission after discharge from inpatient rehabilitation facilities as a national quality indicator. Research is needed to determine the rates and factors related to readmission in this patient population. Objective Determine 30-day readmission rates and factors related to readmission for patients receiving post-acute inpatient rehabilitation. Design Retrospective cohort study. Setting 1,365 post-acute inpatient rehabilitation facilities providing services to Medicare fee-for service beneficiaries. Participants Records for 736,536 post-acute patients discharged from inpatient rehabilitation facilities to the community in 2006 through 2011. Mean age 78.0 (SD = 7.3) years. Sixty-three percent of patients were female and 85.1% were non-Hispanic white. Main Outcome and Measures 30-day readmission rates for the six largest diagnostic impairment categories receiving inpatient rehabilitation. These included stroke, lower extremity fracture, lower extremity joint replacement, debility, neurological disorders and brain dysfunction. Results Mean rehabilitation length of stay was 12.4 (SD = 5.3) days. The overall 30-day readmission rate was 11.8% (95%CI, 11.7%, 11.8%). Rates ranged from 5.8% (95%CI, 5.8%, 5.9%) for patients with lower extremity joint replacement to 18.8% (95%CI, 18.8%, 18.9%). for patients with debility. Rates were highest in men (13.0%; 95%CI, 12.8%, 13.1%), non-Hispanic blacks, (13.8%; 95%CI, 13.5%, 14.1%), dual eligible beneficiaries (15.1%; 95%CI, 14.9%, 15.4%), and in patients with tier 1 comorbidities (25.6%; 95%CI, 24.9%, 26.3%). Higher motor and cognitive functional status were associated with lower hospital readmission rates across the six impairment categories. Variability in adjusted readmission rates by state ranged from 9.2% to 13.6%. Approximately 50% of patients who were rehospitalized within the 30-day period were readmitted within 11 days of discharge. MS-DRG codes for heart failure, urinary tract infection, pneumonia, septicemia, nutritional and metabolic disorders, esophagitis, gastroenteritis and digestive disorders were common reasons for readmission. Conclusion and Relevance Among post-acute rehabilitation facilities providing services to Medicare fee-for-service beneficiaries, 30-day readmission rates ranged from 5.8% to 18.8% for selected impairment groups. Further research is needed to understand the reasons for readmission. PMID:24519300

  17. Hospital-level associations with 30-day patient mortality after cardiac surgery: a tutorial on the application and interpretation of marginal and multilevel logistic regression

    PubMed Central

    2012-01-01

    Background Marginal and multilevel logistic regression methods can estimate associations between hospital-level factors and patient-level 30-day mortality outcomes after cardiac surgery. However, it is not widely understood how the interpretation of hospital-level effects differs between these methods. Methods The Australasian Society of Cardiac and Thoracic Surgeons (ASCTS) registry provided data on 32,354 patients undergoing cardiac surgery in 18 hospitals from 2001 to 2009. The logistic regression methods related 30-day mortality after surgery to hospital characteristics with concurrent adjustment for patient characteristics. Results Hospital-level mortality rates varied from 1.0% to 4.1% of patients. Ordinary, marginal and multilevel regression methods differed with regard to point estimates and conclusions on statistical significance for hospital-level risk factors; ordinary logistic regression giving inappropriately narrow confidence intervals. The median odds ratio, MOR, from the multilevel model was 1.2 whereas ORs for most patient-level characteristics were of greater magnitude suggesting that unexplained between-hospital variation was not as relevant as patient-level characteristics for understanding mortality rates. For hospital-level characteristics in the multilevel model, 80% interval ORs, IOR-80%, supplemented the usual ORs from the logistic regression. The IOR-80% was (0.8 to 1.8) for academic affiliation and (0.6 to 1.3) for the median annual number of cardiac surgery procedures. The width of these intervals reflected the unexplained variation between hospitals in mortality rates; the inclusion of one in each interval suggested an inability to add meaningfully to explaining variation in mortality rates. Conclusions Marginal and multilevel models take different approaches to account for correlation between patients within hospitals and they lead to different interpretations for hospital-level odds ratios. PMID:22409732

  18. Psychiatric disorders impacting critical illness.

    PubMed

    Struble, Laura M; Sullivan, Barbara J; Hartman, Laurie S

    2014-03-01

    An astounding 30% to 50% of older patients who are hospitalized for a medical condition also have a psychiatric disorder. The intent of this article is to prepare acute care nurses to meet the mental health needs of older adults with a critical illness and prevent untoward sequelae of medical events. The authors discuss the importance of baseline assessment data, issues related to informed consent, manifestations of common psychiatric disorders that may be seen in older adults in the acute care setting, as well as strategies to improve patient outcomes. PMID:24484928

  19. Postgraduate education in psychiatric nursing in Israel: closing the gap.

    PubMed

    Haron, Yafa; Gun-Usishkin, Monica; Shor, Razia; Tran, Dror; Riba, Shoshana

    2014-12-01

    Deinstitutionalization policies are being gradually implemented in Israel. Most recently, an insurance reform has been approved, in which mental health services will be included in the HMO's service package. As most Israeli mental health nurses are currently employed in institutional settings, the Ministry of Health's Nursing Division seeks to estimate their scope of employment in preparation for the anticipated changes. The aim of this study is to describe present-day professional practice characteristics of qualified psychiatric nurses and identify practice areas for which advanced training may be required. The research design is cross-sectional on a national level, including all state psychiatric hospitalization services. A countrywide sample of nurses with post-basic training in state psychiatric hospitals identified areas of practice in which further training may be required: psychotherapy intervention (60% of respondents); consultation for the elderly (60%); care prescriptions (64%); community drug treatment management (69%); and referral to professionals and community resources (56%). Nurses reported gaps in continued care and community rehabilitation activities. These findings have training implications in an era of increased focus on chronic mental illness in the community. PMID:25383713

  20. A Clinical Predictor Score for 30-Day Mortality among HIV-Infected Adults Hospitalized with Pneumonia in Uganda

    PubMed Central

    Koss, Catherine A.; Jarlsberg, Leah G.; den Boon, Saskia; Cattamanchi, Adithya; Davis, J. Lucian; Worodria, William; Ayakaka, Irene; Sanyu, Ingvar; Huang, Laurence

    2015-01-01

    Background Pneumonia is a major cause of mortality among HIV-infected patients. Pneumonia severity scores are promising tools to assist clinicians in predicting patients’ 30-day mortality, but existing scores were developed in populations infected with neither HIV nor tuberculosis (TB) and include laboratory data that may not be available in resource-limited settings. The objective of this study was to develop a score to predict mortality in HIV-infected adults with pneumonia in TB-endemic, resource-limited settings. Methods We conducted a secondary analysis of data from a prospective study enrolling HIV-infected adults with cough ?2 weeks and <6 months and clinically suspected pneumonia admitted to Mulago Hospital in Kampala, Uganda from September 2008 to March 2011. Patients provided two sputum specimens for mycobacteria, and those with Ziehl-Neelsen sputum smears that were negative for mycobacteria underwent bronchoscopy with inspection for Kaposi sarcoma and testing for mycobacteria and fungi, including Pneumocystis jirovecii. A multivariable best subsets regression model was developed, and one point was assigned to each variable in the model to develop a clinical predictor score for 30-day mortality. Results Overall, 835 patients were studied (mean age 34 years, 53.4% female, 30-day mortality 18.2%). A four-point clinical predictor score was identified and included heart rate >120 beats/minute, respiratory rate >30 breaths/minute, oxygen saturation <90%, and CD4 cell count <50 cells/mm3. Patients’ 30-day mortality, stratified by score, was: score 0 or 1, 12.6%, score 2 or 3, 23.4%, score 4, 53.9%. For each 1 point change in clinical predictor score, the odds of 30-day mortality increased by 65% (OR 1.65, 95% CI 1.39-1.96, p <0.001). Conclusions A simple, four-point scoring system can stratify patients by levels of risk for mortality. Rapid identification of higher risk patients combined with provision of timely and appropriate treatment may improve clinical outcomes. This predictor score should be validated in other resource-limited settings. PMID:25962069

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

    ERIC Educational Resources Information Center

    Jacobs, Angeline Marchese; And Others

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

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

    ERIC Educational Resources Information Center

    Jacobs, Angeline Marchese; And Others

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

  3. Rates and Predictors of 30-Day Readmission Among Commercially Insured and Medicaid-Enrolled Patients Hospitalized With Systolic Heart Failure

    PubMed Central

    Allen, Larry A.; Tomic, Karen E. Smoyer; Smith, David M.; Wilson, Kathleen L.; Agodoa, Irene

    2013-01-01

    Background Heart failure (HF) readmission rates are primarily derived from Medicare enrollees. Given increasing public scrutiny of HF readmissions, understanding the rate and predictors in populations covered by other payers is also important, particularly among patients with systolic dysfunction, for whom most HF-specific therapies are targeted. Methods and Results MarketScan Commercial and Medicaid Administrative Claims Databases were used to identify all first hospitalizations with an International Classification of Diseases-9 discharge diagnosis code for HF (primary position) and systolic HF (any position) between January 1, 2005, and June 30, 2008. Among 4584 unique systolic HF index admissions (mean age 55 years), 30-day crude readmission rates were higher for Medicaid than commercially insured patients: all-cause 17.4% versus 11.8%; HF-related 6.7% versus 4.0%, respectively. In unadjusted analysis, higher comorbidity and prior healthcare utilization predicted readmission; age, sex, and plan type did not. After adjustment for case mix, the odds of all-cause and HF-related readmission were 32% and 68% higher, respectively, among Medicaid than commercially insured patients (P<0.02 for both). No significant differences in readmission rates were seen for managed care versus fee-for-service or capitated versus noncapitated plan types. Conclusions Compared with commonly cited Medicare HF readmission rates of 20% to 25%, Medicaid patients with systolic HF had lower 30-day readmission rates, and commercially insured patients had even lower rates. Even after adjustment for case mix, Medicaid patients were more likely to be readmitted than commercially insured patients, suggesting that more attention should be focused on readmissions among socioeconomically disadvantaged populations. PMID:23072736

  4. Three Cases of West Nile Encephalitis over an Eight-Day Period at a Downtown Los Angeles Community Hospital

    PubMed Central

    Puchalski, Adam; Liu, Antonio K.; Williams, Byron

    2015-01-01

    Since its introduction in New York City in 1999, the virus has spread throughout the entire North American continent and continues to spread into Central and Latin America. Our report discusses the signs and symptoms, diagnostics, and treatment of West Nile disease. It is important to recognize the disease quickly and initiate appropriate treatment. We present three cases of West Nile encephalitis at White Memorial Medical Center in East Los Angeles that occurred over the span of eight days. All three patients live within four to six miles from the hospital and do not live or work in an environment favorable to mosquitoes including shallow bodies of standing water, abandoned tires, or mud ruts. All the patients were Hispanic. Physicians and other health care providers should consider West Nile infection in the differential diagnosis of causes of aseptic meningitis and encephalitis, obtain appropriate laboratory studies, and promptly report cases to public health authorities. State governments should establish abatement programs that will eliminate sources that allow for mosquito reproduction and harboring. The public needs to be given resources that educate them on what entails the disease caused by the West Nile virus, what the symptoms are, and, most importantly, what they can do to prevent themselves from becoming infected. PMID:26106493

  5. Outpatient Follow-up Visit and 30-Day Emergency Department Visit and Readmission in Patients Hospitalized for Chronic Obstructive Pulmonary Disease

    PubMed Central

    Sharma, Gulshan; Kuo, Yong-Fang; Freeman, Jean L.; Zhang, Dong D.; Goodwin, James S.

    2010-01-01

    Background Readmissions in patients with chronic obstructive pulmonary disease (COPD) are common and costly. We examined the effect of early follow-up visit with patient’s primary care physician (PCP) or pulmonologist following acute hospitalization on the 30-day risk of an emergency department (ER) visit and readmission. Methods We conducted a retrospective cohort study of fee-for-service Medicare beneficiaries with an identifiable PCP who were hospitalized for COPD between 1996 and 2006. Three or more visits to a PCP in the year prior to the hospitalization established a PCP for a patient. We performed a Cox proportional hazard regression with time-dependent covariates to determine the risk of 30-day ER visit and readmission in patients with or without a follow-up visit to their PCP or pulmonologist. Results Of the 62 746 patients admitted for COPD, 66.9% had a follow-up visit with their PCP or pulmonologist within 30 days of discharge. Factors associated with lower likelihood of outpatient follow-up visit were longer length of hospital stay, prior hospitalization for COPD, older age, black race, lower socioeconomic status, and emergency admission. Those receiving care at nonteaching, for-profit, and smaller-sized hospitals were more likely to have a follow-up visit. In a multivariate, time-dependent analysis, patients who had a follow-up visit had a significantly reduced risk of an ER visit (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.83–0.90) and readmission (HR, 0.91; 95% CI, 0.87–0.96). Conclusion Continuity with patient’s PCP or pulmonologist after an acute hospitalization may lower rates of ER visits and readmission in patients with COPD. PMID:20937926

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

    ERIC Educational Resources Information Center

    Crino, Natalie; Djokvucic, Ivana

    2010-01-01

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

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

    PubMed

    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

    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

  8. Psychiatric thoughts in ancient India.

    PubMed

    Abhyankar, Ravi

    2015-01-01

    A review of the literature regarding psychiatric thoughts in ancient India is attempted. Besides interesting reading, many of the concepts are still relevant and can be used in day-to-day practice especially towards healthy and happy living. Certain concepts are surprisingly contemporary and valid today. They can be used in psychotherapy and counselling and for promoting mental health. However, the description and classification of mental illness is not in tune with modern psychiatry. PMID:25838724

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

    PubMed Central

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

    2015-01-01

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

  10. Filmless in 60 Days: The Impact of Picture Archiving and Communications Systems Within a Large Urban Hospital

    Microsoft Academic Search

    David B. Hayt; Steven Alexander; James Drakakis; Nia Berdebes

    2001-01-01

    Many large urban hospitals converting to filmless radiography use a phased approach for digital imaging implementation. In\\u000a fact, this strategy often is recommended by picture archival communication systems (PACS) experts and vendors alike for large,\\u000a busy hospitals installing PACS in existing physical facilities. The concern is that comprehensive conversion from film-based\\u000a to digital imaging may be too overwhelming an adjustment

  11. Thalassemia in the outpatient department of the Yangon Children's Hospital in Myanmar: cost analysis of the day-care-room services for thalassemia.

    PubMed

    Aung Myo Han; Khin Ei Han; Thein Thein Myint

    1992-06-01

    A cost analysis study for the fiscal year 1989-1990 was conducted in the day care room (DCR) for thalassemia patients at the Yangon Children's Hospital in Myanmar to provide a basis for future cost-effectiveness, cost-benefit and efficiency analyses. Two types of costs, hospital costs and costs borne by the patients' families were studied by reviewing hospital records and by interviewing family members of patients. Of the total cost of DCR services for thalassemia 74 to 75% was contributed by material costs most of which were for imported items. The cost of each transfusion visit and the annual cost per patient were Kyats 166.5 to 173.3 and Kyats 1,108.6 to 1,208.7, respectively. The median cost (range) per treatment visit and the averaged annual median cost (range) borne by the patients' families were Kyats 21 (0-302) and Kyats 107 (0-1,509), respectively. PMID:1439981

  12. [One of the forms of operation of a day-night hospital complex (with a stage of round-the-clock hospital stays) at a psychoneurologic dispensary].

    PubMed

    Kucherov, A Iu; Kruglianski?, M Ia

    1984-01-01

    A variant of a diurnal-nocturnal inpatient complex on the basis of a psychoneurological dispensary involving a short period of round-the-clock hospitalization of patients is described. This proved advisable in the treatment of three groups of patients (n = 260): (1) those with acute manifestations of the disease (to carry out intensive therapy), (2) those with subacute paroxysms and prolonged psychotic states (to conduct arresting therapy), (3) with conflicts in the microsocial environment (with the aim of their temporary isolation). Such an organizational form makes it possible to expand intensive therapy and increase a number of patients with acute psychotic manifestations treated outside the settings of a closed hospital. PMID:6506984

  13. Use of Inpatient Psychiatric Services by Children and Youth under Age 18, United States, 1980. Mental Health Statistical Note No. 175.

    ERIC Educational Resources Information Center

    Milazzo-Sayre, Laura J.; And Others

    The report examines data from three sample surveys of admissions during 1980 to the inpatient psychiatric services of state and mental hospitals and private psychiatric hospitals and the separate inpatient psychiatric services of non-federal general hospitals. Findings revealed that an estimated 81,532 persons under 18 years were admitted to…

  14. Psychiatric Adjustment in the Year after Meningococcal Disease in Childhood

    ERIC Educational Resources Information Center

    Shears, Daniel; Nadel, Simon; Gledhill, Julia; Gordon, Fabiana; Garralda, M. Elena

    2007-01-01

    Objective: To assess psychiatric status after meningococcal disease. Method: Cohort study of 66 children (34 boys, 32 girls) ages 4 to 17 years admitted to pediatric hospitals with meningococcal disease. The main outcome measure was psychiatric disorder (1-year period and point prevalence on the Schedule for Affective Disorders and Schizophrenia…

  15. Chromosomal abnormalities in a psychiatric population

    SciTech Connect

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

    1995-02-27

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

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

    PubMed

    González, Ricardo

    2013-10-01

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

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

    PubMed

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

    2007-01-01

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

  18. Analysis of early out-of hospital mortality after transcatheter aortic valve implantation among patients with aortic stenosis successfully discharged from the hospital and alive at 30 days (from the placement of aortic transcatheter valves trial).

    PubMed

    Beohar, Nirat; Zajarias, Alan; Thourani, Vinod H; Herrmann, Howard C; Mack, Michael; Kapadia, Samir; Green, Philip; Arnold, Suzanne V; Cohen, David J; Généreux, Philippe; Xu, Ke; Leon, Martin B; Kirtane, Ajay J

    2014-11-15

    In high-risk or inoperable patients with severe symptomatic aortic stenosis, transcatheter aortic valve implantation (TAVI) is a proven alternative to standard (i.e., medical) therapy or surgical aortic valve replacement. Concerns have been raised, however, about patients who survive the procedure but have short subsequent survival. The aim of this study was therefore to identify correlates of early out-of-hospital mortality (EOHM) in patients who underwent successful TAVI, rendering TAVI potentially "futile." Patients who were discharged from the hospital and survived >30 days but <12 months after TAVI were identified (the EOHM group). Independent predictors of EOHM were explored, including patient-level factors and procedural nonfatal major complications (NFMCs). A sensitivity analysis was also performed, excluding patients with NFMCs. Among 485 patients who were discharged from the hospital and survived 30 days after TAVI, 101 (21%) were dead within 1 year. Independent predictors of EOHM included serum creatinine, liver disease, coagulopathy, mental status, body mass index, male gender, and Society of Thoracic Surgeons score. Although NFMCs were strongly associated with EOHM, patient-level risk factors for EOHM were similar between patients who did and those who did not experience NFMCs. Compared with standard therapy, TAVI patients with EOHM had similar 6-month 6-minute walk distances and functional classes, with higher rates of repeat hospitalization. In conclusion, in high-risk or inoperable patients who underwent TAVI and were discharged and alive at 30 days, EOHM was not infrequent and was determined largely by presenting characteristics and the occurrence of periprocedural NFMCs. Careful screening and minimization of NFMCs may maximize the benefit of TAVI. PMID:25277334

  19. Parental psychiatric disorders and autism spectrum disorders

    PubMed Central

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

    2013-01-01

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

  20. Parental psychiatric disorders and autism spectrum disorders.

    PubMed

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

    2013-05-30

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

  1. The Relationship Between Confidence and Accuracy in Clinical Assessment of Psychiatric Patients' Potential for Violence

    Microsoft Academic Search

    Dale E. McNiel; David A. Sandberg; Renée L. Binder

    1998-01-01

    The authors studied the relationship between confidence and accuracy in clinical assessments of psychiatric patients' short-term risk of violence. At the time of entry to the hospital, physicians (N = 78) estimated the probability that each of 317 patients would physically attack other people during the first week of psychiatric hospitalization. The clinicians also indicated the degree of confidence they

  2. Psychiatric morbidity in prisoners

    PubMed Central

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

    2011-01-01

    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

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

    PubMed Central

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

    2010-01-01

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

  4. Pattern of Smoking and Nicotine Dependence in Patients with Psychiatric Disorders

    PubMed Central

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

    2012-01-01

    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

  5. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...for hospitals; psychiatric hospitals; transplant centers...services; critical access hospitals; or clinic, rehabilitation...for requirements concerning hospitals accredited by JCAHO or AOA...survey, together with any information related to the survey...

  6. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...for hospitals; psychiatric hospitals; transplant centers...services; critical access hospitals; or clinic, rehabilitation...for requirements concerning hospitals accredited by JCAHO or AOA...survey, together with any information related to the survey...

  7. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...for hospitals; psychiatric hospitals; transplant centers...services; critical access hospitals; or clinic, rehabilitation...for requirements concerning hospitals accredited by JCAHO or AOA...survey, together with any information related to the survey...

  8. 42 CFR 488.6 - Other national accreditation programs for hospitals and other providers and suppliers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...for hospitals; psychiatric hospitals; transplant centers...services; critical access hospitals; or clinic, rehabilitation...for requirements concerning hospitals accredited by JCAHO or AOA...survey, together with any information related to the survey...

  9. Epidemiological African day for evaluation of patients at risk of venous thrombosis in acute hospital care settings

    PubMed Central

    Kingue, Samuel; Bakilo, Limbole; Mvuala, Richard; Ze Minkande, Jacqueline; Fifen, Inoussa; Gureja, Yash Pal; Razafimahandry, Henri Jean Claude; Okubadejo, Njideka; Oke, DA; Manga, Alexandre; Rajaonera, Tovohery; Cajetan, Nwadinigwe; Pay Pay, Emmanuel; Rabearivony, Nirina

    2014-01-01

    Summary Introduction This study aimed to identify patients at risk for venous thromboembolism (VTE) among all patients hospitalised, and to determine the proportion of at-risk hospital patients who received effective types of VTE prophylaxis in sub-Saharan Africa (SSA). Methods A multinational, observational, cross-sectional survey was carried out on 1 583 at-risk patients throughout five SSA countries. Results The prevalence of VTE risk was 50.4% overall, 62.3% in medical and 43.8% in surgical patients. The proportion of at-risk patients receiving prophylaxis was 51.5% overall, 36.2% in medical and 64% in surgical patients. Low-molecular weight heparin was the most frequently used prophylactic method in 40.2% overall, 23.1% in medical and 49.9% in surgical patients. Discussion This study showed a high prevalence of VTE risk among hospitalised patients and that less than half of all at-risk patients received an American College of Clinical Pharmacy-recommended method of prophylaxis. Conclusion Recommended VTE prophylaxis is underused in SSA. PMID:25192298

  10. Psychiatric consultation on an otolaryngology liaison service.

    PubMed

    Bronheim, H; Strain, J J; Biller, H F; Fulop, G

    1989-03-01

    Otolaryngology patients (especially those with tracheostomies) present a significant challenge to psychiatrists from both a diagnostic and therapeutic standpoint. To date, no study has been made of psychiatric disorders among this important group of patients. At the Mount Sinai Medical Center, a liaison psychiatrist has been involved with a specialized otolaryngology cluster unit since 1979. Using a 384-item computerized database protocol developed at Mount Sinai, data on 139 otolaryngology patients were recorded and compared with 1662 "Other" inpatient psychiatric consultations on the medical and surgical services during 1980-1987. The otolaryngology patients as a group were more likely to be male (p = 0.011), married (p = 0.001) and employed (p less than 0.001). Cancer was the most common medical disorder, and the average level of stress as reported on DSM-III's Axis IV (5.1, severe) was significantly greater (p less than 0.0001) than that for the "Other." The most common psychiatric response was adjustment disorder (36%). The length of stay of those ENT patients seen in psychiatric consultation was 26.4 days, in contrast to 11.1 days for all ENT patients. However, the length of stay of those patients on ENT receiving a psychiatric consultation was not different from the "Other" psychiatric consultation cohort (26.3 days). Despite the higher level of stress, the incidence of significant psychiatric morbidity was lower for the ENT cohort. The primary effect of the liaison psychiatrist was to lower the threshold for case identification that enhanced the referral rate on the ENT unit. PMID:2707593

  11. Lactate is associated with increased 10-day mortality in acute medical patients: a hospital-based cohort study.

    PubMed

    Haidl, Felix; Brabrand, Mikkel; Henriksen, Daniel P; Lassen, Annmarie T

    2015-08-01

    An increased lactate level is related to increased mortality in subpopulations of critically ill patients. The aim of this study was to investigate whether lactate was related to mortality in an emergency department (ED) setting of undifferentiated medical patients. All adult patients admitted from March 2009 to August 2011 to a medical ED with lactate measured within 6?h after arrival were studied. Lactate was stratified into 1-mmol/l intervals and analysed in a multivariate logistic regression analysis. A total of 5317 patients were included, 46.9% men, median age 71 years (5-95% percentiles 25-90 years). The median lactate level was 1.2?mmol/l (5-95% percentiles 0.6-3.8?mmol/l, range 0.2-22?mmol/l). Lactate was associated with 10-day mortality independent of age, comorbidity and presence of hypotension, with an odds ratio of 1.54 (95% confidence interval 1.44-1.63) per 1?mmol/l increase. Lactate is an independent predictor of 10-day mortality among patients admitted to a medical ED. PMID:25325409

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  13. [Modification of perioperative psychiatric drug therapy].

    PubMed

    Redel, Andreas; Hommers, Leif G; Kranke, Peter; Schwemmer, Ulrich; Prasser, Christopher

    2013-01-01

    Apart from cardiovascular, pulmonary and metabolic drugs, many patients scheduled for surgery are taking antidepressive or antipsychotic drugs. Some of these psychiatric drugs may interfere with anesthetics. The anesthesiologist has to decide whether or not to continue the psychiatric medication during the perioperative period. Since the discontinuation of psychiatric drugs may lead to withdrawal syndromes, the decision should be made in accordance with the attending psychiatrist. Should the discontinuation of any psychiatric drug be recommended, it may be prudent to involve the attending surgeon in order to postpone the procedure, since the modification of psychiatric drugs may take several days.Prospective randomized data about the perioperative modification of psychiatric drugs are scarce. Thus, recommendations in this regard must rely on physiological and pharmacological principles, case reports and published expert opinions. In this article we use the available data to answer the question of a journal reader regarding the perioperative modification of Opipramol therapy for a 59-year-old patient scheduled for elective shoulder surgery. PMID:23364819

  14. Challenges and Outcomes of Parallel Care for Patients with Co-Occurring Psychiatric Disorder in Methadone Maintenance Treatment

    PubMed Central

    King, Van L.; Brooner, Robert K.; Peirce, Jessica; Kolodner, Ken; Kidorf, Michael

    2014-01-01

    Objective Most opioid users seeking treatment in community-based substance abuse treatment programs have at least one co-occurring psychiatric disorder, and the presence of psychiatric comorbidity in this population is associated with increased psychological distress, poorer quality of life, and reduced response to substance abuse treatment. This observational study describes clinical outcomes of referring patients receiving methadone maintenance and diagnosed with at least one co-occurring psychiatric disorder to a community psychiatry program located on the same hospital campus. Methods Participants (n=156) were offered priority referrals to a community psychiatry program that included regularly scheduled psychiatrist appointments, individual and group therapy, and enhanced access to psychiatric medications for one-year. Psychiatric distress was measured with the Symptom Checklist (SCL-90-R), which participants completed monthly. Results While about 80% of the sample (n=124) initiated psychiatric care, the average length of treatment was only 128.2 days (SD = 122.8), participants attended only 33% of all scheduled appointments (M = 14.9 sessions, SD = 14.1), and 84% (n = 104) did not complete a full year of care. Of those who did not complete a full year, almost two-thirds (65%, n = 68) left psychiatric care while still receiving substance abuse treatment. Exploratory negative binomial regression showed that baseline cocaine and alcohol use disorder (p = .002 and .022, respectively), and current employment (p = .034), were associated with worse psychiatric treatment retention. Modest reductions in psychiatric distress over time were observed (SCL-90-R Global Severity Index change score = 2.5; paired t = 3.54, df = 121, p = .001). Conclusions Referral of patients with co-occurring psychiatric disorders receiving methadone maintenance to a community psychiatry program is often ineffective, even after reducing common barriers to care. Service delivery models designed to improve attendance and retention, such as integrated care models, should be evaluated. This study is part of a larger clinical trial, registered at www.clinicaltrials.gov under #NCT00787735. PMID:24976801

  15. 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.

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

    PubMed

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

    2015-02-01

    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

  17. Women in U.S. Psychiatric Training

    ERIC Educational Resources Information Center

    Jain, Shaili; Ballamudi, Bhawani

    2004-01-01

    Objective: The number of women in psychiatric training is predicted to increase over time. This article aims to review and evaluate the existing literature on the topic and identify present areas of concern and recommend future areas for research. Method: A Medline search from 1964 to the present day was conducted. Literature on female physicians…

  18. Psychiatric aspects of alcohol misuse.

    PubMed

    Dunn, N; Cook, C C

    1999-03-01

    Alcohol and psychiatric disorder have a complicated relationship. Certain important psychiatric syndromes arise from the toxic effects of alcohol and thiamine deficiency. Liver disease and hypoglycaemia are also associated with their own psychiatric syndromes. Many psychiatric patients also turn to alcohol as an easily available 'medication'. PMID:10476237

  19. Psychiatric aspects of railway fatalities.

    PubMed

    Symonds, R L

    1985-08-01

    National statistics for railway fatalities in England and Wales show a reduction of train crashes and a fluctuating level of deaths, of which an increasing proportion is from suicide. A closer examination of a two-year sample from the South of England revealed a large proportion of probable suicides and a small proportion of pure accidents. The remainder appeared to have medical, mainly psychiatric, contributions to their death, of which alcohol was an important factor in single young men. Rail suicides appear to be younger, the men less often married, the women more often married, and both sexes less often widowed than other suicides. They included more cases of major psychosis and neurosis, but fewer and less severe alcoholics. Characteristic patterns of this method of suicide are described with examples. Hypotheses to explain the choice of method suggest that it is not related to either volume of traffic, or residence in a rail-dense area or in an area with a high suicide rate, or the proximity of a psychiatric hospital. PMID:4048320

  20. Psychiatric testimony in Britain.

    PubMed

    Chiswick, D

    1989-01-01

    In the criminal-justice system psychiatric evidence may be relevant both before and after conviction. The scope of psychiatric testimony in the criminal courts has been more restricted in Britain than it has been elsewhere. It is generally confined to questions of fitness to plead, responsibility and disposal after conviction. A distinction must be made between matters of clinical psychiatry and those of moral culpability or legal competence. When psychiatric evidence strays from purely clinical questions there is an increased likelihood of misuse and abuse. Even when considering clinical issues there are factors of a non-clinical nature which may distort the type of evidence given. The implications of these matters for psychiatric witnesses are discussed. It is suggested that forensic psychiatrists are refining their role as expert witnesses. PMID:2517968

  1. Psychiatric comorbidity in fibromyalgia

    Microsoft Academic Search

    Laurence A. Bradley

    2005-01-01

    This review examines the current literature regarding psychiatric comorbidities associated with fibromyalgia. The aim of this\\u000a review is to enhance understanding of psychiatric disorders that, alone or in combination with other physiologic (eg, neuroendocrine dysfunction) and psychosocial factors (eg, poor coping skills), may contribute to abnormal pain sensitivity and other illness behaviors of individuals with fibromyalgia.\\u000a The review first identifies

  2. The Geriatric Population and Psychiatric Medication

    PubMed Central

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

    2010-01-01

    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

  3. Psychiatric morbidity in prisoners

    PubMed Central

    Kumar, Vinod; Daria, Usha

    2013-01-01

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

  4. Sickness absence for psychiatric illness: The Whitehall II study

    Microsoft Academic Search

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

    1995-01-01

    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)

  5. Narcissism and relational representations among psychiatric outpatients.

    PubMed

    Kealy, David; Ogrodniczuk, John S; Joyce, Anthony S; Steinberg, Paul I; Piper, William E

    2015-06-01

    Pathological narcissism is associated with maladaptive interpersonal behavior, although less is known regarding the internal relational representations of narcissistic patients. The authors examined the relationship between pathological narcissism and two constructs that reflect internal representations of relational patterns: quality of object relations and attachment style. Patients attending a psychiatric day treatment program (N = 218) completed measures of narcissism, general psychiatric distress, and attachment style in terms of attachment avoidance and anxiety. A semistructured interview was used to assess quality of object relations. Multiple regression analysis was conducted, controlling for general psychiatric distress. Pathological narcissism was associated with anxious attachment, but not with avoidant attachment. Narcissism was also associated with lower levels of quality of object relations. The implications of these results are discussed in terms of internal representations of self-other relations. PMID:23398104

  6. Contingency management of food misbehavior in a psychiatric patient with diabetes.

    PubMed

    Duvinsky, J D; Jacobs, H E; Foy, D W

    1987-06-01

    A contingency management procedure was instituted with a hospitalized 52-year-old male psychiatric patient to alter behavior associated with an exacerbated diabetic condition. A ten-day baseline indicated consistently elevated urine sugar levels and that the patient frequently violated his prescribed low sugar diet by stealing, trading and hoarding high sugar foods. Beginning in baseline, the patient was instructed to measure his urine sugar levels and post the results on a chart next to his bed. During two of the intervention procedures used in the additive design, the patient could earn coupon booklets from the hospital commissary if his daily average urine sugar levels were less than a set criterion. Two such criteria were employed before the reinforcement contingencies were faded. By the end of the intervention, urine sugar levels were under control and follow-up measures six months post-treatment indicated durable treatment effects. PMID:3611387

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

    Microsoft Academic Search

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

    2007-01-01

    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.

  8. Cigarette smoking among psychiatric patients in Brazil.

    PubMed

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

    2014-06-01

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

  9. Informed consent in psychiatric research: Preliminary findings from an ongoing investigation

    Microsoft Academic Search

    Paul R. Benson; Loren H. Roth; William J. Winslade

    1985-01-01

    Preliminary findings from an investigation of informed consent processes in four psychiatric research projects (two being carried out at a university medical center and two at a public psychiatric hospital) are reported. Study methods include the systematic observation of investigator\\/subject information disclosure sessions using audio and videotape, as well as the use of standardized interaction rating forms and subject understanding

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    Microsoft Academic Search

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

    2011-01-01

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

  12. Automated Psychiatric Case Registry

    PubMed Central

    Hoffmann, Norman G.

    1980-01-01

    This paper provides a status report on the evolution of a case registry system, consisting of three independent but coordinate registries, for a psychiatry department. These registries are a checklist of initial observations on psychiatric consults in the emergency room, an inpatient discharge register, and a registry of outpatient visist. Samples of results from the first six months of 1980, are presented and implications of the results are discussed. The case is made that simple, efficient, and economical data registries are viable within the budget constraints of psychiatric facilities and that such data bases readily become viewed as a necessity.

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

    E-print Network

    Cardinal, Rudolf N; Gregory, Carol A

    2009-05-09

    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...

  14. Psychiatric-Mental Health Nursing.

    ERIC Educational Resources Information Center

    Reighley, Joan

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

  15. [Tinnitus and psychiatric comorbidities].

    PubMed

    Goebel, G

    2015-04-01

    Tinnitus is an auditory phantom phenomenon characterized by the sensation of sounds without objectively identifiable sound sources. To date, its causes are not well understood. The perceived severity of tinnitus correlates more closely to psychological and general health factors than to audiometric parameters. Together with limbic structures in the ventral striatum, the prefrontal cortex forms an internal "noise cancelling system", which normally helps to block out unpleasant sounds, including the tinnitus signal. If this pathway is compromised, chronic tinnitus results. Patients with chronic tinnitus show increased functional connectivity in corticolimbic pathways. Psychiatric comorbidities are common in patients who seek help for tinnitus or hyperacusis. Clinicians need valid screening tools in order to identify patients with psychiatric disorders and to tailor treatment in a multidisciplinary setting. PMID:25862621

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

    PubMed Central

    2012-01-01

    Background The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients’ perceived coercion and to increase patient satisfaction, their quality of life and empowerment. Methods/Design This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care procedures (control group). 200 patients each will be assigned to the intervention group or to the control group. Detailed follow-up assessments of service use, psychopathology and patient perceptions are scheduled 12 and 24 months after discharge. Discussion Innovative interventions have to be established to prevent patients with mental disorders from undergoing the experience of compulsory admission and, with regard to society as a whole, to reduce the costs of health care (and detention). The current study will allow for a prospective analysis of the effectiveness of an intervention programme, providing insight into processes and factors that determine involuntary placement. Trial registration Current Controlled Trials ISRCTN63162737. PMID:22946957

  17. Psychotherapy for Psychiatric Disorders

    Microsoft Academic Search

    John R. McQuaid; Laura Campbell-Sills

    Psychotherapy has developed, in the past 100 or more years, from a theoretically derived intervention with little empirical\\u000a support to a broad range of interventions for which there is an equally broad range of evidence. This chapter provides an\\u000a overview of psychotherapy for psychiatric disorders. The goals of this chapter are to review the history of psychotherapy\\u000a development, identify the

  18. Patient health questionnaire for screening psychiatric disorders in secondary healthcare

    PubMed Central

    Barua, Ankur; Jacob, George P.; Mahmood, Syed Safvi

    2013-01-01

    Background: The adult population often suffers from a number of physical and mental problems. This study was conducted to determine the proportion of mental illnesses in adult population visiting the outpatient departments at Dr. TMA Pai Rotary Hospital, Karkala and to study the socio-demographic correlates of psychiatric disorders. Materials and Methods: A cross-sectional study was conducted during March 2004 among 193 adult individuals of 18 years and above at Dr. TMA Pai Rotary Hospital, Karkala, Karnataka. Data was analyzed by the statistical package for social sciences version 10.0 for windows and results were expressed in terms of proportions and their 95% confidence intervals (CI). Chi-square test, multiple logistic regression with adjusted odds ratio and its 95% CI. Results: The proportion of psychiatric disorders in adult population was determined to be 39.9%. Proportion of psychiatric morbidity among males and females were 36.2 and 42.2%, respectively. Conclusion: This study revealed that socio-demographic correlates like age group of 50 years and above, unemployed or housewives, living alone, and a history of psychiatric illness in the family were independently associated with psychiatric disorders in adult population. PMID:23825844

  19. "Auctoritas" psychiatric expert system shell.

    PubMed

    Kovács, M; Juranovics, J

    1995-01-01

    We present a short description of a complex psychiatric computer expert system, including functions that help the physicians and the hospital staff in the administrative, diagnostic, therapeutic, statistical, and scientific work. There are separate data-storing, health insurance-supporting, or simple advisory programs, but we can not avail a system--in our country--that provides us with all these functions together. Hence the aim of our program is to produce a universal computer system that makes the patients' long distance follow-up possible. Our diagnostic expert system shell, which is appropriate for using the symptoms and criteria scheme of the internationally accepted diagnostic systems such as DSM and ICD, helps to archive homogeneous, up-to-date psychiatric nosology; this is essential for the correct diagnostic, statistical, and scientific work. Let us introduce our expert system. It consists of four parts: administration, diagnostic decision support system, activities concerning treatment, and statistics. The part called "Administration" contains all data about actual and emitted in-patients and out-patients, including their particulars and data necessary for health insurance (duration of treatment, diagnosis); here we find and edit medical documents. The most important part of the "Auctoritas" system is the "Diagnostic decision support system." In practice, expert systems use decision trees with yes-no logic, fuzzy logic, and pattern matching on the basis of the method of deduction; and backward chaining or forward chaining on the basis of the direction of deduction. Our system uses the methods of fuzzy logic and backward chaining. In other medical disciplines, good results are achieved by applying the pattern matching method; to make validity and verification researches, however, these systems are inappropriate. The diagnoses relying on the up-to-date psychiatric diagnostic systems--DSM-IV and ICD-X--are based on classical logic and can be correctly validated and verified. Hence we have chosen the fuzzy logic, which is the up-to-date extension of classical logic and influences the validity and verification researches, for the construction of our system. The diagnostic part is a shell that can be filled up optionally with knowledge bases of the DSM-IV, ICD-X, or other diagnostic systems and has the following structure. The diagnostic course is biphased as we can differ symptoms and criteria (duration of the illness, aethyological factors). We managed to extend the traditional applications using yes-no logic with three factors that make the system more sensitive and flexible. These are the scaling, sorting by importance of symptoms, and reliability-validity results. The "scaling" means that the physician scales the input symptoms by severity; this influences the statistical probability of the possible diagnoses. "Sorting by importance" is gauging certain symptoms by importance in a syndrome. Finally the third point, "reliability-validity results," means taking account of the latest validity values of a certain disorder of the used diagnostic system--according to the latest validity researches--and the diagnostical reliability of our expert system. The "Activity concerning treatment" is a practical part of our program that contents the examination and therapy scheduling and monitoring results. Under the point of "Statistics," we can prepare all data of the patients in various ways. In summary, the "Auctoritas" computer system is a global database managing the newly-developed advisory system; it is appropriate for managing a complete hospital network system for the continuing individual long-distance observation of patients. It collects all the necessary information of one patient in one file. The long-term benefit is that it can compile and process large amounts of information about the patients and help physicians come to scientific conclusions for research and publications. PMID:8591608

  20. Noise, noise sensitivity and psychiatric disorder: epidemiological and psychophysiological studies.

    PubMed

    Stansfeld, S A

    1992-01-01

    Noise, a prototypical environmental stressor, has clear health effects in causing hearing loss but other health effects are less evident. Noise exposure may lead to minor emotional symptoms but the evidence of elevated levels of aircraft noise leading to psychiatric hospital admissions and psychiatric disorder in the community is contradictory. Despite this there are well documented associations between noise exposure and changes in performance, sleep disturbance and emotional reactions such as annoyance. Moreover, annoyance is associated with both environmental noise level and psychological and physical symptoms, psychiatric disorder and use of health services. It seems likely that existing psychiatric disorder contributes to high levels of annoyance. However, there is also the possibility that tendency to annoyance may be a risk factor for psychiatric morbidity. Although noise level explains a significant proportion of the variance in annoyance, the other major factor, confirmed in many studies, is subjective sensitivity to noise. Noise sensitivity is also related to psychiatric disorder. The evidence for noise sensitivity being a risk factor for psychiatric disorder would be greater if it were a stable personality characteristic, and preceded psychiatric morbidity. The stability of noise sensitivity and whether it is merely secondary to psychiatric disorder or is a risk factor for psychiatric disorder as well as annoyance is examined in two studies in this monograph: a six-year follow-up of a group of highly noise sensitive and low noise sensitive women; and a longitudinal study of depressed patients and matched control subjects examining changes in noise sensitivity with recovery from depression. A further dimension of noise effects concerns the impact of noise on the autonomic nervous system. Most physiological responses to noise habituate rapidly but in some people physiological responses persist. It is not clear whether this sub-sample is also subjectively sensitive to noise and whether failure to habituate to environmental noise may also represent a biological indicator of vulnerability to psychiatric disorder. In these studies noise sensitivity was found to be moderately stable and associated with current psychiatric disorder and a disposition to negative affectivity. Noise sensitivity levels did fall with recovery from depression but still remained high, suggesting an underlying high level of noise sensitivity. Noise sensitivity was related to higher tonic skin conductance and heart rate and greater defence/startle responses during noise exposure in the laboratory. Noise sensitive people attend more to noises, discriminate more between noises, find noises more threatening and out of their control, and react to, and adapt to noises more slowly than less noise sensitive people.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1488472

  1. Noise, noise sensitivity and psychiatric disorder: epidemiological and psychophysiological studies.

    PubMed

    Stansfeld, S A

    1992-01-01

    Noise, a prototypical environmental stressor, has clear health effects in causing hearing loss but other health effects are less evident. Noise exposure may lead to minor emotional symptoms but the evidence of elevated levels of aircraft noise leading to psychiatric hospital admissions and psychiatric disorder in the community is contradictory. Despite this there are well documented associations between noise exposure and changes in performance, sleep disturbance and emotional reactions such as annoyance. Moreover, annoyance is associated with both environmental noise level and psychological and physical symptoms, psychiatric disorder and use of health services. It seems likely that existing psychiatric disorder contributes to high levels of annoyance. However, there is also the possibility that tendency to annoyance may be a risk factor for psychiatric morbidity. Although noise level explains a significant proportion of the variance in annoyance, the other major factor, confirmed in many studies, is subjective sensitivity to noise. Noise sensitivity is also related to psychiatric disorder. The evidence for noise sensitivity being a risk factor for psychiatric disorder would be greater if it were a stable personality characteristic, and preceded psychiatric morbidity. The stability of noise sensitivity and whether it is merely secondary to psychiatric disorder or is a risk factor for psychiatric disorder as well as annoyance is examined in two studies in this monograph: a six-year follow-up of a group of highly noise sensitive and low noise sensitive women; and a longitudinal study of depressed patients and matched control subjects examining changes in noise sensitivity with recovery from depression. A further dimension of noise effects concerns the impact of noise on the autonomic nervous system. Most physiological responses to noise habituate rapidly but in some people physiological responses persist. It is not clear whether this sub-sample is also subjectively sensitive to noise and whether failure to habituate to environmental noise may also represent a biological indicator of vulnerability to psychiatric disorder. In these studies noise sensitivity was found to be moderately stable and associated with current psychiatric disorder and a disposition to negative affectivity. Noise sensitivity levels did fall with recovery from depression but still remained high, suggesting an underlying high level of noise sensitivity. Noise sensitivity was related to higher tonic skin conductance and heart rate and greater defence/startle responses during noise exposure in the laboratory. Noise sensitive people attend more to noises, discriminate more between noises, find noises more threatening and out of their control, and react to, and adapt to noises more slowly than less noise sensitive people.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1343357

  2. Day Hospital Mentalization-Based Treatment (MBT-DH) versus treatment as usual in the treatment of severe borderline personality disorder: protocol of a randomized controlled trial

    PubMed Central

    2014-01-01

    Background Severe borderline personality disorder is associated with a very high psychosocial and economic burden. Current treatment guidelines suggest that several manualized treatments, including day hospital Mentalization-Based Treatment (MBT-DH), are effective in these patients. However, only two randomized controlled trials have compared manualized MBT-DH with treatment as usual. Given the relative paucity of data supporting the efficacy and cost-effectiveness of MBT-DH, the possible influence of researcher allegiance in one of the trials, and potential problems with the generalization of findings to mental health systems in other countries, this multi-site randomized trial aims to investigate the efficacy and cost-effectiveness of manualized MBT-DH compared to manualized specialist treatment as usual in The Netherlands. Methods/design The trial is being conducted at two sites in The Netherlands. Patients with a DSM-IV-TR diagnosis of borderline personality disorder and a score of???20 on the Borderline Personality Disorder Severity Index were randomly allocated to MBT-DH or treatment as usual. The MBT-DH program consists of a maximum of 18 months’ intensive treatment, followed by a maximum of 18 months of maintenance therapy. Specialist treatment as usual is provided by the City Crisis Service in Amsterdam, a service that specializes in treating patients with personality disorders, offering manualized, non-MBT interventions including family interventions, Linehan training, social skills training, and pharmacotherapy, without a maximum time limit. Patients are assessed at baseline and subsequently every 6 months up to 36 months after the start of treatment. The primary outcome measure is the frequency and severity of manifestations of borderline personality disorder as assessed by the Borderline Personality Disorder Severity Index. Secondary outcome measures include parasuicidal behaviour, symptomatic distress, social and interpersonal functioning, personality functioning, attachment, capacity for mentalizing and quality of life. Cost-effectiveness is assessed in terms of the cost per quality-adjusted life year. Outcomes will be analyzed using multilevel analyses based on intention-to-treat principles. Discussion Severe borderline personality disorder is a serious psychological disorder that is associated with high burden. This multi-site randomized trial will provide further data concerning the efficacy and cost-effectiveness of MBT-DH for these patients. Trial registration NTR2175 PMID:24886402

  3. Deep brain stimulation for psychiatric disorders: where we are now.

    PubMed

    Cleary, Daniel R; Ozpinar, Alp; Raslan, Ahmed M; Ko, Andrew L

    2015-06-01

    Fossil records showing trephination in the Stone Age provide evidence that humans have sought to influence the mind through physical means since before the historical record. Attempts to treat psychiatric disease via neurosurgical means in the 20th century provided some intriguing initial results. However, the indiscriminate application of these treatments, lack of rigorous evaluation of the results, and the side effects of ablative, irreversible procedures resulted in a backlash against brain surgery for psychiatric disorders that continues to this day. With the advent of psychotropic medications, interest in invasive procedures for organic brain disease waned. Diagnosis and classification of psychiatric diseases has improved, due to a better understanding of psychiatric patho-physiology and the development of disease and treatment biomarkers. Meanwhile, a significant percentage of patients remain refractory to multiple modes of treatment, and psychiatric disease remains the number one cause of disability in the world. These data, along with the safe and efficacious application of deep brain stimulation (DBS) for movement disorders, in principle a reversible process, is rekindling interest in the surgical treatment of psychiatric disorders with stimulation of deep brain sites involved in emotional and behavioral circuitry. This review presents a brief history of psychosurgery and summarizes the development of DBS for psychiatric disease, reviewing the available evidence for the current application of DBS for disorders of the mind. PMID:26030702

  4. Facilitating Hospital to School Transitions: Practices of Hospital-Based Therapists

    ERIC Educational Resources Information Center

    Simon, Joan B.; Savina, Elena A.

    2005-01-01

    Mental health services are delivered to children in many settings, including inpatient psychiatric facilities. In 1997, over 280,000 children and adolescents were admitted to inpatient psychiatric settings for services related to emotional or behavioral disorders. Building a bridge between hospital and school professionals is necessary to maintain…

  5. Psychiatric Boarding in Washington State and the Inadequacy of Mental Health Resources.

    PubMed

    Bloom, Joseph D

    2015-06-01

    Psychiatric boarding is a term derived from emergency medicine that describes the holding of patients deemed in need of hospitalization in emergency departments for extended periods because psychiatric beds are not available. Such boarding has occurred for many years in the shadows of mental health care as both inpatient beds and community services have decreased. This article focuses on a 2014 Washington State Supreme Court decision that examined the interpretation of certain sections of the Washington state civil commitment statute that had been used to justify the extended boarding of detained psychiatric patients in general hospital emergency departments. The impact of this decision on the state of Washington should be significant and could spark a national debate about the negative impacts of psychiatric boarding on patients and on the nation's general hospital emergency services. PMID:26071512

  6. Assertive community treatment for people with severe mental illness: the effect on hospital use and costs.

    PubMed Central

    Salkever, D; Domino, M E; Burns, B J; Santos, A B; Deci, P A; Dias, J; Wagner, H R; Faldowski, R A; Paolone, J

    1999-01-01

    OBJECTIVE: To determine the effect of the Program for Assertive Community Treatment (PACT) model on psychiatric inpatient service use in a population of non-emergency psychiatric patients with severe chronic mental illness, and to test for variations in this effect with program staffing levels and patient characteristics such as race and age. DATA SOURCES/STUDY SETTING: Data are taken from a randomized trial of PACT in Charleston, South Carolina for 144 patients recruited from August 1989 through July 1991. STUDY DESIGN: Subjects were randomly assigned either to one of two PACT programs or to usual care at a local mental health center. Effects on hospital use were measured over an 18-month follow-up period via multiple regression analysis. DATA COLLECTION METHODS: Data were obtained from Medicaid claims, chart reviews, subject, case manager, and family interviews; searches of the computerized patient and financial databases of the South Carolina Department of Mental Health and relevant hospitals; and searches of the hard copy and computerized financial databases of the two major local hospitals providing inpatient psychiatric care. PRINCIPAL FINDINGS: PACT participants were about 40 percent less likely to be hospitalized during the follow-up period. The effect was stronger for older patients. Lower PACT client/staff ratios also reduced the risk of hospitalization. No evidence of differential race effects was found. Given some hospital use, PACT did not influence the number of days of use. CONCLUSIONS: Controlling for other covariates, PACT significantly reduces hospitalizations but the size of this effect varies with patient and program characteristics. This study shows that previous results on PACT can be applied to non-emergency patients even when the control condition is an up-to-date CMHC office-based case management program. PMID:10357291

  7. 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

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

    2008-01-01

    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

  8. Planning Patient-Centered Health Homes for Medicaid Psychiatric Patients at Greatest Risk for Intensive Service Use.

    PubMed

    West, Joyce C; Rae, Donald S; Mojtabai, Ramin; Duffy, Farifteh F; Kuramoto, Janet; Moscicki, Eve; Narrow, William E

    2015-07-01

    This study identified characteristics of Medicaid psychiatric patients at risk of hospitalizations and emergency department (ED) visits to identify their service delivery needs. A total of 4,866 psychiatrists were randomly selected from the AMA Physician Masterfile; 62 % responded, 32 % met eligibility criteria and reported on 1,625 Medicaid patients. Patients with schizophrenia, substance use disorders, suicidal and violent ideation/behavior, and psychotic, substance use, or manic symptoms were at high risk for intensive service use, along with homeless and incarcerated patients. Patients with schizophrenia or psychotic symptoms represented 37 % of patients, but used 73 % of all hospital days and 61 % of all ED visits. Patients with substance use problems comprised 21 % of patients, but used nearly half of all ED visits. Our findings highlight opportunities to enhance treatments and interventions, and inform the development of patient-centered health homes to address the needs of patients at high risk for intensive service use. PMID:25666205

  9. [Being personal: the development of community psychiatric mental health nursing].

    PubMed

    Shiau, Shu-Jen; Lee, Shu-Hong

    2009-08-01

    Community psychiatric mental health nursing care emphasizes humanistic values and focuses on serving patient and family needs. In Taiwan, such care is delivered largely as part of patient discharge care plans and hospital / community based service models. Issues involved underscore the importance of operating an effective and integrated transfer system, the role and function of nurses and training in relevant competencies (Shiau, Huang & Lin, 2005). This article again emphasizes the importance of 'being personal' in the development of community psychiatric mental health nursing in Taiwan. Critical issues to consider include humanization, empowerment, nursing competencies, regulations, relating on a personal level, and facilitating empowerment and enlightenment on the healing process. PMID:19634094

  10. 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.

  11. Hysterectomy and psychiatric disorder: II. Demographic psychiatric and physical factors in relation to psychiatric outcome.

    PubMed

    Gath, D; Cooper, P; Bond, A; Edmonds, G

    1982-04-01

    One hundred and fifty-six patients with menorrhagia of benign origin were interviewed before hysterectomy, and again six months (n = 147) and 18 months (n = 148) after the operation. Psychiatric outcome, measured in terms of PSE cases detected at 18 months, was strongly associated with pre-operative mental state, neuroticism, previous psychiatric history, and family psychiatric history. No association was found with organic pathology in the uterus, bilateral oophorectomy or demographic variables. PMID:7201337

  12. 76 FR 40229 - Psychiatric Evaluation and Treatment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ...45(b). Also, the American Psychiatric Association (APA) and the American Civil Liberties Union...Transfer for psychiatric or psychological examination. 549.44...Transfer for psychiatric or psychological examination. The...

  13. Effect of a more monitored but liberal weight loss management policy on hospital referral and readmission in the first 15 days of life

    Microsoft Academic Search

    A Torres; R Balfour; K Jeyasinghe; C Mmuo; N Harivaram; B Williams; K Evans; S Banerjee

    2010-01-01

    IntroductionFeeding related problems are the commonest reason for readmission to hospital in the first fortnight of life. Our institution had a high referral and readmission rate for feeding difficulties due to a pragmatic policy of referral to paediatricians if the infant lost 10% of birth weight; fuelled by reports of serious hypernatraemic dehydration in the UK. A more liberal guideline

  14. Validity of Childhood Autism in the Danish Psychiatric Central Register: Findings from a Cohort Sample Born 1990-1999

    ERIC Educational Resources Information Center

    Lauritsen, Marlene B.; Jorgensen, Meta; Madsen, Kreesten M.; Lemcke, Sanne; Toft, Susanne; Grove, Jakob; Schendel, Diana E.; Thorsen, Poul

    2010-01-01

    The purpose of this study was to assess the validity of the diagnosis of childhood autism in the Danish Psychiatric Central Register (DPCR) by reviewing medical records from 499 of 504 total children with childhood autism born 1990-1999. Based on review of abstracted behaviors recorded in case records from child psychiatric hospitals, case status…

  15. Psychiatric inpatient expenditures and public health insurance programmes: analysis of a national database covering the entire South Korean population

    Microsoft Academic Search

    Woojin Chung

    2010-01-01

    BACKGROUND: Medical spending on psychiatric hospitalization has been reported to impose a tremendous socio-economic burden on many developed countries with public health insurance programmes. However, there has been no in-depth study of the factors affecting psychiatric inpatient medical expenditures and differentiated these factors across different types of public health insurance programmes. In view of this, this study attempted to explore

  16. Smoking attitudes, beliefs, and readiness to change among acute and long term care inpatients with psychiatric diagnoses

    Microsoft Academic Search

    Ann Marie Carosella; DEBORAH J. OSSIP-KLEIN; CHRISTINA A. OWENS

    1999-01-01

    The present study represents an initial assessment of barriers and motives for quitting, health risk knowledge, and readiness to change in a hospitalized acute and long term care population with psychiatric diagnoses, and dual diagnoses of substance abuse and psychiatric disorders. Ninety-two patients residing in admissions, long term care, and mentally impaired\\/chemically addicted (MICA) units of a VA Medical Center

  17. Exposure to environmental tobacco smoke (ETS) and determinants of support for complete smoking bans in psychiatric settings

    Microsoft Academic Search

    M. C. Willemsen; C. A. Gorts; P. van Soelen; R. E. Jonkers; S. R. Hilberink

    2004-01-01

    OBJECTIVE: To measure environmental tobacco smoke (ETS) exposure in psychiatric settings and to assess determinants of support for complete smoking bans. DESIGN: Cross sectional study SETTING: Dutch psychiatric hospitals, outpatient care institutions, and sheltered home facilities. SUBJECTS: A random sample of 540 treatment staff, 306 attendants\\/nurses, and 93 patients. MAIN OUTCOME MEASURES: Self reported ETS exposure, current smoking policy, compliance

  18. Food poisoning in hospitals in Scotland, 1978-87.

    PubMed Central

    Collier, P. W.; Sharp, J. C.; MacLeod, A. F.; Forbes, G. I.; Mackay, F.

    1988-01-01

    During the 10-year period 1978-87 there were 48 outbreaks of food poisoning in Scottish hospitals affecting a total of 2287 persons of whom 12 died. This compared with 50 outbreaks during the previous 5 years (1973-77) when over 1500 persons and 7 deaths were recorded. Although the incidence of outbreaks has decreased the average number of persons affected in outbreaks has increased. A marked reduction was seen in the incidence of outbreaks due to Clostridium perfringens, in contrast to foodborne salmonellosis which remains a problem. Thirty-four hospitals, of which 10 reported two or more outbreaks, were involved. The type of hospitals most frequently affected were general (14), psychiatric (13), geriatric (9) and hospitals for the mentally subnormal (7). Meat, including poultry meat, was incriminated in over 90% of outbreaks where a food vehicle was identified. In modern or re-equipped kitchens cooking in advance with subsequent reheating is being progressively discontinued as more food is being cooked on the day of consumption, a practice which may readily explain the decreasing incidence of outbreaks due to Cl. perfringens. Bacterial cross-contamination from poultry-meat and other raw foods, compounded by inadequate temperature control, however, continues to be a problem in some hospitals. It is too early as yet to determine whether the removal of Crown immunity will have any effect on the future incidence of hospital 'food poisoning'. PMID:2905670

  19. Special report: controlling aggression in hospitals--what security officers must know to avoid physical attacks.

    PubMed

    1992-03-01

    Threats to the safety of security officers by persons they encounter in confrontational or potentially confrontational situations are an ever-present danger. This potential for physical violence can take place in the lobby, cafeteria, halls, elevators, or the parking lot of any corporate entity, not just hospitals. In hospitals, however, this danger is compounded by psychiatric patients and other hospital patients under stress. Hospital security personnel are often called to defuse potentially violent patient situations. Further compounding this risk of violence are increases in cutbacks in hospital personnel. Therefore, programs that teach hospital staff members how to control aggression will become increasingly important. Among the organizations have made a reputation for training security professionals and others in preventing and dealing with violence are R.E.B. Security Training, Inc., Avon, CT, and Wickersty & Associates, Inc., Bladensburg, MD. R.E.B. offers a two-day course in nonverbal communication that is taken by police officers and security directors. According to Ronald W. Ouellette, president, the course has also been attended by nurses, doctors, ambulance drivers, and psychologists. Wickersty & Associates has been conducting "Controlling Aggression" workshops in health care facilities for the past 12 years. According to Dr. Allan Wickersty, more and more hospitals are hiring consultants to teach staff members how to deal with aggressive behavior. But hospital violence remains an underreported problem. "One thing I have noticed is that the type of hospital experiencing violence is changing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:10117487

  20. Case of graves' disease with remarkable psychiatric symptoms.

    PubMed

    Kuno, Fumi; Okada, Yosuke; Arao, Tadashi; Kurozumi, Akira; Tanaka, Yoshiya

    2015-03-01

    A 42-year-old woman visited our hospital with palpitations, excessive sweating, and finger tremors in March 2011. She was diagnosed with Graves' disease based on the following test results: thyroid stimulating hormone < 0.01 ?U/ml, free thyroxine 6.15 ng/ml, and thyrotropin receptor antibody 7.8 U/ml. Treatment with methimazole 30 mg and propranolol 30 mg was started, and her thyroid function showed improvement. However, significant manic symptoms, irritability, hallucinations, and delusions were noted, and she was hospitalized for her own protection in May 2011. Although treatment with aripiprazole 24 mg and lithium 400 mg was started, the hallucinatory and delusional symptoms persisted, necessitating adjustment of the antipsychotics. Her psychiatric symptoms showed amelioration in July 2011 after improvement in her thyroid function, and she was discharged from our hospital. After discharge, her thyroid function remained normal with methimazole 10 mg, and administration of the antipsychotics was discontinued. Affective psychotic symptoms such as altered mood and activity are frequently observed in cases with Graves' disease, but there have been few reports describing cases with full-blown psychiatric disorders manifesting with features such as hallucinations and delusions as the chief symptoms requiring hospitalized treatment, as in the present case. In symptomatic psychosis associated with Graves' disease, prolonged psychiatric symptoms might develop, and close cooperation with psychiatrists is thus important. PMID:25787102

  1. A Look at Psychiatric Education

    Microsoft Academic Search

    Herbert Pardes

    2006-01-01

    he clinical quality of U.S. physicians, the unevenness in their attention to the care of psychiatric patients, and their awareness of the importance of the ability to handle the psychological aspects of nonpsychiatricmedical care are of great consequence. Therefore, education re- garding the behavioral and psychiatric aspects of medical care as well as education of physicians who specialize in the

  2. Occupational Psychiatric Disorders in Korea

    PubMed Central

    Kang, Seong-Kyu

    2010-01-01

    We searched databases and used various online resources to identify and systematically review all articles on occupational psychiatric disorders among Korean workers published in English and Korean before 2009. Three kinds of occupational psychiatric disorders were studied: disorders related to job stress and mental illness, psychiatric symptoms emerging in victims of industrial injuries, and occupational psychiatric disorders compensated by Industrial Accident Compensation Insurance (IACI). Korea does not maintain official statistical records for occupational psychiatric disorders, but several studies have estimated the number of occupational psychiatric disorders using the Korea Workers' Compensation and Welfare Service (COMWEL, formerly KLWC) database. The major compensated occupational psychiatric disorders in Korea were "personality and behavioral disorders due to brain disease, damage, and dysfunction", "other mental disorders due to brain damage and dysfunction and to physical diseases", "reactions to severe stress and adjustment disorders", and "depressive episodes". The most common work-related psychiatric disorders, excluding accidents, were "neurotic, stress-related, and somatoform disorders" followed by "mood disorders". PMID:21258596

  3. College Students with Psychiatric Disabilities

    ERIC Educational Resources Information Center

    Singh, Delar K.

    2011-01-01

    This paper focuses on college students with psychiatric disabilities. It defines and discusses various psychiatric conditions such as mood disorders, anxiety disorders, eating disorders, and personality disorders. It concludes with accommodations that a college professor can make to help these students succeed in higher education. (Contains 1…

  4. Cutaneous factitia in elderly patients: alarm signal for psychiatric disorders

    PubMed Central

    Chiriac, Anca; Foia, Liliana; Birsan, Cristina; Goriuc, Ancuta; Solovan, Caius

    2014-01-01

    Background The factitious disorders, more commonly known in daily practice as pathomimia, are expressed in dermatology units by skin lesions induced voluntarily by the patient, in order to draw attention of the medical staff and/or the family members. The disorder is often challenging to diagnose and even more difficult to document in front of the patient or relatives. It represents a challenge for the physician, and any attempt at treatment may be followed by recurrence of the self-mutilation. This paper describes two cases of pathomimia diagnosed by dermatologists and treated in a psychiatry unit, highlighting the importance of collaboration in these situations. Patients and methods Two case reports, describing old female patients with pathomimia, hospitalized in a department of dermatology for bizarre skin lesions. Results The first case was a 77-year-old female with unknown psychiatric problems and atrophic skin lesions on the face, self-induced for many months, with multiple hospitalizations in dermatology units, with no response to different therapeutic patterns, and full recovery after psychiatric treatment for a major depressive syndrome. The second case was a 61-year-old female patient with disseminated atrophic scars on the face, trunk, and limbs. She raised our interest because of possible psychiatric issues, as she had attempted to commit suicide. The prescription of antidepressants led to a significant clinical improvement. Conclusion These cases indicate that a real psychiatric disease may be recorded in patients suffering from pathomimia. Therefore, complete psychiatric evaluation in order to choose the proper therapy is mandatory for all these cases. Dermatologists and all physicians who take care of old patients must recognize the disorder in order to provide optimum care for this chronic condition. We emphasize therefore the importance of psychiatric evaluation and treatment to avoid the major risk of suicide. Skin lesions must be regarded as an alarm signal in critical cases, especially in senior people. PMID:24648724

  5. Preventing Involuntary Hospitalization: A Family Contracting Approach

    ERIC Educational Resources Information Center

    Nevid, Jeffrey S.; Morrison, James K.

    1976-01-01

    A family contracting approach, delineating those behaviors which could not be used as sole justifications for involuntary hospitalization is recommended to decrease a psychiatric patient's fear of arbitrary, family-initiated commitment. The contract outlines the decision rules which might necessitate involuntary hospitalization. Advantages are…

  6. Exorcism: a psychiatric viewpoint.

    PubMed Central

    Trethowan, W. H.

    1976-01-01

    Doctors, for several reasons, should be concerned with exorcism is the view of Professor Trethowan, who in this paper, looks at the main features of exorcism as practised in the middle ages and now appearing in the modern world, as was seen in the recent Ossett case in Britain. He examines in some detail the nature of supposed demoniacal possession and describes its symptoms and signs. He also touches on the social, as opposed to the religious, background in which demoniacal possession flourished (not lacking in the world today), so leading to an examination of the psychodynamic aspects of demoniacal possession and the question of absolute evil. Finally he compares the techniques of exorcism and of modern psychiatric practice. PMID:966260

  7. Psychiatric morbidity in disintegrative psychosis and infantile autism: A long-term follow-up study.

    PubMed

    Mouridsen, S E; Rich, B; Isager, T

    1999-01-01

    In order to study the validity of disintegrative psychosis (DP), the authors compared 13 patients given this diagnosis in childhood with a control group of 39 patients with infantile autism (IA) matched for sex, age, IQ and social class on measures of psychiatric morbidity. Almost the same proportion of the two groups had been admitted to a psychiatric hospital during a 22-year follow-up period. However, there was a slight tendency (statistically nonsignificant) for the DP group to utilize the psychiatric health care system more frequently than the IA group. They had more admissions and stayed longer in hospital than patients with IA suggesting that they had more psychiatric symptoms than the IA group. The original IA diagnoses were confirmed fairly consistently during the follow-up period, while the DP group was given more heterogenous diagnoses. No diagnosis of schizophrenia was made in either group. PMID:10364726

  8. A contact-based intervention for people recently discharged from inpatient psychiatric care: a pilot study.

    PubMed

    Bennewith, Olive; Evans, Jonathan; Donovan, Jenny; Paramasivan, Sangeetha; Owen-Smith, Amanda; Hollingworth, William; Davies, Rosemary; O'Connor, Susan; Hawton, Keith; Kapur, Navneet; Gunnell, David

    2014-01-01

    People recently discharged from inpatient psychiatric care are at high risk of suicide and self-harm, with 6% of all suicides in England occurring in the 3 months after discharge. There is some evidence from a randomized trial carried out in the United States in the 1960s-70s that supportive letters sent by psychiatrists to high-risk patients in the period following hospital discharge resulted in a reduction in suicide. The aim of the current pilot study was to assess the feasibility of conducting a similar trial, but in a broader group of psychiatric discharges, in the context of present day UK clinical practice. The intervention was piloted on 3 psychiatric inpatient wards in southwest England. On 2 wards a series of 8 letters were sent to patients over the 12 months after discharge and 6 letters were sent from the third ward over a 6 month period. A total of 102 patients discharged from the wards received at least 1 letter, but only 45 (44.1%) received the full series of letters. The main reasons for drop-out were patient opt-out (n = 24) or readmission (n = 26). In the context of a policy of intensive follow-up post-discharge, qualitative interviews with service users showed that most already felt adequately supported and the intervention added little to this. Those interviewed felt that it was possible that the intervention might benefit people new to or with little follow-up from mental health services but that fewer letters should be mailed. PMID:24673299

  9. The Cerebellum and Psychiatric Disorders

    PubMed Central

    Phillips, Joseph R.; Hewedi, Doaa H.; Eissa, Abeer M.; Moustafa, Ahmed A.

    2015-01-01

    The cerebellum has been considered for a long time to play a role solely in motor coordination. However, studies over the past two decades have shown that the cerebellum also plays a key role in many motor, cognitive, and emotional processes. In addition, studies have also shown that the cerebellum is implicated in many psychiatric disorders including attention deficit hyperactivity disorder, autism spectrum disorders, schizophrenia, bipolar disorder, major depressive disorder, and anxiety disorders. In this review, we discuss existing studies reporting cerebellar dysfunction in various psychiatric disorders. We will also discuss future directions for studies linking the cerebellum to psychiatric disorders. PMID:26000269

  10. [Emergency psychiatric care in 2014].

    PubMed

    Baillon, Guy

    2014-01-01

    Emergency psychiatric care is an essential part of psychiatric practice where every detail must be taken into account. The skill of the psychiatric nurses is a major advantage, but for this skill to be activated, it must be enlightened, supported by a psychiatrist, not just in terms of knowledge, but also for recognition of the value of the "team". Their availability as well as the importance of the environment help to establish the necessary trust to enable the patient to face his or her suffering. PMID:24979915

  11. 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 ...

  12. Secondary Psychiatric Schools: Characteristics and Approaches to Curriculum

    ERIC Educational Resources Information Center

    Gagnon, Joseph Calvin; Van Loan, Christopher L.; Barber, Brian R.

    2011-01-01

    This study focused on approaches to curriculum, as well as school, principal, and student characteristics in secondary day treatment and residential psychiatric schools. A national random sample of 148 principals responded to a survey. No statistically significant differences existed between respondent and nonrespondent schools with regard to…

  13. Psychiatric Consultation and Substance Use Disorders

    PubMed Central

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

    2009-01-01

    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

  14. Psychiatric Diagnoses and Psychiatric Treatment Among Bariatric Surgery Candidates

    Microsoft Academic Search

    David B. Sarwer; Naomi I. Cohn; Lauren M. Gibbons; Leanne Magee; Canice E. Crerand; Steven E. Raper; Ernest F. Rosato; Noel N. Williams; Thomas A. Wadden

    2004-01-01

    Background: This study investigated the psychiatric diagnoses and psychiatric treatment histories of 90 bariatric surgery\\u000a candidates. Methods: Prior to surgery, all participants completed the Weight and Lifestyle Inventory, the Questionnaire on\\u000a Eating and Weight Patterns, and the Beck Depression Inventory-II. Participants also underwent a behavioral\\/psychological evaluation\\u000a with a psychologist, which reviewed responses to the measures and provided further assessment of

  15. Multisystemic Therapy Versus Hospitalization for Crisis Stabilization of Youth: Placement Outcomes 4 Months Postreferral

    Microsoft Academic Search

    Sonja K. Schoenwald; David M. Ward; Scott W. Henggeler; Melisa D. Rowland

    2000-01-01

    Hospitalization and out-of-home placement data for 113 youth participating in a randomized trial comparing home-based multisystemic therapy (MST; n = 57) with hospitalization(n = 56) for psychiatric crisis stabilization were analyzed following the completion of MST treatment—approximately 4 months post approval for emergency psychiatric hospitalization. Analyses showed that MST prevented any hospitalization for 57% of the participants in the MST

  16. [Psychiatric advance directives--medical models into psychiatric medicine].

    PubMed

    Mautner, Sigal; Lachman, Max; Kaplan, Zeev; Shalev, Anat

    2014-01-01

    Since the year 2005, in the field of general medicine, the legislature in Israel determined ways to implement medically advanced directives according to the power of the law. Different states in the world had implemented parallel legislation for patients who suffer from mental illness. Psychiatric Advance Directives is a legitimate document which is valid in Australia, New Zealand, Scotland, England and in 25 countries in the U.S.A. Psychiatric advance directives (PAD's) allow competent persons, through advance instructions, to state their preferences for future mental health treatment in the event of an incapacitating psychiatric crisis. Self Determination Theory, Self Care and Autonomy are dominant supportive approaches in the creation of Psychiatric Advance Directives. Research conducted on psychiatric advance directives shows positive potential benefits for mental health clients, therapists and psychiatrists. More research in that area must be conducted. Psychiatric advance directives are currently developed and implemented with the cooperation of the Tauber Foundation and the Beer Sheva Mental Health Center. This is the first step in learning of effective ways to use this intervention in Israel and change perceptions toward a positive connection between medical efficiency and client preferences. PMID:24605406

  17. Hospitality in hospitals?

    Microsoft Academic Search

    Denver Severt; Taryn Aiello; Shannon Elswick; Cheryl Cyr

    2008-01-01

    Purpose – The purpose of this paper is to explore an organization-wide philosophy of hospitality in a hospital setting. Design\\/methodology\\/approach – An exploratory case study method approach matched the research purpose. First, a hospitality centric philosophy (HCP) was defined from the literature review. Next, a triangulation of unstructured visits, structured visits and key informant interviews is used to further explore

  18. THE UNIVERSITY OF CONNECTICUT HEALTH CENTER JOHN DEMPSEY HOSPITAL

    E-print Network

    Oliver, Douglas L.

    to a Physician Assistant (PA), Advanced Practice Registered Nurse (APRN), or Resident. Alternatively inpatient service (excludes psychiatric admissions). DEFINITIONS: Physician: Any MD, DO, clinical. Admitting Physician: That member of the medical staff who makes the decision that inpatient hospital care

  19. 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

  20. Physician-Determined Worsening Heart Failure: A Novel Definition for Early Worsening Heart Failure in Patients Hospitalized for Acute Heart Failure – Association with Signs and Symptoms, Hospitalization Duration, and 60Day Outcomes

    Microsoft Academic Search

    Gad Cotter; Marco Metra; Beth Davison Weatherley; Howard C. Dittrich; Barry M. Massie; Piotr Ponikowski; Daniel M. Bloomfield; Christopher M. O’Connor

    2010-01-01

    Objectives: To evaluate physician-determined worsening heart failure (PD-WHF) in patients admitted with acute heart failure (AHF). Methods: The PROTECT pilot study evaluated rolofylline, an adenosine A1 receptor antagonist, versus placebo in patients with AHF and renal impairment. Signs and symptoms of heart failure (HF) and diuretic administration were prospectively recorded daily for 7 days and patients were followed for 60

  1. Psychiatric comorbidity in forensic psychiatry.

    PubMed

    Palijan, Tija Zarkovi?; Muzini?, Lana; Radeljak, Sanja

    2009-09-01

    For the past several years a numerous studies in the field of forensic psychiatry confirmed a close relationship between violent offenders and comorbid substance abuse. The comorbid substance abuse in violent offenders was usually unrecognized and misdiagnosed. Furthermore, comorbidity in forensic psychiatry describes the co-occurrence of two or more conditions or psychiatric disorder known in the literature as dual diagnosis and defined by World Health Organization (WHO). In fact, many violent offenders have multiple psychiatric diagnoses. Recent studies have confirmed causal relationship between major psychiatric disorders and concomitant substance abuse (comorbidity) in 50-80% of forensic cases. In general, there is a high level of psychiatric comorbidity in forensic patients with prevalence of personality disorders (50-90%), mood disorders (20-60%) and psychotic disorders (15-20%) coupled with substance abuse disorders. Moreover, the high prevalence of psychiatric comorbidities could be found in mentally retarded individuals, as well as, in epileptic patients. Drugs and alcohol abuse can produce serious psychotoxic effects that may lead to extreme violent behavior and consequently to serious criminal offence such as physical assault, rape, armed robbery, attempted murder and homicide, all due to an altered brain function and generating psychotic-like symptoms. Studies have confirmed a significant statistical relevance in causal relationship between substance abuse and violent offences. In terms of forensic psychiatry, the comorbidity strongly contributes in the process of establishing psychiatric diagnosis of diminished mental capacity or insanity at the time of the offence in the course of clinical assessment and evaluation of violent offenders. Today, the primary focus of forensic psychiatry treatment services (in-patient or community) is management of the violent offenders with psychiatric comorbidity which requires a multilevel, evidence based approach to the patient. Forensic treatment service effectiveness appears to be associated with individual case management and approach including psychotherapy, pharmacotherapy and occupational therapy in order to achieve optimal rehabilitation, prevention of recidivism and stability in social functioning of the patient in the community. PMID:19794370

  2. Guide to Choosing a Hospital

    MedlinePLUS

    ... How hospitals’ rates of readmission and 30-day mortality (death) rates for certain conditions compare with the national rate. • How each hospital uses outpatient medical imaging tests (like CT scans ...

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

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

    2004-01-01

    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

  5. 42 CFR 424.16 - Timing of certification for individual admitted to a hospital before entitlement to Medicare...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...for certification and recertification. (b) Example. (Hospital that is not a psychiatric hospital and is not subject to PPS). For a patient who is admitted on August 15 and becomes entitled on September 1— (1) The certification is...

  6. Rate of British psychiatric combat casualties compared to recent American wars.

    PubMed

    Price, H H

    2007-01-01

    This paper examines factors leading to the low rate of combat psychiatric casualties in the British recapture of the Falklands compared to the American experience in North Africa, Italy, Europe and South Pacific theatres during World War II, the Korean Conflict and Vietnam. The factors compared are those thought to affect rates seen in these past wars. The factors highlighted are psychiatric screening of evacuees, presence of psychiatric personnel in line units, intensity of combat and use of elite units. Factors also mentioned are presence of possible occult psychiatric casualties such as frostbite and malaria, amount of indirect fire and the offensive or defensive nature of the combat. A unique aspect of the Falklands War examined is the exclusive use of hospital ships to treat psychiatric casualties and the impact of the Geneva Convention rules regarding hospital ships on the classic treatment principles of proximity and expectancy. The types and numbers of various diagnoses are also presented. The British Campaign in the Falklands produced a remarkably low rate of psychiatric casualties. When viewed in light of American experience in recent wars, this low rate represents a concentration of optimal factors leading to healthy function in combat. The results of this war should not be used to predict a similar outcome in future combat as this particular constellation of factors may not recur. PMID:18214088

  7. Psychiatric pharmaceuticals in the environment.

    PubMed

    Calisto, Vânia; Esteves, Valdemar I

    2009-11-01

    Psychiatric pharmaceuticals, such as anxiolytics, sedatives, hypnotics, and antidepressants, are among the most prescribed active substances throughout the world. The occurrence of these widely used compounds in environmental matrices (wastewaters, surface, ground and drinking waters, soils, sediments, bio-solids and tissue), as well as the first studies indicating their high persistence and toxicity to non-target organisms, justify the growing concern about these emerging environmental pollutants. Despite this increasing interest, there is a considerable lack of knowledge about the environmental fate of a large number of psychiatric pharmaceuticals and further research about this topic is needed. This paper aims to review the literature data related to the occurrence, persistence, environmental fate and toxicity for non-target organisms of this group of pharmaceuticals. The analytical methods developed for the determination of psychiatric medicines in environmental matrices are also highlighted. PMID:19815251

  8. [Movement disorders is psychiatric diseases].

    PubMed

    Hidasi, Zoltan; Salacz, Pal; Csibri, Eva

    2014-12-01

    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, stereotypy, 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

  9. The premature demise of public child and adolescent inpatient psychiatric beds : Part II: challenges and implications.

    PubMed

    Geller, Jeffrey L; Biebel, Kathleen

    2006-01-01

    Psychiatric disorders are the leading reason for hospitalization among 5-19 year olds. Current data, however, suggest there are fewer than necessary available services for children and adolescents requiring intensive, inpatient psychiatric care. Children and adolescents with behavioral health problems, the majority of whom do not receive appropriate treatment, have increased risk of school failure, family disruption, out-of-home placements, poor employment opportunities, and poverty in adulthood. This paper will examine the challenges inherent in serving children and adolescents with serious emotional disturbances, avenues of financing for treatment and services, and various loci of intervention for high-risk children, including inpatient settings and systems of care. The goals of this paper are to illustrate the complexities of working with children and adolescents most in need of intensive psychiatric services, to explore how inpatient services "fit" into existing treatment approaches, and to discuss the efficacy of downsizing or closing inpatient psychiatric units for this population. PMID:16927166

  10. Health service costs and clinical gains of psychotherapy for personality disorders: a randomized controlled trial of day-hospital-based step-down treatment versus outpatient treatment at a specialist practice

    PubMed Central

    2013-01-01

    Background Day-hospital-based treatment programmes have been recommended for poorly functioning patients with personality disorders (PD). However, more research is needed to confirm the cost-effectiveness of such extensive programmes over other, presumably simpler, treatment formats. Methods This study compared health service costs and psychosocial functioning for PD patients randomly allocated to either a day-hospital-based treatment programme combining individual and group psychotherapy in a step-down format, or outpatient individual psychotherapy at a specialist practice. It included 107 PD patients, 46% of whom had borderline PD, and 40% of whom had avoidant PD. Costs included the two treatment conditions and additional primary and secondary in- and outpatient services. Psychosocial functioning was assessed using measures of global (observer-rated GAF) and occupational (self-report) functioning. Repeated assessments over three years were analysed using mixed models. Results The costs of step-down treatment were higher than those of outpatient treatment, but these high costs were compensated by considerably lower costs of other health services. However, costs and clinical gains depended on the type of PD. For borderline PD patients, cost-effectiveness did not differ by treatment condition. Health service costs declined during the trial, and functioning improved to mild impairment levels (GAF?>?60). For avoidant PD patients, considerable adjuvant health services expanded the outpatient format. Clinical improvements were nevertheless superior to the step-down condition. Conclusion Our results indicate that decisions on treatment format should differentiate between PD types. For borderline PD patients, the costs and gains of step-down and outpatient treatment conditions did not differ. For avoidant PD patients, the outpatient format was a better alternative, leaning, however, on costly additional health services in the early phase of treatment. Trial registration Clinical Trials NCT00378248 PMID:24268099

  11. An Approach to the Teaching of Psychiatric Nursing in Diploma and Associate Degree Programs: Final Report on the Project.

    ERIC Educational Resources Information Center

    Walsh, Joan E.

    The purpose of the project was to determine what goals, content, and learning experiences in psychiatric-mental health nursing should be included in diploma and associate degree education for nursing in the light of present-day trends in nursing and psychiatric care. The report follows the sequence of the project: (1) selection of associate degree…

  12. Psychiatric Symptoms, Salivary Cortisol and Cytokine Levels in Young Marijuana Users.

    PubMed

    Cloak, Christine C; Alicata, Daniel; Ernst, Thomas M; Chang, Linda

    2015-06-01

    Psychological maturation continues into young adulthood when substance abuse and several psychiatric disorders often emerge. Marijuana is the most common illicit drug abused by youths, typically preceding other illicit substances. We aimed to evaluate the complex and poorly studied relationships between marijuana use, psychiatric symptoms, and cortisol levels in young marijuana users. Psychiatric symptoms and salivary cortisol were measured in 122 youths (13-23 years old) with and without marijuana use. Psychiatric symptoms were evaluated using the Symptom-Checklist-90-R and Brief Psychiatric Rating Scale. Mid-day salivary cortisol levels were measured. Additionally, salivary cytokine levels were measured in a subset of participants. Although the cortisol levels and salivary cytokine levels were similar, the young marijuana users had more self-reported and clinician rated psychiatric symptoms than controls, especially anxiety-associated symptoms. Moreover, marijuana users with earlier age of first use had more symptoms, while those with longer abstinence had fewer symptoms. Greater cumulative lifetime marijuana use was also associated with greater psychiatric symptoms. The discordant anxiety (feeling stressed or anxious despite normal cortisol) in the marijuana users, as well as symptom exacerbations with early and continued marijuana use in young marijuana users suggest that marijuana use may contribute to an aberrant relationship between stress response and psychiatric symptoms. The greater symptomatology, especially in those with earlier initiation and greater marijuana usage, emphasize the need to intervene for substance use and perceived anxiety in this population. PMID:25875137

  13. Psychiatric Morbidity and Quality of Life in Vitiligo Patients

    PubMed Central

    Ramakrishna, Podaralla; Rajni, Tenali

    2014-01-01

    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

  14. Comorbidity of Psychiatric Disorders and Parental Psychiatric Disorders in a Sample of Iranian Children with ADHD

    ERIC Educational Resources Information Center

    Ghanizadeh, Ahmad; Mohammadi, Mohammad Reza; Moini, Rozita

    2008-01-01

    Objective: To study the psychiatric comorbidity of a clinical sample of children with ADHD and the psychiatric disorders in their parents. Method: Structured psychiatric interviews assessing lifetime psychiatric disorders by "DSM-IV" criteria, using the Farsi version of the Schedule for Affective Disorders and Schizophrenia. Results: The mean age…

  15. Psychiatric Inferences from Data on Psychologic\\/Psychiatric Symptoms in Multiple Chemical Sensitivities Syndrome

    Microsoft Academic Search

    Ann L. Davidoff; Linda Fogarty; Penelope M. Keyl

    2000-01-01

    When abnormal psychologic\\/psychiatric symptom data are obtained on personality tests or psychiatric interviews administered to patients who report symptoms of Multiple Chemical Sensitivities Syndrome, investigators typically attribute these to either psychiatric traits or to psychogenic origins of illness. The primary purpose of these studies was the evaluation of the plausibility of nonpsychiatric explanations of psychologic\\/psychiatric symptom data. In Study 1,

  16. The challenge of psychiatric rehabilitation in schizophrenia

    Microsoft Academic Search

    Shirley M. Glynn

    2001-01-01

    Many persons with schizophrenia continue to struggle with psychiatric symptoms and poor social adjustment, even when prescribed\\u000a appropriate doses of antipsychotic medications. Psychiatric rehabilitation involves using psychosocial interventions to minimize\\u000a symptoms and relapse while maximizing social functioning in schizophrenia. In this article, the scope of psychiatric rehabilitation\\u000a is first defined and then the rationale for psychiatric rehabilitation is presented. The

  17. Academic Accommodations for Students with Psychiatric Disabilities.

    ERIC Educational Resources Information Center

    Souma, Alfred; Rickerson, Nancy; Burgstahler, Sheryl

    This brief paper summarizes the literature on academic accommodations for students with psychiatric disabilities. A definition of psychiatric disability precedes a brief summary of the following specific psychiatric diagnoses: depression, bipolar affective disorder; borderline personality disorder; schizophrenia; and anxiety disorders. Also noted…

  18. Psychiatric disorders and traumatic brain injury

    PubMed Central

    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

    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

  19. Psychiatric Morbidity and Referral on Two General Medical Wards

    Microsoft Academic Search

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

    1974-01-01

    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

  20. [Ethical principles in psychiatric action].

    PubMed

    Rüther, Eckart

    2014-07-01

    There is no specific psychiatric ethic. The ethical principles for practical actions in psychiatry have to be adapted on the basis of the generally accepted ethical principles, which are based on psychobiologically developed ethic of love: honesty, discretion, empathy, patience, distance, consistency, accountability, tolerance, economic neutrality. PMID:24983582

  1. Tobacco and Psychiatric Dual Disorders

    Microsoft Academic Search

    Noni A. Graham; Kimberly Frost-Pineda; Mark S. Gold

    2007-01-01

    Smoking is a leading cause of morbidity and premature mortality in the United States. The relationship between tobacco smoking and several forms of cancer, heart disease, stroke, chronic lung disease, and other medical diseases is well recognized and accepted. Recent epidemiological studies are now focusing on the link between tobacco use and psychiatric diseases. Experts now suggest that in the

  2. Psychiatric genetics: progress amid controversy

    Microsoft Academic Search

    Melvin G. McInnis; Sebastian Zöllner; Margit Burmeister

    2008-01-01

    Several psychiatric disorders — such as bipolar disorder, schizophrenia and autism — are highly heritable, yet identifying their genetic basis has been challenging, with most discoveries failing to be replicated. However, inroads have been made by the incorporation of intermediate traits (endophenotypes) and of environmental factors into genetic analyses, and through the identification of rare inherited variants and novel structural

  3. Psychiatric pharmaceuticals in the environment

    Microsoft Academic Search

    Vânia Calisto; Valdemar I. Esteves

    2009-01-01

    Psychiatric pharmaceuticals, such as anxiolytics, sedatives, hypnotics, and antidepressants, are among the most prescribed active substances throughout the world. The occurrence of these widely used compounds in environmental matrices (wastewaters, surface, ground and drinking waters, soils, sediments, bio-solids and tissue), as well as the first studies indicating their high persistence and toxicity to non-target organisms, justify the growing concern about

  4. Psychiatric Illness and Family Stigma

    Microsoft Academic Search

    Jo C. Phelan; Evelyn J. Bromet; Bruce G. Link

    1998-01-01

    Considerable research has documented the stigmatiza- tion of people with mental illnesses and its negative consequences. Recently it has been shown that stigma may also seriously affect families of psychiatric patients, but little empirical research has addressed this problem. We examine perceptions of and reactions to stigma among 156 parents and spouses of a popula- tion-based sample of first-admissi on

  5. PSYCHIATRIC DISORDERS ASSOCIATED WITH FXTAS

    PubMed Central

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

    2015-01-01

    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. PMID:25620899

  6. Trace elements in psychiatric illness.

    PubMed

    Srinivasan, D P

    1984-08-01

    Trace elements play an active role in various metabolic processes of the body. Current evidence suggests that a disturbance in the concentration of trace elements can produce various psychiatric symptomatology. The precise role of these micronutrients needs further elucidation in view of their potential importance in the field of treatment and prevention. PMID:6536361

  7. [Old and new long stay patients in French psychiatric institutions: results from a national random survey with two-year follow-up].

    PubMed

    Chapireau, F

    2005-01-01

    Long stays are often thought to result from outdated methods of treatment, so that modernization should bring them to an end. The purpose of this work is to find out whether old and new long stay patients are to be found in French psychiatric institutions, as they have been in several other countries, and if so, describe some characters of the patients, in order to give a better understanding of the situation. As early as 1972, Wing and Hailey were able to study old and new long stay patients in the Camberwell register. In 1987, Kastrup published the results from the Danish national cohort; among other conclusions, she was able to show that some patients experienced a long stay when admitted for the first time, while others only did so later during the course of their treatment. In 1994, Lelliott and Wing, published the results of a British national audit of new long stay patients; they reiterated that the closing of psychiatric hospitals should go along with the opening of specialised long stay and rehabilitation facilities. Trieman, Leff, and several other researchers members of the Team for the Assessment of Psychiatric Services (TAPS) published many articles describing the follow-up of patients staying in two large hospitals undergoing closure near London. One of these papers concludes that "difficult to place patients will not disappear with the closure of the psychiatric hospitals..., they continue to arise from the population of patients recently diagnosed". At the end of 1998, a national survey was organised according to the recommendations of the United Nations and of the World Health Organisation by the French National Institute of Statistics and of Economic Studies (INSEE). Its general purpose was to describe disabilities in the French population on a census day. To that end, information was also recorded about schooling, employment, income, lodging, family relations, etc. Persons who were notable to answer by themselves were included; if not, many severe cases would have been excluded. A follow-up survey of the same persons took place 2 years later. Interviews were carried out by trained interviewers of the INSEE. Medical information was recorded from what the patients themselves knew or could say. The survey included a random sample of inpatients in psychiatric institutions. We study here specialised hospitals: this does not include psychiatric wards in general hospitals, nor private hospitals. Compared to what had been planned, the proportion of successful interviews in psychiatric institutions was 75%. The 1180 persons who answered the questionnaire bring information about the estimated 33,600 who were in these psychiatric institutions at the end of 1998. Information about where the persons were by 2000 could be collected about almost all of them. This paper deals with length of stay, sex, age, marital status, age at admission, place of residence before entering hospital and outcome at the end of year 2000 All data relating to age and duration were studied by splitting groups into quartiles. No multivariate analysis was made, since information about diagnosis and disabilities was not included. Among the 33,600 in-patients, six out of ten were men. A quarter were under 32 years of age, half under 43. Two thirds of the patients were bachelors. One patient out of ten had been in hospital for 15 days, and one out of five for 30 days; half had been in hospital for 7 months; the duration of stay was over 1 year for 41%, over 5 years for 23% and over 18 years for 10%. Before being admitted, more than four patients out of ten (44%) lived in an independent home, one out of six (16%) lived with his-her parents more than one out of four (28%) lived in another institution. When they were admitted, one patient out of four was 26 years of age or younger, and one out of two was two was 38 or younger. Men, bachelors, and patients between 43 and 54 years of age had longer lengths of stay than the average. Patients admitted before the age of 26, and in particular those admitted before they were 18, had the longest

  8. Neuroimaging Correlates of Novel Psychiatric Disorders after Pediatric Traumatic Brain Injury

    ERIC Educational Resources Information Center

    Max, Jeffrey E.; Wilde, Elisabeth A.; Bigler, Erin D.; Thompson, Wesley K.; MacLeod, Marianne; Vasquez, Ana C.; Merkley, Tricia L.; Hunter, Jill V.; Chu, Zili D.; Yallampalli, Ragini; Hotz, Gillian; Chapman, Sandra B.; Yang, Tony T.; Levin, Harvey S.

    2012-01-01

    Objective: To study magnetic resonance imaging (MRI) correlates of novel (new-onset) psychiatric disorders (NPD) after traumatic brain injury (TBI) and orthopedic injury (OI). Method: Participants were 7 to 17 years of age at the time of hospitalization for either TBI or OI. The study used a prospective, longitudinal, controlled design with…

  9. Treatment needs and acknowledgement of illness – importance for satisfaction with psychiatric inpatient treatment

    Microsoft Academic Search

    Knut W Soergaard; Mary Nivison; Vidje Hansen; Terje Oeiesvold

    2008-01-01

    BACKGROUND: Patient satisfaction is an important, but controversial part of health service evaluation. This study dealt with how acknowledgement of illness and treatment needs effected the distribution of positive, neutral and negative evaluations in a group of first time admitted patients to a psychiatric hospital. METHOD: The participants filled out a standardized user satisfaction form before discharge. The number of

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

    ERIC Educational Resources Information Center

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

    2010-01-01

    Objective: This retrospective cohort study examined the risk for suicide, psychiatric hospitalization, and violent criminal convictions among offspring of parents who died from suicide, accidents, and other causes. Method: Population-based data from multiple Swedish national registers were linked from 1969 to 2004. Participants were 44,397…

  11. Which Family Factors Predict Children's Externalizing Behaviors Following Discharge from Psychiatric Inpatient Treatment?

    ERIC Educational Resources Information Center

    Blader, Joseph C.

    2006-01-01

    Objective: Parents' behavior management practices, parental stress, and family environment are highly pertinent to children's conduct problems. Preadolescents' psychiatric hospitalization usually arises because of severe conduct problems, so the relationships of family-related variables to postdischarge functioning warrant investigation. This…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of "suicide attempts" among adolescents presenting to an urban general hospital (N = 375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without…

  13. A profile of mentally disordered offenders admitted to inpatient psychiatric services in the United States

    Microsoft Academic Search

    Henry J. Steadman; Marilyn J. Rosenstein; Robin L. MacAskill; Ronald W. Manderscheidt

    1988-01-01

    This research note presents data about mentally disordered offenders (MDOs) treated in inpatient psychiatric services. Data are derived from 1980 admission surveys by the Survey and Reports Branch, National Institute of Mental Health (NIMH). These data report for the first time inpatient services provided to MDOs by non-Federal general and private hospitals. A total of 31,773 MDOs were admitted, with

  14. Development of a Clinical Instrument to Record Sexual Aggression in an Inpatient Psychiatric Setting

    ERIC Educational Resources Information Center

    Jones, Nicole Tuomi; Sheitman, Brian; Hazelrigg, Mark; Carmel, Harold; Williams, Jim; Paesler, Betty

    2007-01-01

    While there are a number of instruments that assess historical factors related to sexual aggression for the purposes of risk assessment, there is a notable absence of measures that assess change in ongoing, sexually aggressive behaviours engaged in by people who reside in psychiatric hospitals. The purpose of this report is to describe the…

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

    Microsoft Academic Search

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

    2004-01-01

    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

  16. Rating Scales for Measuring the Interpersonal Circle in Forensic Psychiatric Patients

    Microsoft Academic Search

    Ronald Blackburn; Stanley J. Renwick

    1996-01-01

    Two studies are reported on nurses' assessments of interpersonal style in hospitalized male forensic psychiatric patients. In Study 1, interpersonal behaviors were rated on a Chart of Interpersonal Reactions in Closed Living Environments (CIRCLE) in a derivation sample (n = 210) and a replication sample (n = 102). Rating items generated a circular arrangement within both samples consistent with recent

  17. Parental Psychiatric Disorders Associated With Autism Spectrum Disorders in the Offspring

    Microsoft Academic Search

    Julie L. Daniels; Ulla Forssen; Christina M. Hultman; Sven Cnattingius; David A. Savitz; Maria Feychting

    2009-01-01

    OBJECTIVE.Autism is a developmental disorder defined by impaired social interaction, communication, and behavior. Causes and correlates of autism are largely unknown, but elevated frequencies of psychiatric disorders and distinct personality traits have been reported among the family members of individuals with autism. Linkage of data from Swedish registries was used to investigate whether hospitalization for psychi- atric conditions was higher

  18. Parental Psychiatric Disorders Associated With Autism Spectrum Disorders in the Offspring

    Microsoft Academic Search

    Julie L. Daniels; Ulla Forssen; Christina M. Hultman; Sven Cnattingius; David A. Savitz; Maria Feychting; P. Sparen

    2008-01-01

    OBJECTIVE.Autism is a developmental disorder defined by impaired social interaction, communication, and behavior. Causes and correlates of autism are largely unknown, but elevated frequencies of psychiatric disorders and distinct personality traits have been reported among the family members of individuals with autism. Linkage of data from Swedish registries was used to investigate whether hospitalization for psychi- atric conditions was higher

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

    ERIC Educational Resources Information Center

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

    2009-01-01

    The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12-19 years of age at hospitalization, repeatedly assessed for up to…

  20. Hospital Waste Management in Nonteaching Hospitals of Lucknow City, India

    PubMed Central

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

    2014-01-01

    Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW) management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices. PMID:25657950

  1. Psychiatric Disorders after Epilepsy Diagnosis: A Population-Based Retrospective Cohort Study

    PubMed Central

    Chang, Hsiu-Ju; Liao, Chien-Chang; Hu, Chaur-Jong; Shen, Winston W.; Chen, Ta-Liang

    2013-01-01

    Background Psychiatric manifestations after occurrence of epilepsy have often been noted. However, the association between newly diagnosed epilepsy and psychiatric disorders afterward is not completely understood. We conducted two longitudinal cohorts for patients with and without epilepsy to investigate the risk factors and hazard ratios of developing psychiatric disorders after patients were newly diagnosed with epilepsy. Methods We identified 938 patients with a new diagnosis of epilepsy and 518,748 participants without epilepsy from the National Health Insurance Research Database in 2000–2002 and tracked them until 2008. We compared the incidence of developing psychiatric disorders between the two cohorts, evaluated risk factors and measured the associated hazard ratios (HRs) and 95% confidence intervals (CIs) of developing psychiatric disorders. Findings The incidences of psychiatric disorders for people with and without epilepsy were 94.1 and 22.6 per 1000 person-years, respectively. After adjusting the covariates, the epilepsy cohort showed the highest risks in mental retardation (HR 31.5, 95% CI 18.9 to 52.4), bipolar disorder (HR 23.5, 95% CI 11.4 to 48.3) and alcohol or drug psychosis (HR 18.8, 95% CI 11.1 to 31.8) among psychiatric complications developed after newly diagnosed epilepsy. The risk increased with epileptic general seizure and frequency of outpatient visits for epilepsy, as well as with emergency room visits and hospitalizations for epilepsy, and with older age. Chronologically, the highest risk occurred in the first year after epilepsy diagnosis (HR 11.4, 95% CI 9.88 to 13.2). Conclusion Various psychiatric disorders were demonstrated after newly diagnosed epilepsy and closely related to general seizure and use of medical services for epilepsy. This shows a need for integrated psychiatric care for patients newly diagnosed with epilepsy, especially in the first year. PMID:23577079

  2. Familial adversities and child psychiatric disorders.

    PubMed

    Blanz, B; Schmidt, M H; Esser, G

    1991-09-01

    The well known association between child and adolescent psychiatric disorders and chronic adversities was proved in a field sample. Children (356) were investigated at the ages of 8 and 13 years. The association between child psychiatric disorders and chronic adverse conditions in the familial environment--measured by the FAI--was analysed with respect to the variables: age, sex, psychiatric diagnoses, and course (stability) of disorder. The FAI proved to be predictive of psychiatric disorder, in particular of early onset disorder, of disorders in boys, and of conduct disorders. According to the results, the common assumption that chronic adversities cause child psychiatric disorders must be viewed cautiously. PMID:1744197

  3. Children With Psychiatric Disorders: The Al Ain Community Psychiatric Survey

    Microsoft Academic Search

    Valsamma Eapen; Mona Essa Jakka; Mohammed T Abou-Saleh

    community, aged 6 to 18 years, in Al Ain, United Arab Emirates (UAE). Results: We obtained a prevalence rate of 22.2% for overall morbidity, as classified in the DSM-1V, and 14.3% for those with significant dysfunction, with the most common diag- nosis being mood disorders. Female sex, large family size, chronic life difficulties, family history of psychiatric disorder, and alcohol-related

  4. [Quality assurance of psychiatric consultations in somatic hospitals].

    PubMed

    Bille, H; Jakhelln, F; Malt, U F; Roaldset, J O; Tveiten, O; Watne, O; Herzog, T; Huyse, F

    1998-11-10

    Research has shown great variety in the clinical practice of consultation-liaison psychiatry in and between different countries. This paper presents the Norwegian experiences from a European collaborative study of quality management in consultation-liaison psychiatry. We describe a dynamic model for total quality management based on regular registration of some clinical data and the subsequent feed-back on changes of these. We discuss our experiences with this model and obstacles met in everyday work. Finally we point to different ways of implementing this method on a broader base in consultation-liaison psychiatry. PMID:9857804

  5. [Death caused by a bolus at a psychiatric hospital].

    PubMed

    Fehlow, P; Tennstedt, A

    1988-06-01

    Among 2000 dead we found a frequency of death by bolus of about 1% in neuropsychiatric patients in the course of 17 years. Severe oligophrenia mostly combined with epilepsy was leading with almost 50% followed by depressive syndrome, schizophrenia and dementia. Organic cerebral lesion, disorders of activity and vigilance, longterm psychopharmacotherapy, alteration of condition by acute internal disease and perhaps disorders of the liver are considered to be risks of death by bolus. PMID:3264920

  6. Post-acute dispositions of older adults hospitalized for depression

    Microsoft Academic Search

    N. L. Morrow-Howell; E. K. Proctor; W. R. Blinne; E. H. Rubin; J. A. Saunders; P. A. Rozario

    2006-01-01

    This study addressed factors associated with six-month post-acute dispositions (continuous community stay, medical hospitalization, psychiatric rehospitalization, nursing home placement, death) for older adults hospitalized for depression and discharged to the community. The sample included 199 older adults; and data were collected via medical records, interviews with discharge planners, patients, and family members. Over half of the sample remained in the

  7. [Ketamine: psychiatric indications and misuses].

    PubMed

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

    2014-01-01

    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

  8. Psychiatric morbidity following Hurricane Andrew.

    PubMed

    David, D; Mellman, T A; Mendoza, L M; Kulick-Bell, R; Ironson, G; Schneiderman, N

    1996-07-01

    The nature of psychiatric morbidity in previously non-ill subjects from the area most affected by Hurricane Andrew was investigated at 6-12 months posthurricane. Preliminary associations of morbidity with personal and event-related risk factors were also determined. Fifty one percent (31/61) met criteria for a new-onset disorder, including posttraumatic stress disorder (PTSD) in 36%, major depression (MD) in 30%, and other anxiety disorders in 20%. Thirty four subjects (56%) had significant symptoms persisting beyond 6 months. Having sustained "severe damage" was the risk factor most strongly associated with outcome. Our data underscore the range of psychiatric morbidity related to a natural disaster, and suggest a relationship to chronic stressors. PMID:8827660

  9. Psychiatric Aspects of Organ Transplantation

    PubMed Central

    Kalra, G.; Desousa, A.

    2011-01-01

    Surgical transplantation of human organs from deceased as well as living donors to sick and dying patients began after the Second World War. Over the past 50 years the transplantation of human organs, tissues and cells has become a worldwide practice which has extended, and greatly enhanced the quality of hundreds of thousands of lives. The field of transplantation medicine provides an important chance for liaison between psychiatric professionals and other transplant physicians and surgeons. The discrepancy between the ever-increasing demand for organs but the decreasing supply makes it important to evaluate and prioritize individuals who are in dire need of the organ. However, this also gives rise to certain ethical questions. The following paper discusses various psychiatric aspects of organ transplantation in general. PMID:25013589

  10. Perinatal psychiatric disorders: an overview.

    PubMed

    Paschetta, Elena; Berrisford, Giles; Coccia, Floriana; Whitmore, Jennifer; Wood, Amanda G; Pretlove, Sam; Ismail, Khaled M K

    2014-06-01

    Perinatal mental illness has a significant implication on maternal health, birth outcomes, and the offspring's development. Prevalence estimates of perinatal psychiatric illnesses range widely, with substantial heterogeneity in different population studies, with a lower prevalence rate in high- rather than low- or middle-income countries. Because of the potential negative impact on maternal and child outcomes and the potential lability of these disorders, the perinatal period is a critical time to identify psychiatric illnesses. Thus, obstetricians and midwives play a crucial role in assessing women's mental health needs and to refer identified women promptly for multidisciplinary specialist assessment. However, there is still limited evidence on best practice assessment and management policies during pregnancy and postpartum. This review focuses on the prevalence of common perinatal mental disorders and antenatal screening policies to identify women at risk. The effect of these conditions and their management on pregnancy, fetal outcomes, and child development are discussed. PMID:24113256

  11. Psychiatric morbidity following Hurricane Andrew

    Microsoft Academic Search

    Daniella David; Thomas A. Mellman; Lourdes M. Mendoza; Renee Kulick-Bell; Gail Ironson; Neil Schneiderman

    1996-01-01

    The nature of psychiatric morbidity in previously non-ill subjects from the area most affected by Hurricane Andrew was investigated at 6–12 months posthurricane. Preliminary associations of morbidity with personal and event-related risk factors were also determined. Fifty one percent (31\\/61) met criteria for a new-onset disorder, including posttraumatic stress disorder (PTSD) in 36%, major depression (MD) in 30%, and other

  12. Genetic counseling for psychiatric disorders

    Microsoft Academic Search

    Debby W. Tsuang; Stephen V. Faraone; Ming T. Tsuang

    2001-01-01

    Like other medical conditions, some psychiatric disorders are inherited, whereas others are not. Human genetics research is\\u000a moving at a rapid pace. Genes for over 450 genetic disorders have been cloned and many disease-causing mutations have also\\u000a been identified. The explosion of this new knowledge has created many new exciting opportunities in the diagnosis of these\\u000a heritable disorders. The rapid

  13. Imaging Genetics and Psychiatric Disorders

    PubMed Central

    Hashimoto, R; Ohi, K; Yamamori, H; Yasuda, Y; Fujimoto, M; Umeda-Yano, S; Watanabe, Y; Fukunaga, M; Takeda, M

    2015-01-01

    Imaging genetics is an integrated research method that uses neuroimaging and genetics to assess the impact of genetic variation on brain function and structure. Imaging genetics is both a tool for the discovery of risk genes for psychiatric disorders and a strategy for characterizing the neural systems affected by risk gene variants to elucidate quantitative and mechanistic aspects of brain function implicated in psychiatric disease. Early studies of imaging genetics included association analyses between brain morphology and single nucleotide polymorphisms whose function is well known, such as catechol-O-methyltransferase (COMT) and brain-derived neurotrophic factor (BDNF). GWAS of psychiatric disorders have identified genes with unknown functions, such as ZNF804A, and imaging genetics has been used to investigate clues of the biological function of these genes. The difficulty in replicating the findings of studies with small sample sizes has motivated the creation of large-scale collaborative consortiums, such as ENIGMA, CHARGE and IMAGEN, to collect thousands of images. In a genome-wide association study, the ENIGMA consortium successfully identified common variants in the genome associated with hippocampal volume at 12q24, and the CHARGE consortium replicated this finding. The new era of imaging genetics has just begun, and the next challenge we face is the discovery of small effect size signals from large data sets obtained from genetics and neuroimaging. New methods and technologies for data reduction with appropriate statistical thresholds, such as polygenic analysis and parallel independent component analysis (ICA), are warranted. Future advances in imaging genetics will aid in the discovery of genes and provide mechanistic insight into psychiatric disorders. PMID:25732148

  14. Tobacco and psychiatric dual disorders.

    PubMed

    Graham, Noni A; Frost-Pineda, Kimberly; Gold, Mark S

    2007-01-01

    Smoking is a leading cause of morbidity and premature mortality in the United States. The relationship between tobacco smoking and several forms of cancer, heart disease, stroke, chronic lung disease, and other medical diseases is well recognized and accepted. Recent epidemiological studies are now focusing on the link between tobacco use and psychiatric diseases. Experts now suggest that in the differential diagnosis of "smoker," depression, alcohol dependence, and schizophrenia are highest on the list. Studies are also focusing on the role of secondhand tobacco exposure, either in utero or during childhood, in the risk of dual disorders. Prenatal exposure may alter gene expression and change the risk for a variety of life-long psychiatric diseases, e.g., ADD/ADHD, antisocial personality disorders, substance use disorders, and major depression. Considerable time and effort have been devoted to studying the link between smoking and depression and also schizophrenia. We will focus on less well-studied areas in tobacco use and psychiatric dual disorders (including eating disorders), prenatal and early childhood secondhand smoke (SHS) exposure, and the relationship to the genesis of these dual disorders. PMID:19283970

  15. Psychiatric nursing: an unpopular choice.

    PubMed

    Jansen, R; Venter I

    2015-03-01

    Research studies in the United States, the United Kingdom, New Zealand and Australia suggest that students do not consider psychiatric nursing as a popular career option. According to this research, there is a widespread concern about the nursing shortages in psychiatry. The demand for mental health services continues to grow and there is a need for strategies to recruit nurses for this specialized field. The purpose of this study was to identify the factors preventing undergraduate nursing students in South Africa (SA) from choosing psychiatric nursing as a career. A qualitative research design that aimed to explore and describe was used. Data were collected through the Nominal Group Technique. A sample of convenience of 27 final year nursing students from the School of Nursing at the University of the Free State as well as the Free State School of Nursing, situated in Bloemfontein (SA), voluntarily participated in this research. The following categories emerged from the content analysis of the data: personal factors, working environment, unprofessional behaviour, learning environment and the unclassified category. Psychiatric nursing as a career choice is in a predicament and nursing schools need to implement practical strategies to recruit future nurses for this field. PMID:25874285

  16. Psychiatric aspects of bariatric surgery

    PubMed Central

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

    2014-01-01

    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

  17. CCPP-Copenhagen Community Psychiatric Project. Implementation of community mental health centres in Copenhagen: effects of service utilization, social integration, quality of life and positive and negative symptoms.

    PubMed

    Nordentoft, M; Knudsen, H C; Jessen-Petersen, B; Krasnik, A; Saelan, H; Treufeldt, P; Wetcher, B

    1996-11-01

    Deinstitutionalization of psychiatry in Denmark has been extensive and the number of psychiatric beds per 1,000 inhabitants is among the lowest in Europe. The effect of supplementing hospital treatment with treatment in community mental health centres was evaluated in a quasi-experimental design. The patient group examined consisted of patients with long-term contact with psychiatric services. When development in intervention and control districts was compared, the only significant difference was that the total patient group in the intervention district had an increased number of day attendances per year. Comparison of patients from intervention districts who attended day-centres regularly with patients from control districts before and after implementation of community mental health centres indicated that patients from intervention districts had a reduction in the use of inpatient services, a significant increase in quality of life and a significant decrease in the presence of the negative symptom, alogia. We concluded that implementation of community mental health centres can increase the quality of life for the patients and decrease the frequency of the negative symptom, alogia. PMID:8952373

  18. [The therapeutic promises of a building. Vijverdal Community Mental Hospital 1969-2004].

    PubMed

    Klijn, Annemieke

    2005-01-01

    In 1972 the psychiatric hospital 'Vijverdal' opened its doors in Maastricht. The building of this Community Mental Hospital was reported to be 'revolutionary'. Inspired by American architectural concepts about the construction of hospitals, Vijverdal arose as a huge complex with a nine storey radial block of flats: a unique building in Dutch psychiatry. The first reactions were very positive. The imposing flat expressed psychiatric optimism and therapeutic promises. However, confronted by the dynamic developments in psychiatry at the end of the seventies, the hospital more and more appeared to be a therapeutic monstrum: the flat became a symbol of alienation and medical detachment. Adapting it to the new ideas about differentiation and de-concentration appeared difficult, however. Only in 2000 Vijverdal started a fundamental renovation. The flat will be torn down in 2006. This changing evaluation of Vijverdal makes us wonder about the biography of this psychiatric hospital. Which intentions and which psychiatric concepts inspired Vijverdal to be built? How functioned the building environment of Vijverdal in practice? Could the hospital be accommodated to the new notions and wishes about psychiatric care? Moreover, in what way did the architecture determine the history of Vijverdal? And eventually, how are new conceptions about psychiatric care translated in the present renovation and reconstruction of Vijverdal? Do therapeutic promises play a role again? The adventures of Vijverdal tell us about the risks of visionary architecture, but also that a building matters: the psychiatric patients appreciate the new houses and the privacy of a room for their own. PMID:17154119

  19. Evidence based practice: decreasing psychiatric revisits to the emergency department.

    PubMed

    Adams, Priscilla; Nielson, Heather

    2012-08-01

    Inpatient psychiatric settings anticipate changes in reimbursement that will link payment rates to objective quality measures. Readmission rates are expected to be one of the quality measures. Inpatient areas are undertaking initiatives to decrease readmission rates in preparation for this change. The emphasis on avoiding readmission could cause an increase in emergency room revisit rates by psychiatric patients. In preparation for this potential impact, the mental health emergency service within the Emergency Department of a not-for-profit community based hospital implemented a proactive process improvement plan. The plan's goal was to insure that all patients' care was provided according to a defined standardize best practice process. Steps of the plan focused on (1) improving treatment providers' communications across the continuum of care, (2) enhancing communication between the mental health emergency department nurses and the on-call psychiatrists, (3) developing on-line decisional support to enhance communication, and (4) providing providers with feedback on the impact of changes. Implementation of the improvement process decreased the mean psychiatric emergency revisit rate from 5.7% to 4.3% and decreased the variability in monthly rates from a range of 1.83%-9.53% to a range of 3.53%-5.56%. PMID:22849781

  20. [Rectal prolapse: etiopathogenetic and therapeutic problems in psychiatric patients].

    PubMed

    D'Eredità, G; Balena, V; Castellano, M; Polizzi, R A

    1994-03-01

    Rectum prolapse is a pathological condition which has long been considered as rare but whose occurrence has been progressively increasing in the past decades. There still exists a degree of uncertainty as to the disease etiopathology: moreover the exact relationship between rectum prolapse and psychic disorders which have been found in up to 50% of the patients with prolapse has not been clarified. Neither on the therapeutic level is there a common opinion as to the ideal surgical approach and over one hundred techniques have been suggested for the surgical correction of the prolapse. A study has been carried out on 10 patients suffering from psychiatric pathology of different kinds (oligophrenia, schizophrenic psychosis), hospitalized at Istituti Ospedalieri Opera Don Uva in Bisceglie. They suffered from complete rectum prolapse and underwent surgical intervention. In this study the etiopathogenetic problems of prolapse are investigated according to recent developments, with particular reference to the very peculiar implications they have in the psychiatric patient. Finally the surgical techniques correctly used and their possible application in the psychiatric patient are examined. PMID:8028728

  1. Posttraumatic intrusive symptoms across psychiatric disorders.

    PubMed

    Bryant, Richard A; O'Donnell, Meaghan L; Creamer, Mark; McFarlane, Alexander C; Silove, Derrick

    2011-06-01

    Reexperiencing symptoms are a key feature of posttraumatic stress disorder (PTSD). This study investigated the pattern of reexperiencing symptoms in non-PTSD posttraumatic disorders. This study recruited 1084 traumatically injured patients during hospital admission and conducted follow-up assessment 12 months later (N = 817, 75%). Twelve months after injury, 22% of patients reported a psychiatric disorder they had never experienced prior to the traumatic injury. One-third of patients with a non-PTSD disorder satisfied the PTSD reexperiencing criteria. Whereas patients with a non-PTSD disorder were more likely to experience intrusive memories, nightmares, psychological distress and physiological reactivity to reminders, only patients with PTSD were likely to experience flashback memories (OR: 11.41, 95% CI: 6.17-21.09). The only other symptom that was distinctive to PTSD was dissociative amnesia (OR: 4.50, 95% CI: 2.09-9.71). Whereas intrusive memories and reactions are common across posttraumatic disorders, flashbacks and dissociative amnesia are distinctive to PTSD. PMID:21159353

  2. Why and how to establish a computerized system for psychiatric case records.

    PubMed

    Modai, I; Rabinowitz, J

    1993-11-01

    Based on experience with successful implementation of an on-line computerized psychiatric case record system in a psychiatric hospital in Israel, the authors discuss the advantages of such systems and outline the process of converting paper records to computerized records. Computerized records can save time by automatically issuing routine reports, improve clinical practice, simplify quality assurance, and ease collection and analysis of data for research. The process of converting paper records to computerized records can begin with analysis of the hospital's reporting requirements and creation and pilot testing of structured paper forms with a multiple-choice format that is eventually incorporated into the computer program. The authors recommend an on-line computerized record system with direct input of data because such a system can be used for case audits and can generate reports, treatment plans, and medication orders without removing records from circulation. Other advantages include the system's usefulness in electronic communication within and outside the hospital. PMID:8288180

  3. Characteristics of people lost to attrition in psychiatric follow-up studies.

    PubMed

    Fischer, E H; Dornelas, E A; Goethe, J W

    2001-01-01

    In a large (N = 1,744) study of previously hospitalized psychiatric patients, multiple follow-up attempts were made to contact the ex-patients over a 1-year period after their discharges. When contacted they were asked to provide information about their posthospital adjustment; 59.5% of the sample was reached at least once and usable data obtained either in a telephone interview or from a mailed survey form. The contacted and noncontacted people represented very different subpopulations, both demographically and in terms of typical psychiatric descriptors. Those who were of lower socioeconomic status, male, unmarried, racial minorities, and those with records of substance abuse or assaultiveness, and who were generally more severely impaired during the baseline hospitalization were underrepresented in the contacted group. Possible reasons for these sample biases, the implications for hospitals conducting outcome assessments (i.e., for research and program evaluation purposes), and strategies for dealing with this kind of methodological problem are discussed. PMID:11206665

  4. Psychiatric patients' religon and MMPI responses.

    PubMed

    Groesch, S J; Davis, W E

    1977-01-01

    The relationship between psychiatric patients' psychological test responses and their religion has been overlooked in the past. MMPI protocols were obtained from samples of 18 Roman Catholic schizophrenic, 18 Protestant drug-dependent male patients. The profiles reflected significant religion related differences in scales L, HY, D; MF, PA and SC. The results suggest that the religion of the psychiatric patient is a potentially important S variable that could influence the psychiatric diagnosis and subsequent treatment. PMID:833295

  5. Homeless and Housed Inpatients with Schizophrenia: Disparities in Service Access upon Discharge from Hospital

    ERIC Educational Resources Information Center

    Burra, Tara A.; Hwang, Stephen W.; Rourke, Sean B.; Stergiopoulos, Vicky

    2012-01-01

    This study examines differences in services available at the time of discharge for homeless and housed psychiatric inpatients. Participants diagnosed with schizophrenia or schizoaffective disorder were recruited from a general hospital psychiatric inpatient unit. Thirty homeless individuals and 21 housed controls (matched for diagnosis, gender,…

  6. Comorbidity of Psychiatric Disorders and Parental Psychiatric Disorders in a Sample of Iranian Children With ADHD

    Microsoft Academic Search

    Ahmad Ghanizadeh; Mohammad Reza Mohammadi; Rozita Moini

    2008-01-01

    Objective: To study the psychiatric comorbidity of a clinical sample of children with ADHD and the psychiatric disorders in their parents. Method: Structured psychiatric interviews assessing lifetime psychiatric disorders by DSM-IV criteria, using the Farsi version of the Schedule for Affective Disorders and Schizophrenia. Results: The mean age of the children was 8.7, mothers, 40.1, and fathers, 34.6 years. Only

  7. Organic brain syndrome. The psychiatric imposter.

    PubMed

    Dubin, W R; Weiss, K J; Zeccardi, J A

    1983-01-01

    Rapid differentiation of organic brain syndrome (OBS) from functional psychiatric illness can be difficult when patients come to an emergency department with predominantly psychiatric symptoms. Using four screening criteria-disorientation, abnormal vital signs, clouded consciousness, and patients older than 40 years with no previous psychiatric history-we detected 38 cases of OBS from 1,140 medically cleared patients. Twelve of these patients were subsequently admitted to a medical unit. Despite the presence of striking behavioral aberration, an increased awareness of the clinical manifestations of OBS will enhance the physician's ability to discriminate OBS from other psychiatric illness. PMID:6848782

  8. Predictors of Time to Discharge in Patients Hospitalized for Behavioral and Psychological Symptoms of Dementia

    PubMed Central

    Kitamura, Tatsuru; Kitamura, Maki; Hino, Shoryoku; Kurata, Koichi

    2013-01-01

    Background/Aims In Japan, more than 50,000 patients with dementia are housed in psychiatric facilities, a trend precipitated by prolonged hospitalizations. This study aimed to determine predictors for the time to discharge in patients hospitalized for behavioral and psychological symptoms of dementia (BPSD). Methods Medical charts of patients admitted to an acute psychogeriatric ward for treatment of BPSD were reviewed. Cox's proportional hazards model was used to evaluate relationships between active behavioral problems and/or demographics at the time of admission, and the time until favorable discharge (FD), defined as discharge to the patient's own home or a care facility. Results For the 402 study patients included in this study, median time to FD was 101 days. In addition to family and residential factors, multivariate analysis identified higher Mini-Mental State Examination scores as independent clinical predictors for a shorter hospital stay, whereas male gender and combative behavior as the primary reason for hospital admission were predictors for a longer hospital stay. Conclusion Clinical characteristics can be predictive of the time to discharge for patients with BPSD. Earlier interventions and enhanced care strategies may be needed for patients with a lower likelihood of FD. PMID:23637701

  9. ‘Often there is a Good Deal to be Done, But Socially Rather Than Medically’: The Psychiatric Social Worker as Social Therapist, 1945–70

    PubMed Central

    LONG, VICKY

    2011-01-01

    Seeking to align psychiatric practice with general medicine following the inauguration of the National Health Service, psychiatric hospitals in post-war Britain deployed new treatments designed to induce somatic change, such as ECT, leucotomy and sedatives. Advocates of these treatments, often grouped together under the term ‘physical therapies’, expressed relief that the social problems encountered by patients could now be interpreted as symptomatic of underlying biological malfunction rather than as a cause of disorder that required treatment. Drawing on the British Journal of Psychiatric Social Work, this article analyses the critique articulated by psychiatric social workers based within hospitals who sought to facilitate the social reintegration of patients following treatment. It explores the development of ‘psychiatric social treatment’, an approach devised by psychiatric social workers to meet the needs of people with enduring mental health problems in hospital and community settings that sought to alleviate distress and improve social functioning by changing an individual’s social environment and interpersonal relationships. ‘Physical’ and ‘social’ models of psychiatric treatment, this article argues, contested not only the aetiology of mental illness but also the nature of care, treatment and cure. PMID:21461311

  10. 28 CFR 549.43 - Involuntary psychiatric treatment and medication.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...2010-07-01 false Involuntary psychiatric treatment and medication. 549.43 Section...Administrative Safeguards for Psychiatric Treatment and Medication § 549.43 Involuntary psychiatric treatment and medication. Title 18...

  11. [Approaches for suicide prevention in Osaka Psychiatric Medical Center: the importance of multi-disciplinary cooperation and partnerships with other organizations].

    PubMed

    Iwata, Kazuhiko

    2012-01-01

    Suicide is a very common problem in psychiatric practice today. Therefore, almost all staff of psychiatric hospitals have encountered the suicide of one or more of their patients. Our hospital, Osaka Psychiatric Medical Center, is a public psychiatric hospital in Japan. We provide treatment and support for patients from the acute to chronic phases of psychiatric disorders, and patients range from children to the elderly. Because we accept many patients with severe mental illness from other hospitals, many of our staff are routinely confronted with patients' violence or suicidal attempts. If a patient commits suicide, the relevant staff immediately have a conference to implement measures for preventing a recurrence. At the same time, information about the incident is conveyed to the medical safety management office and made known to all staff in our hospital. This office was established in 2007. Currently, all information about incidents and accidents in our hospital (e.g., suicide, problems between patients, problems with hospital facilities) is aggregated in the office and distributed to all staff members through the hospital intranet. This system makes it possible for staff to consider countermeasures against similar incidents and accidents, even if not involved in the incident. Additionally, we make an effort to develop cooperative relationships with organizations including the police, public health centers, and the fire department. The social welfare council in Hirakata City, where our hospital is located, provides some services to prevent suicide (e.g., telephone counseling, meetings with bereaved family members). Our hospital cooperates with these services by providing lecturers. The partnerships with these organizations help regarding the mental crises of patients in our hospital and fulfill a role to prevent suicide. Multi-disciplinary cooperation and partnerships with community organizations are not special approaches to suicide prevention, but ordinary approaches in everyday clinical practice. The most important factor is the relationship between staff and organizations relevant to preventing suicide. PMID:23346818

  12. Validation of candidate genes associated with cardiovascular risk factors in psychiatric patients.

    PubMed

    Windemuth, Andreas; de Leon, Jose; Goethe, John W; Schwartz, Harold I; Woolley, Stephen; Susce, Margaret; Kocherla, Mohan; Bogaard, Kali; Holford, Theodore R; Seip, Richard L; Ruaño, Gualberto

    2012-03-30

    The purpose of this study was to identify genetic variants predictive of cardiovascular risk factors in a psychiatric population treated with second generation antipsychotics (SGA). 924 patients undergoing treatment for severe mental illness at four US hospitals were genotyped at 1.2 million single nucleotide polymorphisms. Patients were assessed for fasting serum lipid (low density lipoprotein cholesterol [LDLc], high density lipoprotein cholesterol [HDLc], and triglycerides) and obesity phenotypes (body mass index, BMI). Thirteen candidate genes from previous studies of the same phenotypes in non-psychiatric populations were tested for association. We confirmed 8 of the 13 candidate genes at the 95% confidence level. An increased genetic effect size was observed for triglycerides in the psychiatric population compared to that in the cardiovascular population. PMID:21851846

  13. Psychiatric rehabilitation education for physicians.

    PubMed

    Rudnick, Abraham; Eastwood, Diane

    2013-06-01

    As part of a rapidly spreading reform toward recovery-oriented services, mental health care systems are adopting Psychiatric/Psychosocial Rehabilitation (PSR). Accordingly, PSR education and training programs are now available and accessible. Although psychiatrists and sometimes other physicians (such as family physicians) provide important services to people with serious mental illnesses and may, therefore, need knowledge and skill in PSR, it seems that the medical profession has been slow to participate in PSR education. Based on our experience working in Canada as academic psychiatrists who are also Certified Psychiatric Rehabilitation Practitioners (CPRPs), we offer descriptions of several Canadian initiatives that involve physicians in PSR education. Multiple frameworks guide PSR education for physicians. First, guidance is provided by published PSR principles, such as the importance of self-determination (www.psrrpscanada.ca). Second, guidance is provided by adult education (andragogy) principles, emphasizing the importance of addressing attitudes in addition to knowledge and skills (Knowles, Holton, & Swanson, 2011). Third, guidance in Canada is provided by Canadian Medical Education Directives for Specialists (CanMEDS) principles, which delineate the multiple roles of physicians beyond that of medical expert (Frank, 2005) and have recently been adopted in Australia (Boyce, Spratt, Davies, & McEvoy, 2011). PMID:23750768

  14. Psychiatric assessment of young children.

    PubMed

    Egger, Helen Link

    2009-07-01

    In this article, the author reviews the characteristics of developmentally appropriate criteria for the identification of early childhood mental health symptoms and disorders and the key components of a comprehensive, empirically based, psychiatric assessment of young children and their families. In the first section, the author discusses the infant/early childhood mental health field's perspectives on mental health and mental health problems in infants, toddlers, and preschoolers. The author then provides an overview of the objections to diagnosis of psychiatric disorders in young children and different approaches to the definition of early childhood psychopathology, including descriptive, dimensional, and categorical approaches. In the second section, the author describes the six essential components of a comprehensive mental health assessment of young children: (1) multiple sessions (2) multiple informants (3) a multidisciplinary approach (4) a multicultural perspective (5) multiple modes of assessment, and (6) a multiaxial diagnostic formulation and treatment plan. The author ends with a discussion of the challenges of diagnosing and assessing mental health symptoms and disorders in children younger than 2 years. PMID:19486838

  15. Psychiatric resilience: longitudinal twin study

    PubMed Central

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

    2014-01-01

    Objective There is great variability in response to stressful life events (SLEs), with some individuals demonstrating substantial psychiatric symptoms while others remain largely asymptomatic. The source of this variability is poorly understood. The present study aimed to examine the genetic and environmental underpinning of resilience, defined as the difference between the twins’ total score on a broad measure of internalizing symptoms and their predicted score based on their cumulative exposure to SLEs. Method SLE exposure and internalizing symptoms were assessed at two time points in 7,500 adult twins. Using the residual between actual and predicted internalizing symptom total score, twin modeling was conducted for each wave separately, as well as longitudinally. Quantitative and qualitative sex effects were also tested. Results Resilience was found to have a mild to moderate genetic heritability at each individual wave (~31%). Additionally, qualitative sex effects were found. Incorporating error of measurement into the model increased the estimated heritability for the latent construct of resilience (~50%). Unconfounded by measurement error and occasion specific effects, environmental influences contributed roughly equally to determining the individual level of resilience. Conclusions Genetic factors influence the level of psychiatric resilience, and are largely stable over time. The genes that impact on resilience are not entirely the same in males and females, although the degree of heritability is equal across the sexes. Environmental influences can also have an enduring effect on resilience. The present findings of the genetic and environmental influences on adaptation to SLEs clarify the sources of individual variation to environmental stressors. PMID:24723629

  16. Psychiatric Restraint and Seclusion: Resisting Legislative Solution

    Microsoft Academic Search

    Stacey A. Tovino

    2007-01-01

    The use of restraint and seclusion in the American psychiatric setting has a rich history—rich in medical, ethical, legal, and social controversy. For centuries, mental health care providers used movement restrictions and solitary confinement to manage psychiatric patients. Superintendents of eighteenth and early nineteenth century insane asylums and other institutions of confinement believed that strait-waistcoats, “tranquilizer chairs,” “maniac beds,” chains,

  17. Personal Digital Assistants in Psychiatric Education

    ERIC Educational Resources Information Center

    Luo, John S.; Ton, Hendry

    2006-01-01

    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…

  18. The role of the community psychiatric nurse

    Microsoft Academic Search

    John Keady

    2005-01-01

    As a profession, community psychiatric nurses have a history of working with people with dementia and their families that stretches back to the mid-1950s. While the precise number of community psychiatric nurses working in the dementia field is currently unknown, they are seen as vital members of community mental health teams for older people and are involved in the spectrum

  19. Psychiatric Conditions and the Social Sciences

    Microsoft Academic Search

    Horacio Fabrega

    2005-01-01

    Psychiatric disorders have a distinct shape, come in types and are inherent in Homo sapiens. To a social scientist, disorders exist by stipulation: contingent on a psychiatric frame of reference. Their materiality has meaning only in that framework. What is important is what that material might correspond to in a society’s systems of representation and associated institutions. If one assigns

  20. Psychiatric Residents' Experience Conducting Disability Evaluations

    ERIC Educational Resources Information Center

    Christopher, Paul P.; Boland, Robert J.; Recupero, Patricia R.; Phillips, Katharine A.

    2010-01-01

    Objective: The increasing frequency and societal cost of psychiatric disability underscore the need for accuracy in evaluating patients who seek disability benefits. The authors investigated senior psychiatric residents' experiences performing disability evaluations, their self-assessment of competence for this task, and whether they perceived a…

  1. Psychiatric Mental Health Nurse Practitioner Clinical Courses

    E-print Network

    Cui, Yan

    0 Psychiatric Mental Health Nurse Practitioner Clinical Courses Student Preceptor Guide Revised 1..............................................................................................................................................28 #12;2 TO: Psychiatric Mental Nurse Practitioner (PMH) Students, Preceptors, and Clinical Faculty Concentration Coordinator, Department of Advanced Practice & Doctoral Studies The University of Tennessee Health

  2. 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

  3. 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).

  4. Hospitalization Rates Jump Near 'Fracking' Sites

    MedlinePLUS

    ... news/fullstory_153600.html Hospitalization Rates Jump Near 'Fracking' Sites: Study Researchers suggest exposure to toxins, high ... 15, 2015 (HealthDay News) -- People who live near "fracking" sites may be at increased risk for hospitalization ...

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

    PubMed Central

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

    2014-01-01

    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. PMID:25568475

  6. Psychiatric diagnosis: the indispensability of ambivalence.

    PubMed

    Callard, Felicity

    2014-08-01

    The author analyses how debate over the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has tended to privilege certain conceptions of psychiatric diagnosis over others, as well as to polarise positions regarding psychiatric diagnosis. The article aims to muddy the black and white tenor of many discussions regarding psychiatric diagnosis by moving away from the preoccupation with diagnosis as classification and refocusing attention on diagnosis as a temporally and spatially complex, as well as highly mediated process. The article draws on historical, sociological and first-person perspectives regarding psychiatric diagnosis in order to emphasise the conceptual-and potentially ethical-benefits of ambivalence vis-à-vis the achievements and problems of psychiatric diagnosis. PMID:24515564

  7. [Hiv patients in a psychiatric outpatient clinic].

    PubMed

    Lunter, C H; Sno, H N; van den Boom, F M

    1991-11-16

    The most often reported psychiatric complications among HIV-infected outpatients include: mood and anxiety disorders, and alcohol or nonopiate drug abuse. Medical records of 32 HIV-infected psychiatric outpatients in the Netherlands were studied. The most common DSM-III(-R) diagnoses included: major depression (n = 10) and adjustment disorder with depressive or anxious mood (n = 10). The psychiatric treatment of the HIV-infected outpatients did not differ fundamentally from the treatment of other psychiatric outpatients with similar problems. The increasing number of HIV infected patients in the Netherlands living outside of Amsterdam, would appear to urge more education of psychiatric and other health care professionals concerning specific aspects of HIV infection, homosexuality, prostitution and intravenous drug abuse. PMID:1956445

  8. 42 CFR 405.1208 - Hospital requests expedited QIO review.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...that review. (2) The hospital must supply any pertinent information the QIO requires to conduct...within 2 working days of the hospital's request and receipt of any pertinent information submitted by the hospital. (d) Notice of...

  9. 42 CFR 405.1208 - Hospital requests expedited QIO review.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...that review. (2) The hospital must supply any pertinent information the QIO requires to conduct...within 2 working days of the hospital's request and receipt of any pertinent information submitted by the hospital. (d) Notice of...

  10. 42 CFR 405.1208 - Hospital requests expedited QIO review.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...that review. (2) The hospital must supply any pertinent information the QIO requires to conduct...within 2 working days of the hospital's request and receipt of any pertinent information submitted by the hospital. (d) Notice of...

  11. 42 CFR 405.1208 - Hospital requests expedited QIO review.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...that review. (2) The hospital must supply any pertinent information the QIO requires to conduct...within 2 working days of the hospital's request and receipt of any pertinent information submitted by the hospital. (d) Notice of...

  12. 42 CFR 405.1208 - Hospital requests expedited QIO review.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...that review. (2) The hospital must supply any pertinent information the QIO requires to conduct...within 2 working days of the hospital's request and receipt of any pertinent information submitted by the hospital. (d) Notice of...

  13. Dinosaur Day!

    ERIC Educational Resources Information Center

    Nakamura, Sandra; Baptiste, H. Prentice

    2006-01-01

    In this article, the authors describe how they capitalized on their first-grade students' love of dinosaurs by hosting a fun-filled Dinosaur Day in their classroom. On Dinosaur Day, students rotated through four dinosaur-related learning stations that integrated science content with art, language arts, math, and history in a fun and time-efficient…

  14. Does primary care mental health resourcing affect the use and costs of secondary psychiatric services?

    PubMed

    Sadeniemi, Minna; Pirkola, Sami; Pankakoski, Maiju; Joffe, Grigori; Kontio, Raija; Malin, Maili; Ala-Nikkola, Taina; Wahlbeck, Kristian

    2014-09-01

    Collaborative care models for treatment of depression and anxiety disorders in primary care have been shown to be effective. The aim of this study was to investigate at the municipal level to what extent investment in mental health personnel at primary care health centres in the study area is reflected in the costs and use of secondary psychiatric services. Furthermore, we analysed whether the service provision and use of secondary psychiatric care correlates with the socioeconomic indicators of need. We found significant variation in the amount of mental health personnel provided at the health centres, uncorrelated with the indicators of need nor with the costs of secondary psychiatric care. The amount of mental health nurses at the health centres correlated inversely with the number of secondary psychiatric outpatient visits, whereas its relation to inpatient days and admission was positive. The costs of secondary psychiatric care correlated with level of psychiatric morbidity and socioeconomic indicators of need. The results suggest that when aiming at equal access of care and cost-efficiency, the primary and secondary care should be organized and planned with integrative collaboration. PMID:25162710

  15. Rural hospitals

    PubMed Central

    Radford, Andrea; Slifkin, Rebecca; Schur, Claudia; Cheung, Karen; Baernholdt, Marianne

    2013-01-01

    The 340B Drug Pricing Program has the potential to reduce outpatient pharmaceutical costs for qualifying hospitals—hut many rural hospital administrators are unaware of their organization’s eligibility. PMID:18637547

  16. Understanding the milieu experiences of patients on an acute inpatient psychiatric unit.

    PubMed

    Thibeault, Catherine A; Trudeau, Kenneth; d'Entremont, Marguerite; Brown, Teresa

    2010-08-01

    The role of inpatient mental health units is changing. Increasingly, people with acute and severe mental illness are admitted for short periods of intense treatment and are discharged quickly to community-based care. Reduction in average lengths of stay for psychiatric inpatients has been accompanied by a marginalization of the concept of therapeutic milieu in the mental health discourse. This phenomenological inquiry focuses on understanding the life-world of six people with acute psychiatric illness who were hospitalized on an acute inpatient psychiatric unit. Working together, a team of four, including mental health clinicians and consumers, developed and implemented this interpretive study using the phenomenology of Heidegger and Taylor. The principle investigator conducted the interviews, and the research team engaged in a complex interpretive process, reviewing narrative accounts, exploring personal meanings and key themes, and reconstructing shared meaning as lived and shared by participants. In this report, the authors describe patient experiences of a rule-bound, controlling, and sometimes oppressive milieu while highlighting patient experiences of healing and health as lived within that same milieu. The authors describe patients' embodied, dialectical, and often paradoxical experiences of fear and affirmation, alienation and connection, and abandonment and healing. The authors share selected narrative accounts to generate new understanding of patient experiences and suggest that the inpatient psychiatric milieu remains an important but often neglected component of psychiatric treatment. PMID:20650367

  17. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...requirements for psychiatric residential treatment facilities. 483.354 Section 483...or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric...requirements for psychiatric residential treatment facilities. A psychiatric...

  18. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...requirements for psychiatric residential treatment facilities. 483.354 Section 483...or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric...requirements for psychiatric residential treatment facilities. A psychiatric...

  19. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...requirements for psychiatric residential treatment facilities. 483.354 Section 483...or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric...requirements for psychiatric residential treatment facilities. A psychiatric...

  20. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...requirements for psychiatric residential treatment facilities. 483.354 Section 483...or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric...requirements for psychiatric residential treatment facilities. A psychiatric...

  1. New Methods of Psychiatric Treatment

    PubMed Central

    Flinn, Don E.

    1971-01-01

    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

  2. The Checkered History of American Psychiatric Epidemiology

    PubMed Central

    Horwitz, Allan V; Grob, Gerald N

    2011-01-01

    Context American psychiatry has been fascinated with statistics ever since the specialty was created in the early nineteenth century. Initially, psychiatrists hoped that statistics would reveal the benefits of institutional care. Nevertheless, their fascination with statistics was far removed from the growing importance of epidemiology generally. The impetus to create an epidemiology of mental disorders came from the emerging social sciences, whose members were concerned with developing a scientific understanding of individual and social behavior and applying it to a series of pressing social problems. Beginning in the 1920s, the interest of psychiatric epidemiologists shifted to the ways that social environments contributed to the development of mental disorders. This emphasis dramatically changed after 1980 when the policy focus of psychiatric epidemiology became the early identification and prevention of mental illness in individuals. Methods This article reviews the major developments in psychiatric epidemiology over the past century and a half. Findings The lack of an adequate classification system for mental illness has precluded the field of psychiatric epidemiology from providing causal understandings that could contribute to more adequate policies to remediate psychiatric disorders. Because of this gap, the policy influence of psychiatric epidemiology has stemmed more from institutional and ideological concerns than from knowledge about the causes of mental disorders. Conclusion Most of the problems that have bedeviled psychiatric epidemiology since its inception remain unresolved. In particular, until epidemiologists develop adequate methods to measure mental illnesses in community populations, the policy contributions of this field will not be fully realized. PMID:22188350

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

    PubMed

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

    2014-09-01

    Although aggression is part of daily life in psychiatric units for adolescents, empirical data on its prevalence are sparse. Only few studies have described prevalence of aggressive incidents in adolescent psychiatric wards, and data in forensic psychiatric care are even more limited. Available studies reported high prevalence rates of aggression, ranging from 0.4 to 2.4 incidents of aggression per day across (forensic) child and adolescent psychiatric units. Between 27 and 78 % of all admitted youth committed an aggressive act. In this study, we collected systematically registered data of all aggressive incidents from the first 2 years (2010-2012) on a newly established forensic adolescent psychiatric unit, which used a formal aggression management program embedded in the social competence model, which is based on early intervention in the 'chain of behavior' to prevent any further escalation. The inclusion of also minor aggressive incidents is unique in the literature and the clinical relevance is highlighted. A mean of one incident a day took place, with each adolescent involved in at least one incident. Notably, 1.7 aggressive incidents per month made seclusion of restraint use necessary. Based on the social competence theory, the aggression management model suggests intervening early in the cascade of aggression, in order to prevent further escalation and reduce the need for intrusive interventions. Evidence supported that aggression is a contextual event, as external factors clearly influence the incidence of aggression. Aggression management should be built on both relational and structural security. PMID:24682593

  4. Psychiatric education and training in Asia.

    PubMed

    Singh, Bruce; Ng, Chee H

    2008-10-01

    Psychiatric education and training, whilst playing a pivotal role in addressing the burden of mental illness in Asia, is very variable in quality and quantity across the continent. In this article formal postgraduate programmes in Indonesia, Thailand, Philippines, Singapore and India are described. The special situation in China where both basic and advanced psychiatric training receives particular attention, including the role of Asia Australia Mental Health in assisting the process, similarly the long hard road of re-establishing psychiatric training in Cambodia following the tragedy of the Pol Pot era are described. The article concludes with an overview of common issues involving education and training across the region. PMID:19012125

  5. Caffeine-induced psychiatric manifestations: a review.

    PubMed

    Wang, Hee Ryung; Woo, Young Sup; Bahk, Won-Myong

    2015-07-01

    The association between caffeine consumption and various psychiatric manifestations has long been observed. We present two cases that show the ability of caffeine to induce psychotic and manic symptoms, and we also review the extant literature on caffeine-induced psychiatric manifestations. On the basis of our own and others' findings, we suggest that caffeine may be related to not only de-novo psychotic or mood symptoms but also to aggravation of pre-existing psychotic or mood disorders. We therefore suggest that caffeine consumption among patients with mood or psychotic symptoms should be assessed carefully in clinical practice as part of routine psychiatric evaluations. PMID:25856116

  6. PSYCHIATRIC MORBIDITY IN A CHILDREN'S HOME1

    PubMed Central

    Chaturvedi, P. K.; Agarwal, A. K; Gupta, S. C.

    1980-01-01

    SUMMARY Sixty-two inmates of a children's home were examined by using a symptom check list and Hindi adaptation of Stanford Binet Intelligence Scale—Form LM (1960). A high proportion (69.4%) of the inmates had one or other psychiatric problem. Mild mental retardation (I. Q. 50—70) was most common (40.3%), 11.3% were diagnosed as having unsocialized disturbance of conduct. Four most common psychiatric symptoms were stealing, quarrelsome behaviour, destructive behaviour and bed wetting. No significant correlation was found between psychiatric illnesses and present age, duration of stay and age at entry into the home. PMID:22058478

  7. Post-Discharge Services and Psychiatric Rehospitalization Among Children and Youth

    Microsoft Academic Search

    Sigrid JamesSherma; Sherma J. Charlemagne; Amanda B. Gilman; Qais Alemi; Rhoda L. Smith; Priya R. Tharayil; Kimberly Freeman

    2010-01-01

    This study examined risk and determinants of rehospitalization of children and adolescents (n = 186) following a first psychiatric hospitalization. It specifically examined the role of post-discharge services. Data\\u000a were collected for a 30-month follow-up period through structured telephone interviews with caregivers and case record abstractions.\\u000a 43% of youth experienced readmissions during the follow-up period. Risk of rehospitalization was highest during the

  8. Teaching and Training in the Psychiatric-Psychosomatic Consultation-Liaison Setting

    Microsoft Academic Search

    M. Rigatelli; S. Ferrari; U. Uguzzoni; A. Natali

    2000-01-01

    Background: The consultation-liaison (C-L) psychiatrist is in an opportune position to undertake the tasks of education, training and assessment of performance as regards future physicians, psychiatrists, specialists in other branches and nurses. This paper describes the education and training programme in the Psychiatric-Psychosomatic C-L Service of Modena University Hospital. Description of the Programme: This programme consists of the following main

  9. Adult Attachment Orientations, Depressive Symptoms, Anger, and Self-Directed Aggression by Psychiatric Patients

    Microsoft Academic Search

    Barbara Gormley; Dale E. McNiel

    2010-01-01

    This study applied adult attachment theory to better understand self-directed aggression, defined as suicide attempts and\\u000a nonsuicidal self-injury, reported by 109 hospitalized psychiatric patients. As expected, patients with higher levels of adult\\u000a attachment anxiety were more likely to report suicide attempts and self-injury. We tested depressive symptoms and anger as\\u000a mediators of the relationship between attachment orientations and self-directed aggression.

  10. The Behavior Objective Checklist: Reliability and Validity with Child Psychiatric Patients.

    ERIC Educational Resources Information Center

    Moore, Steven R.

    1985-01-01

    The Behavior Objective Checklist, (BOC) a measure to determine social/emotional/behavioral goals and objectives on the Individualized Education Program, was administered to 27 psychiatric day or inpatient children (preschool-grade six). Analysis suggested adequate reliability and validity for the BOC. (CL)

  11. Training in Psychiatric Genomics during Residency: A New Challenge

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

  12. Concurrent Medical and Psychiatric Disorders among Schizophrenic and Neurotic Outpatients.

    ERIC Educational Resources Information Center

    Lima, Bruno R.; Pai, Shaila

    Although the occurrence of medical illnesses in psychiatric patients is quite high, medical illnesses manifested by psychiatric symptoms are often overlooked. The higher mortality rates among psychiatric patients when compared to the general population may be a reflection of neglect or inadequate treatment of the psychiatric patients' medical…

  13. [The revised system of hospitalization for medical care and protection].

    PubMed

    Fukuo, Yasuhisa

    2014-01-01

    The Act to Partially Amend the Act on Mental Health and Welfare for the Mentally Disabled was passed on June 13, 2013. Major amendments regarding hospitalization for medical care and protection include the points listed below. The guardianship system will be abolished. Consent by a guardian will no longer be required in the case of hospitalization for medical care and protection. In the case of hospitalization for medical care and protection, the administrators of the psychiatric hospital are required to obtain the consent of one of the following persons: spouse, person with parental authority, person responsible for support, legal custodian, or curator. If no qualified person is available, consent must be obtained from the mayor, etc. of the municipality. The following three obligations are imposed on psychiatric hospital administrators. (1) Assignment of a person, such as a psychiatric social worker, to provide guidance and counseling to patients hospitalized for medical care and protection regarding their postdischarge living environment. (2) Collaboration with community support entities that consult with and provide information as necessary to the person hospitalized, their spouse, a person with parental authority, a person responsible for support, or their legal custodian or curator. (3) Organizational improvements to promote hospital discharge. With regard to requests for discharge, the revised law stipulates that, in addition to the person hospitalized with a mental disorder, others who may file a request for discharge with the psychiatric review board include: the person's spouse, a person with parental authority, a person responsible for support, or their legal custodian or curator. If none of the above persons are available, or if none of them are able to express their wishes, the mayor, etc. of the municipality having jurisdiction over the place of residence of the person hospitalized may request a discharge. In order to promote transition to life in the community by persons with mental disorders, efforts will be made to enhance psychiatric care for them, with guidelines to be developed to ensure the provision of medical care to persons with mental disorders. The revised law clarifies that members of psychiatric review boards shall be "persons with expert knowledge and experience pertaining to the health and/or welfare of persons with mental disorders." Provision is made for a review of conditions related to implementation of the revised law approximately three years after it takes effect, with measures to be taken as necessary based on results of the review. The main focus of this presentation will be the revisions to the system of hospitalization for medical care and protection, and the deletion of provisions relating to the system of guardianship. PMID:24864562

  14. Community psychiatric care for homeless people in inner London.

    PubMed

    Hamid, W A; McCarthy, M

    1989-08-01

    Data about 'homeless' and 'home-based' clients referred to and recorded by community psychiatric nurses (CPNs) in Bloomsbury, an inner London health district, in 1985 and 1986 were reviewed. Of the 974 people seen, 642 were home-based and 322, homeless at time of referral. The homeless were more commonly under 65-years-of-age, living alone and unemployed. Two thirds of both groups had a psychiatric history, with half also having been admitted to a mental hospital. CPNs identified mental health problems in both groups with equal frequency, but homeless people were more likely to express their main problem as related to housing, finance or unemployment. Four out of five home-based clients were referred by statutory services compared with only two out of five homeless clients. The latter were less likely to receive supportive care from the CPN service and were more often referred to other agencies; these differences remained after controlling for the presenting problems. One in three people referred to this service were homeless. The social aspects of their problems, and their lack of contact with statutory services, suggest that homeless people need a multi-disciplinary approach for mental health care. PMID:10295815

  15. Adverse childhood experiences and suicidal behavior of adolescent psychiatric inpatients.

    PubMed

    Isohookana, Reetta; Riala, Kaisa; Hakko, Helinä; Räsänen, Pirkko

    2013-01-01

    The present study examines the association of adverse childhood experiences (ACEs) to suicidal behavior and mortality in 508 Finnish adolescents (aged 12-17 years) who required acute psychiatric hospitalization between April 2001 and March 2006. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) and the European Addiction Severity Index (EuropASI) were used to obtain information about ACEs, adolescents' suicidal behavior and psychiatric diagnoses. The cases of death were obtained from Statistics Finland. The results of our study indicated that, among girls, exposure to sexual abuse statistically significantly increased the risk of non-suicidal self-injury (NSSI) (OR, 1.8; 95 % CI, 1.0-3.2) and suicide attempts (OR, 2.3; 95 % CI, 1.0-4.5). The cumulative number of ACEs was also associated with an increased risk of NSSI (OR, 1.2; 95 % CI, 1.0- 1.4) and suicide attempts (OR, 1.2; 95 % CI, 1.0-1.4) in girls. Among all deceased adolescents, ACEs were most notable among those who had died due to accidents and injuries. Gender differences in the types of ACEs were noted and discussed. PMID:22842795

  16. Brief Guidelines for Documentation of Psychiatric Disorders

    E-print Network

    Brief Guidelines for Documentation of Psychiatric Disorders Harvard University Division your clinician in preparing documentation of your disability in order to help determine the appropriate accommodation. Please forward documentation that meets these guidelines to the Disability Services Coordinator

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

    PubMed

    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

    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

  18. Psychiatric management of the hepatitis C patient

    Microsoft Academic Search

    Muhamad Aly Rifai; David Indest; Jennifer Loftis; Peter Hauser

    2006-01-01

    Opinion statement  Patients with hepatitis C virus (HCV) infection have a higher prevalence of psychiatric illness compared with the general\\u000a US population, and the prevalence of HCV infection in patients with severe mental illness ranges between 8% and 19%, which\\u000a is four to nine times that of the general US population (1.8%). Given the association between HCV infection and psychiatric\\u000a illness,

  19. Couple relationship in hysterical patients staying in a psychiatric ward.

    PubMed

    Maci, C; Vella, G

    1992-01-01

    The study starts from the observation about the high frequency of hysteric patient that spontaneously ask the psychiatric admission often with a consent of the husband. The hospitalization has revealed important clinical information, gained by the use of integrated story. In fact extending the observation about the familiar context of the hysteric patient, and in particular to the interaction with the partner, have showed some redundance: 1) patient were especially household; 2) with a lower education level; 3) were married with sons in the age of independency; 4) live important life events; 5) the husbands were often involved with the families of origin; 6) the symptomatology presented; 7) the beginning of the symptomatology often happen after the marriage and the birth of the first son; 8) the husbands of these patients present mostly an obsessive personality with hypochondriac manner; 9) the patient often manifest several dissatisfied request. PMID:1476358

  20. Psychological and psychiatric investigations of HIV infection in Singapore.

    PubMed

    Ang, A L; Long, F Y; Chan, R K; Peh, L H; Oh, T G

    1990-06-01

    A psychosocial study was carried out on 10 out of the 18 HIV positive persons who were under surveillance and receiving counselling at either Middle Road Hospital or the Communicable Disease Centre in February 1988. The results of the psychological testing and psychiatric findings are presented. All 10 were male: 9 of them were homosexual and 1 heterosexual. Only one had significant depressive symptoms at the time of study. All had fears about their infection being found out by others and of the stigma that this might bring to their families. Psychometric tests on memory function did not show any signs of visuo-verbal memory impairment but did reveal a possible indication of audio-verbal memory dysfunction. PMID:2392695

  1. 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.

  2. Inspire Day

    ERIC Educational Resources Information Center

    Bohach, Barbara M.; Meade, Birgitta

    2014-01-01

    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…

  3. Dinosaur Day!

    NSDL National Science Digital Library

    H. Prentice Baptiste

    2006-01-01

    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.

  4. Election Day

    NSDL National Science Digital Library

    University of Washington

    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.

  5. Predictors of psychiatric disorders in combat veterans

    PubMed Central

    2013-01-01

    Background Most previous research that has examined mental health among Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combatants has relied on self-report measures to assess mental health outcomes; few studies have examined predictors of actual mental health diagnoses. The objective of this longitudinal investigation was to identify predictors of psychiatric disorders among Marines who deployed to combat in Iraq and Afghanistan. Methods The study sample consisted of 1113 Marines who had deployed to Iraq or Afghanistan. Demographic and psychosocial predictor variables from a survey that all Marines in the sample had completed were studied in relation to subsequent psychiatric diagnoses. Univariate and multivariate logistic regression were used to determine the influence of the predictors on the occurrence of psychiatric disorders. Results In a sample of Marines with no previous psychiatric disorder diagnoses, 18% were diagnosed with a new-onset psychiatric disorder. Adjusting for other variables, the strongest predictors of overall psychiatric disorders were female gender, mild traumatic brain injury symptoms, and satisfaction with leadership. Service members who expressed greater satisfaction with leadership were about half as likely to develop a mental disorder as those who were not satisfied. Unique predictors of specific types of mental disorders were also identified. Conclusions Overall, the study’s most relevant result was that two potentially modifiable factors, low satisfaction with leadership and low organizational commitment, predicted mental disorder diagnoses in a military sample. Additional research should aim to clarify the nature and impact of these factors on combatant mental health. PMID:23651663

  6. [Topical questions of psychiatric ethics].

    PubMed

    Kovács, József

    2015-01-01

    The article analyzes some ethical problems in psychiatry that have been emerging in recent years. It deals with the ongoing intensive debates about the DSM-5 before its publication, and with some of the criticisms of the DSM-5 itself. Then it goes on to analyze the use of placebo. This is followed by the ethical problems of the treatment of ADHD with stimulant drugs, among which one is the question of authenticity, namely whether the pre-treatment or the post-treatment personality is the real, authentic self of the patient. This question has been raised not only in the case of the ADHD, but also in relation with the antidepressant treatment of depression earlier, and in relation with deep brain stimulation and dopamine replacement therapy now, all of which causes changes in the treated patient's personality and motivations. Finally the article describes some ethical problems of informed consent in the case of antidepressant medication, together with the necessity to involve psychiatric nurses and rating scales in the assessment of the patient's decision making capacity. PMID:25867886

  7. Add grace to psychiatric practice

    PubMed Central

    Patkar, Shobha V.

    2013-01-01

    Background: The uniqueness of mindset of an individual makes psychiatric practice interesting, sensitive, and at times subjective. The practice in setup of an organization makes the situation more complex in view of administrative regulations, existing work culture, and issues like confidentiality, etc., Dilemmas are often faced while balancing loyalty between an organization and the patients, values of the therapist and the patient, and different dimension of justice coming from different cultural backgrounds of the patients and the treating doctors. A lot of mental work needs to be put in by the practitioner to consistently adhere to medical ethics and professional approach for taking key decisions despite of contradictory external forces from within and without. Aims: I thought of sharing my experiences especially in setup of an organization with my colleagues so that the decision-taking process becomes somewhat easy and balancing for them. Settings and Design: I have to try to interpret my clinical experiences gathered while working with my patients from the Department of Atomic Energy as well as from my private practice. Conclusion: The need of psycho education to self and others from time to time never ceases simply to make the practice more objective, justified, and graceful. PMID:23825861

  8. Psychiatric Medication Use Among Manhattan Residents Following the World Trade Center Disaster

    Microsoft Academic Search

    Joseph A. Boscarino; Sandro Galea; Jennifer Ahern; Heidi Resnick; David Vlahov

    2003-01-01

    To assess medication use in New York after the September 11th attacks, a telephone survey was conducted in October 2001 (N = 1,008). The prevalence of psychiatric medication use 30 days before the disaster was 8.9 and 11.6% 30 days after, a small but significant increase. The most important factor predicting postdisaster use was predisaster use—92% of those who used

  9. Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis

    PubMed Central

    Iozzino, Laura; Ferrari, Clarissa; Large, Matthew; Nielssen, Olav; de Girolamo, Giovanni

    2015-01-01

    Background Violence in acute psychiatric wards affects the safety of other patients and the effectiveness of treatment. However, there is a wide variation in reported rates of violence in acute psychiatric wards. Objectives To use meta-analysis to estimate the pooled rate of violence in published studies, and examine the characteristics of the participants, and aspects of the studies themselves that might explain the variation in the reported rates of violence (moderators). Method Systematic meta-analysis of studies published between January 1995 and December 2014, which reported rates of violence in acute psychiatric wards of general or psychiatric hospitals in high-income countries. Results Of the 23,972 inpatients described in 35 studies, the pooled proportion of patients who committed at least one act of violence was 17% (95% confidence interval (CI) 14–20%). Studies with higher proportions of male patients, involuntary patients, patients with schizophrenia and patients with alcohol use disorder reported higher rates of inpatient violence. Conclusion The findings of this study suggest that almost 1 in 5 patients admitted to acute psychiatric units may commit an act of violence. Factors associated with levels of violence in psychiatric units are similar to factors that are associated with violence among individual patients (male gender, diagnosis of schizophrenia, substance use and lifetime history of violence). PMID:26061796

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

    PubMed Central

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

    2013-01-01

    Objective To address nationally recognized needs for increased numbers of psychiatric clinician-scholars and physician-scientists, the American Association of Directors of Psychiatric Residency Training (AADPRT) has provided a series of full-day conferences of psychiatry residency training directors designed to increase their competence in evidence-based medicine, enhance their research literacy, and aid them in transmitting that knowledge to their programs. Method These conferences take place on the day before AADPRT's annual meeting. Each year's pre-meeting conference includes a series of morning plenary sessions covering new information pertaining to a contemporary clinical theme. Results The clinical theme serves as a vehicle to teach evidence-based practice and research and neuroscience literacy. The theme is carried into the afternoon with a series of highly interactive small-group teaching sessions designed to consolidate knowledge and provide pragmatic teaching tools appropriate for residents. A detailed report of the first 5 years documented the excellent attendance, perceived satisfaction, and usefulness of the material. Conclusion This report highlights the evolution of the program from the first 5 years to Years 6 and 7, details how new pedagogic and funding challenges have been approached, discusses the strengths and weaknesses of the revised format, and describes plans for the future. PMID:23475234

  11. Tourette Syndrome: A Training Day for Teachers.

    ERIC Educational Resources Information Center

    Chowdhury, Uttom; Christie, Deborah

    2002-01-01

    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)

  12. IIT CRD Handbook Psychiatric Documentation Guidelines Page 1 of 1 Psychiatric Disabilities Documentation Guidelines

    E-print Network

    Heller, Barbara

    IIT CRD Handbook ­Psychiatric Documentation Guidelines Page 1 of 1 Psychiatric Disabilities Documentation Guidelines The following guidelines describe the necessary components of acceptable documentation to provide their clinicians with a copy of these guidelines. Documentation must include all of the following

  13. Effects of psychiatric history on cognitive performance in old-age depression

    PubMed Central

    Pantzar, Alexandra; Atti, Anna Rita; Bäckman, Lars; Laukka, Erika J.

    2015-01-01

    Cognitive deficits in old-age depression vary as a function of multiple factors; one rarely examined factor is long-term psychiatric history. We investigated effects of psychiatric history on cognitive performance in old-age depression and in remitted persons. In the population-based Swedish National Study on Aging and Care in Kungsholmen study, older persons (?60 years) without dementia were tested with a cognitive battery and matched to the Swedish National Inpatient Register (starting 1969). Participants were grouped according to current depression status and psychiatric history and compared to healthy controls (n = 96). Group differences were observed for processing speed, attention, executive functions, and verbal fluency. Persons with depression and psychiatric inpatient history (n = 20) and late-onset depression (n = 49) performed at the lowest levels, whereas cognitive performance in persons with self-reported recurrent unipolar depression (n = 52) was intermediate. Remitted persons with inpatient history of unipolar depression (n = 38) exhibited no cognitive deficits. Heart disease burden, physical inactivity, and cumulative inpatient days modulated the observed group differences in cognitive performance. Among currently depressed persons, those with inpatient history, and late onset performed at the lowest levels. Importantly, remitted persons showed no cognitive deficits, possibly reflecting the extended time since the last admission (m = 15.6 years). Thus, the present data suggest that cognitive deficits in unipolar depression may be more state- than trait-related. Information on profiles of cognitive performance, psychiatric history, and health behaviors may be useful in tailoring individualized treatment. PMID:26175699

  14. Engram formation in psychiatric disorders

    PubMed Central

    Gebicke-Haerter, Peter J.

    2014-01-01

    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

  15. Tobacco use treatment in primary care patients with psychiatric illness

    PubMed Central

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

    2014-01-01

    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

  16. Investigation of Borderline Personality Disorder among Nonpsychotic, Involuntarily Hospitalized Clients.

    ERIC Educational Resources Information Center

    Sansone, Randy A.; Gage, Mark D.; Wiederman, Michael W.

    1998-01-01

    Clients (N=32) who were involuntarily hospitalized in a psychiatric facility were assessed for borderline personality disorder (BPD) using an interview and two self-report questionnaires. The majority (53.1%) met criteria for BPD on all three measures, 18.8% on two measures, and 18.8% on only one measure. Implications of these findings are…

  17. TwelveMonth Outcome After a First Hospitalization for Affective Psychosis

    Microsoft Academic Search

    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

    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

  18. Are prenatal, obstetric, and infant complications associated with postpartum psychosis among women with pre-conception psychiatric hospitalisations?

    PubMed Central

    Hellerstedt, WL; Phelan, SM; Cnattingius, S; Hultman, CM; Harlow, BL

    2014-01-01

    Objective To examine the associations of maternal and infant complications with postpartum hospitalisation for psychosis in women with a pre-conception history of psychiatric hospitalisation. Design Population-based study. Setting Swedish medical birth register. Population Primiparous women who gave birth between 1 January 1987 and 31 December 2001, and who had a pre-conception history of psychiatric hospitalisation but who were not hospitalised during pregnancy (n = 1842). Methods International Classification of Diseases (ICD) codes were used to identify prenatal, obstetric, postpartum maternal complications, and newborn health conditions. We used multivariable logistic regression to describe the associations between maternal and infant health conditions and the odds for postpartum hospitalisation for psychosis. Main outcome measure Psychiatric hospitalisation within 90 days of delivery. Results Compared with women who did not have a postpartum psychiatric hospitalisation, hospitalised women were at 2.3 times higher odds (95% CI 1.0–4.9) of having non-psychiatric puerperium complications (e.g. infection, lactation problems or venous complications). No other maternal complications were associated with postpartum psychiatric hospitalisation. Although their infants were at no higher odds for health complications, the offspring of women who had a postpartum psychiatric hospitalisation were at 4.1 times higher odds (95% CI 1.3–12.6) of death within the first 365 days of life than those of women who were not hospitalised. Conclusions We found no prenatal indicators of postpartum risk for psychiatric hospitalisation among high-risk women, but they had higher odds of postpartum pregnancy-related medical problems and, rarely, offspring death. PMID:23194279

  19. Mental Disorders among Children and Adolescents Admitted to a French Psychiatric Emergency Service

    PubMed Central

    Boyer, Laurent; Henry, Jean-Marc; Samuelian, Jean-Claude; Belzeaux, Raoul; Auquier, Pascal; Lancon, Christophe; Da Fonseca, David

    2013-01-01

    The aim of this study was to describe the characteristics of children and adolescents admitted to the psychiatric emergency department (ED) of a French public teaching hospital over a six-year study period (2001–2006). Data for all episodes of care in the psychiatric ED from January 1, 2001, to December 31, 2006, delivered to adolescents aged less than 18 years were retrospectively analyzed. During the six-year study period, 335 episodes of care in the psychiatric ED were experienced by 264 different adolescents. They accounted for 2.0% of the 16,754 care episodes of the ED; 164 patients (62.1) were female and the average age was 16.5 (SD = 1.6). The neurotic, stress-related, and somatoform disorders were the most frequent (25.4%) and concerned mainly anxiety disorders (15.2%). The frequency of the absence of psychiatric diagnosis (22.7%) was high. A total of 48 children and adolescents (18.2%) benefited from more than one episode of care. Several factors were associated to a higher number of visits to the ED: substance use, schizophrenia, disorders of adult personality and behaviour, disorders occurring in childhood and adolescence, and dual diagnosis. In conclusion, mental health disorders in children and adolescents are a serious problem associated with several potentially modifiable factors. PMID:23431454

  20. Prevalence of dissociative disorders among psychiatric inpatients in a German university clinic.

    PubMed

    Gast, U; Rodewald, F; Nickel, V; Emrich, H M

    2001-04-01

    The aim of the study was to determine the frequency of dissociative disorders among psychiatric inpatients in Germany and to investigate the relationship between childhood trauma and dissociation. The German version of the Dissociative Experiences Scale (DES), the Fragebogen für Dissoziative Symptome (FDS), was used to screen 115 consecutive inpatients admitted to the psychiatric clinic of a university hospital. Patients with FDS scores higher than 20 were interviewed by a trained clinician, using the German translation of the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D-R). The German version of the Childhood Trauma Questionnaire (CTQ) was administered to investigate prevalence of childhood trauma and relations between childhood trauma and dissociation in adult life. Twenty-five of the 115 patients (21.7%) had a score higher than 20 on the FDS. Of these, 15 patients were interviewed with the SCID-D-R. One patient was diagnosed with a dissociative identity disorder, three with dissociative disorders not otherwise specified, and one patient with depersonalization disorder. All diagnoses were confirmed clinically. A significant positive relationship was found between the severity of childhood trauma and dissociation. Dissociative disorders are common among German psychiatric inpatients. Clinicians who work in psychiatric inpatient units should be mindful of these disorders. PMID:11339321

  1. Frequency of ICD-10 psychiatric diagnosis in children with intellectual disability in Lahore, Pakistan & Caregivers Perspective

    PubMed Central

    Imran, Nazish; Azeem, Muhammad Waqar; Sattar, Ahsan; Bhatti, Mohammad Riaz

    2015-01-01

    Objective: Association between Intellectual disability (ID) and psychiatric disorders in children & adolescents is well established but there is a paucity of published studies from Pakistan on this topic. The main aim of the study was to assess the frequency of ICD-10 psychiatric diagnosis in the hospital outpatient sample of children with ID in Lahore, Pakistan as well as to find out which challenging behaviors, caregivers find difficult to manage in this setup. Methods: Socio-demographic information was collected, Wechsler Intelligence Scale for Children-Revised & ICD-10 diagnostic criteria was used to assess children (age range 6 – 16 years) with suspected ID along with identification of behaviors found to be difficult to manage by caregivers. Results: 150 children were assessed with mean age of 10.7 years (males 70 %). Majority (72%) had mild ID while 18.7% and 9.3% had moderate and severe ID respectively. Thirty percent of children met the criteria for any psychiatric diagnosis, the most common being Oppositional Defiant Disorder (14%) and Hyperkinetic Disorders (10%). Verbal and physical aggression, school difficulties, socialization problems, inappropriate behaviors (e.g. disinhibition), sleep & feeding difficulties were the significant areas identified by the caregivers as a cause of major concern. Conclusions: Significantly high prevalence of ICD-10 psychiatric diagnosis in children with ID was found in Lahore, Pakistan. Support services for these children should be responsive not only to the needs of the child, but also to the needs of the family.

  2. Parental psychiatric hospitalisation and offspring schizophrenia.

    PubMed

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M; Mednick, Sarnoff A

    2009-01-01

    The risk of schizophrenia has been linked with a family history of schizophrenia and less strongly with other psychiatric disorders in family members. Using data from the Copenhagen Perinatal Cohort and from the Danish Psychiatric Case Register, we studied the relationship between offspring risk of schizophrenia and a range of psychotic and non-psychotic psychiatric diagnoses in parents. Psychiatric admission data after 1969 were available for 7047 cohort members born between 1959 and 1961, and for 7006 mothers and 6993 fathers. Univariate analysis showed that neurosis, alcohol and substance dependence in both parents were associated with elevated risk of offspring schizophrenia; in addition, maternal schizophrenia, affective disorder and personality disorder were associated with elevated risk. Controlling for parental age, parental social status, and parental psychiatric co-diagnosis, offspring risk of schizophrenia was associated with maternal schizophrenia (OR = 15.41 with 95% CI 5.96-39.81) and, independently, with paternal hospitalisation with neurosis (OR = 5.90 with 95% CI 2.23-15.62). The risk of schizophrenia associated with paternal neurosis remained significant after excluding offspring of parents with non-affective psychosis from the sample. These findings suggest that genetic and family studies should not only focus on parental history of schizophrenia since the simple distinction between positive and negative family history could not accurately describe offspring risk in this sample. PMID:17853283

  3. The role of human rights and personal dignity in the rehabilitation of chronic psychiatric patients. A rural therapeutic community in Yanbian, Jilin.

    PubMed

    Jin, D; Li, G

    1994-08-01

    In 1983 the branch hospital of the Yanbian Community Psychiatric Hospital, a rural residential centre for 120 chronic psychiatric patients who have no means of financial support, adopted a new treatment philosophy that emphasised psychosocial rehabilitation and made the protection of patients' human rights and respect for their personal dignity the central organising principles for the hospital's treatment programme. From being a boarding facility for chronic psychiatric patients, the hospital became a thriving community. Comparison of the status of the 81 continuously resident schizophrenic patients before and after the policy change showed that (a) the proportion who actively participated in agricultural labour increased from 10% in 1982 to 38% in 1990; (b) the proportion who worked at non-agricultural jobs increased from 7% in 1982 to 22% in 1990; and (c) their mean yearly income increased from 1.67 Rmb in 1982 to 246.70 Rmb in 1990. Moreover, the number of successful suicides among all the patients in the hospital dropped from 13 in 1975-1982 to 1 in 1983-1990. We conclude that the success of psychiatric rehabilitation programmes depends on the extent to which they address the core issues of personal dignity and basic human rights. PMID:7946225

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

    PubMed Central

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

    2010-01-01

    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

  5. Hydrology day

    NASA Astrophysics Data System (ADS)

    Morel-Seytoux, H. J.

    Registration for the Hydrology Day sponsored by the Front Range Branch of AGU on April 23 at Colorado State University in Fort Collins, Colorado, totaled 121 participants, of whom 61 were students.Thirty-one individuals joined the Front Range Branch. Three students from Colorado State University won the awards for best paper in their category: Thomas W. Anzia (Sr.), ‘A Comprehensive Table of Standard Deviates for Confidence Limits on Extreme Events’ Victor Nazareth (M.S.), ‘Aquifer Properties from Single-Hole Aquifer Tests’ and Roy W. Koch (Ph.D.), ‘A Physically Based Derivation of the Distribution of Excess Precipitation.’ Judges for the awards were Dr. Bittinger, Resource Consultants, Fort Collins; George Leavesley and Daniel Bauer, USGS, Water Resources Division, Denver; Scott Tucker, Executive Director, Denver Urban Drainage and Flood Control District; Charles Brendecke, Department of Civil Engineering, Univ. of Colorado, Boulder.

  6. Sleep-disordered breathing and psychiatric disorders.

    PubMed

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

    2014-12-01

    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

  7. A network medicine approach to psychiatric genetics.

    PubMed

    Lasky-Su, Jessica

    2013-10-01

    The major psychiatric disorders are complex in nature, meaning that they are influenced by multiple environmental and genetic exposures that perturb the intricate cellular network, resulting in disease. In general, psychiatric diseases are highly heritable but also have important environmental etiologies. Environmental influences include neonatal exposures, social environments, psychological mechanisms, and abnormal functioning of the neurotransmitter system. Molecular influences can be identified using many data types including genomics, epigenomics, transcriptomics, metabolomics, and proteomics. The emerging field of network medicine offers a new approach to explore the complexities of disease development in a framework that considers a holistic, rather than a reductionist viewpoint. In this review we explain a general framework of how the network medicine approach can provide valuable insight into understanding important molecular mechanisms that contribute to the pathogenesis of psychiatric disorders. PMID:24132892

  8. Childhood maltreatment, emotional dysregulation, and psychiatric comorbidities.

    PubMed

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

    2014-01-01

    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

  9. Indian – American contributions to psychiatric research

    PubMed Central

    Pandurangi, Anand K.

    2010-01-01

    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

  10. [Pharmacological therapy of an addiction psychiatric patient].

    PubMed

    Niemelä, Solja

    2013-01-01

    Properly conducted pharmacological therapy is expected to improve the prognosis of both the psychic disturbance and the substance abuse problem. Considering the extent of the problem there is, however, relatively little evidence-based knowledge of pharmacological therapy of an addiction psychiatric patient. Separation of psychiatric therapy from addiction therapy may hamper the realization of coherent pharmacological therapy. Psychosocial forms of therapy, especially motivating talking therapies, constitute the most pivotal part of treatment. In addition to the patient's own aims, the interactions of smoking, drugs and medicines must be considered in the planning of the pharmacological therapy. PMID:24218736

  11. MicroRNA dysregulation in psychiatric disease

    PubMed Central

    Miller, Brooke H.; Wahlestedt, Claes

    2010-01-01

    MicroRNAs (miRNAs) are small regulatory RNAs that individually regulate up to several hundred genes, and collectively may regulate as much as two-thirds of the transcriptome. Recent evidence supports a role for miRNA dysregulation in psychiatric and neurological disorders, including schizophrenia, bipolar disorder, and autism. Small changes in miRNA expression can fine-tune the expression of multiple genes within a biological network, suggesting that miRNA dysregulation may underlie many of the molecular changes observed in psychiatric disease, and that therapeutic regulation of miRNA levels may represent a novel treatment option. PMID:20303342

  12. Psychiatric inpatient expenditures and public health insurance programmes: analysis of a national database covering the entire South Korean population

    PubMed Central

    2010-01-01

    Background Medical spending on psychiatric hospitalization has been reported to impose a tremendous socio-economic burden on many developed countries with public health insurance programmes. However, there has been no in-depth study of the factors affecting psychiatric inpatient medical expenditures and differentiated these factors across different types of public health insurance programmes. In view of this, this study attempted to explore factors affecting medical expenditures for psychiatric inpatients between two public health insurance programmes covering the entire South Korean population: National Health Insurance (NHI) and National Medical Care Aid (AID). Methods This retrospective, cross-sectional study used a nationwide, population-based reimbursement claims dataset consisting of 1,131,346 claims of all 160,465 citizens institutionalized due to psychiatric diagnosis between January 2005 and June 2006 in South Korea. To adjust for possible correlation of patients characteristics within the same medical institution and a non-linearity structure, a Box-Cox transformed, multilevel regression analysis was performed. Results Compared with inpatients 19 years old or younger, the medical expenditures of inpatients between 50 and 64 years old were 10% higher among NHI beneficiaries but 40% higher among AID beneficiaries. Males showed higher medical expenditures than did females. Expenditures on inpatients with schizophrenia as compared to expenditures on those with neurotic disorders were 120% higher among NHI beneficiaries but 83% higher among AID beneficiaries. Expenditures on inpatients of psychiatric hospitals were greater on average than expenditures on inpatients of general hospitals. Among AID beneficiaries, institutions owned by private groups treated inpatients with 32% higher costs than did government institutions. Among NHI beneficiaries, inpatients medical expenditures were positively associated with the proportion of patients diagnosed into dementia or schizophrenia categories. However, for AID beneficiaries, inpatient medical expenditures were positively associated with the proportion of all patients with a psychiatric diagnosis that were AID beneficiaries in a medical institution. Conclusions This study provides evidence that patient and institutional factors are associated with psychiatric inpatient medical expenditures, and that they may have different effects for beneficiaries of different public health insurance programmes. Policy efforts to reduce psychiatric inpatient medical expenditures should be made differently across the different types of public health insurance programmes. PMID:20819235

  13. 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

  14. 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

  15. The de facto national system of psychiatric inpatient care. Piecing together the national puzzle.

    PubMed

    Kiesler, C A; Simpkins, C

    1991-06-01

    National data regarding psychiatric inpatient episodes can be viewed in 2 ways. The normative method surveys the "specialty mental health sector." A more inclusive method includes smaller sites (e.g., the military), all of general hospital treatment (rather than only the psychiatric unit), residential treatment centers, and other residential care. The difference between the 2 methods represents approximately 725,000 episodes, at a direct cost of more than $6 billion. The more inclusive analysis of the years 1980 and 1985 reveals a strong shift to the private sector and an increase in inpatient care of children and youth that might be obscured by limiting national treatment statistics to the specialty mental health sector. PMID:1952419

  16. Cognitive–behavioural therapy by psychiatric trainees: can a little knowledge be a good thing?

    PubMed Central

    Kelleher, Eric; Hayde, Melissa; Tone, Yvonne; Dud, Iulia; Kearns, Colette; McGoldrick, Mary; McDonough, Michael

    2015-01-01

    Aims and method To establish the competency of psychiatric trainees in delivering cognitive–behavioural therapy (CBT) to selected cases, following introductory lectures and supervision. Supervisor reports of trainees rotating through a national psychiatric hospital over 8.5 years were reviewed along with revised Cognitive Therapy Scale (CTS-R) ratings where available. Independent t-test was used to compare variables. Results Structured supervision reports were available for 52 of 55 (95%) trainees. The mean result (4.6, s.d. = 0.9) was at or above the accepted level for competency (?3) for participating trainees. Available CTS-R ratings (n = 22) supported the supervisor report findings for those particular trainees. Clinical implications This study indicates that trainees under supervision can provide meaningful clinical interventions when delivering CBT to selected cases. The costs of supervision need to be judged against these clinical gains. PMID:26191424

  17. [Psychiatric aspects of infectious diseases -- a literature review].

    PubMed

    Gazdag, Gabor; Szabo, Zsuzsa; Szlavik, Janos

    2014-12-01

    It is essential for the psychiatrist working in the consultation-liaison field or with comorbid patients to be familiar with the psychiatric aspects of central nervous infectious diseases or infectious diseases with psychiatric symptoms. Authors have reviewed the most important psychiatric aspects of common infectious diseases. Essential knowledge for setting up a diagnosis and starting appropriate treatment has been summarized. The most important interactions of infectological and psychiatric treatments have also been discussed. PMID:25577481

  18. Availability of software services for a hospital information system

    Microsoft Academic Search

    Norihiro Sakamoto

    1998-01-01

    Hospital information systems (HISs) are becoming more important and covering more parts in daily hospital operations as order-entry systems become popular and electronic charts are introduced. Thus, HISs today need to be able to provide necessary services for hospital operations for a 24-h day, 365 days a year. The provision of services discussed here does not simply mean the availability

  19. Prevalence of nosocomial infections in representative German hospitals

    Microsoft Academic Search

    P. Gastmeier; G. Kampf; N. Wischnewski; T. Hauer; G. Schulgen; M. Schumacher; F. Daschner; H. Rüden

    1998-01-01

    The nosocomial infection (NI) rate in German hospitals was studied in order to create reference data for comparison in hospitals where ongoing surveillance is impossible. The study was designed as a one-day prevalence study. Patients in 72 selected hospitals (inclusion criteria: acute care hospitals with departments for general medicine, surgery, obstetrics\\/ gynaecology) were examined by four external investigators (physicians trained

  20. Psychiatric Disorders in Patients Attending a Dermatology Outpatient Clinic

    Microsoft Academic Search

    Erol Özmen

    1998-01-01

    Background: Psychiatric comorbidity in patients with skin disorders has been reported. Objective: To find out the prevalence of psychiatric disorders in dermatology outpatients and to investigate the factors that affect the psychiatric symptoms. Methods: 256 patients attending our dermatology outpatient clinic completed a 12-item General Health Questionnaire (GHQ) following their dermatologic examination. A standardized personal interview was performed to establish

  1. Amylin and Amylin Agonists for Treating Psychiatric Diseases and Disorders

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Methods and compositions for treating psychiatric diseases and disorders are disclosed. The methods provided generally involve the administration of an amylin or an amylin agonist to a subject in order to treat psychiatric diseases and disorders, and conditions associated with psychiatric diseases a...

  2. Epidemiology of psychiatric and alcohol disorders in Ukraine

    Microsoft Academic Search

    Evelyn J. Bromet; Semyon F. Gluzman; Volodymyr I. Paniotto; Charles P. M. Webb; Nathan L. Tintle; Victoria Zakhozha; Johan M. Havenaar; Zinoviy Gutkovich; Stanislav Kostyuchenko; Joseph E. Schwartz

    2005-01-01

    Background This study presents the life- time, 12-month, and 1-month prevalence estimates of nine psychiatric and alcohol disorders in Ukraine assessed as part of the World Health Organization (WHO) World Mental Health (WMH) research pro- gram. The Ukraine WMH survey is the first psychiatric epidemiologic study in a former Soviet Union country to administer a structured psychiatric interview to a

  3. The Value of Screening for Psychiatric Disorders in Rheumatology Referrals

    Microsoft Academic Search

    Patrick G. O'Malley; Jeffrey L. Jackson; Kurt Kroenke; In Kyu Yoon; Edmund Hornstein; Gregory J. Dennis

    1998-01-01

    Background: Musculoskeletal complaints are com- mon and often unexplained and often lead to rheuma- tology referrals. The prevalence of psychiatric disease in patients with musculoskeletal complaints is unknown. Objectives: To determine the prevalence of common psychiatric disorders among patients referred to a rheu- matology clinic and the likelihood of establishing a rheu- matic diagnosis if a psychiatric disorder is present.

  4. Psychiatric Disabilities and the Americans with Disabilities Act

    Microsoft Academic Search

    John T. Pardeck

    1998-01-01

    People with psychiatric disabilities are often victims of job discrimination. The Americans with Disabilities Act (ADA) of 1990 makes it very clear that job discrimination based on a psychiatric impairment is illegal. The Equal Employment Opportunity Commission (EEOC) reports that psychiatric disability is one of the leading causes why persons file discrimination complaints. Given this situation, an analysis is offered

  5. Ethnic Group, Acculturation, and Psychiatric Problems in Young Immigrants

    ERIC Educational Resources Information Center

    Oppedal, Brit; Roysamb, Espen; Heyerdahl, Sonja

    2005-01-01

    Background: The goal of this study was to investigate the effects of ethnic origin and acculturation factors on psychiatric problems among immigrant adolescents. One aim was to examine variations in psychiatric problems according to gender and immigrant generation level. Another aim was to explore ethnic group differences in psychiatric problems…

  6. Prevalence of Psychiatric Symptoms in ALL Patients during Maintenance Therapy

    PubMed Central

    Farhangi, H; Badiei, Z; Moharreri, F

    2015-01-01

    Background Cancer diagnosis may cause deep emotional and affective problems in patients and their families. Nowadays, however, despite its rising prevalence, cancer is no longer synonymous with death. Given the significance of emotional well-being in cancer patients, we decided to assess the frequency of psychological problems in seven to seventeen year-olds with acute lymphoblastic leukemia. Materials and Methods Our sample included 42 children and adolescents with ALL referred to pediatric hematology department of Dr. Sheikh hospital, who were put under maintenance course of the treatment. Psychiatric disorders such as anxiety, depression and behavioral disturbances were examined by using RCMAS, CDI and SDQ questionnaires respectively. Results The entire population showed depressive symptoms.59.5% of patients (25 person) suffered from anxiety and 26.2% (11 person) had behavioral problems. No significant relation was found between depressive symptoms, and age (p=0.77), sex (p=0.97), length of disease (p=0.50), and type of treatment (p=0.064). Anxiety did not show any significant relation with age (p= 0.63), sex (p= 0.32), length of disease (p= 0.16) and treatment type (p= 0.064).Similarly behavioral disturbances did not indicate any suggestive relation with age (p= 0.20), sex (p= 0.56), length of disease (p= 0.81) and type of treatment (p= 0.19). Conclusion Our findings suggest a high prevalence of psychiatric disorders in children and adolescents with ALL. It is strongly recommended, therefore, that besides somatic symptoms, careful attention be paid to psychological disorders. This can prevent rapid development of the disease reduce treatment costs, and improve the quality of life for both patients and their families.

  7. Epidemiology, symptoms, and treatment characteristics of hyponatremic psychiatric inpatients.

    PubMed

    Lange-Asschenfeldt, Christian; Kojda, Georg; Cordes, Joachim; Hellen, Florence; Gillmann, Andreas; Grohmann, Renate; Supprian, Tillmann

    2013-12-01

    Hyponatremia is a common phenomenon in psychiatry occurring as an adverse effect to drugs or following polydipsia. We performed a retrospective in-depth analysis of hyponatremia cases in a large unselected population of psychiatric inpatients. During a 3-year period, all cases of hyponatremia were identified among patients admitted to a large psychiatric state and university hospital by the institution's electronic laboratory database. Demographic, treatment-related, and laboratory data were obtained by consecutive chart review, respectively. Hyponatremia occurred in 347 (4.9%) of 7113 cases, of which the majority (78%) displayed only a mild manifestation. Symptoms were recorded in 28.8% of cases, already occurred in mild forms, and comprised gait impairment (45%, including falls), confusion (30%), sedation (26%), and dyspepsia (41%). Age, female sex, nonpsychiatric drug polypharmacy-particularly with thiazides and/or angiotensin-converting enzyme inhibitors-and diagnosis of a mood disorder were associated with more severe hyponatremia, respectively. The proportion of hyponatremic patients treated with venlafaxine, trazodone, carbamazepine, oxcarbazepine, and first-generation antipsychotics, respectively, was significantly higher in the hyponatremia sample than in the normonatremic population. This was, surprisingly, not the case with selective serotonin reuptake inhibitors or any other antidepressant drug class. We found prescription with second-generation antipsychotics to be significantly associated with less severe hyponatremia.Hyponatremia may be mainly attributed to the syndrome of inappropriate antidiuretic hormone secretion, as indicated by decreased serum osmolarity in our sample. Besides old age and female sex, treatment with certain drugs-rather than whole drug classes-carries a substantially increased risk. PMID:24052056

  8. Association between a Hospital’s Quality Performance for In-Hospital Cardiac Arrest and Common Medical Conditions

    PubMed Central

    Chen, Lena M.; Nallamothu, Brahmajee K.; Krumholz, Harlan M.; Spertus, John A.; Tang, Fengming; Chan, Paul S.

    2015-01-01

    Background Public reporting on hospital quality has been widely adopted for common medical conditions. Adding a measure of inpatient survival after cardiac arrest is being considered. It is unknown if this measure would be redundant, given evidence that hospital organization and culture can have hospital-wide effects on quality. Therefore, we sought to evaluate the correlation between inpatient survival after cardiac arrest and 30-day risk-standardized mortality rates for common medical conditions. Methods and Results Using data between 2007 and 2010 from a national in-hospital cardiac arrest registry, we calculated risk-standardized in-hospital survival rates for cardiac arrest at each hospital. We obtained risk-standardized 30-day mortality rates for acute myocardial infarction (AMI), heart failure (HF), and pneumonia from Hospital Compare for the same period. The relationship between a hospital’s performance on cardiac arrest and these other medical conditions was assessed using weighted Pearson correlation coefficients. Among 26,270 patients with in-hospital cardiac arrest at 130 hospitals, survival rates varied across hospitals, with a median risk-standardized hospital survival rate of 22.1% and an inter-quartile range (IQR) of 19.7% to 24.2%. There were no significant correlations between a hospital’s outcomes for its cardiac arrest patients and its patients admitted for AMI (correlation of ?0.12; P=0.16), HF (correlation of ?0.05; P=0.57), or pneumonia (correlation of ?0.15, P=0.10). Conclusions Hospitals that performed better on publicly reported outcomes for three common medical conditions did not necessarily have better cardiac arrest survival rates. Public reporting on cardiac arrest outcomes could provide new information about hospital quality. PMID:24221831

  9. [Art therapy in the psychiatric clinic. A historical analysis of the development of art studios].

    PubMed

    Günter, M

    1990-09-01

    The present study examines the building up of art classes in psychiatric hospitals in the thirties and forties of this century. Until 1950 the worldwide total of 34 art classes had come into being. The growing psychiatric interest in drawings of patients in the 19th century is related to changes in psychiatric theory moving from "moral treatment" to descriptive psychiatry at the turn of the century. All in all the installation of 11 artistic workshops for patients can be traced before the 1st world war. They were part of work therapy in german private clinics as a means to put patients of a higher social standing to a regular activity instead of field and garden work, which was medically indicated but socially unacceptable. During the course of development of a diagnostic interest since 1870 the drawings were all along considered to be the immediate expression of the patients inner world. Such a view had become possible, after in modern art the conceptions about the meaning of art had changed. Paradigmatically this connection can be shown in the work of Prinzhorn. First therapeutic attempts were then started by different psychoanalysts especially in the treatment of children. These formed an important basis for the establishment of art classes in psychiatric hospitals later on. Painting was now considered as a means to approach the hidden unconscious. The study continues to explain in which way the therapeutic applications of art therapy depended on the convergence of view points in esthetic and therapeutic theory.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2267259

  10. Perspectives on reasons of medication nonadherence in psychiatric patients

    PubMed Central

    Mert, Derya Güliz; Turgut, Nergiz Hacer; Kelleci, Meral; Semiz, Murat

    2015-01-01

    Purpose This study was carried out to evaluate factors resulting in medication nonadherence within 6 months before admission to the psychiatric service of our hospital for bipolar disorder, schizophrenia/schizoaffective disorder, depression, and other psychiatric diseases. Patients and methods Two hundred and three patients admitted to the Psychiatry Service of the Medical Faculty were included in this study. Sociodemographic parameters and clinical findings within 6 months before admission and patients’ views on reasons of medication nonadherence were examined. Results Patients were classified into four groups according to their diagnosis: bipolar disorder (n=68, 33.5%), schizophrenia/schizoaffective disorder (n=59, 29.1%), depression (n=39, 19.2%), and others (n=37, 18.2%). The ratio of medication nonadherence was higher in the bipolar disorder group when compared to the groups with schizophrenia/schizoaffective disorder, depression, and other disorders (12.1%, 18.2%, and 24.2% vs 45.5%); however, the ratio of medication nonadherence was similar in schizophrenia/schizoaffective disorder, depression, and the others group. In logistic regression analysis, irregular follow-up (odds ratio [OR]: 5.7; 95% confidence interval [CI]: 2.92–11.31) and diagnosis (OR: 1.5; 95% CI: 1.07–1.95) were determined to be important risk factors for medication nonadherence. The leading factors for medication nonadherence were: “not willing to use medication”, “not accepting the disease”, and “being disturbed by side effects” in the bipolar disorder group, “not accepting the disease” in the schizophrenia/schizoaffective disorder group, “feeling well” in the depression group, and “being disturbed by side effects” in the other diseases group. Conclusion Medication nonadherence is an important problem in psychiatric patients and should be dealt with by taking into account the diagnosis, attendance to follow-up appointments, and the patient’s attitude. Ensuring regular attendance to follow-up appointments, adjusting the management plan according to the diagnosis, and improving their thoughts about resistance to medication can be beneficial in terms of medication adherence. PMID:25609930

  11. Cholinergic connectivity: it's implications for psychiatric disorders.

    PubMed

    Scarr, Elizabeth; Gibbons, Andrew S; Neo, Jaclyn; Udawela, Madhara; Dean, Brian

    2013-01-01

    Acetylcholine has been implicated in both the pathophysiology and treatment of a number of psychiatric disorders, with most of the data related to its role and therapeutic potential focusing on schizophrenia. However, there is little thought given to the consequences of the documented changes in the cholinergic system and how they may affect the functioning of the brain. This review looks at the cholinergic system and its interactions with the intrinsic neurotransmitters glutamate and gamma-amino butyric acid as well as those with the projection neurotransmitters most implicated in the pathophysiologies of psychiatric disorders; dopamine and serotonin. In addition, with the recent focus on the role of factors normally associated with inflammation in the pathophysiologies of psychiatric disorders, links between the cholinergic system and these factors will also be examined. These interfaces are put into context, primarily for schizophrenia, by looking at the changes in each of these systems in the disorder and exploring, theoretically, whether the changes are interconnected with those seen in the cholinergic system. Thus, this review will provide a comprehensive overview of the connectivity between the cholinergic system and some of the major areas of research into the pathophysiologies of psychiatric disorders, resulting in a critical appraisal of the potential outcomes of a dysregulated central cholinergic system. PMID:23653591

  12. Cholinergic connectivity: it's implications for psychiatric disorders

    PubMed Central

    Scarr, Elizabeth; Gibbons, Andrew S.; Neo, Jaclyn; Udawela, Madhara; Dean, Brian

    2013-01-01

    Acetylcholine has been implicated in both the pathophysiology and treatment of a number of psychiatric disorders, with most of the data related to its role and therapeutic potential focusing on schizophrenia. However, there is little thought given to the consequences of the documented changes in the cholinergic system and how they may affect the functioning of the brain. This review looks at the cholinergic system and its interactions with the intrinsic neurotransmitters glutamate and gamma-amino butyric acid as well as those with the projection neurotransmitters most implicated in the pathophysiologies of psychiatric disorders; dopamine and serotonin. In addition, with the recent focus on the role of factors normally associated with inflammation in the pathophysiologies of psychiatric disorders, links between the cholinergic system and these factors will also be examined. These interfaces are put into context, primarily for schizophrenia, by looking at the changes in each of these systems in the disorder and exploring, theoretically, whether the changes are interconnected with those seen in the cholinergic system. Thus, this review will provide a comprehensive overview of the connectivity between the cholinergic system and some of the major areas of research into the pathophysiologies of psychiatric disorders, resulting in a critical appraisal of the potential outcomes of a dysregulated central cholinergic system. PMID:23653591

  13. Asperger Syndrome: Associated Psychiatric and Medical Conditions.

    ERIC Educational Resources Information Center

    Ghaziuddin, Mohammad

    2002-01-01

    This article explores the association of medical and psychiatric conditions with Asperger syndrome, based mainly on publications from the last two decades. It examines comorbidity of Asperger syndrome with mood disorders, schizophrenia, obsessive-compulsive disorder, attention deficit/hyperactivity disorder, tic disorders, violence and aggression,…

  14. Psychiatric-Mental Health Nursing: Course Outline.

    ERIC Educational Resources Information Center

    Cardinal, Judith L.

    A guide to Nursing 5, a course on psychiatric-mental health nursing offered at East Los Angeles College is presented. The guide first details classroom and clinical course requirements and then identifies long-range and end-of-course objectives. A list of required texts and manuals is followed by an outline of the objectives for each of four…

  15. Psychiatric consultation for Project Head Start

    Microsoft Academic Search

    Saul L. Brown

    1966-01-01

    Psychiatric and\\/or “mental health” services for the Project Head Start program need to be adapted to the character of the population group to be dealt with. This requires special knowledge and skills, not only in relation to the psychopathology of the preschool-age child, but also to the subtleties of family pathology and the ways in which a disturbed child of

  16. [Nutrition and dietary supplements in psychiatric diseases].

    PubMed

    Himmerich, H; Erbguth, F

    2014-12-01

    Nutrition and specific nutritional supplements can have prophylactic or therapeutic properties with respect to certain psychiatric disorders. A traditional Mediterranean diet, for example, seems to have prophylactic benefits against depression and dementia, whereas overeating and obesity increase the risk for both.Although evidence for nutritional supplements in the treatment of psychiatric disorders is not sufficient for general recommendations, data from observational studies and randomized controlled trials (RCT) seem to point to their use for specific indications. Folate, S-adenosylmethionine (SAM) and eicosapentaenoic acid (EPA), for instance, seem to have antidepressant properties, zinc may be beneficial in attention deficit hyperactivity disorder (ADHD), vitamin B6 (pyridoxine) could reduce extrapyramidal side effects of antipsychotics and N-acetylcysteine (NAC) seems to be effective against negative symptoms, abnormal movements and akathisia in schizophrenia.Psychiatric disorders, in turn, may lead to deficiency of mineral nutrients and vitamins. For instance, vitamin B1 (thiamine) deficiency is common in alcohol-dependent patients and should therefore be considered during withdrawal treatment. Although vitamin malnutrition is uncommon in developed countries, vitamin deficiency syndromes, such as pernicious anemia or Wernicke's encephalopathy are still relevant differential diagnoses.Some psychopharmacological drugs may additionally change the nutritional habits of the patients in an unfavorable way leading to weight gain and obesity and the risk for further psychiatric problems. PMID:25421417

  17. Psychiatric Mental Health Evidence-Based Practice

    Microsoft Academic Search

    Michael J. Rice

    2008-01-01

    This article is the first in a new column focusing on evidence-based practice (EBP) in psychiatric mental health nursing. The EBP movement was strongly influenced by a British epidemiologist, Dr. Cochrane, who advocated care based on randomized clinical controlled trials in the late 1900s. Although the majority of the EBP movement is directed toward developing clinical guidelines, the critical element

  18. Psychiatric drugs and inhibited female orgasm

    Microsoft Academic Search

    R. T. Segraves

    1988-01-01

    The available evidence concerning sexual side effects of psychiatric drugs suggests that inhibited female orgasm may be associated with the use of heterocyclic antidepressants, monoamine oxidase inhibitors, benzodiazepines, and neuroleptics. Possible mechanisms of action including anticholinergic, alpha adrenergic blockade, and serotonergic effects are discussed.

  19. Novel Therapeutic GPCRs for Psychiatric Disorders.

    PubMed

    Komatsu, Hidetoshi

    2015-01-01

    G protein-coupled receptors (GPCRs) are the most common targets of the neuropharmacological drugs in the central nervous system (CNS). GPCRs are activated by manifold neurotransmitters, and their activation in turn evokes slow synaptic transmission. They are deeply involved in multiple neurological and psychiatric disorders such as Parkinson's disease and schizophrenia. In the brain, the striatum is strongly innervated by the ventral tegmental area (VTA) and plays a central role in manifestation of psychiatric disorders. Recently, anatomical and comprehensive transcriptome analysis of the non-odorant GPCR superfamily revealed that the orphan GPCRs GPR88, GPR6, and GPR52, as well as dopamine D1 and D2 receptors and the adenosine A2a receptor, are the most highly enriched in the rodent striatum. Genetically engineered animal models and molecular biological studies have suggested that these striatally enriched GPCRs have a potential to be therapeutic psychiatric receptors. This review summarizes the current understanding of the therapeutic GPCR candidates for psychiatric disorders. PMID:26101869

  20. Substance Abuse and Psychiatric Dual Disorders

    Microsoft Academic Search

    Mark S. Gold; Kimberly Frost-Pineda

    2005-01-01

    Smoking is a leading cause of morbidity and is the single most important preventable cause of mortality in the United States. The link between tobacco smoking and lung cancer, heart disease, stroke, chronic lung disease, other cancers, and other medical diseases is now generally accepted. The link between tobacco and psychiatric diseases has become a focus for recent epidemiological studies,

  1. Tobacco Smoking in Adolescent Psychiatric Outpatients

    ERIC Educational Resources Information Center

    Ditchburn, K. Marie; Sellman, J. Douglas

    2013-01-01

    Three main aims of this study were to ascertain the prevalence rate of smoking among adolescent psychiatric outpatients; estimate smokers' degree of nicotine dependence; and investigate the relationship between smoking and common mental health disorders. Face-to-face interviews were conducted on 93 patients ages 13-18 presenting to an adolescent…

  2. [Prevalence of psychiatric disorders among homeless adolescents].

    PubMed

    Aichhorn, Wolfgang; Santeler, Stefan; Stelzig-Schöler, Renate; Kemmler, Georg; Steinmayr-Gensluckner, Maria; Hinterhuber, Hartmann

    2008-01-01

    Various studies show a high prevalence of mental disorders among homeless people. So far most of these studies deal solely with single men, mainly affected by homelessness. Few data exist for women, children, adolescents and whole families that are more and more affected by poverty and homelessness. This study, conducted in Innsbruck/Austria, determined the prevalence of psychiatric disorders among homeless adolescents. The adolescents were recruited in a counselling centre and homeless shelter specifically founded for homeless youth. Mental disorders were diagnosed with the Structured Clinical Interview for DSM-IV (SKID-I). 40 adolescents and young adults ranging from 14-23 years (mean 17.9 years) were included in the study. The results show that 58% of the homeless adolescents were exposed to continuous violence in their families and that violence was a major reason for them to leave home. The overall prevalence of diagnosed psychiatric disorders was 80% in the whole sample; the leading disorder was substance abuse/dependence (65%), followed by mood disorders (42.5%), anxiety disorders (17.5%) and eating disorders (17.5%). 57.5% of the adolescents had a history of self-harm and 25% reported at least one suicide attempt. Duration of homelessness had the greatest influence on the prevalence of mental disorders. Longer duration of homelessness was associated with a higher risk of psychiatric disorder or self-harm. These results demonstrate the urgent need for early psychosocial and psychiatric help for homeless adolescents. PMID:18826872

  3. Psychiatric comorbidity of smoking and nicotine dependence

    Microsoft Academic Search

    Naomi Breslau

    1995-01-01

    Recent epidemiologic studies have revealed that comorbidity of psychiatric disorders is far more pervasive than previously suspected. Strong associations have been reported between specific substance use disorders and between any mental disorder and any substance use disorder. This report focuses on comorbidity of nicotine dependence, a substance use disorder on which little epidemiologic information is available. Data come from an

  4. Prosecuting Assaultive Forensic and Psychiatric Inpatients

    ERIC Educational Resources Information Center

    Angus, Kerri C.; Reddon, John R.; Chudleigh, Michele D.

    2008-01-01

    Inpatient assault of forensic and psychiatric staff is a complex and multifaceted issue. Hence, the consequences reported in the literature regarding prosecuting assaultive inpatients are quite variable. In this article, issues pertaining to the prosecution of violent inpatients are reviewed. Illustrative cases, challenges of prosecution,…

  5. Ensuring Research Competency in Psychiatric Residency Training

    ERIC Educational Resources Information Center

    Roane, David M.; Inan, Eda; Haeri, Sophia; Galynker, Igor I.

    2009-01-01

    Objective: This article discusses the importance of research training in psychiatric residency programs and makes recommendations for enhancement. Methods: The authors examine the literature detailing the shortage of psychiatrist-researchers and the limitations of research training during residency. The authors then describe the Psychiatrists…

  6. Psychiatric Summer School Date: September 2nd

    E-print Network

    Pfeifer, Holger

    of Nicolaus Copernicus University in Toru, University Hotel Mental health care in Europe ­ innovation Ministry of Health and the Department of Psychiatry Collegium Medicum at Nicolaus Copernicus of Psychiatric Summer School will be held from 2nd to 8th September at Nicolaus Copernicus

  7. Novel Therapeutic GPCRs for Psychiatric Disorders

    PubMed Central

    Komatsu, Hidetoshi

    2015-01-01

    G protein-coupled receptors (GPCRs) are the most common targets of the neuropharmacological drugs in the central nervous system (CNS). GPCRs are activated by manifold neurotransmitters, and their activation in turn evokes slow synaptic transmission. They are deeply involved in multiple neurological and psychiatric disorders such as Parkinson’s disease and schizophrenia. In the brain, the striatum is strongly innervated by the ventral tegmental area (VTA) and plays a central role in manifestation of psychiatric disorders. Recently, anatomical and comprehensive transcriptome analysis of the non-odorant GPCR superfamily revealed that the orphan GPCRs GPR88, GPR6, and GPR52, as well as dopamine D1 and D2 receptors and the adenosine A2a receptor, are the most highly enriched in the rodent striatum. Genetically engineered animal models and molecular biological studies have suggested that these striatally enriched GPCRs have a potential to be therapeutic psychiatric receptors. This review summarizes the current understanding of the therapeutic GPCR candidates for psychiatric disorders. PMID:26101869

  8. Padua University Psychiatric Student Counseling Service

    ERIC Educational Resources Information Center

    Marini, Massimo; Piovan, Cristiano; Gambaro, Francesca; Grana, Simona; Frasson, Alberto; Fusco, Elisabetta; Romano, Enza; Semenzin, Massimo; Pavan, Luigi

    2004-01-01

    Although the literature reports a high prevalence of psychological distress among the university student population, still very few intervention schemes have been proposed to manage the problem. The authors describe the main sources of inspiration for the psychiatric counseling service established at Padua University (Italy) and how it operates.…

  9. Padua University Psychiatric Student Counseling Service

    Microsoft Academic Search

    Massimo Marini; Cristiano Piovan; Francesca Gambaro; Simona Granà; Alberto Frasson; Elisabetta Fusco; Enza Romano; Massimo Semenzin; Luigi Pavan

    2004-01-01

    Although the literature reports a high prevalence of psychological distress among the university student population, still very few intervention schemes have been proposed to manage the problem. The authors describe the main sources of inspiration for the psychiatric counseling service established at Padua University (Italy) and how it operates. Emphasis is laid on counseling quality, operator professionalism, research activities, ethical

  10. [Emergency care at the hospital].

    PubMed

    Larcan, A

    1991-03-01

    Emergencies are very diversified: clinical setting, age, sex, circumstances, medicine, surgery, psychiatry, specialties. The admission into the specific departments depends on geographical, demographical features (distances to be covered...). They are theoretically unscheduled but sometimes out-hospital messages can be sent to improve the reception or to decide a very short circuit. Emergency rooms exist in most hospitals and are not so often appropriate. Emergency reception requires a place and a technical assistance where to get in touch with and to perform as quick as possible the formalities, first diagnosis and first aid procedures and orientation to the appropriate department. As a main frame in the network of assistance and care, emergency department ought to be a unique place with multiple disciplines (medicine, surgery, psychiatry), where universal first aid technical assistance and unified working would open to al hospital departments or a piece of hospitals. This structure relies on well dispatched areas, with easy ways, many examinations, simultaneous actions, urgent complementary tests and families reception. A hospital, practitioner must be in charge, whom speciality deals with emergency. Staff must include on-call doctors who can be helped by at-home physicians and many competent paramedics: nurses, health workers, stretcher-bearers, X-ray handlers, drivers, operators, secretaries, social workers, hostesses... Specific arrangements must be taken for special X-rays, biology and hospital reception of medico-surgical, obstetrical, psychiatric, social, medico-legal and medico-judicial emergencies. Running of that structure, mainly facing severe emergencies, must go together with out-hospital medical advises, patients admission for some time or a brief relief (control and social cases). In all cases, connection between out-hospital set-ups, various medical sittings and hospitals in the main goal which must be achieved with the S.A.M.U. Emergency medicine is universal, sequential, discontinuous with a social aspect open to a town or a district. If someone wants to be technically irreproachable, he needs to get together most of the existent structures to have a performant material and as much and efficient staff as possible. PMID:1933461

  11. The promise of psychiatric pharmacogenomics.

    PubMed

    Hamilton, Steven P

    2015-01-01

    Clinicians already face "personalized" medicine every day while experiencing the great variation in toxicities and drug efficacy among individual patients. Pharmacogenetics studies are the platform for discovering the DNA determinants of variability in drug response and tolerability. Research now focuses on the genome after its beginning with analyses of single genes. Therapeutic outcomes from several psychotropic drugs have been weakly linked to specific genetic variants without independent replication. Drug side effects show stronger associations to genetic variants, including human leukocyte antigen loci with carbamazepine-induced dermatologic outcome and MC4R with atypical antipsychotic weight gain. Clinical implementation has proven challenging, with barriers including a lack of replicable prospective evidence for clinical utility required for altering medical care. More recent studies show promising approaches for reducing these barriers to routine incorporation of pharmacogenetics data into clinical care. PMID:25483343

  12. Factors affecting alcohol treatment in males: an estimation of gender-role issues, self-concept, and psychiatric symptomatology 

    E-print Network

    Clark, Betty Lynn

    1993-01-01

    to the hospital, at time of discharge, and at three-months post- discharge. At each assessment phase, the veterans completed measures of psychiatric symptomatology, gender- role orientation and related stress, self-concept, emotional expressiveness..., psychosocial functioning, and patterns of alcohol use. Results revealed that the veteran's status on gender-role orientation, gender-role stress, emotional expressiveness, psychosocial functioning, and emotional expressiveness remained consistent across...

  13. Hospitality Management.

    ERIC Educational Resources Information Center

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  14. MORTALITY IN PERSONS WITH MENTAL DISORDERS IS SUBSTANTIALLY OVERESTIMATED USING INPATIENT PSYCHIATRIC DIAGNOSES

    PubMed Central

    Ioannidis, John P. A.; Sundquist, Kristina; Winkleby, Marilyn A.; Sundquist, Jan

    2013-01-01

    Mental disorders are associated with premature mortality, and the magnitudes of risk have commonly been estimated using hospital data. However, psychiatric patients who are hospitalized have more severe illness and do not adequately represent mental disorders in the general population. We conducted a national cohort study using outpatient and inpatient diagnoses for the entire Swedish adult population (N=7,253,516) to examine the extent to which mortality risks are overestimated using inpatient diagnoses only. Outcomes were all-cause and suicide mortality during 8 years of follow-up (2001–2008). There were 377,339 (5.2%) persons with any inpatient psychiatric diagnosis, vs. 680,596 (9.4%) with any inpatient or outpatient diagnosis, hence 44.6% of diagnoses were missed using inpatient data only. When including and accounting for prevalent psychiatric cases, all-cause mortality risk among persons with any mental disorder was overestimated by 15.3% using only inpatient diagnoses (adjusted hazard ratio [aHR], 5.89; 95% CI, 5.85–5.92) vs. both inpatient and outpatient diagnoses (aHR, 5.11; 95% CI, 5.08–5.14). Suicide risk was overestimated by 18.5% (aHRs, 23.91 vs. 20.18), but this varied widely by specific disorders, from 4.4% for substance use to 49.1% for anxiety disorders. The sole use of inpatient diagnoses resulted in even greater overestimation of all-cause or suicide mortality risks when prevalent cases were unidentified (~20–30%) or excluded (~25–40%). However, different methods for handling prevalent cases resulted in only modest variation in risk estimates when using both inpatient and outpatient diagnoses. These findings have important implications for the interpretation of hospital-based studies and the design of future studies. PMID:23806577

  15. Accumulated coercion and short-term outcome of inpatient psychiatric care

    PubMed Central

    2010-01-01

    Background The knowledge of the impact of coercion on psychiatric treatment outcome is limited. Multiple measures of coercion have been recommended. The aim of the study was to examine the impact of accumulated coercive incidents on short-term outcome of inpatient psychiatric care Methods 233 involuntarily and voluntarily admitted patients were interviewed within five days of admission and at discharge or after maximum three weeks of care. Coercion was measured as number of coercive incidents, i.e. subjectively reported and in the medical files recorded coercive incidents, including legal status and perceived coercion at admission, and recorded and reported coercive measures during treatment. Outcome was measured both as subjective improvement of mental health and as improvement in professionally assessed functioning according to GAF. Logistic regression analyses were performed with patient characteristics and coercive incidents as independent and the two outcome measures as dependent variables Results Number of coercive incidents did not predict subjective or assessed improvement. Patients having other diagnoses than psychoses or mood disorders were less likely to be subjectively improved, while a low GAF at admission predicted an improvement in GAF scores Conclusion The results indicate that subjectively and professionally assessed mental health short-term outcome of acute psychiatric hospitalisation are not predicted by the amount of subjectively and recorded coercive incidents. Further studies are needed to examine the short- and long-term effects of coercive interventions in psychiatric care. PMID:20584301

  16. 76 FR 39006 - Medicare Program; Hospital Inpatient Value-Based Purchasing Program; Correction

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-05

    ...the FY 2014 Hospital VBP Program Mortality Outcome Measures...survival rates...the FY 2014 Hospital VBP Program Mortality Outcome Measures...survival rates...30-Day .9021 Mortality Rate...Program'' Hospitals is...

  17. Management of HIV-infected children in the home and institutional settings. Care of children and infections control in schools, day care, hospital settings, home, foster care, and adoption.

    PubMed

    Dominguez, K L

    2000-02-01

    The likelihood of high-risk pediatric exposure to HIV infection, other than perinatal exposure, has been shown to be low in most cases, and HIV PEP should be considered on a case-by-case basis. Generic considerations in the management of children who have become HIV infected emphasizes the principles of inclusion, maintaining confidentiality of a child's HIV status, and notifying those who need to know about the HIV status to care properly for the child or adolescent. Although appropriate infection-control precautions are applicable for all children and for many pathogens, children especially HIV-infected children, exposed to such pathogens, must be managed in a timely fashion. In many cases, recommendations that are applicable in one setting are applicable in others. Some exceptions apply, including infection-control precautions in hospitals versus other settings. A few additional considerations have been made for special settings and activities, including adoption, foster care, athletics, summer camp, and other recreational activities. PMID:10697649

  18. Courts' misplaced confidence in psychiatric diagnoses.

    PubMed

    Mellsop, Graham W; Fraser, Debra; Tapsell, Rees; Menkes, David B

    2011-01-01

    In considering psychiatric evidence, criminal justice systems make considerable use of labels from official psychiatric classificatory systems. There are legislated requirements for psychological and/or behavioural phenomena to be addressed in legal tests, however medico-legal use of the current categorical diagnostic frameworks which are increasingly complex is difficult to justify. The lack of validity in large domains of the present classificatory systems is now more openly acknowledged, prompting a critical rethink. Illustrative examples include post-traumatic stress disorder, various personality disorders, and dissociative identity disorder. It follows that the Courts' faith in the present categorical classifications (e.g., DSMIV and ICD10) is misplaced and may be ultimately unhelpful to the administration of justice. PMID:21907412

  19. Catatonic signs in medical and psychiatric catatonias.

    PubMed

    Carroll, B T; Kennedy, J C; Goforth, H W

    2000-07-01

    Patients with psychiatric catatonias vs those with medical catatonias may differ in catatonic phenomenology. To determine if these could be distinguished, the following methods were used: 1) a review of the literature; 2) a chart review; and 3) a prospective series. The literature review of 467 reports of medical catatonias yielded 240 cases that met research criteria. A chart review of 47 episodes of catatonia revealed a higher frequency of negativism in patients with medical catatonias. Prospective data obtained from rating scales revealed an increased frequency of echophenomena in patients with medical catatonias; however, no discriminate pattern of catatonic signs for medical catatonias arose. Overall, catatonic signs appear to share a similar distribution. These findings suggest that psychiatric and medical catatonias are indistinguishable based upon catatonic sign. PMID:18197158

  20. Cotard syndrome in neurological and psychiatric patients.

    PubMed

    Ramirez-Bermudez, Jesus; Aguilar-Venegas, Luis C; Crail-Melendez, Daniel; Espinola-Nadurille, Mariana; Nente, Francisco; Mendez, Mario F

    2010-01-01

    The authors describe the frequency and characteristics of Cotard syndrome among neurological and psychiatric inpatients at a tertiary referral center. All inpatients from the National Institute of Neurology of Mexico (March 2007-May 2009) requiring neuropsychiatric consultation were reviewed. Among 1,321 inpatient consultations, 63.7% had neurological disease and one (0.11%) had viral encephalitis and Cotard syndrome. Of inpatients, 36.2% had pure psychiatric disorders and three (0.62%) had Cotard syndrome, associated with psychotic depression, depersonalization, and penile retraction (koro syndrome). This review discusses potential mechanisms for Cotard syndrome, including the role of a perceptual-emotional dissociation in self-misattribution in the deliré des negations. PMID:21037126

  1. Obesity and Psychiatric Disorder: Developmental Trajectories

    Microsoft Academic Search

    E. Jane Costello; Sarah Mustillo; Carol Worthman; Alaattin Erkanli; Gordon Keeler; Adrian Angold

    2010-01-01

    ABSTRACT. Objectives. To identify age-related tra- jectories of obesity from childhood into adolescence, and to test the association of these trajectories with the de- velopment of psychiatric disorders (conduct disorder, op- positional defiant disorder, attention-deficit\\/hyperactiv- ity disorder, substance abuse, depression, and anxiety). Methods. White children (N,991) 9 to 16 years old from the Great Smoky Mountains Study, a representative sample

  2. [Forensic psychiatric assessment in the USSR].

    PubMed

    Friemert, K

    1988-11-01

    Basing on the author's experiences during his study stay at the Serbsky All-Union Research Institute for General and Forensic Psychiatry in Moscow a report is given about the theoretical foundations and the carrying-out of forensic-psychiatric expert-opinions in the field of penal as well as civil law in the U.S.S.R. Some peculiarities in comparison with the practice in the G.D.R. are taken in special account. PMID:3237873

  3. Meta-analysis in psychiatric genetics

    Microsoft Academic Search

    Douglas F. Levinson

    2005-01-01

    The article reviews literature on methods for meta-analysis of genetic linkage and association studies, and summarizes and\\u000a comments on specific meta-analysis findings for psychiatric disorders. The Genome Scan Meta-Analysis and Multiple Scan Probability\\u000a methods assess the evidence for linkage across studies. Multiple Scan Probability analysis suggested linkage of two chromosomal\\u000a regions (13q and 22q) to schizophrenia and bipolar disorder, whereas

  4. Hostility and violence of acute psychiatric inpatients

    Microsoft Academic Search

    Michele Raja; Antonella Azzoni

    2005-01-01

    OBJECTIVE: The aim of the present study was to find out the extent of hostility and violence and the factors that are associated with such hostility and violence in a psychiatric intensive care unit. METHODS: Retrospective analysis of data prospectively collected in a 6-year period. RESULTS: No hostility was observed in 56.1%, hostility in 40.9%, and violence in 3.0% of

  5. Psychiatric considerations in the oncology setting.

    PubMed

    Mehta, Reema D; Roth, Andrew J

    2015-07-01

    Answer questions and earn CME/CNE An aging population and advances in diagnostics and treatment have resulted in a rapidly growing population of people impacted by cancer. People live longer after a cancer diagnosis and tolerate more aggressive treatments than in the past. Younger patients struggle with diversions from the normal developmental milestones in career and relationships, while older patients deal with the dual challenges of aging and cancer. Cancer's transition from likely death to survival has increased interest in its impact on psychosocial issues and quality of life, rather than just longevity. In this article, the authors review the psychiatric diagnosis and management of the mental health issues most often encountered in oncology. Oncology treatment teams, including oncologists, nurses, social workers, and other ancillary staff, are often on the front lines of addressing psychiatric distress and clinical syndromes when psychiatrists are not easily available. The purpose of this review article is to highlight opportunities for nonpsychiatrists to improve identification and treatment of psychosocial distress and psychiatric syndromes and to request formal psychiatric consultation in appropriate situations. Psychotherapeutic, psychopharmacologic, cognitive, and behavioral-oriented interventions, as well as supportive interventions, are discussed for treating patients who are facing challenges during active cancer treatment, survivorship, and at the end of life. This review is not exhaustive but highlights the more common psychosomatic medicine and palliative care scenarios that impact cancer patient care. The importance of recognizing and addressing burnout and compassion fatigue in multidisciplinary professionals who care for those treated for cancer is also discussed given the secondary impact this can have on patient care. CA Cancer J Clin 2015;65:299-314. © 2015 American Cancer Society. PMID:26012508

  6. Paranoid atmospheres: psychiatric knowledge and delusional realities.

    PubMed

    Schlimme, Jann E

    2009-01-01

    In this paper I investigate the topic of paranoid atmospheres. This subject is especially of interest with respect to persons who are deluded, and also, I will demonstrate, sheds light upon the psychiatrist's "gaze" and knowledge of delusions. In my argument I will follow a path initially outlined by Karl Jaspers (1883-1969): modern psychiatric diagnosis of delusions is a diagnosis of form and not content. Jaspers' emphasis on the form of delusions enables psychiatrists to be self-critical about their professional knowledge and, consequently, prevent the development of dogmatic attitudes. In accord with Jaspers, my argument will focus on the basic structure of delusions and highlight the difference between delusional realities and non-delusional realities, a difference that follows from the possibility of self-criticism of one's own conscious and explicit convictions. I will demonstrate the importance of self-criticism with regard to paranoid atmospheres and also to psychiatric knowledge. In this manner, an understanding of delusions as lived experience will be developed, which argues that an escalation of the influence of delusional convictions, resulting in a profoundly paranoid atmosphere, is most problematic for the deluded person. To acknowledge this insight mirrors the need for a self-critique of psychiatric discourse, encourages an empathic and respectful relationship between professionals and deluded patients, and enables deluded persons to restrict their paranoid atmosphere. It is the main conclusion of my paper that a deluded person cannot do (with respect to his delusional convictions) what a psychiatrist must do (with respect to his psychiatric knowledge and his own existential convictions) in order to prevent a profoundly paranoid atmosphere in their relationship: be self-critical. PMID:19761600

  7. Paranoid atmospheres: Psychiatric knowledge and delusional realities

    PubMed Central

    Schlimme, Jann E

    2009-01-01

    In this paper I investigate the topic of paranoid atmospheres. This subject is especially of interest with respect to persons who are deluded, and also, I will demonstrate, sheds light upon the psychiatrist's "gaze" and knowledge of delusions. In my argument I will follow a path initially outlined by Karl Jaspers (1883-1969): modern psychiatric diagnosis of delusions is a diagnosis of form and not content. Jaspers' emphasis on the form of delusions enables psychiatrists to be self-critical about their professional knowledge and, consequently, prevent the development of dogmatic attitudes. In accord with Jaspers, my argument will focus on the basic structure of delusions and highlight the difference between delusional realities and non-delusional realities, a difference that follows from the possibility of self-criticism of one's own conscious and explicit convictions. I will demonstrate the importance of self-criticism with regard to paranoid atmospheres and also to psychiatric knowledge. In this manner, an understanding of delusions as lived experience will be developed, which argues that an escalation of the influence of delusional convictions, resulting in a profoundly paranoid atmosphere, is most problematic for the deluded person. To acknowledge this insight mirrors the need for a self-critique of psychiatric discourse, encourages an empathic and respectful relationship between professionals and deluded patients, and enables deluded persons to restrict their paranoid atmosphere. It is the main conclusion of my paper that a deluded person cannot do (with respect to his delusional convictions) what a psychiatrist must do (with respect to his psychiatric knowledge and his own existential convictions) in order to prevent a profoundly paranoid atmosphere in their relationship: be self-critical. PMID:19761600

  8. Neural Principles of Neurological and Psychiatric Disorders

    Microsoft Academic Search

    Frank I. Tarazi; Marc J. Kaufman

    Recent progress in understanding the neurobiology and pharmacology of brain neurotransmitters and their neural circuits and\\u000a pathways has been remarkable and serves as the foundation for in-depth preclinical research on neurological and psychiatric\\u000a disorders. Most of the neurotransmitter receptors have been cloned and their anatomical localization and distribution have\\u000a been clarified using advanced neurochemical methods. Novel discoveries have greatly stimulated

  9. Connectomic intermediate phenotypes for psychiatric disorders.

    PubMed

    Fornito, Alex; Bullmore, Edward T

    2012-01-01

    Psychiatric disorders are phenotypically heterogeneous entities with a complex genetic basis. To mitigate this complexity, many investigators study so-called intermediate phenotypes (IPs) that putatively provide a more direct index of the physiological effects of candidate genetic risk variants than overt psychiatric syndromes. Magnetic resonance imaging (MRI) is a particularly popular technique for measuring such phenotypes because it allows interrogation of diverse aspects of brain structure and function in vivo. Much of this work however, has focused on relatively simple measures that quantify variations in the physiology or tissue integrity of specific brain regions in isolation, contradicting an emerging consensus that most major psychiatric disorders do not arise from isolated dysfunction in one or a few brain regions, but rather from disturbed interactions within and between distributed neural circuits; i.e., they are disorders of brain connectivity. The recent proliferation of new MRI techniques for comprehensively mapping the entire connectivity architecture of the brain, termed the human connectome, has provided a rich repertoire of tools for understanding how genetic variants implicated in mental disorder impact distinct neural circuits. In this article, we review research using these connectomic techniques to understand how genetic variation influences the connectivity and topology of human brain networks. We highlight recent evidence from twin and imaging genetics studies suggesting that the penetrance of candidate risk variants for mental illness, such as those in SLC6A4, MAOA, ZNF804A, and APOE, may be higher for IPs characterized at the level of distributed neural systems than at the level of spatially localized brain regions. The findings indicate that imaging connectomics provides a powerful framework for understanding how genetic risk for psychiatric disease is expressed through altered structure and function of the human connectome. PMID:22529823

  10. Links between Circadian Rhythms and Psychiatric Disease

    PubMed Central

    Karatsoreos, Ilia N.

    2014-01-01

    Determining the cause of psychiatric disorders is a goal of modern neuroscience, and will hopefully lead to the discovery of treatments to either prevent or alleviate the suffering caused by these diseases. One roadblock to attaining this goal is the realization that neuropsychiatric diseases are rarely due to a single gene polymorphism, environmental exposure, or developmental insult. Rather, it is a complex interaction between these various influences that likely leads to the development of clinically relevant syndromes. Our lab is exploring the links between environmental exposures and neurobehavioral function by investigating how disruption of the circadian (daily) clock alters the structure and function of neural circuits, with the hypothesis that disrupting this crucial homeostatic system can directly contribute to altered vulnerability of the organism to other factors that interact to produce psychiatric illness. This review explores some historical and more recent findings that link disrupted circadian clocks to neuropsychiatric disorders, particularly depression, mania, and schizophrenia. We take a comparative approach by exploring the effects observed in human populations, as well as some experimental models used in the laboratory to unravel mechanistic and causal relationships between disruption of the circadian clock and behavioral abnormalities. This is a rich area of research that we predict will contribute greatly to our understanding of how genes, environment, and development interact to modulate an individual’s vulnerability to psychiatric disorders. PMID:24834040

  11. Role of the forensic psychiatric nurse.

    PubMed

    Lyons, Tamsen

    2009-01-01

    Abstract The article clarifies the role of the forensic psychiatric nurse (FPN) and challenges interchangeable terms confusing forensic and correctional nursing. It addresses the varied venues where the FPN may assess the patient (victim or perpetrator) and gather evidence that may influence conviction, sentencing, recidivism, treatment, and prevention. In depth knowledge of medical and psychiatric nursing as well as the criminal justice system is germane to competent advanced practice forensic nursing. An analogy is drawn between the forensic assessment for risk of violence which is commonly performed by psychiatric nurses in Emergency Departments and the collection and preservation of evidence by medical nurses in Emergency Departments. Both instances require evidence-based techniques and a familiarity with forensic procedures and are often performed by nurses who are not specifically trained in these areas. A case analysis demonstrates the value of an in depth and broad assessment of victim and perpetrator. Evidence based training and the application of structured clinical judgment used in the evaluation of victims and perpetrators make it possible for the FNP to provide expert testimony and to make recommendations for treatment. PMID:19222692

  12. [Blood platelets: neuronal model in psychiatric disorders].

    PubMed

    Dreux, C; Launay, J M

    1985-01-01

    There are some evidences to propose blood platelets as a model of bioaminergic neurons. Similarities between platelets and neurons are particularly important with respect to serotonin metabolism but now it is possible to extend this model to other neurotransmitters such as dopamine, GABA, glutamate... The reason for these similarities may be due to the common embryonic origin of these two very different cell types. Some changes of platelet functions are observed in psychiatric syndromes. For example: serotonin uptake, bioamine storage, enzymatic activities are modified in different types of depression and schizophrenia, infantile autism, neurologic diseases (migraine, chorea, Down syndrom). Furthermore, psychotropic drugs also alter the platelet functions. Recently, the discovery of neuro-endocrine disorders in psychiatric diseases has led to the proposal of platelets as a model in neuro-endocrinology. Some arguments can be developed to support this hypothesis. In biological psychiatry, the platelet model seems actually useful essentially in the classification of psychiatric diseases, the management of treatments and the study of new psychotropic drugs. However methodologic difficulties still presently limit the development of this model. PMID:2862006

  13. Virtual Hospital

    NSDL National Science Digital Library

    Provided and maintained by the University of Iowa Health Care, the Virtual Hospital is designed as a "medical reference and health promotion tool for health care providers and patients." To that end, the site offers current and authoritative medical information for patients and professional and pedagogical information for health care providers. The former includes patient educational briefs browseable by organ system or by a topical list, a collection of peer-reviewed and annotated Web resources, an internal search engine, and archives of a column offering medical advice to middle-aged users. Resources in the health care provider section include several digital libraries aimed at certain specialties (Pediatrics, Pediatric Radiology, Family Medicine, and Medical Student); multimedia textbooks and teaching files grouped by organ system; lectures and publications; and clinical practice guidelines. Additional resources at the site include links to the Virtual Children's and Virtual Naval Hospitals, an internal search engine, and online continuing education courses.

  14. Psychiatric clinical course strengthens the student-patient relationships of baccalaureate nursing students.

    PubMed

    Ketola, J; Stein, J V

    2013-02-01

    Psychiatric nursing teaches students how to engage and communicate with patients who have severe emotional distress. Nurses need this knowledge as the majority of patients encountered in hospitals are distressed. This study explores the impact of a psychiatric clinical course in helping students learn to relate to distressed patients. The study used a mixed research methodology to survey 67 baccalaureate students about their experiences in the placement portion of the psychiatric nursing course. The pre-clinical questions focused on students' anticipation regarding individuals with mental illness and how the clinical experience would affect them as nurses and as individuals. The post-clinical questions asked how the clinical experience affected them. The students stated that their time with patients had changed them. Ninety-nine per cent were no longer frightened of the patients. Students realized the patients were distressed and were glad to help them. This work sensitized them to the individual rather than the generic patient. It initiated a process in self-awareness, in sensitivity to the feelings of another person and in communication skills. These are steps in the development of an empathetic presence. The students recognized the need for these skills in all nursing. The authors recommend strategies to assist students in developing an empathetic presence. PMID:22413758

  15. Self-care program for inpatients in a mental hospital.

    PubMed Central

    Voineskos, G.; Butler, J. A.; Bullock, L. J.; El-Gaaly, A. A.

    1975-01-01

    Summary: A self-care program for selected inpatients in a mental hospital has been developed and has been in operation for more than a year. The 12-bed unit operates without any nursing or other professional staff during the night and weekend. Certain factors, including the mental hospital as an organization, tend to hamper the development of this type of program as well as the progress and growth of other programs in psychiatric hospitals. It is suggested that the much needed progress in the mental hospital would be facilitated by an open-systems approach to its organization. Mental hospitals should consider the introduction of self-care programs for selected patients, mainly in view of their therapeutic potential, but also because of the financial savings such programs offer. PMID:1111874

  16. Psychiatric Disorders in HTLV-1-Infected Individuals with Bladder Symptoms

    PubMed Central

    Orge, Glória O.; Dellavechia, Thais R.; Carneiro-Neto, José Abraão; Araújo-de-Freitas, Lucas; Daltro, Carla H. C.; Santos, Carlos T.; Quarantini, Lucas C.

    2015-01-01

    Background Previous studies have reported high rates of depression and anxiety in HTLV-1 infected individuals with the neurological disease and in the asymptomatic phase. No study has investigated the rates in individuals that already show bladder symptoms without severe neurological changes; that is, during the oligosymptomatic phase. The present study investigated patients in this intermediate form on the spectrum of the infection. Methodology/Principal Findings Participants answered a sociodemographic questionnaire, the Mini International Neuropsychiatric Interview Brazilian Version 5.0.0 (MINI PLUS) and the Hospital Anxiety and Depression Scale (HADS). Data analysis was performed in STATA statistical software (version 12.0). Depressive disorder was the most frequent comorbidity. Current depressive disorder was higher in the group of overactive bladder subjects (11.9%), and lifelong depression was more frequent in the HAM/TSP group (35%). The three groups had similar frequencies of anxiety disorders. Increased frequency and severity of anxiety and depression symptoms were observed in the overactive bladder group. Conclusion/Significance The results suggest that individuals with overactive bladders need a more thorough assessment from the mental health perspective. These patients remain an understudied group regarding psychiatric comorbidities. PMID:26018525

  17. Effects of competition on hospital quality: an examination using hospital administrative data.

    PubMed

    Palangkaraya, Alfons; Yong, Jongsay

    2013-06-01

    This paper investigates the effects of competition on hospital quality using hospital administration data from the State of Victoria, Australia. Hospital quality is measured by 30-day mortality rates and 30-day unplanned readmission rates. Competition is measured by Herfindahl-Hirschman index and the numbers of competing public and private hospitals. The paper finds that hospitals facing higher competition have lower unplanned admission rates. However, competition is related negatively to hospital quality when measured by mortality, albeit the effects are weak and barely statistically significant. The paper also finds that the positive effect of competition on quality as measured by unplanned readmission differs greatly depending on whether the hospital is publicly or privately owned. PMID:22395668

  18. The Risk of Repetition of Attempted Suicide Among Iranian Women with Psychiatric Disorders as Quantified by the Suicide Behaviors Questionnaire

    PubMed Central

    Shakeri, Jalal; Farnia, Vahid; Abdoli, Nasrin; Akrami, Mohammad R.; Arman, Farid; Shakeri, Hania

    2015-01-01

    Objectives: The factors associated with repetition of attempted suicide are poorly categorized in the Iranian population. In this study, the prevalence of different psychiatric disorders among women who attempted suicide and the risk of repetition were assessed. ?Methods: Participants were women admitted to the Poisoning Emergency Hospital, Kermanshah University of Medical Sciences following failed suicide attempts. Psychiatric disorders were diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) symptom checklist. Risk of repetition was evaluated using the Suicide Behaviors Questionnaire-Revised (SBQ-R). ?Results: About 72% of individuals had a SBQ-R score >8 and were considered to be at high risk for repeated attempted suicide. Adjustment disorders were the most common psychiatric disorders (40.8%). However, the type of psychiatric disorder was not associated with the risk of repetition (p=0.320). Marital status, educational level, employment, substance use, history of suicide among family members, and motivation were not determinant factors for repetition of suicide attempt (p=0.220, 0.880, 0.220, 0.290, 0.350 and 0.270, respectively). Younger women were associated with violent methods of attempted suicide, such as self-cutting, whereas older individuals preferred consumption of poison (p<0.001). Drug overdose was more common among single and married women whereas widows or divorcees preferred self-burning (p=0.004). ?Conclusion: About 72% of patients with failed suicide attempts were at high risk for repeated attempts. Age, marital status, and type of psychiatric disorder were the only determinants of suicide method. Adjustment disorders were the most common psychiatric disorders among Iranian women. However, this did not predict the risk of further attempts.

  19. Early trajectory of psychiatric symptoms after traumatic brain injury: relationship to patient and injury characteristics.

    PubMed

    Hart, Tessa; Benn, Emma K T; Bagiella, Emilia; Arenth, Patricia; Dikmen, Sureyya; Hesdorffer, Dale C; Novack, Thomas A; Ricker, Joseph H; Zafonte, Ross

    2014-04-01

    Psychiatric disturbance is common and disabling after traumatic brain injury (TBI). Few studies have investigated the trajectory of psychiatric symptoms in the first 6 months postinjury, when monitoring and early treatment might prevent persistent difficulties. The aim of this study was to examine the trajectory of psychiatric symptoms 1-6 months post-TBI, the patient/injury characteristics associated with changes, and characteristics predictive of persisting symptoms. A secondary analysis was performed on data from a clinical trial with three data collection points. Across eight centers, 872 participants with complicated mild to severe TBI were administered the Brief Symptom Inventory (BSI) at 30, 90, and 180 days postinjury. Mixed-effects models were used to assess longitudinal changes in the BSI Global Severity Index (GSI). Multi-variate logistic regression was used to assess predictors of clinically significant GSI elevations persisting to 6 months post-TBI. In general, GSI scores improved over time. Women improved faster than men; race/ethnicity was also significantly associated with rate of change, with Hispanics showing the most and African Americans the least improvement. Clinically significant psychiatric symptoms (caseness) occurred in 42% of the sample at 6 months, and more than one type of symptom was common. Significant predictors of caseness included African American race, age from 30 to 60 years, longer post-traumatic amnesia (PTA) duration, pre-TBI unemployment, and pre-TBI risky alcohol use. Findings indicate that psychiatric symptoms are common in the first 6 months post-TBI and frequently extend beyond the depression and anxiety symptoms that may be most commonly screened. Patients with longer PTA and preinjury alcohol misuse may need more intensive monitoring for symptom persistence. PMID:24237113

  20. Early Trajectory of Psychiatric Symptoms after Traumatic Brain Injury: Relationship to Patient and Injury Characteristics

    PubMed Central

    Benn, Emma K.T.; Bagiella, Emilia; Arenth, Patricia; Dikmen, Sureyya; Hesdorffer, Dale C.; Novack, Thomas A.; Ricker, Joseph H.; Zafonte, Ross

    2014-01-01

    Abstract Psychiatric disturbance is common and disabling after traumatic brain injury (TBI). Few studies have investigated the trajectory of psychiatric symptoms in the first 6 months postinjury, when monitoring and early treatment might prevent persistent difficulties. The aim of this study was to examine the trajectory of psychiatric symptoms 1–6 months post-TBI, the patient/injury characteristics associated with changes, and characteristics predictive of persisting symptoms. A secondary analysis was performed on data from a clinical trial with three data collection points. Across eight centers, 872 participants with complicated mild to severe TBI were administered the Brief Symptom Inventory (BSI) at 30, 90, and 180 days postinjury. Mixed-effects models were used to assess longitudinal changes in the BSI Global Severity Index (GSI). Multi-variate logistic regression was used to assess predictors of clinically significant GSI elevations persisting to 6 months post-TBI. In general, GSI scores improved over time. Women improved faster than men; race/ethnicity was also significantly associated with rate of change, with Hispanics showing the most and African Americans the least improvement. Clinically significant psychiatric symptoms (caseness) occurred in 42% of the sample at 6 months, and more than one type of symptom was common. Significant predictors of caseness included African American race, age from 30 to 60 years, longer post-traumatic amnesia (PTA) duration, pre-TBI unemployment, and pre-TBI risky alcohol use. Findings indicate that psychiatric symptoms are common in the first 6 months post-TBI and frequently extend beyond the depression and anxiety symptoms that may be most commonly screened. Patients with longer PTA and preinjury alcohol misuse may need more intensive monitoring for symptom persistence. PMID:24237113