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1

A comparison of psychiatric day hospitals in five European countries  

Microsoft Academic Search

Objective: As the use of “day hospitals” increases, conceptual models of these services are changing dramatically across Europe. Therefore, the need arises for mental health services research to assess this process cross-nationally in a standardised and systematic way. Such research approaches should seek to maximise the generalisability of results from high-quality (e. g. randomised controlled) single- or multi-site trials assessing

Thomas W. Kallert; Matthias Glöckner; Stefan Priebe; Jane Briscoe; Joanna Rymaszewska; Tomasz Adamowski; P?tr Nawka; Helena Reguliova; Ji?í Raboch; Andrea Howardova; Matthias Schützwohl

2004-01-01

2

Institutional therapeutic alliance and its relationship with outcomes in a psychiatric day hospital program.  

PubMed

The article shows the results of a longitudinal study aimed to explore the institutional therapeutic alliance (ITA) that is the alliance formed by a patient and all the therapeutic staff. Fifty five patients who have psychiatric disorders in partial hospitalization were evaluated at admission (global functional level, social support, symptomatic condition, and treatment expectancies), at discharge, and after 3 months. ITA was assessed after 1 week of treatment and at discharge, from patient's and staff's perspectives. Preliminary findings suggest that the ITA represents a specific phenomenon different from the classical therapeutic alliance (patienttherapist), which would be particularly relevant for the treatment of patients who are severely disturbed. PMID:18809120

Pulido, Ricardo; Monari, Marco; Rossi, Nicolino

2008-10-01

3

Patterns of acute psychiatric hospitalization in Massachusetts.  

PubMed

This study identifies long-term patterns of patient utilization in acute hospitals in Massachusetts based on the 47,787 psychiatric patients. Cluster analyses are used to identify six patterns of hospitalization based on the number and length of episodes, variety of institutions, length of stay, and time between stays. The study demonstrates that while the 74% of one-time patients with short stays use only a fifth (18.0%) of the bed days, the highest users were not the long-term users, but instead the 22.9% occasional extended-stay patients who use 70.0% of the total bed days. The study also finds that extending the length of the initial stay has little impact on limiting subsequent hospitalization. PMID:15844846

Hudson, Christopher G

2005-01-01

4

Medication safety in a psychiatric hospital  

Microsoft Academic Search

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

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

2007-01-01

5

Psychiatric Hospitalization after Deliberate Self-Poisoning  

ERIC Educational Resources Information Center

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

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

2006-01-01

6

Patterrns of Acute Psychiatric Hospitalization in Massachusetts  

Microsoft Academic Search

This study identifies long-term patterns of patient utilization in acute hospitals in Massachusetts based on the 47,787 psychiatric patients. Cluster analyses are used to identify six patterns of hospitalization based on the number and length of episodes, variety of institutions, length of stay, and time between stays. The study demonstrates that while the 74% of one-time patients with short stays

Christopher G. Hudson

2005-01-01

7

Mortality of Finnish acute psychiatric hospital patients  

Microsoft Academic Search

Objective  The mortality of psychiatric patients is higher than that of the general population. Earlier studies have typically focused\\u000a on specific diagnostic categories or causes of death. The aim of this study was to assess the overall mortality in acute psychiatric\\u000a hospital patients covering all diagnostic groups, with special emphasis on substance abuse.\\u000a \\u000a \\u000a \\u000a Methods  The sample consisted of all 18–64-year old patients

Heidi Honkonen; Aino K. Mattila; Klaus Lehtinen; Teemu Elo; Riina Haataja; Matti Joukamaa

2008-01-01

8

[The day hospital in search of its identity].  

PubMed

After more than fifty years of existence, the day hospital remains a little known tool. Submerged in the new psychiatric landscape, between part time therapeutic care centres, home hospital care and mutual support groups, this institution, which offers appropriate care, finds itself being questioned with regard to its place, its development and its future. PMID:21972744

Muller, Christian

2011-01-01

9

Comorbidity and Pattern of Substance Use in Hospitalized Psychiatric Patients  

PubMed Central

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

Sepehrmanesh, Zahra; Ahmadvand, Afshin; Moraveji, Alireza

2014-01-01

10

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

PubMed

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

Furlan, Marcela Martins; Ribeiro, Cléa Regina de Oliveira

2011-04-01

11

Hospitalized youth and child abuse: a systematic examination of psychiatric morbidity and clinical severity.  

PubMed

Many children and adolescents who require psychiatric hospitalization have been physically or sexually abused, yet the association between reported histories of abuse and the complexity and severity of mental illness among psychiatrically hospitalized youth is poorly described with regard to current inpatient psychiatric practice. We sought to determine the association between histories of abuse and psychiatric complexity and severity in psychiatrically hospitalized youth including comorbidity patterns, psychotropic medication use, reason for admission and length of hospitalization. A systematic chart review was performed on 1433 consecutive psychiatric hospitalizations of children and adolescents that occurred over a 10-month period. Children with a history of abuse were more likely to be diagnosed with multiple DSM-IV-TR disorders than non-traumatized children. A history of sexual abuse was associated with more medication use than in their non-traumatized peers and a higher likelihood of treatment with antipsychotic medications, both at admission and discharge. Physical and sexual abuse were independently associated with increased length of stays, with exposure to both physical and sexual abuse associated with a 2-day increase in duration of hospitalization compared to non-traumatized patients. The findings from this study draw attention to the adverse impact of abuse on psychiatric morbidity and complexity and suggest the need for trauma-informed treatment in psychiatric hospital settings. PMID:24041456

Keeshin, Brooks R; Strawn, Jeffrey R; Luebbe, Aaron M; Saldaña, Shannon N; Wehry, Anna M; DelBello, Melissa P; Putnam, Frank W

2014-01-01

12

Psychiatric Hospitalization among Children with Autism Spectrum Disorders  

ERIC Educational Resources Information Center

This study examined predictors of psychiatric hospitalization among children with autism spectrum disorders (ASD). Data were collected from 760 caregivers of children with ASD. Cox regression was used to determine factors associated with hospitalization. Almost 11% were hospitalized. Youth in single parent homes were more likely to be hospitalized

Mandell, David S.

2008-01-01

13

Call for research: detecting early vulnerability for psychiatric hospitalization.  

PubMed

This study delineated the extent to which a broad set of risk factors in youth, a period well suited to primary prevention strategies, influences the likelihood and timing of first lifetime psychiatric hospitalizations. Logistic regression was used to delineate early risk factors for psychiatric hospitalization among Americans in a nationally representative survey (NCS-R, Part II, 2001-2003: N?=?5,692). Results suggest that inpatient stay is more common and happens at earlier ages among Americans who report growing up with versus without: (1) depressed parents or caregivers, (2) family members who victimized them, or (3) one of three child mental illnesses (conduct, oppositional defiant, or separation anxiety disorder). In order to prevent inpatient stay, findings call for longitudinal research on early vulnerability for psychiatric hospitalization among families with: (1) depressed parents of children or adolescents, (2) violence against children, and (3) children that have externalizing or separation anxiety disorders. PMID:23160760

Prince, Jonathan D

2013-01-01

14

Evolution of an active psychogeriatric day hospital.  

PubMed Central

A geriatric day hospital was established as part of the psychogeriatric unit of the Royal Ottawa Hospital. While initially this day hospital was integrated with day hospital programs of other units, it became apparent that a separate facility was desirable. The activities and programs of the psychogeriatric day hospital, run by one registered nurse, were integrated with those of the geriatric inpatient unit. It was found to be advantageous for inpatients and day hospital patients to share the same physical facilities. The majority of day hospital patients came from the inpatient unit; almost all had affective disorders. The emphasis was on reintegration into the community. During the 1st year of operation there were 75 patients in the program; only 3 needed admission to the inpatient unit and 1 was readmitted after discharge. PMID:991034

Goldstein, S. E.; Carlson, S.

1976-01-01

15

Psychiatric disorder in hospital and general practice  

Microsoft Academic Search

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.

Brian Cooper

1966-01-01

16

Risk Factors Associated with Psychiatric Hospitalization Among Iranian Schizophrenic Patients  

PubMed Central

Objective: Psychiatric hospitalization of patients imposes heavy burdens on caregivers, but little is known about this issue in Iran. The present cross-sectional study aimed to investigate the risk factors associated with psychiatric hospitalization of patients with schizophrenia who were the regular clients for the educational programs of The Iranian Society for Supporting Individuals with Schizophrenia (ISSIS) in Tehran, Iran. Methods: 231 male and female study subjects and 231 of their caregivers participated in the study. The study subjects were independently assessed in demographics, clinical and symptom-related characteristics and basic life skills domains. Their caregivers were assessed in domains of knowledge on schizophrenia, burden, social support, family function, and the patterns of relationships with their patients and the role of health and supportive services. Data were analyzed by performing logistic regression model. Results: Old age, low level of education, unemployment, greater severity of positive and negative symptoms, poor basic life skills among subjects, and objective family burden, inadequate knowledge on schizophrenia, low perceived social support and lack of medical insurance among caregivers were the most important factors associated with psychiatric hospitalization among the clients. Conclusions: Some factors originated in Iranian patients and their caregivers could cause patients’ pathways to psychiatric hospitalization. Although the study results did not establish causation, based on the findings, psychoeducational interventions may reduce schizophrenia referral and lower the rate of need to inpatient services in Iran. Declaration of interest: None. PMID:24644506

Mansouri, Nader; Chimeh, Narges; Dehghani, Mohsen; Malakouti, Seyed Kazem; Taherkhani, Hamid; Abarashi, Zohreh

2013-01-01

17

Serum Dopamine Beta Hydroxylase and Maltreatment in Psychiatrically Hospitalized Boys.  

ERIC Educational Resources Information Center

Males (ages 7 to 17) in a psychiatric hospital were studied while off psychoactive medication to determine how serum dopamine beta hydroxylase (DBH) activity varies with childhood maltreatment experiences. Lowest DBH levels were found in boys maltreated before 72 months of age or with the principal diagnosis of conduct disorder solitary aggressive…

Galvin, Matthew; And Others

1995-01-01

18

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

PubMed Central

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

2013-01-01

19

Dual Diagnosis: Examination of Service Use and Length of Stay During Psychiatric Hospitalization  

Microsoft Academic Search

Anecdotal reports suggest that persons with a dual diagnosis (mental retardation and psychiatric illness) admitted to acute psychiatric hospitals stay longer and require more services than individuals without mental retardation. To test these hypotheses, a questionnaire was completed for 64 people with dual diagnosis admitted to 10 psychiatric hospitals over 3 months. Multivariate analysis revealed that a diagnosis of mental

Steven P. Lohrer; Elliot Greene; Charles J. Browning; Michael S. Lesser

2002-01-01

20

A preliminary investigation into patterns of aggression in an Australian forensic psychiatric hospital  

Microsoft Academic Search

The aggressive behaviour of psychiatric inpatients has profound consequences for patients, staff, ward atmosphere and psychiatric hospitals in general. Considerable international research exists, primarily conducted in general psychiatric hospitals, on the prevalence and determinants of aggression. Conclusions drawn from this research contribute valuable information about the clinical and demographic characteristics of aggressive patients. There is little Australian research available, however,

Michael Daffern; Maggie M. Mayer; Trish Martin

2003-01-01

21

42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.  

Code of Federal Regulations, 2011 CFR

...medical record requirements for psychiatric hospitals. 482.61 Section 482.61 Public Health...CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Requirements for Specialty Hospitals § 482.61 Condition of...

2011-10-01

22

42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.  

Code of Federal Regulations, 2013 CFR

...medical record requirements for psychiatric hospitals. 482.61 Section 482.61 Public Health...CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Requirements for Specialty Hospitals § 482.61 Condition of...

2013-10-01

23

42 CFR 482.61 - Condition of participation: Special medical record requirements for psychiatric hospitals.  

Code of Federal Regulations, 2012 CFR

...medical record requirements for psychiatric hospitals. 482.61 Section 482.61 Public Health...CERTIFICATION CONDITIONS OF PARTICIPATION FOR HOSPITALS Requirements for Specialty Hospitals § 482.61 Condition of...

2012-10-01

24

42 CFR 482.60 - Special provisions applying to psychiatric hospitals.  

Code of Federal Regulations, 2010 CFR

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

2010-10-01

25

42 CFR 482.60 - Special provisions applying to psychiatric hospitals.  

Code of Federal Regulations, 2011 CFR

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

2011-10-01

26

42 CFR 482.60 - Special provisions applying to psychiatric hospitals.  

Code of Federal Regulations, 2012 CFR

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

2012-10-01

27

42 CFR 482.60 - Special provisions applying to psychiatric hospitals.  

Code of Federal Regulations, 2013 CFR

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

2013-10-01

28

Coping strategies of hospitalized people with psychiatric disabilities in Taiwan.  

PubMed

Research has found that people with psychiatric disabilities Taiwan tended to utilize passive and emotional-focused strategies to cope with their illness unlike Western studies. A self-reported questionnaire that incorporated categories: socio-demographic characteristics, the self-impact of illness, illness adaptation, and coping strategy scale was administrated to 140 persons with psychiatric disabilities routinely hospitalized over a long period of time to explore the strategies of coping with their mental disorders. Analysis of survey data found the sense of helplessness and the overall illness adaptation significantly impact negative emotion coping utilization. Those who felt highly impact by the illness, more sense of helplessness, less actively managing their illness, and more social support availability were more likely to use positive emotion as a coping strategy. The better overall adaption to the illness significantly impact procrastination and previous illness experience utilization. Only a positive coping strategy was found significantly to manage the illness. PMID:19826952

Wu, Hui-Ching; Wu, Ching-Kuan; Liao, Jing-Wei; Chang, Li-Hsin; I-Chen, Tang

2010-03-01

29

[Census of hospitalized patients in a psychiatric institution of Rio de Janeiro State: preliminary data].  

PubMed

Rio de Janeiro State has one of the largest networks of psychiatric hospitals in Brazil, one of them the Dr. Eiras Paracambi Hospital (CSDE-P). In late 2000, the current Mental Health Advisory Division of the Rio de Janeiro State Health Department conducted a clinical and psychosocial census of patients hospitalized in the CSDE-P. The hospital population consisted of 1,494 individuals, the majority men (53.4%), single (81.6%), working-age (66.4%), and with limited schooling (only 11.5% with a complete primary education or more). Most had been in hospital for at least two years (77.6%), received visits from relatives (60.5%), but did not have hospital leave (73.8%). The predominant diagnoses were schizophrenia (53.6%) and mental retardation (26.4%). The main therapeutic approach was psychiatric (84.1%). Only 13.3% took part in systematic activities during the day, although 36% were in a condition to do so. CSDE-P is a mega-hospital where most patients have precarious social links, demanding treatment strategies which take this characteristic into account. PMID:12488910

Gomes, Maria Paula Cerqueira; Couto, Maria Cristina Ventura; Pepe, Vera Lúcia Edais; de Almeida, Liz Maria; Delgado, Pedro Gabriel Godinho; Coutinho, Evandro da Silva Freire

2002-01-01

30

Prevalence and correlates of autism in a state psychiatric hospital.  

PubMed

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 (ROC) curves were used to evaluate the SRS as a screening instrument. Chi-squared Automatic Interaction Detector (CHAID) analysis estimated the role of other variables, in combination with the SRS, in separating cases and non-cases. Ten percent of the sample had ASD. More than other patients, their onset was prior to 12 years of age, they had gait problems and intellectual disability, and were less likely to have a history of criminal involvement or substance abuse. Sensitivity (0.86) and specificity (0.60) of the SRS were maximized at a score of 84. Adding age of onset < 12 years and cigarette use among those with SRS <80 increased sensitivity to 1.00 without lowering specificity. Adding a history substance abuse among those with SRS >80 increased specificity to 0.90 but dropped sensitivity to 0.79. Undiagnosed ASD may be common in psychiatric hospitals. The SRS, combined with other information, may discriminate well between ASD and other disorders. PMID:21846667

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

2012-11-01

31

Comparison of outpatient care of discharged state hospital and non-hospitalized psychiatric emergency room patients  

Microsoft Academic Search

The present article compares a cohort discharged from two state hospitals in a large urban area with a cohort referred for outpatient services from a psychiatric emergency room. Both cohorts were referred into the same community mental health system of services. The two cohorts are examined in terms of clinical and social demographic characteristics, in part to consider how distinct

Phyllis Solomon; Barry Gordon

1988-01-01

32

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

PubMed

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

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

1975-11-01

33

Coping Strategies of Family Members of Hospitalized Psychiatric Patients  

PubMed Central

This exploratory research paper investigated the coping strategies of families of hospitalized psychiatric patients and identified their positive and negative coping strategies. In this paper, the coping strategies of 45 family members were examined using a descriptive, correlational, mixed method research approach. Guided by the Neuman Systems Model and using the Family Crisis Oriented Personal Evaluation Scales and semistructured interviews, this paper found that these family members used more emotion-focused coping strategies than problem-focused coping strategies. The common coping strategies used by family members were communicating with immediate family, acceptance of their situation, passive appraisal, avoidance, and spirituality. The family members also utilized resources and support systems, such as their immediate families, mental health care professionals, and their churches. PMID:21994826

Eaton, Phyllis M.; Davis, Bertha L.; Hammond, Pamela V.; Condon, Esther H.; McGee, Zina T.

2011-01-01

34

Hospitalized psychiatric patients view the World Trade Center disaster  

Microsoft Academic Search

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.

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

2004-01-01

35

Psychotic inpatients' social class and their first admission to state or private psychiatric Baltimore hospitals.  

PubMed Central

Social class differences were investigated among patients admitted to public and private psychiatric hospitals. Participants included first admission White psychotic men admitted to Baltimore metropolitan area hospitals between 1983 and 1989. After adjusting for age and diagnosis, patients with low levels of skills/credentials were found to be more likely than patients with higher levels to be admitted to state psychiatric hospitals. These findings underscore the persistence of social class as a determinant of differences in the use of psychiatric care. PMID:8296956

Muntaner, C; Wolyniec, P; McGrath, J; Pulver, A E

1994-01-01

36

Effect of Low Birth Weight and Gender on the Need for Adult Psychiatric Hospitalization  

E-print Network

childhood developmental outcomes may prove to be a useful strategy to reduce psychiatric illness among males. A different early intervention strategy may be needed to address psychiatric problems in women. Conclusion The present study supports previous... and Asperger’s Disorders among extremely low birth weight children (Hack et al., 2009). Longitudinal follow up of individuals who were born prematurely have identified increased rates of psychiatric hospitalization in adolescence and young adulthood...

Manzardo, Ann M.

2011-12-31

37

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

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

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

38

Daily weather variables and affective disorder admissions to psychiatric hospitals  

NASA Astrophysics Data System (ADS)

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

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

2014-03-01

39

Smoking bans in secure psychiatric hospitals and prisons.  

PubMed

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

Sullivan, Danny H; Rees, Megan A

2014-09-01

40

Daily weather variables and affective disorder admissions to psychiatric hospitals.  

PubMed

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

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

2014-12-01

41

Hospital Admission Day Tied to Outcomes for Children with Leukemia  

MedlinePLUS

... on this page, please enable JavaScript. Hospital Admission Day Tied to Outcomes for Children With Leukemia Those ... admitted on weekends stayed in hospital 1.4 days longer, waited an average of about eight hours ...

42

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

ERIC Educational Resources Information Center

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

Simon, Joan B.; Savina, Elena A.

2010-01-01

43

The Closure of a Major Psychiatric Hospital: Can Psychiatric Patients in Long-Term Care Be Integrated Into Existing Nursing Homes?  

Microsoft Academic Search

Nursing homes are important alternatives to large hospitals when psychiatrically ill patients are relocated in the commu nity, but their suitability for this type of patient is being questioned. This study compared patients in two traditional Swedish nursing homes (n = 66) and patients in long-term care at a large psychiatric hospital (n = 106). The results showed that both

Karina Dencker; Carl-Gerhard Gottfries

1991-01-01

44

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

PubMed

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

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

2014-04-01

45

The Use of Movies to Facilitate Family Engagement in Psychiatric Hospitalization  

ERIC Educational Resources Information Center

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

Garrison, David

2007-01-01

46

The elderly in a mental subnormality hospital: A comparison with the elderly psychiatric patient  

Microsoft Academic Search

Approximately 6 % of the patients in a mental subnormality hospital were over the age of 65, in contrast to 61 % of patients in a psychiatric hospital. The mean time spent in institutional care was 46.4 years for the mentally handicapped individuals. The level of self care of the mentally handicapped patients was generally better than that of the

Brian R. Ballinger

1978-01-01

47

PROGNOSTIC STUDY OF PATIENTS WHO LEFT, RETURNED, AND STAYED IN A PSYCHIATRIC HOSPITAL  

Microsoft Academic Search

STUDIED PSYCHIATRIC SS IN A VETERANS ADMINISTRATION HOSPITAL. 776 SS WERE PLACED IN 1 OF 3 GROUPS: (1) THOSE WHO LEFT THE HOSPITAL AND DID NOT RETURN AT THE TIME OF DATA ANALYSIS, (2) THOSE WHO RETURNED WITHIN 12 MO., AND (3) THOSE WHO DID NOT LEAVE. DATA WERE OBTAINED ON THE FOLLOWING VARIABLES: AGE, SERVICE DATES, FUNDS, SOURCE OF

CEASAR C. GREGORY; N. M. DOWNIE

1968-01-01

48

Adverse Drug Reactions: A Retrospective Review of Hospitalized Patients at a State Psychiatric Hospital  

PubMed Central

Background: There is a paucity of information regarding adverse drug reactions (ADRs) in psychiatric patients. Information on common and preventable ADRs (pADRs) in psychiatric patients will allow for targeted improvement projects. Objective: To characterize reported ADRs and pharmacist interventions to prevent ADRs in an extended-care state psychiatric hospital. Methods: Four years of ADR reports were assessed for probability, reaction severity, pharmacological class of medication involved, preventability, change in therapy, and transfers to a medical facility. The pharmacist intervention database was queried for interventions classified as “prevention of ADR.” The interventions were assessed for type of medication and recommendation acceptance. Results: Medication classes responsible for ADRs included mood stabilizers (30%), typical antipsychotics (25%), atypical antipsychotics (25%), and antidepressants (8%). Nine percent resulted in transfer to a medical facility. Of all ADRs, 34.4% were pADRs; mood stabilizers (41%) and atypical antipsychotics (27%) were the most common pADRs. The most common causes of pADRs were supratherapeutic serum concentrations, drug-drug interactions, and history of reaction. There were 87 pharmacist interventions that were classified as “prevention of ADR,” and the acceptance rate of pharmacists’ recommendations was 96.5%. Mood stabilizers (20%), atypical antipsychotics (17%), and typical antipsychotics (11%) were commonly associated with prevented ADRs. Lithium accounted for 13.8% of prevented ADRs; these ADRs were most often due to a drug–drug interaction with a nonsteroidal anti-inflammatory drug. Conclusions: ADRs were most commonly associated with mood stabilizers and antipsychotics, and pADRs were common. There is an opportunity to provide education to medical staff on therapeutic drug monitoring and drug–drug interactions for these classes, particularly lithium. PMID:24474834

Iuppa, Courtney A.; Nelson, Leigh Anne; Elliott, Ellie; Sommi, Roger W.

2013-01-01

49

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

ERIC Educational Resources Information Center

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.

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

50

Effects of Multiple Maltreatment Experiences among Psychiatrically Hospitalized Youth  

ERIC Educational Resources Information Center

Objective: Relying on indicators coded from information collected routinely during intake assessments at a secure inpatient psychiatric facility, this study examined the extent to which different forms of maltreatment accounted for variations in youths' emotional and behavioral problems. Methods: Clinical information was reviewed for a large (N =…

Boxer, Paul; Terranova, Andrew M.

2008-01-01

51

Strategies of Rehabilitation in the Day Hospital  

Microsoft Academic Search

A correct and fruitful rehabilitation strategy should consider the following points: (1) the achievement of a psychic equilibrium with a reduction of the psychopathological symptoms; (2) the evaluation of the psychological handicap; (3) a profile of the abilities of the subject that undergoes rehabilitation. You can easily achieve the first two points during hospitalization. The third point can be achieved

Gabriella Ba

1988-01-01

52

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

PubMed

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

Carranza, Fredy J; Parshall, Alice M

2005-02-14

53

Adverse Events Associated With Organizational Factors of General Hospital Inpatient Psychiatric Care Environments  

PubMed Central

Objective Although general hospitals receive nearly 60% of all inpatient psychiatric admissions, little is known about the care environment and related adverse events. The purpose of this study was to determine the occurrence of adverse events and examine the extent to which organizing factors of inpatient psychiatric care environments were associated with the occurrence of these events. The events examined were wrong medication, patient falls with injuries, complaints from patients and families, work-related staff injuries, and verbal abuse directed toward nurses. Methods This cross-sectional study used data from a 1999 nurse survey linked with hospital data. Nurse surveys from 353 psychiatric registered nurses working in 67 Pennsylvania general hospitals provided information on nurse characteristics, organizational factors, and the occurrence of adverse events. Linear regression models and robust clustering methods at the hospital level were used to study the relationship of organizational factors of psychiatric care environments and adverse event outcomes. Results Verbal abuse toward registered nurses (79%), complaints (61%), patient falls with injuries (44%), and work-related injuries (39%) were frequent occurrences. Better management skill was associated with fewer patient falls and fewer work-related injuries to staff. In addition, fewer occurrences of staff injuries were associated with better nurse-physician relationship and lower patient-to-nurse staffing ratios. Conclusions Adverse events are frequent for inpatient psychiatric care in general hospitals, and organizational factors of care environments are associated with adverse event outcomes. Further development of evidence-based quality and safety monitoring of inpatient psychiatric care in general hospitals is imperative. PMID:20513679

Kumar, Aparna; Aiken, Linda H.

2010-01-01

54

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

PubMed

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

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

2014-07-01

55

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

PubMed Central

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

Ali, Akleema; Maharajh, Hari D.

2003-01-01

56

Psychiatric Morbidity and Emotional Exhaustion Among Hospital Physicians and Nurses: Association With Perceived Job-Related Factors  

Microsoft Academic Search

The objective of this study was to evaluate psychiatric morbidity and emotional exhaustion among physicians and nurses of a general hospital in central Italy, examining the association with perceived job-related factors. Anonymous questionnaires were distributed to all 323 hospital physicians and 609 nurses of a nonprofit health organization in Rome, Italy. Standardized instruments were used to evaluate psychiatric morbidity (General

Cristina Renzi; Cristina Di Pietro; Stefano Tabolli

2012-01-01

57

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

PubMed Central

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

2014-01-01

58

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

Microsoft Academic Search

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 hospital. From daily hospital information bulletins, incidents of verbal abuse, verbal threat, physical violence, and violation

MartIn Hildebrand; Corine De Ruiter; Henk Nijman

2004-01-01

59

Evaluating a GP Consultative Psychiatric Service in an Australian Metropolitan Hospital District  

Microsoft Academic Search

Objective: The aim was to develop a psychiatric assessment and advisory service for local general practitioners (GPs).Method: In July 2001, five full-time psychiatrists at Royal Brisbane Hospital each dedicated a 1-h appointment per week in their hospital private practice clinic to assess patients referred by local GPs. The ‘Psych Opinion’ clinic was advertised through the Division of General Practice Newsletter.

Brett Emmerson; Aaron Frost; Jacinta Powell; Warren Ward; Mark Barnes; Rowena Frank

2003-01-01

60

A Wilderness Therapy Program as an Alternative to Adolescent Psychiatric Hospitalization  

Microsoft Academic Search

In two pilot backpacking trips, 14 adolescent inpatients were taken from acute psychiatric hospitals into the wilder ness. Patients selected were either withdrawn or acting out, except for four adolescents diagnosed as ADD or conduct disordered. The former group showed greater change than the latter on a variety of measures including treatment plan objectives, behavioral symptomatology and locus of control.

Dene S. Berman

1988-01-01

61

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

ERIC Educational Resources Information Center

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

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

2009-01-01

62

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

ERIC Educational Resources Information Center

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

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

2005-01-01

63

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

ERIC Educational Resources Information Center

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

Eack, Shaun M.; Newhill, Christina E.

2012-01-01

64

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

ERIC Educational Resources Information Center

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

Manderson, J.; McCune, N.

2004-01-01

65

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

Microsoft Academic Search

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

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

2004-01-01

66

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

Microsoft Academic Search

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

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

2004-01-01

67

Stakeholders' views of legal and advice services for people admitted to psychiatric hospital  

Microsoft Academic Search

This paper describes a study that used a mixed method approach to elicit the views of a range of stakeholders about experiences of compulsory admission to psychiatric hospital, and the use of the Mental Health Review Tribunal (MHRT). The paper begins with an introduction to the background of the study, one that took place in Northern Ireland, a region in

James Campbell

2008-01-01

68

DETERMINANTS OF INPATIENT PSYCHIATRIC LENGTH OF STAY IN AN URBAN COUNTY HOSPITAL  

Microsoft Academic Search

?  This study investigated predictors of length of stay (LOS) for two inpatient psychiatric units (a crisis stabilization unit and a longer-stay milieu unit) in a large, urban, university-affiliated, county hospital. It was hypothesized that three variables would be independently associated with shorter LOS: (1) higher Global Assessment of Functioning (GAF) scale scores, (2) not requiring the use of seclusion or

Michael T. Compton; Jason Craw; Bruce E. Rudisch

2006-01-01

69

[Internal structure of inpatient psychiatric hospital care 22 years after the psychiatry inquest].  

PubMed

Starting with the recommendations of the "Psychiatrie-Enquête", a current empirical stock-taking was undertaken about the structure of care in psychiatric hospital units. 319 treatment units (289 in Germany, 11 in Austria, and 19 in Switzerland) were investigated concerning size of the treatment unit, number of wards, centrality of admission, existence of large observation rooms ("Wachsäle"), specialized wards, single sex wards, regionalization/sectorialization, open-door wards, coercive measures, and intended structural changes. The return rate of questionnaires amounted 59%. The results show that the recommendations of the "Psychiatrie-Enquête" are mostly realized today, but not everywhere. Across countries differences resulted in size of ward, centrality of admission, open-door wards, and coercive measures. Treatment units in the western and eastern parts of germany differed in size of ward and centrality of admission. Differences between psychiatric hospitals, psychiatric departments at general hospitals and psychiatric university hospitals were, though significant, smaller than expected in the light of past controversies. Intended structural changes mainly concerned open-door wards, internal sectorialization, decentralization of admission, and mixing the sexes in single sex wards. PMID:9789271

Gebhardt, R P; Steinert, T

1998-09-01

70

Pathway for inpatients with depressive episode in Flemish psychiatric hospitals: a qualitative study  

PubMed Central

Background Within the context of a biopsychosocial model of the treatment of depressive episodes, a multidisciplinary approach is needed. Clinical pathways have been developed and implemented in hospitals to support multidisciplinary teamwork. The aim of this study is to explore current practice for the treatment of depressive episodes in Flemish psychiatric hospitals. Current practice in different hospitals is studied to get an idea of the similarities (outlined as a pathway) and the differences in the treatment of depressive episodes. Methods A convenience sample of 11 Flemish psychiatric hospitals participated in this qualitative study. Semi-structured interviews were conducted with different types of health care professionals (n = 43). The websites of the hospitals were searched for information on their approach to treating depressive episodes. Results A flow chart was made including the identified stages of the pathway: pre-admission, admission (observation and treatment), discharge and follow-up care. The characteristics of each stage are described. Although the stages are identified in all hospitals, differences between hospitals on various levels of the pathway exist. Hospitals emphasized the individual approach of each patient. The results point to a biopsychosocial approach to treating depressive episodes. Conclusion This study outlined current practice as a pathway for Flemish inpatients with depressive episodes. Within the context of surveillance of quality and quantity of care, this study may encourage hospitals to consider developing clinical pathways. PMID:19840384

Desplenter, Franciska A; Laekeman, Gert M; Simoens, Steven R

2009-01-01

71

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

PubMed Central

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

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

2014-01-01

72

Ethical issues in family planning for hospitalized psychiatric patients.  

PubMed

The authors present guidelines based on their experience with a family planning program for patients in mental hospitals. They believe that informed consent for these patients should include an adequate knowledge base, the patients' competence to make decisions, and the absence of coercion. Among safeguards are the reversibility of contraceptive procedures, the separation of the family planning counselor from the treatment staff to avoid possible covert coercion, and careful choice of the stage of hospitalization at which counseling occurs. The authors examine the implications of a patient's refusal to use contraception, noting the impossibility of involuntary contraception and the ethical and legal problems regarding sterilization procedures. PMID:1115263

Grunebaum, H; Abernethy, V

1975-03-01

73

An investigation of factors associated with psychiatric hospital admission despite the presence of crisis resolution teams  

E-print Network

hours referrals less likely to be accepted. Referral from less senior practitioner less likely to be accepted. Bracken P 1999 [13] UK 53 patients admitted to HT versus 63 admitted to hospital. Chi-squared test. Typical crisis resolution team. Decision... . Psychological Medicine 2002, 32:383-401. 12. Dean C, Gadd E: Home treatment for acute psychiatric illness. British Medical Journal 1990, 301:1021-3. 13. Bracken P, Cohen B: Home treatment in Bradford. Psychiatric Bulletin 1999, 23:349-352. 14. Harrison J, Alam...

Cotton, Mary-Anne; Johnson, Sonia; Bindman, Jonathan; Sandor, Andrew; White, Ian R; Thornicroft, Graham; Nolan, Fiona; Pilling, Stephen; Hoult, John; McKenzie, Nigel; Bebbington, Paul

2007-10-02

74

Assessment of hospital services by consumers: a study from a psychiatric setting.  

PubMed

The present study revealed perception of forty-five patients and fifty nine family members selected from the outpatinet deptt. of a Psychiatric hospital. A semi-structured questionnaire was used. The issues like efficiency, punctuality, behaviour of doctors and other staff, waiting time, supply of draugs and diet and cleanliness of the hospital etc were enquired. More than ninety % of the patients and their escorts appreciated the services provided. Most of them (75-80%) was satisfied with supply of drugs, quality of diet, clinical care and cleanliness of the hospital. Measures for improvement were also suggested. PMID:14723290

Sing, M M; Chadda, R K; Bapna, S J J

2003-01-01

75

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

PubMed Central

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

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

2013-01-01

76

Psychiatric Comorbidity and Mortality among Veterans Hospitalized for Congestive Heart Failure  

PubMed Central

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

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

2011-01-01

77

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

PubMed

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

Kiesler, C A; Simpkins, C

1992-05-01

78

Effects of climate on admission rates of schizophrenia patients to psychiatric hospitals  

Microsoft Academic Search

Data on admissions of schizophrenia- and schizoaffective disorder patients to Tel-Aviv’s seven public psychiatric hospitals during 11 consecutive years were obtained along with relevant meteorological information. Mean monthly admission rates were significantly higher during the summer (for schizophrenia patients) and fall (for schizoaffective patients). Schizophrenia patients’ mean monthly admission rates correlated with mean maximal monthly environmental temperature (R =0.35, N

Roni Shiloh; Avraham Shapira; Oded Potchter; Haggai Hermesh; Miriam Popper; Abraham Weizman

2005-01-01

79

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

Code of Federal Regulations, 2012 CFR

...hospitalization of the patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special...physician or by the hospital's medical staff. (2) Exception...because his or her underlying medical condition and...

2012-10-01

80

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

Code of Federal Regulations, 2010 CFR

...hospitalization of the patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special...physician or by the hospital's medical staff. (2) Exception...because his or her underlying medical condition and...

2010-10-01

81

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

Code of Federal Regulations, 2011 CFR

...hospitalization of the patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special...physician or by the hospital's medical staff. (2) Exception...because his or her underlying medical condition and...

2011-10-01

82

Psychiatric morbidity, phenomenology and management in hospitalized female foreign domestic workers in Lebanon.  

PubMed

40 million female domestic workers worldwide experience the inhumane conditions associated with this unregulated occupation, a situation that induces psychiatric morbidities in many. The case in Lebanon is not any better where it is estimated that one foreign domestic worker (FDW) commits suicide weekly. 33 female FDW and 14 female Lebanese (control group, CG) were enrolled. Brief Psychotic Rating Scale (BPRS) and Clinical Global Impression (CGI) scales were administered on admission and discharge and socio-demographic, living conditions, mental health care data and phenomenological observations were collected. Sexual, physical, and verbal abuses were detected in FDW (12.5, 37.5, and 50.0 %. respectively). 66.7 % of them were diagnosed with brief psychotic episode. The mean duration of hospital stay (13.1 days) was significantly lower in the FDW group. The mean cumulative antipsychotic dose of the FDW was 337.1 mg of chlorpromazine equivalent and the mean BPRS total pre-score of FDW was 66.4 with a much improved state on the CGI global improvement scale, all of which were nonsignificantly different from the CG. Striking phenomenological findings among FDW were acute anorexia (39.4 %), nudity (30.3 %), catatonic features (21.2 %), and delusion of pregnancy (12.1 %). Inpatient FDW are more diagnosed with psychotic than affective disorders and receive approximately similar treatment as controls in spite of the trend to rapidly discharge and deport the worker to limit the costs. Both groups presented with similar severity, although the FDW had peculiar phenomenological observations. PMID:24370752

Zahreddine, Nada; Hady, Rima Talaat; Chammai, Rabih; Kazour, François; Hachem, Dory; Richa, Sami

2014-07-01

83

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

PubMed Central

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

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

2014-01-01

84

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

PubMed Central

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

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

2011-01-01

85

The psychiatric nurse specialist: a valuable asset in the general hospital.  

PubMed

In summary, what are the ways in which the psychiatric/mental clinical specialist contributes to cost-effectiveness, the professional growth of nursing staff, and quality patient care in the general hospital setting? All services of the psychiatric/mental health clinical specialist are ultimately directed toward increasing the effectiveness with which staff can deliver care. This goal is accomplished by helping staff nurses maximize their knowledge, by providing needed educational opportunities, by promoting the use of a holistic model of care, and by helping staff cope with their own stress. In our experience, high quality care that meets the physiological, psychological, and sociological needs of patients decreases the length of the hospital stay, prevents repeated hospitalizations, and minimizes the development of psychosocial problems secondary to the illness. With the necessary support and cooperation from administration, this clinical specialist role reduces health care costs, promotes a higher level of functioning in patients and their families, and increases the level of job satisfaction for the staff who provide direct bedside care. PMID:6403677

Fife, B; Lemler, S

1983-04-01

86

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

Microsoft Academic Search

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

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

2006-01-01

87

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

Microsoft Academic Search

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

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

88

Psychiatric hospital length of stay for Medicaid clients before and after managed care.  

PubMed

Managed care systems allegedly discharge psychiatric inpatients "quicker and sicker" than fee-for-service programs. Study subjects were admitted to a general hospital that served adjacent counties. During 1994, both counties operated fee-for-service Medicaid mental health systems. In 1995, one county remained fee-for-service and the other assumed inpatient financial risk. Lengths of stay declined in both counties between 1994 and 1996. Managed care patients had longer lengths of stay than their fee-for-service counterparts (even after adjustment for confounders). Secular trends and practice patterns may influence length of stay more than managed care. PMID:12033665

McFarland, Bentson H; Khorramzadeh, Suzann; Millius, Rebecca; Mahler, Jo

2002-01-01

89

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

ERIC Educational Resources Information Center

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

Johnson, Daniel C.

2010-01-01

90

Task-oriented group in a day hospital.  

PubMed

The authors report on the usefulness of a task-oriented group in stabilizing acutely psychotic patients. The group was responsible for the task of preparing lunch for a day hospital community and was useful in helping individual patients function in a socially responsive and responsible manner. Theoretical issues raised by the success of such a group are addressed. It is postulated that activity groups may have a broader usefulness than is currently recognized in psychiatry. PMID:4078928

Fullilove, M T; Pacheco, O; Fourchard, C

1985-12-01

91

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

PubMed

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

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

2012-02-01

92

Efficacy and intensity of day hospital treatment for eating disorders.  

PubMed

The purpose of the study was to compare the effectiveness of 4-day versus 5-day day hospital (DH) treatment and to document effectiveness based on a large sample size. Participants were 801 patients, diagnosed with an eating disorder, who participated in DH treatment from 1985 to 2009. The study followed a sequential cohort ABA design. Higher intensity DH was associated with higher rates of abstinence from bingeing and vomiting and larger improvements in depression and body dissatisfaction. Higher intensity DH provided no consistent advantage in rates of weight restoration or improvement on other indices of psychological functioning. These findings suggest that the optimal intensity of treatment may vary depending on treatment goals, but 5-day DH is recommended for eating disorders. PMID:22989039

Olmsted, Marion P; McFarlane, Traci; Trottier, Kathryn; Rockert, Wendi

2013-01-01

93

Neuropsychiatric Diagnosis and Psychotropic Medication Prescription Patterns in a Mental Hospital-Based Child and Adolescent Psychiatric Service in Nigeria  

Microsoft Academic Search

Mental hospital-based data on child and adolescent psychiatric services are uncommon in low-resource countries, although such data are important for service development and planning. Data are reported on neuropsychiatric diagnoses and psychotropic medication prescription in a child and adolescent psychiatric service in southeastern Nigeria. Schizophrenia-like and other psychotic disorders, followed by seizure disorders, were the most prevalent, while the least

Muideen O. Bakare; Monday N. Igwe; Obiora Iteke; Paul C. Odinka

2011-01-01

94

Neuropsychiatric Diagnosis and Psychotropic Medication Prescription Patterns in a Mental Hospital-Based Child and Adolescent Psychiatric Service in Nigeria  

Microsoft Academic Search

:Mental hospital-based data on child and adolescent psychiatric services are uncommon in low-resource countries, although such data are important for service development and planning. Data are reported on neuropsychiatric diagnoses and psychotropic medication prescription in a child and adolescent psychiatric service in southeastern Nigeria. Schizophrenia-like and other psychotic disorders, followed by seizure disorders, were the most prevalent, while the least

Muideen O. Bakare; Monday N. Igwe; Obiora Iteke; Paul C. Odinka

2011-01-01

95

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

PubMed Central

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

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

2014-01-01

96

Temporal relationship between substance use and delinquent behavior among young psychiatrically hospitalized adolescents.  

PubMed

There is considerable evidence linking substance use and delinquent behavior among adolescents. However, the nature and temporal ordering of this relationship remain uncertain, particularly among early adolescents and those with significant psychopathology. This study examined the temporal ordering of substance use and delinquent behavior in a sample of psychiatrically hospitalized early adolescents. Youth (N = 108) between the ages of 12 and 15 years completed three assessments over 18 months following hospitalization. Separate cross-lagged panel models examined the reciprocal relationship between delinquent behavior and two types of substance use (e.g., alcohol and marijuana). Results provided evidence of cross-lagged effects for marijuana: Delinquent behavior at 9 months predicted marijuana use at 18 months. No predictive effects were found between alcohol use and delinquent behavior over time. Findings demonstrate the stability of delinquent behavior and substance use among young adolescents with psychiatric concerns. Furthermore, results highlight the value of examining alcohol and marijuana use outcomes separately to better understand the complex pathways between substance use and delinquent behavior among early adolescents. PMID:22197300

Becker, Sara J; Nargiso, Jessica E; Wolff, Jennifer C; Uhl, Kristen M; Simon, Valerie A; Spirito, Anthony; Prinstein, Mitchell J

2012-09-01

97

Characteristics of aggression in a German psychiatric hospital and predictors of patients at risk.  

PubMed

This study investigated the aggressive behaviour of all mentally ill patients within a whole psychiatric hospital with a catchment area of 325 000 inhabitants over a 1-year period (i) to assess the 1-year prevalence and characteristics of aggressive episodes and index inpatients, and (ii) to identify predictors of patients at risk by a multivariate approach. Staff Observation of Aggression Scale was used to assess aggressive behaviour. Characteristics of index inpatients were compared with those of non-index inpatients. Logistic regression analysis was applied to identify risk factors. A total of 171 out of 2210 admitted patients (7.7%) exhibited 441 aggressive incidents (1.7 incidents per bed per year). Logistic regression analyses revealed as major risk factors of aggression: diagnoses (organic brain syndromes OR = 3.6, schizophrenia OR = 2.9), poor psychosocial living conditions (OR = 2.2), and critical behaviour leading to involuntary admission (OR = 3.3). Predictors of aggressive behaviour can be useful to identify inpatients at risk. Nevertheless, additional situational determinants have to be recognized. Training for professionals should include preventive and de-escalating strategies to reduce the incidence of aggressive behaviour in psychiatric hospitals. The application of de-escalating interventions prior to admission might be effective in preventing aggressive behaviour during inpatient treatment especially for patients with severe mental disorders. PMID:17244011

Ketelsen, R; Zechert, C; Driessen, M; Schulz, M

2007-02-01

98

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

PubMed Central

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

Loch, Alexandre Andrade

2014-01-01

99

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

PubMed Central

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

2013-01-01

100

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

PubMed

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

Kazano, Haruki

2012-01-01

101

Clinical decision-making about inpatient violence risk at admission to a public-sector acute psychiatric hospital.  

PubMed

This is an examination of the extent to which patients who are violent in the hospital can be distinguished from nonviolent patients, based on information that is readily available at the time of admission to a state acute psychiatric hospital. The charts of 235 inpatients were examined retrospectively, by selecting 103 patients who had engaged in inpatient violence and comparing them with 132 randomly selected patients who had not during the same period. Data were gathered from initial psychiatric assessment and admissions face sheets in patients' charts, reflecting information available to a mental health professional within the first 24 hours of a patient's admission. Multivariate analysis showed that violent and nonviolent patients were distinguished by diagnosis, age, gender, estimated intelligence, psychiatric history, employment history, living situation, and agitated behavior. These factors led to an 80 percent correct classification of violent patients and thus may assist clinicians to structure decision-making about the risk of inpatient violence. PMID:22635292

Newton, Virginia M; Elbogen, Eric B; Brown, Carrie L; Snyder, Jennifer; Barrick, Ann Louise

2012-01-01

102

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

NSDL National Science Digital Library

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

2008-10-06

103

Reducing the use of seclusion in a forensic psychiatric hospital: assessing the impact on aggression, therapeutic climate and staff confidence  

Microsoft Academic Search

Against the background of an emerging international demand, this study examined the impact of a suite of interventions designed to reduce the use of seclusion in a forensic psychiatric hospital. These interventions included a review of existing seclusion practices and staff training in the management of aggression as well as the implementation of evidence-based alternatives. Evaluation occurred via pre- and

Hannah Ching; Michael Daffern; Trish Martin; Stuart Thomas

2010-01-01

104

Paranoid Personality Disorder and Sociodemography: a 25-year Study of First Admissions to a Danish General Psychiatric Hospital  

Microsoft Academic Search

Paranoid personality disorder is predominantly characterized by suspiciousness, self-reference, and exquisite sensitivity. Scarce research exists on the sociodemographic characteristics of patients with a paranoid personality disorder. A chart review was conducted on patients first admitted to a Danish general psychiatric hospital between 1975 and 2000 with a) an original paranoid (and\\/or sensitive type) personality disorder, b) no primary organic or

Søren Fryd Birkeland

2011-01-01

105

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

ERIC Educational Resources Information Center

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

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

2007-01-01

106

Prevalence and correlates of seclusion with or without restraint in a Canadian psychiatric hospital: a 2-year retrospective audit.  

PubMed

Seclusion with or without restraint is a measure used to manage patients with challenging behaviours. Although controversial, the intervention remains poorly documented, especially in Canadian psychiatric hospitals. The purpose of this study is to assess the prevalence of the measure and identify any correlated demographic characteristics and psychiatric disorders. Episodes of seclusion with or without restraint were extracted from a computerized, hospital-based system introduced specifically to track such interventions. Of 2721 patients hospitalized during that time, 23.2% (n = 632) were secluded with or without restraint, and 17.5% (n = 476) were secluded with restraint. Younger age, schizophrenia or other psychosis, bipolar and personality disorder, and longer stay in hospital are predictors of an episode of seclusion with or without restraint. Younger age, bipolar and personality disorders and a longer stay in hospital are predictors of an episode of seclusion with restraint. For patients who spent longer in seclusion and under restraint, there is a positive association with longer stay in hospital. In this inpatient psychiatric facility, seclusion with or without restraint thus appears to be common. More research is warranted to better identify the principal factors associated with seclusion and restraint and help reduce resort to these measures. PMID:21539684

Dumais, A; Larue, C; Drapeau, A; Ménard, G; Giguère Allard, M

2011-06-01

107

Differences in Hospital-Associated Multidrug-Resistant Organisms and Clostridium difficile Rates Using 2-Day versus 3-Day Definitions.  

PubMed

We surveyed infection prevention programs in 16 hospitals for hospital-associated methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci, extended-spectrum ?-lactamase, and multidrug-resistant Acinetobacter acquisition, as well as hospital-associated MRSA bacteremia and Clostridium difficile infection based on defining events as occurring >2 days versus >3 days after admission. The former resulted in significantly higher median rates, ranging from 6.76% to 45.07% higher. PMID:25333439

Gombosev, Adrijana; Fouad, Salah E; Cui, Eric; Cao, Chenghua; Terpstra, Leah; Avery, Taliser R; Kim, Diane; Meyers, Hildy; Cheung, Michele; Huang, Susan S

2014-11-01

108

Hospitalization of adolescents for psychiatric and substance abuse treatment. Legal and ethical issues.  

PubMed

It has been estimated that as many as 12%-15% of the nations 63 million children are in need of mental health treatment. We have a responsibility to do everything we can to see to it that these children receive the services they need. Unfortunately, there is mounting evidence that a significant proportion of our health care resources are being misspent on the unnecessary and inappropriate hospitalization of children and youths in psychiatric and substance abuse treatment programs. More alarming is the evidence of poor quality programs, abusive practices, and greed. The intense competition to capture a "share of the market" and turn a profit or keep a nonprofit hospital from closing its doors is contributing to unprofessional and unethical advertising and public relations practices. In the end these practices will reflect poorly on the broader mental health and health care community. Hopefully, the stakeholders in the system will recognize these problems and assume a leadership role in turning the situation around. If not, we can expect intervention from forces outside the system (e.g., courts, elected public officials, public interest groups, the business community, and child advocates). PMID:2691465

Schwartz, I M

1989-11-01

109

Managing aggression in a psychiatric hospital using a behaviour plan: a case study.  

PubMed

This paper focuses on the critical role of nursing in implementing a behaviour plan in a psychiatric hospital. The plan was implemented with a 40-year-old man with a long history of aggression towards others and self. The study used a single-subject research design with baseline and intervention phases (AB Design). Data were collected on (1) frequency of incidents of aggression towards others and self; (2) use of restrictive interventions to manage aggression (i.e. restraints, pro re nata medication, 1:1 special observation); and (3) frequency of staff injury. The data show a decrease in frequency of aggression towards others and self, a concurrent reduction in the use of restrictive interventions to manage aggression, and a decrease in incidents of staff injury. The behaviour plan helped staff maintain a safe and therapeutic milieu. The behaviour plan has given the patient an opportunity to learn positive replacement behaviours and skills, and the opportunity eventually to leave the hospital to live in a less restrictive community home. PMID:16965469

Bisconer, S W; Green, M; Mallon-Czajka, J; Johnson, J S

2006-10-01

110

Neuropsychiatric diagnosis and psychotropic medication prescription patterns in a mental hospital-based child and adolescent psychiatric service in Nigeria.  

PubMed

Mental hospital-based data on child and adolescent psychiatric services are uncommon in low-resource countries, although such data are important for service development and planning. Data are reported on neuropsychiatric diagnoses and psychotropic medication prescription in a child and adolescent psychiatric service in southeastern Nigeria. Schizophrenia-like and other psychotic disorders, followed by seizure disorders, were the most prevalent, while the least prevalent included autism spectrum disorders, enuresis, adolescent postpartum psychosis, and adjustment disorders, among others. Most frequently prescribed psychotropic medications included antipsychotics, benzodiazepines, and antiepileptics (either for seizure disorders or as mood stabilizer). Antidepressants and stimulants were not commonly prescribed. PMID:21841276

Bakare, Muideen O; Igwe, Monday N; Odinka, Paul C; Iteke, Obiora

2011-08-01

111

Hospital days, hospitalization costs, and inpatient mortality among patients with mucormycosis: a retrospective analysis of US hospital discharge data  

PubMed Central

Background Mucormycosis is a rare and potentially fatal fungal infection occurring primarily in severely immunosuppressed patients. Because it is so rare, reports in the literature are mainly limited to case reports or small case series. The aim of this study was to evaluate inpatient mortality, length of stay (LOS), and costs among a matched sample of high-risk patients with and without mucormycosis in a large nationally representative database. Methods We conducted a retrospective analysis using the 2003–2010 Healthcare Cost and Utilization Project – Nationwide Inpatient Sample (HCUP-NIS). The NIS is a nationally representative 20% sample of hospitalizations from acute care United States (US) hospitals, with survey weights available to compute national estimates. We classified hospitalizations into four mutually exclusive risk categories for mucormycosis: A- severely immunocompromised, B- critically ill, C- mildly/moderately immunocompromised, D- major surgery or pneumonia. Mucormycosis hospitalizations (“cases”) were identified by ICD-9-CM code 117.7. Non-mucormycosis hospitalizations (“non-cases”) were propensity-score matched to cases 3:1. We examined demographics, clinical characteristics, and hospital outcomes (mortality, LOS, costs). Weighted results were reported. Results From 319,366,817 total hospitalizations, 5,346 cases were matched to 15,999 non-cases. Cases and non-cases did not differ significantly in age (49.6 vs. 49.7 years), female sex (40.5% vs. 41.0%), White race (53.3% vs. 55.9%) or high-risk group (A-49.1% vs. 49.0%, B-20.0% vs. 21.8%, C-25.5% vs. 23.8%, D-5.5% vs. 5.4%). Cases experienced significantly higher mortality (22.1% vs. 4.4%, P?days and $90,272 vs. $25,746; both P?hospital database, hospitalizations with mucormycosis had significantly higher inpatient mortality, LOS, and hospital costs than matched hospitalizations without mucormycosis. Findings suggest that interventions to prevent or more effectively treat mucormycosis are needed. PMID:24903188

2014-01-01

112

Impact of hospital nursing care on 30-day mortality for acute medical patients  

Microsoft Academic Search

Title. Impact of hospital nursing care on 30-day mortality for acute medical patients Aim. This paper reports on structures and processes of hospital care influencing 30-day mortality for acute medical patients. Background. Wide variation in risk-adjusted 30-day hospital mortality rates for acute medical patients indicates that hospital structures and processes of care affect patient death. Because nurses provide the majority

Ann E. Tourangeau; Diane M. Doran; Linda McGillis Hall; Linda O'Brien Pallas; Dorothy Pringle; Jack V. Tu; Lisa A. Cranley

2007-01-01

113

One day survey by the Mental Health Act Commission of acute adult psychiatric inpatient wards in England and Wales  

PubMed Central

Objectives To provide (via the Mental Health Act Commission’s “national visit”) empirical evidence on ward occupancy levels, use of the Mental Health Act 1983, nurse staffing, and care of female patients on acute adult psychiatric wards. Design One day survey of a stratified random sample. Settings 119/250 (47%) acute adult psychiatric inpatient units in England and Wales. Subjects End sample of 263 acute psychiatric inpatient wards. Main outcome measures Ward occupancy rates; number of patients detained under the Mental Health Act and proportion “absent without leave”; nurse staffing levels, skill mix, and vacancies; proportion of women with self contained, women-only facilities. Results Mean ward occupancy was 99% (95% confidence interval 97% to 102%). A ward mean of 30% (28% to 32%) of patients were detained under the Mental Health Act; of all detained patients, 1% (1% to 2%) were absent without leave. A ward mean of 0.3 (0.29 to 0.31) nurses were on duty per patient at the time of the visit. An estimated ward mean of 31% (30% to 32%) of nurse staffing may have been through casual contracts—higher in inner (48% (43% to 53%)) and outer London (45% (41% to 48%)). On 26% (21% to 32%) of wards, there were no nurses interacting with patients. A ward mean of 36% (30% to 41%) of female patients had self contained, women-only facilities. Conclusions Attention should focus on improving the quality of acute inpatient psychiatric care as well as of community care. Key messagesLeave arrangements on adult psychiatric wards cause considerable difficulties in bed managementAn estimated third of nursing staff on duty are employed on a casual basisNurses spend much of their time engaged in intensive observation of a few patients, but a quarter of wards had no nurse interacting with patients at the time of the national visitOnly a third of female patients had the use of self contained, women-only areasPolicymaking, management, and training must be refocused to improve the quality of acute inpatient psychiatric care PMID:9804713

Ford, Richard; Durcan, Graham; Warner, Lesley; Hardy, Pollyanna; Muijen, Matt

1998-01-01

114

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

PubMed Central

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

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

2013-01-01

115

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

PubMed

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

Sadeh, Naomi; McNiel, Dale E

2013-08-01

116

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

PubMed Central

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

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

1988-01-01

117

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

PubMed Central

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

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

2014-01-01

118

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

Microsoft Academic Search

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

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

2000-01-01

119

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

PubMed

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

Kutscher, S; Schiffer, B; Seifert, D

2009-02-01

120

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

PubMed

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

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

2014-06-01

121

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

ERIC Educational Resources Information Center

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

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

2004-01-01

122

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

PubMed

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

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

2014-04-01

123

A one-day prevalence survey of hospital-acquired infections in Lebanon  

Microsoft Academic Search

A one-day survey was carried out in 14 acute care hospitals in Lebanon in May 1997, to determine the prevalence of nosocomial infection (NI) by site of infection, hospital department, micro-organism and pathology. Hospitals (N=14) with more than 50 beds were selected at random from the official Lebanese Health Ministry Registration Directory. All patients who presented that day on the

R. Azzam; M. Dramaix

2001-01-01

124

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

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

2012-01-01

125

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

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

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

1997-01-01

126

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

ERIC Educational Resources Information Center

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…

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

2004-01-01

127

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

ERIC Educational Resources Information Center

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

Lunsky, Yona; Gracey, Carolyn; Gelfand, Sara

2008-01-01

128

Communication of psychiatric diagnosis.  

PubMed

We examined whether psychiatric patients knew their diagnosis, the significance they attached to it, and the impact of being informed in a systematic fashion according to their wishes. We also assessed whether the nature of the psychiatric diagnosis influenced what patients were told by their psychiatrists. The three parts of the study included questionnaire responses from 28 consultant psychiatrists: case-note reviews and questionnaire responses of 200 adult psychiatric in-patients: and a pilot study informing 28 adult psychiatric day hospital patients of their diagnosis according to their wishes. The results showed that of 126 in-patients, 53% had not been told their diagnosis, although most wanted to know. Of those informed, 75% agreed with their diagnosis. The majority of patients considered a psychiatric diagnosis to be as real as a physical diagnosis and helpful in their treatment. Patients with schizophrenia were less likely to have been informed of their diagnosis, and psychiatrists were also more reticent regarding the diagnosis of personality disorder. All patients who were systematically informed, in the pilot study agreed with their diagnosis. We conclude that most patients agree with their diagnosis and its usefulness. All patients should be asked whether they want to know their diagnosis and be informed appropriately. PMID:9448443

Shergill, S S; Barker, D; Greenberg, M

1998-01-01

129

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

PubMed Central

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

Bokser, Seth; Newman, Thomas B.

2010-01-01

130

Video recording in the assessment of violent incidents in psychiatric hospitals.  

PubMed

Research into causes and management of aggressive behavior in mental illness has been hampered by difficulties related to the accurate detection, description, and classification of aggression. Much aggressive behavior, particularly verbal aggression, is unreported or reported inaccurately. We describe the use of video surveillance to study aggression in psychiatric inpatients. The videos supplement or correct eyewitness accounts, accurately identifying aggressors and victims, as well as specific aggressive behaviors. Video has provided a tool for studying behavioral precursors and environmental catalysts of assaults. These observations have contributed to our efforts to create a typology of aggression based on underlying causes. Furthermore, video has played a direct role in clinical care, documenting or revealing medication side effects, as well as feigned or self-induced injuries. The ethical and responsible use of video surveillance of psychiatric inpatients has the potential to enhance our understanding and treatment of aggression. PMID:16432448

Nolan, Karea A; Volavka, Jan

2006-01-01

131

Violence in public sector psychiatric hospitals. Benchmarking nursing staff injury rates.  

PubMed

1. Violence toward healthcare workers, particularly psychiatric nursing staff, has only recently been identified as a workplace health hazard. An occupational health perspective underscores the need for proactive monitoring and heightens incentives for prevention through the introduction of external regulation. 2. Nursing staff injury rates from violence alone are higher than injuries seen in industries traditionally considered high risk such as mining, lumber, and heavy construction. Nursing employment categories at particular risk include psychiatric technicians, male staff, and on-unit supervisory personnel. 3. It is exceedingly difficult to accurately measure the extent of violence in a given facility and injury rates are known to underestimate the actual number of violent events that occur. Nursing staff, labor organizations, and managers must work toward more reliable monitoring and risk prevention programs. PMID:8732980

Love, C C; Hunter, M E

1996-05-01

132

Mental illness stigma among nurses in psychiatric wards of teaching hospitals in the north-west of Iran  

PubMed Central

Background: Stigma is one of the obstacles in the treatment and regaining the mental health of people with mental illness. The aim was determination of mental illness stigma among nurses in psychiatric wards. This study was conducted in psychiatric wards of teaching hospitals in Tabriz, Urmia, and Ardabil in the north-west of Iran. Materials and Methods: This research is a descriptive analysis study in which 80 nurses participated. A researcher-made questionnaire was used, which measured demographic characteristics and mental illness stigma in the three components of cognitive, emotional, and behavioral. All data were analyzed using SPSS13 software and descriptive and analytical statistics. Results: Majority of nurses (72.5%) had medium level of stigma toward people with mental illness. About half of them (48.8%) had great inclination toward the social isolation of patients. The majority of them (62.5%) had positive emotional responses and 27.5% had stereotypical views. There was a significant correlation between experience of living with and kinship of nurses to person with mental illness, with prejudice toward and discrimination of patients. There was also a significant correlation between interest in the continuation of work in the psychiatric ward and prejudice, and also between educational degree and stereotypical views. Conclusions: The data suggest there is a close correlation between the personal experience of nurses and existence of mental illness stigma among them. Therefore, the implementation of constant educational programs on mental illness for nurses and opportunities for them to have direct contact with treated patients is suggested. PMID:23922602

Ebrahimi, Hossein; Namdar, Hossein; Vahidi, Maryam

2012-01-01

133

Factors Affecting Length of Stay on Maximum Security in a Forensic Psychiatric Hospital  

Microsoft Academic Search

Forensic hospitals are responsible for both the custody and treatment of patients, including treatment that will minimize the risk of future violence to the community. This study examined factors that affected length of stay (LOS) in Maryland’s only maximum-security forensic hospital for mentally ill patients who were adjudicated not criminally responsible (NCR) for serious violent crimes. The current study focused

Marianne J. Moran; M. Richard Fragala; Beverly F. Wise; Tammy Lynn Novak

1999-01-01

134

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

ERIC Educational Resources Information Center

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

Pary, Robert J.

1993-01-01

135

Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning  

PubMed Central

Background Patients who self-poison have high repetition and high mortality rates. Therefore, appropriate follow-up is important. The aims of the present work were to study treatment received, satisfaction with health care services, and psychiatric symptoms after hospitalization for self-poisoning. Methods A cohort of patients who self-poisoned (n = 867) over a period of 1 year received a questionnaire 3 months after discharge. The Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), and Generalized Self-Efficacy Scale (GSE) were used. The participation rate was 28% (n = 242); mean age, 41 years; 66% females. Results Although only 14% of patients were registered without follow-up referrals at discharge, 41% reported no such measures. Overall, satisfaction with treatment was fairly good, although 29% of patients waited more than 3 weeks for their first appointment. A total of 22% reported repeated self-poisoning and 17% cutting. The mean BDI and BHS scores were 23.3 and 10.1, respectively (both moderate to severe). The GSE score was 25.2. BDI score was 25.6 among patients with suicide attempts, 24.9 for appeals, and 20.1 for substance-use-related poisonings. Conclusions Despite plans for follow-up, many patients reported that they did not receive any. The reported frequency of psychiatric symptoms and self-harm behavior indicate that a more active follow-up is needed. PMID:22520705

2012-01-01

136

Quality of Nursing Care in Psychiatric Wards of University Hospitals in Northwest of Iran from the Perceptions of Nurses  

PubMed Central

Introduction: Nursing care is considered as an essential component of health services. Patients’ health improvement depends upon the quality of nursing care. As an important principle, perceptions of nurses as well as their active participation in decision-makings has an important role in the quality of services. This study aimed to determine the percep-tion of nurses toward the quality of nursing care in psychiatric wards. Methods: In this descriptive study, we used census sampling. Seventy-six nurses employed at psychiatric wards of university hospitals in Northwest of Iran participated in this study. Quality Patient Care Scale (QUALPAC) was used to collect data. The score of each aspect and total scores were categorized as desirable, partly desirable and undesirable. The collected data were analyzed using descriptive statistics. Results: Findings showed that 60.5% of nurses perceived the quality of nursing care as desirable, while 65.8% and 53.9% reported the quality of physical and communicational aspects of care as desirable. Moreover, 51.3% of nurses considered the quality of care in psychosocial aspect as partly desirable. Conclusion: Although research findings indicated the desirability of care quality from the perceptions of most nurses, designing and applying educational programs and continuous evaluation are necessary to improve nursing care quality especially in psychosocial aspects in these centers.

Ebrahimi, Hossein; Namdar, Hossein; Vahidi, Maryam

2012-01-01

137

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

Microsoft Academic Search

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

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

1997-01-01

138

Falls in an Inpatient Geriatric Psychiatric Population  

Microsoft Academic Search

BACKGROUND:Falls are a major health care concern for older adults in hospital settings. The incidence of falls on psychiatric units tends to be higher than that on general acute care hospital units, with estimated rates of 13.1 to 25 per 1,000 inpatient days compared to 3 to 5 per 1,000 inpatient days, respectively.OBJECTIVE:The purposes of this study were to quantify

Ellen Blair; Cynthia Gruman

2005-01-01

139

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

PubMed Central

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

2013-01-01

140

Contemporary Evidence about Hospital Strategies for Reducing 30-Day Readmissions: A National Study  

PubMed Central

Objectives We sought to determine the range and prevalence of practices being implemented by hospitals to reduce 30-day readmissions of patients with heart failure or acute myocardial infarction (AMI). Background Readmissions of patients with heart failure or AMI are both common and costly; however evidence on strategies adopted by hospitals to reduce readmission rates is limited. Methods We used a web-based survey to conduct a cross-sectional study of hospitals’ reported use of specific practices to reduce readmissions for patients with heart failure or AMI. We contacted all hospitals enrolled in the Hospital to Home (H2H) quality improvement initiative as of July 2010. Of 594 hospitals, 537 completed the survey (response rate of 90.4%). We used standard frequency analysis to describe the prevalence of key hospital practices in the areas of 1) quality improvement resources and performance monitoring, 2) medication management efforts, and 3) discharge and follow-up processes. Results Nearly 90% of hospitals agreed or strongly agreed that they had a written objective of reducing preventable readmission for patients with heart failure or AMI. More hospitals reported having quality improvement teams to reduce preventable readmissions for patients with heart failure (87%) than for patients with AMI (54%). On average, hospitals used 4.8 of 10 key practices; fewer than 3% of hospitals utilized all 10 practices. Conclusions Although most hospitals have a written objective of reducing preventable readmissions of patients with heart failure or AMI, the implementation of recommended practices varied widely. More evidence establishing the effectiveness of various practices is needed. PMID:22818070

Bradley, Elizabeth H.; Curry, Leslie; Horwitz, Leora I.; Sipsma, Heather; Thompson, Jennifer W.; Elma, Mary Anne; Walsh, Mary Norine; Krumholz, Harlan M.

2012-01-01

141

Services Received and Treatment Outcomes in Day Hospital and Residential Programs  

PubMed Central

This longitudinal health services study (N=733) 1) examines the impact of services received on 6-month outcomes and 2) compares day hospital to residential programs on services received. Services were measured at 2, 4, and 8 weeks post-baseline using a version of the Treatment Services Review (TSR). Higher odds of total sobriety at 6 months were associated with greater participation in a) extracurricular (but not curricular) 12-step meetings, b) sober recreational events, and c) educational sessions. Program effects also emerged. Unexpectedly, extracurricular 12-step meeting attendance and odds of having a sponsor were lower among residential (vs. day hospital) participants through 4 weeks—despite higher participation in curricular 12-step meetings among residential participants at 2 weeks. Still, residential participants reported higher involvement in sober recreation and informal peer socialization across most analyses. Findings suggest that residential and day hospital programs might maximize outcomes by facilitating optional 12-step involvement and sober recreation, respectively. PMID:18329223

Zemore, Sarah E.; Kaskutas, Lee Ann

2008-01-01

142

Differences between patients with schizophrenia with and without co-occurring methamphetamine use disorders in a taiwanese public psychiatric hospital.  

PubMed

This study aimed to examine the factors related to and the outcomes of schizophrenic patients with co-occurring methamphetamine use disorders (MUDs). All schizophrenic patients discharged from a psychiatric hospital between January 1, 2006, and December 31, 2006, were monitored. This study compared the important demographic and clinical variables between patients with co-occurring MUDs and those without, and postdischarge measured time to rehospitalization during a 1-year period. Seven hundred fifty-six patients were included in this study. Of these patients, 88 (11.6%) reported the use of methamphetamine. Univariate analyses indicated that male sex, low educational level, discharge against medical advice, missed first appointment after discharge, co-occurring other illicit substance use disorder, age (younger), diazepam equivalents prescribed at discharge (higher), number of previous admissions within the past 5 years (higher), and length of hospital stay (longer) were predictive of patients with co-occurring MUDs. There were also significant differences in time to rehospitalization between these two groups during the follow-up periods. Many factors can be identified in schizophrenic patients with co-occurring MUDs. Furthermore, schizophrenic patients with co-occurring MUDs were more likely to be rehospitalized. Future studies in many different mental health systems are needed before these findings can be generalized. PMID:25268153

Lin, Ching-Hua; Huang, Yu-Hui; Wu, Hung-Chi; Chen, Cheng-Chung

2014-11-01

143

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

Microsoft Academic Search

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

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

2009-01-01

144

THIRTY-DAY HOSPITAL READMISSION RATE AMONG ADULTS LIVING WITH HIV  

PubMed Central

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

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

2013-01-01

145

Message-Based Patient Guidance in Day-Hospital Patrick Lamber, Bernd Ludwig, Francesco Ricci, Floriano Zini, and Manfred Mitterer  

E-print Network

Message-Based Patient Guidance in Day-Hospital Patrick Lamber, Bernd Ludwig, Francesco Ricci.ricci@unibz.it, floriano.zini@unibz.it Hospital Franz Tappeiner via Rossini 5, 39012 Meran (BZ), Italy Email: manfred.mitterer@asbmeran-o.it Abstract--Day hospital workflows are highly dynamic. It is, therefore, important to provide patients

Ricci, Francesco

146

Hospital Strategies Associated with 30-Day Readmission Rates for Patients with Heart Failure  

PubMed Central

Background Reducing hospital readmission rates is a national priority; however, evidence about hospital strategies that are associated with lower readmission rates is limited. We sought to identify hospital strategies that were associated with lower readmission rates for patients with heart failure. Methods and Results Using data from a Web-based survey of hospitals participating in national quality initiatives to reduce readmission (N=599; 91% response rate) during 2010–2011, we constructed a multivariable linear regression model, weighted by hospital volume, to determine strategies independently associated with risk-standardized 30-day readmission rate (RSRR) adjusted for hospital teaching status, geographic location, and number of staffed beds. Strategies that were associated with lower hospital RSRR included: 1) partnering with community physicians or physician groups to reduce readmission (0.33 percentage point lower RSRR, P-value = 0.017), 2) partnering with local hospitals to reduce readmissions (0.34 percentage point, P-value = 0.020), 3) having nurses responsible for medication reconciliation (0.18 percentage point, P-value = 0.002), 4) arranging follow-up appointments before discharge (0.19 percentage point, P-value = 0.037), 5) having a process in place to send all discharge paper or electronic summaries directly to the patient's primary physician (0.21 percentage point, P-value = 0.004), and 6) assigning staff to follow up on test results that return after the patient is discharged (0.26 percentage point, P-value =0.049). Although statistically significant, the magnitude of the effects was modest with individual strategies associated with less than half a percentage point reduction in RSRR; however, hospitals that implemented more strategies had significantly lower RSRRs (reduction of 0.34 percentage point for each additional strategy). Conclusions Several strategies were associated with lower hospital RSRR for patients with heart failure. PMID:23861483

Bradley, Elizabeth H.; Curry, Leslie; Horwitz, Leora I.; Sipsma, Heather; Wang, Yongfei; Walsh, Mary Norine; Goldmann, Don; White, Neal; Pina, Ileana L.; Krumholz, Harlan M.

2013-01-01

147

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

PubMed Central

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

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

2013-01-01

148

[Adolescents psychiatric hospitalization younger than 17 years: complexity of the problematic and the resolution].  

PubMed

Emotional pathology in adolescents is usually a problematic which involves thus adolescents and their environment, from its genesis, as in the time to evaluate resolution strategies. This concept led us to attempt to evaluate how much the family context modifies the decision to the hospitalization or not of the patient in crisis. Psychopathological variables were examined and family characteristics with the aim to find factors which associated. PMID:21977605

Abadi, Andrea; Pallia, Roberto; Blanco, María Florencia; Rotbalt, Gisela; Nieva, Juliana; Olguin, María Carolina; Lesta, Pedro

2011-01-01

149

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

E-print Network

in structuring and modifying intervention strategies that can make the post-hospitalization transition less stressful for the patient. The empirical literature reflects increasing emphasis on the social context of patients' mental disorders, and on the roles...) training the patient in a structured strategy for problem- solving and stress reduction. The psychoeducational intervention model included both retrospective (prehospitalization stressors and premorbid adjustment during the preceding 12 months...

Velasquez, John Martin

2012-06-07

150

Effectiveness of Outpatient, Day Hospital, and Inpatient Psychotherapeutic Treatment for Patients with Cluster B Personality Disorders  

Microsoft Academic Search

Background: For patients with cluster B personality disorders there is no consensus regarding the optimal treatment setting. The aim of this study was to compare the effectiveness of different psychotherapeutic settings for patients with cluster B personality disorders, i.e. outpatient, day hospital, and inpatient treatment. Methods: The study was conducted between March 2003 and June 2008 in 6 mental health

Anna Bartak; Helene Andrea; Marieke D. Spreeuwenberg; Uli M. Ziegler; Jack Dekker; Bert V. Rossum; Elisabeth F. M. Hamers; Wubbo Scholte; Janneke Aerts; Jan J. V. Busschbach; Roel Verheul; Theo Stijnen; Paul M. G. Emmelkamp

2011-01-01

151

Antenatal day care units versus hospital admission for women with complicated pregnancy  

PubMed Central

Background Antenatal day care units have been widely used as an alternative to inpatient care for women with pregnancy complications including mild and moderate hypertension, and preterm prelabour rupture of the membranes. Objectives The objective of this review is to compare day care units with routine care or hospital admission for women with pregnancy complications in terms of maternal and perinatal outcomes, length of hospital stay, acceptability, and costs to women and health services providers. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (February 2009). Selection criteria Randomised controlled trials comparing day care with inpatient or routine care for women with complicated pregnancy. Data collection and analysis Two review authors independently carried out data extraction and assessed studies for risk of bias. Main results Three trials with a total of 504 women were included. For most outcomes it was not possible to pool results from trials in meta-analyses as outcomes were measured in different ways. Compared with women in the ward/routine care group, women attending day care units were less likely to be admitted to hospital overnight (risk ratio 0.46, 95% confidence interval 0.34 to 0.62). The average length of antenatal admission was shorter for women attending for day care, although outpatient attendances were increased for this group. There was evidence from one study that women attending for day care were significantly less likely to undergo induction of labour, but mode of birth was similar for women in both groups. For other outcomes there were no significant differences between groups. The evidence regarding the costs of different types of care was mixed; while the length of antenatal hospital stays were reduced, this did not necessarily translate into reduced health service costs. While most women tended to be satisfied with whatever care they received, women preferred day care compared with hospital admission. Authors’ conclusions Small studies suggest that there are no major differences in clinical outcomes for mothers or babies between antenatal day units or hospital admission, but women may prefer day care. PMID:19821282

Dowswell, Therese; Middleton, Philippa; Weeks, Andrew

2014-01-01

152

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

PubMed

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

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

2012-12-01

153

Hospital-based, acute care use among patients within 30-days of discharge after coronary artery bypass surgery  

PubMed Central

Background There is growing interest in how frequently patients undergoing coronary artery bypass graft (CABG) surgery require hospital readmission within 30-days of discharge. Readmissions, however, may not capture all hospital-based, acute care needs after discharge. The purpose of this study is to describe the frequency of and diagnoses associated with emergency department (ED) visits and hospital readmissions within 30-days of discharge following CABG surgery and to compare outcomes across hospitals. Methods Using the California State Inpatient and Emergency Department Databases, we identified all adults who underwent isolated CABG surgery between January 2005 and June 2009. We then calculated hospital's 30-day, risk-standardized readmission and ED visit rates using hierarchical generalized linear models. The correlation between hospital readmission and ED visit rates was estimated, weighting for hospital volume. Results We identified 63,911 adults who underwent isolated CABG surgery at 114 hospitals. Hospital 30-day, risk-standardized ED visit without readmission rates (median ED visit rate = 11.9%, 25th-75th percentile, 10.5%-13.7%) nearly equaled the hospital 30-day risk-standardized readmission rates (median readmission rate = 15.0%, 25th-75th percentile, 13.5%-16.5%). Both outcomes varied widely among hospitals. A composite of these outcomes, the median 30-day risk-standardized hospital-based, acute care rate was 23.9% (25th-75th percentile, 22.2%-25.5%). Post-operative infections, congestive heart failure, and chest discomfort were among the most common reasons for both readmissions and ED visits. Hospitals' 30-day risk-standardized ED visit and readmission rates were not significantly correlated (weighted correlation coefficient = -0.07, p = 0.44). Conclusions Patients discharged after CABG surgery frequently experienced ED visits and hospital readmissions within 30 days, often for similar diagnoses. Monitoring both hospital readmissions and ED visits following CABG surgery is important to our understanding of hospital-based, acute care needs following discharge. PMID:23702228

Fox, Justin P.; Suter, Lisa G.; Wang, Karen; Wang, Yongfei; Krumholz, Harlan M.; Ross, Joseph S.

2013-01-01

154

The effect of Massachusetts health reform on 30 day hospital readmissions: retrospective analysis of hospital episode statistics  

PubMed Central

Objectives To analyse changes in overall readmission rates and disparities in such rates, among patients aged 18-64 (those most likely to have been affected by reform), using all payer inpatient discharge databases (hospital episode statistics) from Massachusetts and two control states (New York and New Jersey). Design Difference in differences analysis to identify the post-reform change, adjusted for secular changes unrelated to reform. Setting US hospitals in Massachusetts, New York, and New Jersey. Participants Adults aged 18-64 admitted for any cause, excluding obstetrical. Main outcome measure Readmissions at 30 days after an index admission. Results After adjustment for known confounders, including age, sex, comorbidity, hospital ownership, teaching hospital status, and nurse to census ratio, the odds of all cause readmission in Massachusetts was slightly increased compared with control states post-reform (odds ratio 1.02, 95% confidence interval 1.01 to 1.04, P<0.05). Racial and ethnic disparities in all cause readmission rates did not change in Massachusetts compared with control states. In analyses limited to Massachusetts only, there were minimal overall differences in changes in readmission rates between counties with differing baseline uninsurance rates, but black people in counties with the highest uninsurance rates had decreased odds of readmission (0.91, 0.84 to 1.00) compared with black people in counties with lower uninsurance rates. Similarly, white people in counties with the highest uninsurance rates had decreased odds of readmission (0.96, 0.94 to 0.99) compared with white people in counties with lower uninsurance rates. Conclusions In the United States, and in Massachusetts in particular, extending health insurance coverage alone seems insufficient to improve readmission rates. Additional efforts are needed to reduce hospital readmissions and disparities in this outcome. PMID:24687184

2014-01-01

155

CLINICAL POSTDOCTORAL FELLOWSHIP IN CHILD PSYCHOLOGY New York Presbyterian Hospital  

E-print Network

CLINICAL POSTDOCTORAL FELLOWSHIP IN CHILD PSYCHOLOGY New York Presbyterian Hospital Children of children and adolescents with a wide range of psychiatric disorders. The intern's responsibilities include are inpatients in the Childrens Day Hospital and small adolescent unit at New York State Psychiatric Institute

Salzman, Daniel

156

Cardiac arrest teams and time of day: effects on surviving in-hospital resuscitation  

PubMed Central

Objectives Little is known about the factors that influence survival following in-hospital resuscitation, but previous investigations have suggested that in-hospital resuscitations outside of regular working hours are associated with worse survival rates. Material and methods In-hospital cardiac arrest teams at our hospital were instructed to complete a questionnaire following every emergency call between July 2011 and June 2013. Data on all resuscitation attempts were collected and analyzed. Results A total of 65 in-hospital resuscitations were recorded in 42 males (64.6%) and 23 females (35.4%) (mean age 72.0±14.3 years). A total of 54 (83.1%) cardiac arrests were witnessed; seven (10.8%) showed a shockable rhythm at the time of the first ECG. Resuscitation attempts lasted 29.3±41.3 minutes, and 4.1±3.1 mg epinephrine was given. Return of spontaneous circulation could be achieved in 38 patients (58.5%); 29 (44.6%) survived the first day, 23 (35.4%) the seventh day, and 15 patients (23.1%) were discharged alive. Significantly more in-hospital resuscitations were obtained for those performed during non-regular working hours (P<0.001), with higher neuron-specific enolase levels at 72 hours after resuscitation during nonregular working hours (P=0.04). Patients who were discharged alive were significantly younger (P=0.01), presented more often with an initial shockable rhythm (P=0.04), and had a shorter duration of resuscitation (P<0.001) with the need of a lower dose of epinephrine (P<0.001). Discussion Survival rates following in-hospital resuscitation were poor at any time, but appear to depend less on time-dependent effects of the quality of resuscitation and more on time-dependent effects of recognition of cardiac arrests. PMID:25061331

Christ, Martin; Dierschke, Wolfgang; von Auenmueller, Katharina Isabel; van Bracht, Marc; Grett, Martin; Trappe, Hans-Joachim

2014-01-01

157

Initial Hospital / Hospice Care and Discharge on Same Day A 92 year old female has been in the hospital for 2 weeks, her health is deteriorating and the  

E-print Network

Initial Hospital / Hospice Care and Discharge on Same Day A 92 year old female has been in the hospital for 2 weeks, her health is deteriorating and the decision was made to transfer the patient to hospice care. The patient will not be moving from her hospital room; just the status of the patient has

Oliver, Douglas L.

158

The politics of black patients' identity: ward-rounds on the 'black side' of a South African psychiatric hospital.  

PubMed

There are many macrosocial studies of the political organisation of health and mental health care in South Africa, and the maldistribution of resources by race is well known. Little attention, however, has been given to the minutiae of the negotiation of power in the clinical setting. This article, which reports on part of a larger study of aspects of culture in South African psychiatry, focuses on interactions in ward-rounds on the 'Black side' of a South African psychiatric hospital. Through analysis of cases, the complexity of interpreting what transpires in such a setting and the central role that the concept of culture has in debates amongst staff members are demonstrated. Close analysis demonstrates the inadequacy of models which seek to locate the institutional racism of apartheid psychiatry in the motives of individual clinicians. Clinicians may simultaneously reproduce and subvert aspects of apartheid practice. A consideration of the social positioning of the clinician both as a South African and as a practitioner of psychiatry is central to the development of psychiatry in a post-apartheid South Africa. PMID:1874004

Swartz, L

1991-06-01

159

Job Title LCDC for Adult Intensive Outpatient Treatment Program Employer/ Agency New Dimensions Day Hospital of The Woodlands  

E-print Network

background in treating psychiatric disorders, addictions, and dual diagnosis patients. The ability to work will have experience working with chemical dependency and dual diagnosis patients in a partial day with a Master's in Psychology or Social Work and licensed as an LPC, LMFT, LCSW, or Clinical Psychologist

Azevedo, Ricardo

160

Psychiatric rehabilitation.  

PubMed

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

Wallace, C J

1993-01-01

161

Factors Associated within 28 Days In-Hospital Mortality of Patients with Acute Respiratory Distress Syndrome  

PubMed Central

Objective. To determine the factors leading to in-hospital mortality within 28 days in hospitalized patients with ARDS. It was a prospective observational cohort study conducted in Intensive Care Unit of Aga Khan University Hospital Karachi from March to August 2011. Methodology. Data was collected from patients admitted in the intensive care unit on the basis of inclusion and exclusion criteria. The patients were followed daily for 28 days to record any in-hospital complications and the outcome of patients. Results. Total of 46 patients were included during this period out of which 56% (26) were males and 43% (20) were females. Mean age was 44 ± 19 years. There were 11 (23.9%) patients with age >65 and 35 (76%) had age <65 years. There were 21 (45.6%) patients with pulmonary ARDS and 25 (54.3%) had extrapulmonary ARDS. APACHE II score of >20 was present in 23 (50%) patients while the rest had score of <20. Regarding in-hospital complications, 23 (50%) patients developed sepsis, 31 (67.4%) had multiorgan failure, 14 (30%) had refractory shock, and 15 (32.6%) developed refractory hypoxemia. Out of 46 patients, 26 (56.5%) died within 28 days. On univariate analysis, high APACHE score, multiorgan failure, refractory shock, and refractory hypoxemia were main causes of death. Conclusion. ARDS is a syndrome of high mortality with mortality rate of 56.5% in this study. High APACHE, sepsis, multiorgan failure, refractory shock, and refractory hypoxemia are the leading causes of death in our patients. PMID:23878811

Sharif, Nadia; Irfan, Muhammad; Hussain, Javaid; Khan, Javaid

2013-01-01

162

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

ERIC Educational Resources Information Center

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…

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

163

The incorporation of the stage of change model in the day hospital treatment of patients with anorexia nervosa  

Microsoft Academic Search

The development of day hospital programmes for patients with anorexia nervosa has received much interest of late. However, there has often been little attention paid to the unique nature of this disorder. For this reason, we set out to design day hospital treatment programmes to reflect and incorporate an understanding of the ambivalence towards change demonstrated by the majority of

Stephen Touyz; Christopher Thornton; Elizabeth Rieger; Louise George; Peter Beumont

2003-01-01

164

[Clinical psychopathological research on late-onset schizophrenia--mainly patients with schizophrenia from a hospital psychiatric ward].  

PubMed

In the field of clinical psychiatry, cases of late-onset schizophrenia are often observed in the population of 40 years or older. Female patients seem to significantly predominate those diagnosed with late-onset schizophrenia. Generally, paranoid delusions of reference with family members, neighbors, and friends are observed as clinical features of such late-onset schizophrenia conditions. Medical treatment for such a condition is often effective and considered to improve the prognosis. The authors conducted clinical research at Jichi Medical University Hospital psychiatric ward involving 38 late-onset schizophrenia patients (7 males; 31 females) diagnosed over the age of 40 using DSM-IV-TR diagnostic criteria. Subjects were selected from 316 schizophrenia patients (164 males; 152 females) admitted to the hospital for schizophrenia treatment at some time during the 13 years from April 1, 1993 to March 31, 2006. Also, another 14 late-onset schizophrenia patients diagnosed over the age of 40 (1 male; 13 females), with additional investigation, were selected from 130 cases (50 males; 80 females) treated in related facilities at some time during the 2 years from April 1, 2004 to March 31, 2006. The investigation revealed the following results: (1) Cases showing an onset after the age of 40 comprised 12% of the total population. Female cases comprised 20.4%, being significantly higher than that of male cases (4.3%). Within the psychiatric ward, cases showing an onset after 40 made up 10.8% of the total population. Female cases comprised 16.3%, being significantly higher than that of male cases (2.0%). (2) The paranoid type comprised 55.3% of the total population of late-onset cases, being significantly higher than in early-onset cases younger than 40 years old. A total of 55.3% of late-onset cases also showed depressive symptoms, being significantly higher than in early-onset cases. (3) For late-onset, 55.3% of patients showed an introverted premorbid character, while 15.8% of patients exhibited an extroverted premorbid character. Regarding late-onset cases, the number of introverted premorbid character cases significantly lower than in early-onset cases diagnosed at 40 years or younger; however, no significant difference was observed for the extroverted premorbid character. (4) A total of 65.8% of the population of late-onset cases were diagnosed as having psychosocial stresses as their cause. In addition, 36 % of subjects with psychosocial stress recognition had experienced a sense of loss. Of these, 66.6% of the loss experience involved separation from their family members. (5) Cases showing a successful recovery from schizophrenia comprised 55.3 % of the total population. On the other hand, cases with an unsuccessful outcome were observed in 34.2% of the total population, accounting for a relatively large portion. A total of 30.8% of subjects with an unsuccessful outcome were unmarried at the time of onset, and made up 57.1% of the late-onset population. According to the results of this investigation, late-onset schizophrenia represents about 10% of the total cases, and female cases are significantly more common than male cases. For late-onset patients, subjects' self-functions were more developed compared to those of early-onset patients, so they did not seem to clearly show early-onset symptoms during a younger period. The late-onset type has a tendency to show a better rate of successful recovery; however, there are situations where the condition reverts toward the "disorganized type", moving closer toward Kraepelin's early-onset disorganized schizophrenia. PMID:19425390

Yasuda, Manabu; Kato, Satoshi

2009-01-01

165

A nurse-physician co-leadership model in psychiatric hospitals: results of a survey among leading staff members in three sites.  

PubMed

In three psychiatric hospitals in Baden-Wuerttemberg, Germany, a physician-nurse shared leadership model was implemented in 1997 by the hospital management. The whole hospital, departments, and single wards are led each by a leadership team consisting of a physician, psychologist or social worker and a nurse, being responsible for organization, staff, and budgets. The consequences for staff opinion in leadership positions were evaluated. All 165 leading staff members of all professional groups were anonymously interviewed with a questionnaire containing 45 items regarding their satisfaction with this new leadership model. The response rate was 79.4%. Overall, the leading staff members were satisfied with the shared leadership model both in their own clinical practice and in general. Non-medical staff members were significantly more in favour of several aspects of shared leadership than physicians, but even the latter reported to be generally satisfied. However, both professional groups estimated leading positions to be only modestly attractive. The results yield some evidence that the change from traditional leadership models to the physician-nurse shared leadership model may have advantages in the management of psychiatric hospitals. PMID:17064321

Steinert, Tilman; Goebel, Rita; Rieger, Wolfgang

2006-12-01

166

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

PubMed Central

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

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

2014-01-01

167

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

PubMed

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

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

2013-01-01

168

Days of heroin use predict poor self-reported health in hospitalized heroin users.  

PubMed

This study examined associations between substance use behaviors and self-reported health among hospitalized heroin users. Of the 112 participants, 53 (47%) reported good or better health. In multivariable logistic regression models, each day of heroin use in the last month was associated with an 8% lower odds of reporting health as good or better (OR=.92; 95% CI 0.87, 0.97, p<.05). Cocaine, cannabis, cigarettes, alcohol use, unintentional overdose, nor injection drug use was associated with health status. PMID:24045030

Meshesha, Lidia Z; Tsui, Judith I; Liebschutz, Jane M; Crooks, Denise; Anderson, Bradley J; Herman, Debra S; Stein, Michael D

2013-12-01

169

Palliative inpatients in general hospitals: a one day observational study in Belgium  

PubMed Central

Background Hospital care plays a major role at the end-of-life. But little is known about the overall size and characteristics of the palliative inpatient population. The aim of our study was to analyse these aspects. Methods We conducted a one-day observational study in 14 randomly selected Belgian hospitals. Patients who met the definition of palliative patients were identified as palliative. Then, information about their socio-demographic characteristics, diagnoses, prognosis, and care plan were recorded and analysed. Results There were 2639 in-patients on the day of the study; 9.4% of them were identified as "palliative". The mean age of the group was 72 years. The primary diagnosis was cancer in 51% of patients and the estimated life expectancy was shorter than 3 months in 33% of patients and longer than 1 year in 28% of patients. The professional caregivers expected for most of the patients (73%), that the treatment would improve patient comfort rather than prolong life. Antibiotics, transfusions, treatments specific to the pathology, and artificial nutrition were administered in 90%, 78%, 57% and 50% of the patients, respectively, but were generally given with a view to controlling the symptoms. Conclusions This analysis presents a first national estimate of the palliative inpatient population. Our results confirm that hospitals play a major role at the end-of-life, with one out of ten inpatients identified as a "palliative" patient. These data also demonstrate the complexity of the palliative population and the substantial diversity of care that they can require. PMID:21362204

2011-01-01

170

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

PubMed Central

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

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

2014-01-01

171

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

NASA Astrophysics Data System (ADS)

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

Shimazaki, Yoichi

172

Substance abuse and the chronically mentally ill: A description of dual diagnosis treatment services in a psychiatric hospital  

Microsoft Academic Search

Between 20% and 70% of psychiatric patients have a co-occurring substance use disorder and rates of substance abuse among patients with psychotic disorders are especially high. Patients with co-existing psychosis and substance use disorders typically have poorer outcomes than patients diagnosed with either disorder alone. Frequently, treatment services for such dually diagnosed patients are not integrated and organizational barriers may

Shelly F. Greenfield; Roger D. Weiss; Maurico Tohen

1995-01-01

173

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

Code of Federal Regulations, 2013 CFR

... Medical, Psychiatric, and Social Evaluations and Admission Review... Medical, psychiatric, and social evaluations. (a) Before...or beneficiary's need for care in the hospital; and appropriate...must make a psychiatric and social evaluation. (b) Each...

2013-10-01

174

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

Code of Federal Regulations, 2011 CFR

... Medical, Psychiatric, and Social Evaluations and Admission Review... Medical, psychiatric, and social evaluations. (a) Before...applicant's or recipient's need for care in the hospital; and appropriate...must make a psychiatric and social evaluation. (b) Each...

2011-10-01

175

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

Code of Federal Regulations, 2012 CFR

... Medical, Psychiatric, and Social Evaluations and Admission Review... Medical, psychiatric, and social evaluations. (a) Before...or beneficiary's need for care in the hospital; and appropriate...must make a psychiatric and social evaluation. (b) Each...

2012-10-01

176

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

Code of Federal Regulations, 2010 CFR

... Medical, Psychiatric, and Social Evaluations and Admission Review... Medical, psychiatric, and social evaluations. (a) Before...applicant's or recipient's need for care in the hospital; and appropriate...must make a psychiatric and social evaluation. (b) Each...

2010-10-01

177

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

PubMed Central

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

2013-01-01

178

HIV Risk Behaviour among Psychiatric Inpatients: Results from a Hospital-Wide Screening Study in Southern India  

PubMed Central

Summary This study was carried out to investigate the prevalence and correlates of sexual risk behaviour among psychiatric inpatients in India. Consecutive inpatients (n = 618) were assessed using a structured interview and standardized measures. Women were more likely to be sexually active (50%) than men (36%), but equally likely (6% v. 5%) to engage in risky behaviour. Common risk behaviours included having a risky partner, having multiple partners, and exchanging money for sex. Being sexually active was associated with younger age, being married, being diagnosed with a disorder other than schizophrenia, and a history of drug use problems. Engaging in risky sexual behaviour was associated with being male, using tobacco products, and screening positive for either drug use or alcohol problems. Screening psychiatric patients for HIV risk behaviour can identify those who may benefit from risk reduction programs. PMID:12935383

Chandra, P. S.; Carey, M. P.; Carey, K. B.; Rao, P.S.D.V.Prasada; Jairam, K. R.; Thomas, T.

2008-01-01

179

Overriding Psychiatric Advance Directives: Factors Associated with Psychiatrists' Decisions to Preempt Patients' Advance Refusal of Hospitalization and Medication  

Microsoft Academic Search

Psychiatric advance directives (PADs) are intended to support patients' treatment decisions during a crisis. However, PAD\\u000a statutes give clinicians broad discretion over whether to carry out patients' advance instructions. This study uses data from\\u000a a survey of psychiatrists (N=164) to examine reasons for overriding PADs. In response to a hypothetical vignette, 47% of psychiatrists indicated that\\u000a they would override a

Jeffrey W. Swanson; S. Van McCrary; Marvin S. Swartz; Richard A. Van Dorn; Eric B. Elbogen

2007-01-01

180

Duration of Hospitalization and Post Discharge Suicide  

ERIC Educational Resources Information Center

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

Ho, Ting-Pong

2006-01-01

181

[Psychiatric nursing at the Hospital Saint-Jean-de-Dieu School of Nursing: striking a balance between the spiritual and the technical sides].  

PubMed

The art of taking care of the insane developed and solidified at the Hospital Saint-Jean-de-Dieu after a School of Nurses was created there in 1912. Founded by the Sisters of Providence, this new school participated in the transformation of the asylum into a regular hospital. The archives of the Sisters of Providence and the monthly magazine La garde-malade canadienne-française allow us to analyze the discourse of nursing leaders, which was based on the importance of professional training. Scientific discoveries and new technologies were at the heart of the care process at Saint-Jean-de-Dieu, where students were introduced to a technical, as well as a spiritual, education. This article first considers the marginal status of psychiatric nursing training within the larger nurses' professionalization movement. In a second step, it describes the socio-religious context between 1912 and 1962 within which the School of Nurses of the Hospital Saint-Jean-de-Dieu evolved. PMID:21560368

Thifault, Marie-Claude

2010-01-01

182

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

PubMed Central

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

Baur, Nicole

2013-01-01

183

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

PubMed

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

Baur, Nicole

2013-09-01

184

The quality of psychiatric nurses' interactions with patients: an observational study  

Microsoft Academic Search

The behaviour of nursing staff in each ward of a psychiatric hospital was observed at 5-min intervals for between 7 and 10 h per day for 10 days. The nurses' behaviour was equally divided between interacting with patients, interacting with staff, solitary task oriented behaviour and other behaviours. There was less staff-patient interaction in the acute ward than in the

W. G. Lambert; L. Beattie

1995-01-01

185

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

ERIC Educational Resources Information Center

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

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

2010-01-01

186

Psychiatric Medication  

Microsoft Academic Search

This exploratory, descriptive study assessed psychiatric medication use in two samples. Students in three social work courses and practicing social workers in a midwestern city were surveyed by mail. Respondents were asked to identify symptoms, psychiatric medication use, effectiveness of drug therapy, side effects, stigma, and to rate the impact of psychiatric medication use on their current or future social

Jennifer Davis-Berman; H. Frances Pestello

2002-01-01

187

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

PubMed Central

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

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

2008-01-01

188

Midnight census revisited: Reliability of patient day measurements in US hospital units  

Microsoft Academic Search

BackgroundPatient days are widely used in nurse staffing research and for nursing quality measurement. Nursing hours per patient day (NHPPD) and fall rates incorporate patient days in the denominator and are endorsed by the US National Quality Forum (NQF) as nursing sensitive consensus measures. Measurement error introduced by patient days would affect the accuracy of these nursing quality indicators.

Michael Simon; Eugene Yankovskyy; Susan Klaus; Byron Gajewski; Nancy Dunton

2011-01-01

189

HOSPITAL STAY OF IN-PATIENTS IN A GENERAL HOSPITAL PSYCHIATRY UNIT  

PubMed Central

SUMMARY This report examines the hospital stay of psychiatric in-patients in a general hospital psychiatric setting. The hospital stay days, psychiatric diagnosis, outcome, number of re-admission and some socio-demographic details of patients admitted during one year period were recorded and analysed. The mean hospital stay was 29.39 ± 20.43 days. 60% patients stayed less than 4 weeks. The mean hospital stay of various categories was calculated. Schizophrenics 29.62 ± 25.82 days, manic depressives 35.29 ± 33.04 days and neuroses 24.83±18.43 days. Chronic Schizophrenics stayed longest (43.64±22.56) days. Of the Affective Psychosis group, between manics and depressives no difference was noticed. Good prognosis and relatively benign conditions had a briefer stay. Patients with no improvement stayed for significantly shorter- period (p< .001). Readmission cases tend to stay longer than fresh admissions (p< .05). The implications and interpretations especially in a general hospital psychiatric setting are discussed. PMID:21847306

Chaturvedi, S.K.; Varma, V.K.; Malhotra, Savita; Kumar, Pradeep

1983-01-01

190

New employee strategies pay off. Identity crisis at Jeanes Hospital gives way to a new day.  

PubMed

A new spirit is evident at Jeanes Hospital in Philadelphia, where morale had slumped following the combination of the 128-year old Quaker-based institution with the Temple University Health System. The key is a new CEO with a passion for open communication, honest messaging and consistent follow-up. PMID:11915205

Botvin, Judith D

2002-01-01

191

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

NSDL National Science Digital Library

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

2008-10-06

192

Diversity and Adaptation of Human Respiratory Syncytial Virus Genotypes Circulating in Two Distinct Communities: Public Hospital and Day Care Center  

PubMed Central

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

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

2012-01-01

193

The Psychiatrically Disturbed Developmentally Disabled Adult  

Microsoft Academic Search

The developmentally disabled adult with a concomitant psychiatric disorder presents special challenges to the medical and human service professions. When these patients are hospitalized for psychiatric reasons, they are likely to be admitted for short-term stays in general hospitals. With this information as a foundation, an inpatient behavioral treatment program, implemented by the authors, is presented. This program has been

H. Russell Searight; Jonathan J. Noce

1991-01-01

194

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

PubMed Central

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

Banerjee, Sohini

2013-01-01

195

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

Code of Federal Regulations, 2013 CFR

...prospective payment system for inpatient hospital services of psychiatric facilities...PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital Services of Inpatient Psychiatric...

2013-10-01

196

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

Code of Federal Regulations, 2012 CFR

...prospective payment system for inpatient hospital services of psychiatric facilities...PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital Services of Inpatient Psychiatric...

2012-10-01

197

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

Code of Federal Regulations, 2011 CFR

...prospective payment system for inpatient hospital services of psychiatric facilities...PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital Services of Inpatient Psychiatric...

2011-10-01

198

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

Code of Federal Regulations, 2010 CFR

...prospective payment system for inpatient hospital services of psychiatric facilities...PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment System for Inpatient Hospital Services of Inpatient Psychiatric...

2010-10-01

199

The health of irregular and illegal immigrants: analysis of day-hospital admissions in a department of migration medicine.  

PubMed

It is difficult to trace full details of the path which irregular or illegal immigrants follow when seeking assistance in the network of the various hospital departments and health structures. The aim of this work was to analyze the health needs of immigrant people by reviewing the types of treatment given to them in the day-hospital of our Department of Migration Medicine. Our study analyzed day-hospital admissions between 2003 and 2009. The patient charts used for managing day-hospital activity were adopted in 2002 in conformity with the "OSI project". From these it is possible to draw up a scale picture of the distribution of each pathology in the immigrant population. The sample population consisted of 1,758 subjects, representing 7.4% of potential users. More than half came from Africa, followed by Asia, and then Europe. Gastroenterological diseases ranked first, with dyspeptic syndromes most frequently diagnosed. Infections and parasitic diseases ranked second, and the most frequent diagnoses were sexually transmitted diseases. Third were diseases of the genitourinary system. Metabolic disorders ranked fourth, among them, more than half of the cases were of diabetes mellitus, in patients from south-east Asia. Diseases of the circulatory system were sixth, with hypertension the most frequent pathology. Our data confirm a marked persistence of the phenomenon known as the "healthy immigrant effect" in these types of patients, as well as the prominent role played by "social determinants" in conditioning the health of immigrants, particularly in the case of some infectious diseases. PMID:21647689

Affronti, Mario; Affronti, Andrea; Pagano, Salvatore; Soresi, Maurizio; Giannitrapani, Lydia; Valenti, Miriam; La Spada, Emanuele; Montalto, Giuseppe

2013-10-01

200

Psychiatric Emergencies  

PubMed Central

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

Bayrakal, Sadi

1972-01-01

201

College Student Utilization of a Comprehensive Psychiatric Emergency Program  

ERIC Educational Resources Information Center

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

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

2013-01-01

202

Psychiatric interviewing and clinical skills.  

PubMed

Does the ability of medical students to assess and relate to their patients through the psychiatric interview reflect in traditional academic achievement scores? A previous publication by our group offers data suggesting that certain personality traits of final year medical students have a fundamental importance in determining a successful performance on a psychiatry rotation. As the literature is vague and contradictory about the relationship between the psychiatric interview and clinical performance, a study was developed to determine what outcome variables are associated with the performance of clinical clerks on the Psychiatric Interview. An attempt was made to develop and test a new scale designed to measure the Psychiatric Interview. The Psychiatric Interview Scale was used to measure performance on 33 final year medical students on a 1 month psychiatry rotation at a University of Toronto teaching hospital, and subsequently, as a basis for analysis and training of these students in interviewing. Inter-rater reliability of the Psychiatric Interview Scale was rho = 0.72 and internal reliability was 0.74. Psychiatric Interview Scores were compared with other achievement scores, and with patients' ratings of the students interviews. A significant correlation emerged between the Psychiatric interview scores and final clinical examinations, but surprisingly, there was no relationship between the patients' evaluation of the Psychiatric Interview and the raters' evaluations and a strongly significant negative correlation between patients' ratings and clinical scores.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3971284

Pollock, D C; Shanley, D F; Byrne, P N

1985-02-01

203

Hospital Length of Stay in the First 100 Days after Allogeneic Hematopoietic Cell Transplantation for Acute Leukemia in Remission: Comparison among Alternative Graft Sources.  

PubMed

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

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

2014-11-01

204

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

ERIC Educational Resources Information Center

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…

CRAWFORD, ANNIE L.

205

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

ERIC Educational Resources Information Center

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

Silverman, Michael J.

2009-01-01

206

Lunar phase and psychiatric illness in goa.  

PubMed

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

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

1999-01-01

207

LUNAR PHASE AND PSYCHIATRIC ILLNESS IN GOA  

PubMed Central

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

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

1999-01-01

208

Job Title Adolescent Program Therapist for Intensive Outpatient Treatment Program Employer/ Agency New Dimensions Day Hospital of The Woodlands  

E-print Network

clinical background in treating psychiatric disorders, addictions, and dual diagnosis patients. The ability and be able to work independently. Must have a minimum of a Master's in Psychology or Social Work

Azevedo, Ricardo

209

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

PubMed Central

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

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

2014-01-01

210

[The evaluation of day hospital activities: an analysis of intervention protocols and a comparison between the indicators of the activities of the day hospital and of the regular admission].  

PubMed

Day hospital (DH) activity may avoid in-staying of patients resulting in an increase of efficiency and in a more satisfying diagnostical-therapeutical process for the patient. All the same, it is quite difficult to identify parametres and indicators to be used in the evaluation and quantification of DH, so that both scientific literature reporting experiences and law are lacking. One of the reasons is probably due to the lack of nosological characterization of patients and protocols of DH activity, so that the definition relies only on organizational and technical parameters. Characterization of protocols of intervention is the basic approach to the present DH investigation. Parameters such as: multiplicity of services, weekly planning of the activity and surveillance needed by the patient are considered the fundamental criteria to identify and quantify DH in the present research carried out at the University Regional Hospital of Pisa. The aim of this article is, on one side, to give a methodology of investigation based, as far as possible, on "explicit" indicators and parameters, so that the experience may be exported into other contexts and on the other, to give an example of resource analysis and efficiency evaluation which were internally used for "audit" review. PMID:9157026

Giuliano, G; Geracitano, A; Scarselli, G; Rossi, A; Ursino, P; Azadegan, M; Caroli, G

1997-01-01

211

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

PubMed Central

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

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

2014-01-01

212

Medicare Inpatient Treatment for Elderly Non-dementia Psychiatric Illnesses 1992–2002; Length of Stay and Expenditures by Facility Type  

PubMed Central

We summarize Medicare utilization and payment for inpatient treatment of non-dementia psychiatric illnesses (NDPI) among the elderly during 1992 and 2002. From 1992 to 2002, overall mean Medicare expenditures per elderly NDPI inpatient stay declined by $2,254 (in 2002 dollars) and covered days by 2.8. However, these changes are complicated by expanded use of skilled nursing facilities and hospital psychiatric units, and decreased use of long-stay hospitals and general hospital beds. This suggests that inpatient treatment for NDPI is shifting into less expensive settings which may reflect cost-cutting strategies, preferences for less restrictive settings, and outpatient treatment advances. PMID:18293080

Akincigil, Ayse; Prince, Jonathan D.; Kalay, Ece; Lucas, Judith A.; Walkup, James T.; Crystal, Stephen

2010-01-01

213

STATISTICAL ANALYSES OF PSYCHIATRIC PATIENT RETURN TIMES  

E-print Network

STATISTICAL ANALYSES OF PSYCHIATRIC PATIENT RETURN TIMES IN THE V.A. HOSPITAL SYSTEM || Mike West, Viridiana Lourdes & Jim Burgess August 16, 1999 This report summarises investigations of VA hospital quality of information for all individuals in the M20 care area of the VA hospital system, with a primary focus

West, Mike

214

[Oncologic day hospital].  

PubMed

Due to its physical and psychosocial complexity, cancer requires forms of treatment which are becoming more diverse all the time and which involve a growing number of specialists in all fields. Nursing occupies a very important place in the care of these patients, and inside of the ambulatory care which nurses deal in, nurses are in charge of informing and caring for patients receiving chemotherapy. We develop a nursing care plan based on the most common problems or complications such as secondary effects of new generation cytostatic drugs, but one can extrapolate from those already known. We use the NANDA diagnostics and we keep in mind that almost all of the problems which we deal with are interdependent. PMID:10030159

García Aguado, M; Magallón Pedrera, I

1998-10-01

215

Study of Staffing Patterns in Psychiatric Nursing.  

National Technical Information Service (NTIS)

Findings of a study of the effects of selected combinations of nursing staff with prescribed functions upon the therapeutic milieu and nursing care of patients in a psychiatric hospital are reported in an investigation undertaken by research nurses at Sai...

K. Bueker, H. K. Sainato

1968-01-01

216

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

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

2012-01-01

217

Evaluation of a Discharge Medication Service on an Acute Psychiatric Unit  

PubMed Central

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

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

2013-01-01

218

Appropriate treatment targets or products of a demanding environment? The relationship between aggression in a forensic psychiatric hospital with aggressive behaviour preceding admission and violent recidivism  

Microsoft Academic Search

Effective treatment of aggressive behaviour and accurate release decision making are necessary components of adequate clinical practice in forensic psychiatric units. Unfortunately, methods to identify treatment targets and ameliorate aggressive behaviour have developed at a slower pace than risk assessment technologies. Recent progress on the identification of offence paralleling or functionally equivalent behaviour offers a framework for individually tailored treatment

Michael Daffern; Murray Ferguson; James Ogloff; Lindsay Thomson; Kevin Howells

2007-01-01

219

Cross-sectional Study on Psychiatric Symptoms in Immigrant Patients in a First Aid Setting: The Situation at Padova Hospital, 2003-2004  

Microsoft Academic Search

Italy has recently become a country of net immigration, posing new challenges for health care, particularly psychiatry. Previous studies on migration and mental health have focused predominantly on individual psychopathologies or individual immigrant populations. The aim of this work is to determine the demand by foreign citizens for intervention at Padova-based psychiatric services and to assess any differences in presentation

F Sessa; N Campagnola; M Marini; I Toniolo; C Cremonese

2008-01-01

220

Adolescent psychiatric inpatients: Characteristics, outcome, and comparison between discharged patients from a specialized adolescent unit and nonspecialized units  

Microsoft Academic Search

We have recently studied the outcome of school-aged children treated in day hospital and inpatient psychiatric units using four operationally defined preadmission child and parent\\/family variables as predictors of outcome. Our studies have provided considerable support for these preadmission variables singly and\\/or in combination in predicting poor outcome in school-aged children in these hospital settings. The present study describes the

Stewart Gabel; Richard Shindledecker

1992-01-01

221

Biochemical identification of patients with gallstones associated with acute pancreatitis on the day of admission to hospital.  

PubMed Central

Current trends in the treatment of gallstone pancreatitis require rapid diagnosis of cholelithiasis. This study evaluates the diagnostic potential of plasma aspartate aminotransferase (AST), alkaline phosphatase, and bilirubin on the day of admission to hospital in 215 attacks of acute pancreatitis. The optimal diagnostic cut-off level for AST was 60 IU/1. A transient elevation above 60 IU/1 was recorded in 111 (84.1%) of 132 attacks associated with gallstones, but in only 12 (14.5%) of 83 attacks without stones, and was unrelated to the severity of the attack. Elevated levels of alkaline phosphatase and bilirubin were also more common in attacks associated with gallstones but were less reliable for the identification of cholelithiasis than AST. As a sensitive indicator of hepatocyte disruption, the early and transient rise in plasma AST is consistent with the concept of transient ampullary obstruction in gallstone pancreatitis, and may be useful in identifying patients who require urgent surgical or endoscopic disimpaction. PMID:2578276

Mayer, A D; McMahon, M J

1985-01-01

222

Psychiatric manifestations in cerebrotendinous xanthomatosis  

PubMed Central

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

Fraidakis, M J

2013-01-01

223

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

PubMed Central

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

Frick, Ulrich; Frick, Hannah; Langguth, Berthold; Landgrebe, Michael; Hubner-Liebermann, Bettina; Hajak, Goran

2013-01-01

224

The impact of prior outpatient ACE inhibitor use on 30-day mortality for patients hospitalized with community-acquired pneumonia  

Microsoft Academic Search

BACKGROUND: Recent studies suggest that angiotensin-converting enzyme (ACE) inhibitors may have beneficial effects for patients at risk for some types of infections. We examined the effect of prior outpatient use of ACE inhibitors on mortality for patients hospitalized with community-acquired pneumonia. METHODS: A retrospective cohort study conducted at two tertiary teaching hospitals. Eligible subjects were admitted with a diagnosis of,

Eric M Mortensen; Marcos I Restrepo; Antonio Anzueto; Jacqueline Pugh

2005-01-01

225

The prevalence of anemia and its association with 90-day mortality in hospitalized community-acquired pneumonia  

Microsoft Academic Search

BACKGROUND: The prevalence of anemia in the intensive care unit is well-described. Less is known, however, of the prevalence of anemia in hospitalized patients with lesser illness severity or without organ dysfunction. Community-acquired pneumonia (CAP) is one of the most frequent reasons for hospitalization in the United States (US), affecting both healthy patients and those with comorbid illness, and is

Michael C Reade; Lisa Weissfeld; Derek C Angus; John A Kellum; Eric B Milbrandt

2010-01-01

226

The impact of attachment insecurity and sleep disturbance on symptoms and sick days in hospital-based health-care workers  

Microsoft Academic Search

ObjectiveAdult attachment insecurity is associated with many health outcomes and may be associated with sleep disturbance. The purpose of this study was to test the hypothesis that sleep disturbance mediates the relationship between attachment insecurity and three measures of health (perceived general health, physical symptoms and sick days) in a group that is at high risk of sleep disturbance: hospital

Robert G. Maunder; Jonathan J. Hunter; William J. Lancee

2011-01-01

227

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

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…

Crino, Natalie; Djokvucic, Ivana

2010-01-01

228

[Some resolutions in difficulties of postgraduate psychiatric education in Japan].  

PubMed

1. Board Certification System of Psychiatry There was a heated debate about "Postgraduate Psychiatric Education and Board Certification of Psychiatry" in the annual meeting for the Japanese Society of Psychiatry and Neurology held in Nagasaki in 1968 and in Kanazawa in 1969. The oppositions of young psychiatrists were as follows; 1) Issues of low cost of medical expense as government politics, social protect politics from psychiatric patients, and improper management of patients in mental hospitals should be dealt before making Board Certification System of Psychiatry. 2) Management of the Society of Psychiatry and Neurology dissatisfies many psychiatrists. Board Certification Systems started in many medical societies from 1969 to 1987. Main nine departments except psychiatry started the system. In 1987, the Japan Association of Chairmen of Department of Psychiatry of Medical Colleges (JACDPM) proposed a program for a postgraduate course. The Japanese Society of Psychiatry and Neurology (JSPN) formed the Committee on Psychiatric Education in 1987 and Working Group on Accreditation Program (WGAP) in 1991 under the Committee of Psychiatric Education. After intensive discussions on the Board certification, the WGAP reported a summary of their discussions in 1994. The essence of the WGAP recommended model for the Board of Association was as follows: Minimal Requirements Outline Training Period--three years psychiatric training after two years primary care experience by rotation through other departments. Field of Training--WGAP recommended that post-graduate training should be given at different kinds of institutes such as the department of psychiatry in medical schools, mental hospitals, out-patient mental clinics, community experiences in rehabilitation, day care, social clubs and health centers. Assessment--both oral examination and case reports are requested for evaluation and board certification. Re-evaluation every five years is required. However, there have been the following opinions and the Board Certification System has not been realized. 1) Making improvement in mental hospital is more important than starting Post-graduate Training and Organization for Board Certification of Psychiatry System (PTOBCP). 2) Starting PTOBCP makes professors in department of psychiatry in medical colleges give great power to suppress the right of personal management. 3) Financial support for postgraduate trainee and trainer is insufficient. Medical and psychiatric situations have changed from 2001 to 2002. 1) A neutral organization instead of academic societies will make Board Certification System in each department in the future. 2) Postgraduate educational rotation system (two years) will start in 2004. 3) Advertisement of being certificated by the Board has been possible. In recent situation, necessity for making of PTOBCP is increasing and many members of JSPN long to make it. In the 98th annual meeting, 2002 it was decided to make PTOBCP. 2. Post-graduate mandatory education system including psychiatry Recently, it was legally decided that post-graduate education for two years should be mandatory for every medical doctor who has passed a national board from 2004. Furthermore, psychiatric training should be mandatory for every rotating resident. The period of psychiatric training is one, two or three months, which depends upon each teaching hospital. It is epoch-making that every resident should receive psychiatric training, however, in other words, it means that psychiatric education in Japan will be re-evaluated through such a new training system. PMID:12708019

Kojima, Takuya; Hosaka, Takashi

2003-01-01

229

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

PubMed

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

Chiland, C

1992-01-01

230

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

PubMed

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

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

2014-12-01

231

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

ERIC Educational Resources Information Center

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…

Jacobs, Angeline Marchese; And Others

232

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

ERIC Educational Resources Information Center

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…

Jacobs, Angeline Marchese; And Others

233

[Treatments for otorhinolaryngological patients with psychiatric disorders].  

PubMed

There are few systems in place for patients with psychiatric disorders who need treatments for physical complications. In Tokyo, "The Tokyo metropolitan psychiatric emergency system" was established in 1981, and Ome Municipal General Hospital participated in it. Under this system, fifteen patients with psychiatric disorders were treated for otorhinolaryngological diseases in our department from April 2005 to March 2011. We reviewed the fifteen patients. The coexisting psychiatric disorders were schizophrenia in twelve patients, and mental retardation, Korsakoff's syndrome, and Alzheimer's dementia in one patient each, respectively. All the patients had been receiving psychiatric treatment. The otorhinolaryngological diseases were head and neck cancer in nine patients, chronic sinusitis in three patients, and benign salivary gland tumor, cholesteatoma, and epistaxis in one patient each, respectively. Among the fifteen patients, thirteen could complete their treatment, but two dropped out due to exacerbation of their psychiatric symptoms. The therapeutic course is uncertain in otorhinolaryngological diseases occurring concomitantly with psychiatric disorders, especially in head and neck cancer, because it may be difficult to prioritize the problem when determining the treatment options and delivering the treatment. Thus, we should treat patients with psychiatric disorders carefully on a case-by-case basis depending on their psychiatric symptoms. It is also important to cooperate with psychiatrists and patients' families. PMID:23539958

Nishio, Ayako; Sumi, Takuro; Yamada, Masato; Kuwahata, Yuko

2013-02-01

234

Residential mobility among patients admitted to acute psychiatric wards.  

PubMed

Residential mobility among those with mental disorders is consistently associated with hospital admission. We studied 4485 psychiatric admissions in South London, aiming to describe the prevalence, timing and associations of residential moves occurring in association with admission. Moves tended to cluster around discharge; 15% of inpatients moved during admission or up to 28 days after discharge. The strongest associations were with younger age (especially 16-25 years) and homelessness. Unadjusted effects of gender, marital status and previous service use were mediated by homelessness. Possible mechanisms for the associations with homelessness and younger age are discussed. PMID:21612971

Tulloch, Alex D; Fearon, Paul; David, Anthony S

2011-07-01

235

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

PubMed Central

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

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

2011-01-01

236

Laparoscopic Cholecystectomy as a Day Surgery Procedure: Implementation and Audit of 136 Consecutive Cases in a University Hospital  

Microsoft Academic Search

Laparoscopic cholecystectomy (LC) has been routinely performed since 1989 at our institution, and patients were traditionally admitted for 2 days. In 1996 we implemented a protocol for LC as a day surgery procedure at our center. Although initially reported by others, it has not yet been introduced as routine in Switzerland. The objective of this prospective study was to determine

Henri Vuilleumier; Nermin Halkic

2004-01-01

237

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

Microsoft Academic Search

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

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

2005-01-01

238

Polypharmacy in psychiatric treatment. Patterns of psychotropic drug use in Austrian psychiatric clinics  

Microsoft Academic Search

There are great variations in the way psychotropic drugs are prescribed. Most experts are in favour of psychopharmacological monotherapy, but little is known about the extent to which it is actually practised. A survey of the psychopharmacological medication of all patients under treatment was carried out in three Austrian psychiatric clinics of various types on two separate days. A psychiatric

H Rittmannsberger; U Meise; K Schauflinger; E Horvath; H Donat; H Hinterhuber

1999-01-01

239

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

PubMed

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

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

2005-03-01

240

Profiling psychiatric inpatient suicide attempts in Japan.  

PubMed

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

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

2014-01-01

241

Creative Art Therapy Groups: A Treatment Modality for Psychiatric Outpatients  

Microsoft Academic Search

This brief report examines the benefits of a creative art therapy group program for outpatients suffering from psychiatric disorders. Included is a review of relevant treatment outcomes literature on the effectiveness of group art therapy. The authors describe the Creative Art Therapy Group Program offered to adult psychiatric outpatients that is followed in various teaching hospitals. Case examples illustrate the

Marie-Céline Drapeau; Neomi Kronish

2007-01-01

242

42 CFR 485.647 - Condition of participation: psychiatric and rehabilitation distinct part units.  

Code of Federal Regulations, 2010 CFR

...2010-10-01 false Condition of participation: psychiatric and rehabilitation distinct...STANDARDS AND CERTIFICATION CONDITIONS OF PARTICIPATION: SPECIALIZED PROVIDERS Conditions of Participation: Critical Access Hospitals...

2010-10-01

243

Ecological correlates of psychiatric illness in the City of Calgary  

Microsoft Academic Search

Hospital admissions for psychiatric disorders in the City of Calgary were reviewed during a six-month period. Rates of hospitalization for the city's 77 census tract areas were calculated and correlated with data collected in the 1976 Canada Census. The study identified areas in the city with high rates of pathology requiring hospitalization. The correlational analysis reveals a significant association between

Renato Y. Pablo; Gerald M. McDougall

1986-01-01

244

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

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

González, Ricardo

2013-10-01

245

Negative rumor: contagion of a psychiatric department.  

PubMed

Over the past few decades, a sizable body of literature on the effects of rumors and gossip has emerged. Addressing rumors in the workplace is an important subject, as rumors have a direct impact on the quality of the work environment and also on the productivity and creativity of the employees. To date, little has been written on the effect of rumors and gossip in psychiatric hospitals. This article presents case vignettes of rumors spread in psychiatric hospitals and the impact on team cohesion and morale among the staff implicated in these, too often, neglected occurrences. Dynamic aspects with particular focus on rumors in psychiatric units and suggestions for remedy and treatment are presented. PMID:25133051

Novac, Andrei; McEwan, Stephanie; Bota, Robert G

2014-01-01

246

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

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

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

2010-01-01

247

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

PubMed

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

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

2007-01-01

248

PSYCHIATRIC DISORDERS AND SLEEP  

PubMed Central

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

Krystal, Andrew D.

2012-01-01

249

Attitudes of adolescents toward adolescent psychiatric treatment  

Microsoft Academic Search

Perceptions held by adolescents about the value and social stigma of both psychiatric hospitalization and outpatient therapy for adolescents are examined. Perceptions about preferred forms of treatment for specific adolescent problems are also analyzed. The results indicate that attitudes are significantly influenced by proximity to treatment setting, i.e., adolescents currently being treated are more positive than adolescents who have been

Robert L. Pugh; Bette J. Ackerman; Edgar B. McColgan; Paul B. de Mesquita; Patricia J. Worley; Nancy J. Goodman

1994-01-01

250

Data quality assessment in healthcare: a 365-day chart review of inpatients' health records at a Nigerian tertiary hospital  

PubMed Central

Background Health records are essential for good health care. Their quality depends on accurate and prompt documentation of the care provided and regular analysis of content. This study assessed the quantitative properties of inpatient health records at the Federal Medical Centre, Bida, Nigeria. Method A retrospective study was carried out to assess the documentation of 780 paper-based health records of inpatients discharged in 2009. Results 732 patient records were reviewed from the departments of obstetrics (45.90%), pediatrics (24.32%), and other specialties (29.78%). Documentation performance was very good (98.49%) for promptness recording care within the first 24?h of admission, fair (58.80%) for proper entry of patient unit number (unique identifier), and very poor (12.84%) for utilization of discharge summary forms. Overall, surgery records were nearly always (100%) prompt regarding care documentation, obstetrics records were consistent (80.65%) in entering patients' names in notes, and the principal diagnosis was properly documented in all (100%) completed discharge summary forms in medicine. 454 (62.02%) folders were chronologically arranged, 456 (62.29%) were properly held together with file tags, and most (80.60%) discharged folders reviewed, analyzed and appropriate code numbers were assigned. Conclusions Inadequacies were found in clinical documentation, especially gross underutilization of discharge summary forms. However, some forms were properly documented, suggesting that hospital healthcare providers possess the necessary skills for quality clinical documentation but lack the will. There is a need to institute a clinical documentation improvement program and promote quality clinical documentation among staff. PMID:22798477

Adekanye, Adedeji Olugbenga; Onawola, Kayode Abiodun; Okuku, Alaba George; Adefemi, Samuel Adebowale; Erinle, Sunday Adesubomi; Shehu, AbdurRahman Alhaji; Yahaya, Olubunmi Edith; Adebisi, AbdulLateef Adisa; James, John Adeniran; AbdulGhaney, Oloundare Olanrewaju; Ogundiran, Lateef Mosebolatan; Jibril, Abdullahi Daniyan; Atakere, Moses Esimy; Achinbee, Moses; Abodunrin, Oluwaseun Ayoade; Hassan, Muhammad Wasagi

2012-01-01

251

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

PubMed Central

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

Rodriguez, Erika A.; Correa, Margarita M.; Ospina, Sigifredo; Atehortua, Santiago L.; Jimenez, J. Natalia

2014-01-01

252

Parental psychiatric disorders and autism spectrum disorders  

PubMed Central

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

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

2013-01-01

253

Who's Boarding in the Psychiatric Emergency Service?  

PubMed Central

Introduction When a psychiatric patient in the emergency department requires inpatient admission, but no bed is available, they may become a “boarder.” The psychiatric emergency service (PES) has been suggested as one means to reduce psychiatric boarding, but the frequency and characteristics of adult PES boarders have not been described. Methods We electronically extracted electronic medical records for adult patients presenting to the PES in an urban county safety-net hospital over 12 months. Correlative analyses included Student’s t-tests and multivariate regression. Results 521 of 5363 patient encounters (9.7%) resulted in boarding. Compared to non-boarding encounters, boarding patient encounters were associated with diagnoses of a primary psychotic, anxiety, or personality disorder, or a bipolar manic/mixed episode. Boarders were also more likely to be referred by family, friends or providers than self-referred; arrive in restraints; experience restraint/seclusion in the PES; or be referred for involuntary hospitalization. Boarders were more likely to present to the PES on the weekend. Substance use was common, but only tobacco use was more likely associated with boarding status in multivariate analysis. Conclusion Boarding is common in the PES, and boarders have substantial psychiatric morbidity requiring treatment during extended PES stays. We question the appropriateness of PES boarding for seriously ill psychiatric patients. PMID:25247041

Simpson, Scott A.; Joesch, Jutta M.; West, Imara I.; Pasic, Jagoda

2014-01-01

254

Reported comorbidity of mental disorders with substance abuse among psychiatric inpatients in israel  

Microsoft Academic Search

In preparation for shifting of care from psychiatric hospital to the community, the prevalence of substance abuse comorbidity\\u000a among discharged psychiatric patients was studied. Such patients are not usually treated by substance abuse programs or mental\\u000a health clinics. Data from the Israeli National Psychiatric Case Registry were analyzed on reported substance abuse among all\\u000a 53,379 psychiatric discharges during 1989–92. The

Jonathan Rabinowitz; Mordechai Mark; Miriam Popper; Michael Slyuzberg

1996-01-01

255

Psychiatric morbidity in prisoners  

PubMed Central

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

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

2011-01-01

256

Benzodiazepine prescription and length of hospital stay at a Japanese university hospital  

PubMed Central

Background The relationship between bed days and benzodiazepine prescription (BDZ) in Western countries is inconclusive, and no hospital-based report has documented this phenomenon in Japan. This study was done to assess the association between bed days and BDZ in a Japanese hospital. Methods 21,489 adult patients (55.1% men, mean age 59.9 years old) hospitalized between April, 2005 and December, 2006 were enrolled in the study. Patient age, sex, ICD-10 diagnosis, prescription profile, and days of hospital stay were assessed in 13 non-psychiatric departments using a computer ordering system. Patients prescribed a benzodiazepine during hospitalization were defined as positive. Results Of the total sample, 19.9% were allocated to the benzodiazepine (+) group. Female sex and older age were significant factors associated with benzodiazepine prescription. The median number of bed days was 13, and the likelihood of BDZ significantly increased with the number of bed days, even after controlling for the effects of age, gender, and ICD-10 diagnosis. For example, when the analysis was limited to patients with 50 bed days or longer, the percentage of BDZ (32.7%) was equivalent to that of a report from France. Conclusion Irrespective of department or disease, patients prescribed benzodiazepine during their hospital stay tended to have a higher number of bed days in the hospital. The difference in the prevalence of BDZ between this study and previous Western studies might be attributed to the relatively short length of hospital stay in this study. Because BDZs are often reported to be prescribed to hospitalized patients without appropriate documentation for the indications for use, it is important to monitor the rational for prescriptions of benzodiazepine carefully, for both clinical and economical reasons. PMID:19818119

Nakao, Mutsuhiro; Sato, Mikiya; Nomura, Kyoko; Yano, Eiji

2009-01-01

257

Fall in admission rate of old people to psychiatric units.  

PubMed Central

The numbers of the elderly, and particularly the very old, have been increasing and continue to increase rapidly; but admission rates of old people to psychiatric hospitals in England and Wales suddenly started to fall in 1970. They were still generally falling in 1974 (the most recent year for which figures are available). There is no evidence that the incidence of dementia has suddenly fallen, or that expansion of extramural or other non-psychiatric services is everywhere coping with the severely demented. It is probably becoming more difficult for demented people to be admitted to psychiatric hospitals that are often still overcrowded, in view of the greater scrutiny of institutional care that has become established since the Ely Report of 1969. If this is so the cost to the demented and those who care for them of the undoubted improvements in conditions in psychiatric hospitals needs to be counted. PMID:620236

Shulman, K; Arie, T

1978-01-01

258

Psychiatric Programs: Their Medical Integration  

PubMed Central

The basic premise that psychiatry and medicine are one and the same discipline is advanced. Patients present with symptoms: sometimes largely the result of structural change, sometimes largely the result of emotional perturbation, but most frequently a mixture of both. The physician can never do his job satisfactorily without attention to the emotional problems of his patient, which is essentially the subject matter of psychiatry. He must have adequate training during his medical school years in order to recognize and handle emotional problems. The psychiatrically oriented general practitioner and the psychiatrist, who live in the community, are most valuable mental health resources and must have treatment facilities in the general hospital. Furthermore, hospital and medical insurance plans must be devised that will not penalize either doctor or patient when mental illness is recognized and dealt with in the most appropriate manner. PMID:14243868

Jones, Robert O.

1965-01-01

259

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

PubMed

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

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

2014-09-01

260

[The nurse's work in psychiatric emergencies].  

PubMed

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

Balanger, Vincent; Calas, Jean-François

2014-01-01

261

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

Microsoft Academic Search

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

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

1998-01-01

262

Motivation for physical activity of psychiatric patients when physical activity was offered as part of treatment.  

PubMed

This study examined motivation variables, self-determination and self-schema, in relation to physical activity, among psychiatric patients with experience with physical activity as part of their treatment. Participants were patients (N=109) from 15 psychiatric hospitals or day-care institutions. Data were collected by questionnaires. A positive relationship between physical activity level, positive experiences of the activity and higher degree of self-determination and exercise self-schema was expected. Intrinsically regulated motives (motivated by the experience of the activity in itself) were positively and significantly related to physical activity level and the experience of decrease in symptoms during physical activity, and extrinsically regulated motives were negatively correlated with physical activity level. Intrinsically regulated motives gave an odds ratio of 20.0 for being physically active rather than inactive. Holding an exercise self-schema gave an odds ratio of 6.1 for being physically active. The majority of the patients (57.4%) reported that physical activity decreased their illness symptoms, but a few (11.9%) reported negative effects. The findings demonstrated that psychiatric patients do not differ from the normal population in relation to motivational mechanisms, even if they may experience more barriers to physical activities because of their illness. Therefore, in trying to motivate psychiatric patients, it is important to make physical activity as intrinsically motivating as possible by focusing on the positive experiences of the activity itself, as well as helping to develop an exercise self-schema. PMID:17121640

Sørensen, M

2006-12-01

263

MONTREAL NEUROLOGICAL INSTITUTE AND HOSPITAL RESEARCH ETHICS BOARD (REB) REQUIREMENTS  

E-print Network

. Categorize subject as: psychiatric ; neurological ; juvenile ; mentally challenged ; competent ; incompetentspecsubj 2002-06-18 MONTREAL NEUROLOGICAL INSTITUTE AND HOSPITAL RESEARCH ETHICS BOARD (REB medically as indicated: 1 Definition: Patients diagnosed with psychiatric, neurologic or other medical

Shoubridge, Eric

264

Costs for Hospital Stays in the United States, 2011  

MedlinePLUS

... Excluded are long-term care, rehabilitation, psychiatric, and alcoholism and chemical dependency hospitals. However, if a patient received long-term care, rehabilitation, or treatment for psychiatric or chemical dependency conditions in a community ...

265

Part-time hospitalization programs: the neglected field of community psychiatry.  

PubMed Central

Part-time hospitalization for persons with psychiatric disorders is underdeveloped, underutilized and often poorly understood, but should be encouraged in view of the unsatisfactory living conditions of patients discharged from hospital who still require care, the reductions in psychiatric impatient populations and numbers of beds, the increasing costs of health services and the current fiscal restraints. Day and night hospitals can provide an alternative to inpatient or outpatient treatment, rehabilitation for the long-term patient or treatment for the patient in transition from inpatient to outpatient status. The day hospital can also provide a diagnostic setting. Such programs help preserve the patient's position in the family and the community, minimize the ill effects of hospitalization, and lower capital and operating costs of the psychiatric services. Awareness by medical and paramedical services of the value of these programs would increase their utilization. Shifting the emphasis of administrative and fiscal policies from inpatient to part-time hospitalization programs is also required. PMID:1253069

Voineskos, G.

1976-01-01

266

[Historical and current principles of the design of psychiatric clinics].  

PubMed

At the beginning of the 19th century, institutional care for the insane was established by the various German states. At first, the separation of curable and incurable patients influenced psychiatric care and the construction of hospitals. The combination of care and cure in one hospital in Illenau was a turning point in institutional care. Contradictory tendencies characterized the second half of the 19th century: the integration with general medicine in the cities, on the one hand, the social separation and cure in the seclusion of the countryside, on the other. The characteristic psychiatric construction in different countries was influenced by individual architects. The following building styles were dominant: in England, panoptic architecture; in the United States, linear staggered structures; in France, the "carrés isol?"; and in Germany, the structure of blocks with cross-axes. At the end of the 19th century, the system of pavilions was internationally accepted; occupational therapy and mental care in the countryside were introduced. From the First World War until the end of the 1960s, a standstill in psychiatric buildings was noted in Germany, and institutional care came under increasing criticism. There was a reorientation from the middle of the 1970s as a result of more effective therapeutic possibilities. A variety of complementary institutions, outpatient and partly inpatient therapies, which were recommended by the "Psychiatrie-Enquete", started to be realized. Smaller units and different models of integration of psychiatric care, such as building the hospital next to a general hospital or psychiatric wards within a general hospital, became relevant criteria for planning the construction of psychiatric hospitals, as did the integration into the community and the city. Principles of organization like the construction of a communicative quiet inner room, or grading the rooms from public to private, were structurally integrated. Specific structural requirements for the construction and design of psychiatric hospitals should be evaluated in more detail by post-occupancy methods. PMID:9198778

Müller, N

1997-03-01

267

An Interprofessional Psychiatric Advanced Pharmacy Practice Experience  

PubMed Central

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

Cooley, Janet

2013-01-01

268

Psychiatric Advance Directives: Getting Started  

MedlinePLUS

... Home Getting Started National Resource Center on Psychiatric Advance Directives - Getting Started Getting Started Psychiatric advance directives (PADs) are relatively new legal instruments that may ...

269

Evolution and evaluation of a Medical Psychiatric Unit  

Microsoft Academic Search

In 1991, the first Medical Psychiatric Unit (MPU) in Australia was established at the Royal Prince Alfred Hospital, Sydney. The processes involved in introducing it to the hospital staff and administration, as well as its structure and criteria for admission, are described. Its development was compared to the experiences of others in North America over the past 15 years. The

Robert Gertler; Elzbieta M. Kopec-Schrader; Christopher J. Blackwell

1995-01-01

270

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.

271

Nonhospital alternatives for acute psychiatric care in California.  

PubMed

In California multiple social forces and financial constraints are leading to the rapid development of local alternatives not only to state hospitals but to general hospital psychiatric units as well. Two dissimilar patterns of acute-care services are emerging: the use of skilled nursing facilities with additional staff to provide mental health services and the development of a wide range of primarily nonmedical facilities under the licensing category of "residential care facility." The author summarizes characteristics of both kinds of programs and describes how they draw on all available sources of revenue before using state and county mental health funds. He also describes Santa Clara County's plan for local acute-care services in which a 54-bed residential building and a 15-bed psychiatric unit in a county hospital will replace two county-hospital psychiatric wards. PMID:658895

Meinhardt, K

1978-07-01

272

Resistance to alternatives to hospitalization.  

PubMed

Hospitalization has endured as the predominant form of psychiatric treatment for serious mental illness, despite accumulated evidence that outpatient treatment, ranging from halfway houses to day programs to traditional clinics, is equal or superior to inpatient treatment. Reasons for the apparent reluctance to use alternatives to the hospital include social prejudice against community treatment, economic disincentives, administrative chaos, training, professional sociology, and the countertransference meanings of hospitalization. The foregoing is not an argument against hospitalization, but rather an argument for being very clear about policy objectives and treatment goals. If these objectives and goals are made explicit, proposals can be evaluated for their efficacy. If community tenure, the assumption of responsibility for him or herself, and relinquishment of the patient role are goals, then hospitalization must be examined more skeptically. For society, this means the assumption of more responsibility for the establishment of a system of mental health care, for enunciating national policy goals and implementing them consistently, and for committing the necessary funds and manpower to this endeavor. For the clinician, it means examining the clinical efficacy of his or her treatment recommendations and distinguishing between responsibility for the patient's treatment and responsibility for the patient's life. The abdication of social responsibility for the patient and the assumption of omnipotent clinical responsibility for him or her lead inexorably to more institutional and more restrictive treatment, even in the absence of evidence that such measures are therapeutically effective. PMID:3932981

Friedman, R S

1985-09-01

273

Jail hospitalization of prearraignment patient arrestees with mental illness.  

PubMed

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

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

2014-01-01

274

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

PubMed

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

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

2012-01-01

275

Psychiatric disorders and sleep issues.  

PubMed

Sleep issues are common in people with psychiatric disorders, and the interaction is complex. Sleep disorders, particularly insomnia, can precede and predispose to psychiatric disorders, can be comorbid with and exacerbate psychiatric disorders, and can occur as part of psychiatric disorders. Sleep disorders can mimic psychiatric disorders or result from medication given for psychiatric disorders. Impairment of sleep and of mental health may be different manifestations of the same underlying neurobiological processes. For the primary care physician, key tools include recognition of potential sleep effects of psychiatric medications and familiarity with treatment approaches for insomnia in depression and anxiety. PMID:25134876

Sutton, Eliza L

2014-09-01

276

Neuroinflammation and psychiatric illness.  

PubMed

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

Najjar, Souhel; Pearlman, Daniel M; Alper, Kenneth; Najjar, Amanda; Devinsky, Orrin

2013-01-01

277

American Psychiatric Association  

MedlinePLUS

... More Learn More Learn More New APA Meetings app now available Plan your time at APA’s Institute on Psychiatric Services with the new APA Meetings app. IPS will be at the San Francisco Marriott ...

278

Advance Directives (Psychiatric)  

MedlinePLUS

... org/ (800) 950-NAMI; info@nami.org ©2014 Advance Directives by Ronald S. Honberg National Director for Policy and ... psychosurgery from their scope. Laws specifically authorizing psychiatric advance directives have been enacted in twelve states. The first ...

279

Cigarette Smoking Among Adolescent Psychiatric Inpatients: Prevalence and Correlates  

Microsoft Academic Search

The aim of this study was to ascertain the rate of smoking among adolescent (13–17 years old) psychiatric inpatients and to examine factors related to smoking status in this population. The medical records of all adolescents admitted to a private psychiatric hospital during a 1-year period were reviewed. The rate of current smoking was 59.8%. Of the adolescents who reported

Susan E. Ramsey; Richard A. Brown; David R. Strong; Suzanne D. Sales

2002-01-01

280

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

PubMed Central

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

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

2012-01-01

281

Insomnia in Psychiatric Disorders  

Microsoft Academic Search

\\u000a Management of insomnia without a basic understanding of the possible underlying psychiatric disorders might result in an inadequate,\\u000a if not hazardous outcome. Insomnia is listed in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a symptom of several psychiatric disorders.\\u000a \\u000a \\u000a Insomnia related to other DSM-IV mental disorders was found to be as high as

Samy S. Karaz

282

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

PubMed Central

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

Thompson, Ronald G.; Hasin, Deborah S.

2013-01-01

283

The Geriatric Population and Psychiatric Medication  

PubMed Central

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

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

2010-01-01

284

Measurement of Psychiatric Treatment Adherence  

PubMed Central

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

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

2014-01-01

285

Fitness to Drive of Psychiatric Patients  

PubMed Central

Background: Driving a motor vehicle could be central to the functional autonomy of patients with psychiatric illnesses. For patients, a driver's license could mean independence, the ability to care for themselves, and the freedom to travel when they wish. However, both psychiatric disorders and psychiatric drug treatments can produce changes in perception, information processing and integration, and psychomotor activity that can disturb and/or interfere with the ability to drive safely. Objective: To assess the fitness to drive of psychiatric outpatients in a sample representative of current clinical practice. Method: Cognitive functioning and psychomotor performance of 208 consecutive psychiatric outpatients treated in a community mental health center in the Canary Islands (Spain) were assessed in different clinical situations. The LNDETER 100 battery, an electronic assessment unit–based measurement that consists of 5 screenbased tests, was used to assess concentrated attention and resistance to monotony, multiple discriminative reactions and their correctness, anticipation of speed, bimanual coordination, and the decision making process and tendency to assume risk. The study was conducted from July 2007 to September 2007. Results: Of 208 patients, only 33 had scores compatible with the requirements of a driver's license, and 84% failed at least 1 of the required tests. Of patients with a driver's license who drive almost every day, 79.5% registered scores that would not allow obtaining or renewal of the license. None of the driving patients studied notified the traffic authorities that they had a psychiatric condition that may affect safe driving. No patient stopped driving, although 10% of them recognized that their ability to drive was somehow damaged. Conclusion: Guidance on how best to formulate and deliver recommendations on driving fitness in stable psychiatric patients is lacking and much needed. PMID:19158977

De las Cuevas, Carlos; Sanz, Emilio J.

2008-01-01

286

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

PubMed

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

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

2004-01-01

287

Psychiatric patient and anaesthesia  

PubMed Central

Many patients with psychiatric illnesses are prescribed long-term drug treatment, and the anaesthesiologist must be aware of potential interactions with anaesthetic agents. Psychotropic drugs often given in combination with each other or with other non-psychiatric drugs generally exert profound effects on the central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anaesthesia and surgery. This article highlights the effects of anaesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors and lithium carbonate. The risk that should be considered in the perioperative period are the extent of surgery, the patient's physical state, anaesthesia, the direct and indirect effects of psychotropics, risk of withdrawal symptoms and risk of psychiatric recurrence and relapse. PMID:22529413

Attri, Joginder Pal; Bala, Neeru; Chatrath, Veena

2012-01-01

288

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

Microsoft Academic Search

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

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

2008-01-01

289

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

Microsoft Academic Search

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

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

2007-01-01

290

Therapeutic challenges identified while implementing a mission and cultural change on an acute inpatient psychiatric unit.  

PubMed

This article describes the transformation of a unit culture within a federal hospital inpatient psychiatric unit. A change from a 30-bed inpatient acute psychiatric unit to a locked acute psychiatric unit with a diversified complex mix of inpatients including management of medical comorbidities required a considerable effort. Extensive reorganization and changes were made through staff education, training and evaluation, unit policy and procedure revision, and unit physical reconstruction for safety and aesthetics. Issues and ongoing challenges are described. PMID:17607132

Weiss, Lizabeth M; Delia, Linda L

2007-01-01

291

Alcohol and Other Psychiatric Disorders  

MedlinePLUS

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

292

Home treatment for acute psychiatric illness.  

PubMed Central

OBJECTIVE--To determine the factors influencing the successful outcome of community treatment for severe acute psychiatric illnesses that are traditionally treated in hospital. DESIGN--All patients from a single electoral ward who were either admitted to hospital or treated at home over a two year period (1 October 1987 to 30 September 1989) were included in the study and their case notes audited. The second year of the study is reported. SETTING--Electoral ward of Sparkbrook, Birmingham. SUBJECTS--99 Patients aged 16-65 with severe acute psychiatric illness. RESULTS--65 Patients were managed by home treatment alone; 34 required admission to hospital. The location of treatment was significantly (all p less than 0.05) influenced by social characteristics of the patients (marital state, age (in men), ethnicity, and living alone) and by characteristics of the referral (occurring out of hours; assessment taking place at hospital or police station). DSM-III-R diagnosis was more weakly associated with outcome. Violence during the episode was significantly related to admission, although deliberate self harm was not. CONCLUSIONS--Home treatment is feasible for most patients with acute psychiatric illness. A 24 hour on call assessment service increases the likelihood of success because admission is determined more strongly by social characteristics of the patient and the referral than by illness factors. Admission will still be required for some patients. A locally based mental health resource centre, a 24 hour on call service, an open referral system, and an active follow up policy increase the effectiveness of a home treatment service. PMID:2249049

Dean, C; Gadd, E M

1990-01-01

293

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

Microsoft Academic Search

The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12–19 years of age at hospitalization, repeatedly assessed for up to 13 years (n = 1,825 assessments). Semistructured psychiatric diagnostic instruments were administered at

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

2009-01-01

294

Ethnic differences in the prediction of eating and body image disturbances among female adolescent psychiatric inpatients  

Microsoft Academic Search

Objective: The current study examined predictors of eating and body image dis- turbances in psychiatrically hospitalized female adolescents and investigated whether the predictors differ by ethnicity. Method: Participants were 427 (320 Caucasian, 53 Latina, 54 African Ameri- can) female adolescent psychiatric inpati- ents. Predictors of eating disorder features (dietary restraint, binge eating, and purging) and body image dissatisfac- tion (BID)

Marney A. White; Carlos M. Grilo

2005-01-01

295

Body Image in Chronic Alcoholics and Non-Alcoholic Psychiatric Patients  

Microsoft Academic Search

The present study evaluates the body image of chronic alcoholics and compares the body attitudes of alcoholics with those entertained by a group of nonalcoholic psychiatric patients. Seventy male veterans hospitalized for chronic alcoholism were compared with 50 non-alcoholic psychiatric patients on a variety of body image measures. Chronic alcoholics differed from controls in their body attitudes and perceptions. Alcoholics

Sidney E. Cleveland; Melvin P. Sikes

1966-01-01

296

Treatment Effects on Forensic Psychiatric Patients Measured With the HCR-20 Violence Risk Assessment Scheme  

Microsoft Academic Search

This study focuses on the foundational issue of change in violence risk factors in forensic psychiatric patients across multiple assessment periods using the HCR-20 scheme. HCR-20 assessments performed on 150 forensic psychiatric patients at two special (forensic) hospitals in Sweden were studied in relation to the patients' time at institution, with the aim to investigate a possible relation between level

Henrik Belfrage; Kevin S. Douglas

2002-01-01

297

Psychosocial characteristics discriminating between battered women and other women psychiatric inpatients  

Microsoft Academic Search

Background: Research has shown that abused women often come to outpatient clinics and that their psychological symptoms are often confused with those of psychiatric patients. Objectives: The purpose of this research was to examine the psychosocial differences between battered and nonbattered women admitted to a psychiatric unit in a French New Brunswick hospital. Study design: Data were collected from 221

Norma Poirier

2000-01-01

298

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

ERIC Educational Resources Information Center

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

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

2010-01-01

299

Psychiatric-Mental Health Nursing.  

ERIC Educational Resources Information Center

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…

Reighley, Joan

300

Pathological Gambling: Psychiatric Models  

ERIC Educational Resources Information Center

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

Westphal, James R.

2008-01-01

301

CLINICAL PROFILE OF PATIENTS ATTENDING A PRISON PSYCHIATRIC CLINIC  

PubMed Central

Psychiatric morbidity is higher in prison inmates as compared to that in general population but treatment facilities are often inadequate. The present work reports the profile of psychiatric patients seen in a jail hospital over a period of three months. The jail had about 9000 inmates. Psychiatric services consisted of weekly visit by a psychiatrist. Seventy two male inmates were seen during the period of study. Most of them (80%) were undertrials. Diagnosis included schizophrenia, depression, bipolar disorder, anxiety disorders, and malingering. Stress of imprisonment contributed to the illness only in a small percentage of patients. Among the admitted patients, jail environment interfered with improvement. Frequent relapses were noted among the improved schizophrenic patients when transferred back to the jail. The study emphasises the need for improving the conditions in jail and developing prison psychiatric units to be managed by psychiatrists. PMID:21494482

Chadda, R.K.; Amarjeet

1998-01-01

302

Psychiatric nursing care in Brazil: legal and ethical aspects.  

PubMed

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

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

2007-12-01

303

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

ERIC Educational Resources Information Center

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

Kjelsberg, Ellen

2004-01-01

304

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

E-print Network

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

Cardinal, Rudolf N; Gregory, Carol A

2009-05-09

305

Mobile psychiatric consultation-education for primary physicians  

Microsoft Academic Search

A psychiatrist meets with physicians, individually or in groups, in their offices, in hospitals, or in any convenient place to provide consultation-education training in basic psychiatric skills, including community psychiatry. The pilot project, reported here, indicates that this program is not only feasible but highly successful. The implications are broad. In addition to providing increased skills for local physicians, the

J. L. Cathell; N. E. Stratas

1967-01-01

306

Histories of Child Maltreatment and Psychiatric Disorder in Pregnant Adolescents  

ERIC Educational Resources Information Center

Objective: The study investigated histories of child maltreatment and psychiatric disorder in a high-risk sample of pregnant adolescents. Method: Cross-sectional data were obtained for 252 pregnant adolescents from high school, hospital, and group home settings in Montreal (Canada). Adolescents completed a child maltreatment questionnaire and a…

Romano, Elisa; Zoccolillo, Mark; Paquette, Daniel

2006-01-01

307

Comorbid Psychiatric and Alcohol Abuse\\/Dependence Disorders  

Microsoft Academic Search

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

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

2002-01-01

308

Intimacy Training in a Forensic Psychiatric Setting: An Experiment  

Microsoft Academic Search

This article is about intimacy training in two forensic psychiatric hospitals. This training is an experiment in which patients are trained in skills relating to intimacy and sexuality through real physical contact with a therapist. It is a way of treatment in those cases in which other, usually verbal methods, have failed to accomplish (sexual) behaviour change, and it can

Yvonne van den Berg-Lotz; Bram le Grand; Carla Kriek; Thieu Verhagen

2002-01-01

309

The prosecution of psychiatric inpatients: overcoming the barriers  

Microsoft Academic Search

The prosecution of psychiatric inpatients can present problems for psychiatrists and others. These include perceived conflicts of interest, issues with breaching confidentiality and whether prosecution is in the public interest. This paper describes the practical issues which were faced in achieving prosecution of patients who committed assaults within an English high security hospital. A major factor was a mutual lack

Christopher R. Clark; Bernadette A. McInerney; Ian Brown

2012-01-01

310

Brief Report: Prevalence of Psychiatric Disorders in Pregnant Teenagers  

ERIC Educational Resources Information Center

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

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

2009-01-01

311

Low blood pressure in psychiatric inpatients.  

PubMed Central

Blood pressure recordings in 116 female psychiatric inpatients were analysed. Sixty-nine women had schizophrenia, the remainder a variety of psychiatric conditions. All had been in hospital continuously for more than one year, the average for 19 years continuously. An average of seven recordings of blood pressure per patient had been made during that time. The latest of these compared well with measurements made independently using a sphygmomanometer free from observer bias. On admission to hospital the blood pressure of these patients was close to that of two normal populations. Thereafter it failed to rise at the normal rate and after an average of 19 years, in the women having measurements made by special sphygmomanometer, systolic pressure was 28 mmHg lower than controls of the same age while diastolic pressure was 12.8 mmHg lower. Lower than control blood pressure was apparent in schizophrenic and non-schizophrenic women and in women taking no drugs, phenothiazines, and other drugs. Weight loss is an unlikely explanation: the mean weight of these women was 61.5 kg compared with 64.1 kg in a local control population of the same age. Some factor related to prolonged isolation in hospital seems more important. PMID:7225257

Masterton, G; Main, C J; Lever, A F; Lever, R S

1981-01-01

312

Day to Day  

ERIC Educational Resources Information Center

A clean, healthy and safe school provides students, faculty and staff with an environment conducive to learning and working. However, budget and staff reductions can lead to substandard cleaning practices and unsanitary conditions. Some school facility managers have been making the switch to a day-schedule to reduce security and energy costs, and…

Jurecki, Dennis

2006-01-01

313

Genetics of Psychiatric Disorders  

Microsoft Academic Search

The major psychiatric disorders are common disorders with a complex genetics, similar to other common medical disorders such\\u000a as diabetes and hypertension. For most of these disorders, linkage studies in families with multiple cases have revealed chromosomal\\u000a areas that contain susceptibility genes. In recent years, specific single genes have begun to be identified for disorders\\u000a such as schizophrenia (e.g., DISC1,

John I. Nurnberger Jr; Wade Berrettini; Alexander B. Niculescu III

314

Neuroimaging in Psychiatric Disorders  

Microsoft Academic Search

Summary  In psychiatry, neuroimaging facilitates the diagnosis of psychiatric disorders and the development of new medications. It\\u000a is used to detect structural lesions causing psychosis and to differentiate depression from neurodegenerative disorders or\\u000a brain tumors. Functional neuroimaging, mostly in the form of molecular neuroimaging with positron emission tomography or single\\u000a photon emission tomography, facilitates the identification of therapeutic targets, the determination

Joseph C. Masdeu

2011-01-01

315

Culture and psychiatric diagnosis.  

PubMed

Since the publication of DSM-IV in 1994, neurobiologists and anthropologists have criticized the rigidity of its diagnostic criteria that appear to exclude whole classes of alternate illness presentations, as well as the lack of attention in contemporary psychiatric nosology to the role of contextual factors in the emergence and characteristics of psychopathology. Experts in culture and mental health have responded to these criticisms by revising the very process of diagnosis for DSM-5. Specifically, the DSM-5 Cultural Issues Subgroup has recommended that concepts of culture be included more prominently in several areas: an introductory chapter on Cultural Aspects of Psychiatric Diagnosis - composed of a conceptual introduction, a revised Outline for Cultural Formulation, a Cultural Formulation Interview that operationalizes this Outline, and a glossary on cultural concepts of distress - as well as material directly related to culture that is incorporated into the description of each disorder. This chapter surveys these recommendations to demonstrate how culture and context interact with psychiatric diagnosis at multiple levels. A greater appreciation of the interplay between culture, context, and biology can help clinicians improve diagnostic and treatment planning. PMID:23816860

Lewis-Fernández, Roberto; Aggarwal, Neil Krishan

2013-01-01

316

An analysis of paramilitary referrals to psychiatric services at a tertiary care center  

PubMed Central

Background: There is a dearth of specialized mental health services for Indian paramilitary service personnel. Those requiring psychiatric evaluation are referred to government psychiatric services often with minimal information. Hence, major diagnostic and decision making relies on the psychiatrist's clinical evaluation and judgment. The aim of the present study was to quantitatively evaluate the paramilitary referrals to psychiatric services at a tertiary care referral center. Materials and Methods: A retrospective chart analysis of all consecutive referrals by various Indian paramilitary services to a tertiary care hospital (2008-2010) was carried out. Results: Among the sample of 18 referrals, all were males (mean age: 37 years ± standard deviation (SD) =7.79). Various reasons for referral included: Evaluation of fitness for duty (83.3%), fitness to handle firearms (16.7%), and for disability certification (5.6%). There were no informants at all in 22.2%, and family members were available in only 11.1%. Hence, most referrals were admitted to the psychiatry ward for observation for various lengths of time. The mean duration of assessment (outpatient and inpatient) was 17.89 days (SD = 20.74) and final reported diagnoses were schizophrenia, depression, and bipolar disorder in 16.7, 11.1, and 11.1%, respectively. There was concurrent history of alcohol and nicotine dependence (40%). A large group (40%) was diagnosed not to suffer from a major mental illness, while a firm and final diagnosis could not be arrived at in 16.7% subjects. Only one subject was given the fitness to handle firearms, fitness for duty was refused in three (16.7%) subjects, and one subject was referred to neurology after being diagnosed as a case of seizure disorder. Conclusion: There is an urgent need for intensive training both to paramilitary physicians as well as to general hospital psychiatrists regarding proper assessment of paramilitary personnel, as there are frequent chances of the cases being undiagnosed or improperly diagnosed. PMID:24459375

Verma, Rohit; Mina, Shaily; Deshpande, Smita N.

2013-01-01

317

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

PubMed Central

Tobacco dependence is the leading cause of death in persons with psychiatric and substance use disorders. This has lead to interest in the development of pharmacological and behavioral treatments for tobacco dependence in this subset of smokers. However, there has been little attention paid to the development of tobacco-free environments in psychiatric institutions despite the creation of smoke-free psychiatric hospitals mandated by the Joint Commission for Accreditation of Health Organizations (JCAHO) in 1992. This review article addresses the reasons why tobacco should be excluded from psychiatric and addictions treatment settings, and strategies that can be employed to initiate and maintain tobacco-free psychiatric settings. Finally, questions for further research in this field are delineated. This Tobacco Reconceptualization in Psychiatry (TRIP) is long overdue, given the clear and compelling benefits of tobacco-free environments in psychiatric institutions. PMID:20653636

Moss, Taryn G.; Weinberger, Andrea H.; Vessicchio, Jennifer C.; Mancuso, Vincenza; Cushing, Sandra J.; Pett, Michael; Kitchen, Kate; Selby, Peter; George, Tony P.

2010-01-01

318

Managed psychiatric care: a suburban medical department activity model.  

PubMed

Munson Army Community Hospital has successfully realized substantial cost savings by instituting psychiatric managed care. The development of an external partnership with a civilian psychiatric facility is a unique aspect of the psychiatric managed care initiative and has resulted in most of the savings. We staff this partnership hospital with one-half full-time-equivalent psychiatrist. Other psychiatric managed care program elements include: (1) using CHAMPUS "recapture" funds to hire additional personnel; (2) maximizing personnel utilization by combining mental health staff from the social work and psychiatry services; (3) working closely with the community to identify local mental health needs; (4) offering additional therapeutic modalities; and (5) reducing rehospitalization rates through improved discharge planning. We reduced our financial-year first quarter costs by 76% from 1993 to 1995. We attributed much of these savings to reduced residential treatment admissions. Although the total number of outpatient visits increased, Munson's psychiatric services reduced outpatient costs by increasing clinic access. We have used the Gateway to Care program to prepare for the initiation of Tri-Care in our region. PMID:8840798

Shuman, C R

1996-09-01

319

Prevalence of Psychiatric Morbidities in Acute Coronary Heart Disease  

PubMed Central

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

Shoja shafti, Saeed

2014-01-01

320

The Effects of Sociodemographic Factors on Psychiatric Diagnosis  

PubMed Central

Objective Several studies have reported that ethnic differences influence psychiatric diagnoses. Some previous studies reported that African Americans and Hispanics are diagnosed with schizophrenia spectrum disorders more frequently than Caucasians, and that Caucasians are more likely to be diagnosed with affective disorders than other ethnic groups. We sought to identify associations between sociodemographic factors and psychiatric diagnosis. Methods We retrospectively examined the medical records of all psychiatric inpatients (ages over 18 years) treated at Kern county mental hospital (n=2,051) between July 2003 and March 2007 for demographic, clinical information, and discharge diagnoses. Results African American and Hispanic males were more frequently diagnosed with schizophrenia spectrum disorders than Caucasians, whereas Caucasian females were more frequently diagnosed with affective disorders than females in the other ethnic groups, suggesting that patient ethnicity and gender may influence clinical diagnoses. Demographic variables, that is, a lower education, failure of marriage, homelessness, and low quality insurance, were found to be significantly associated with a diagnosis of schizophrenia spectrum disorders after adjusting for clinical variables. And, the presence of a family psychiatric history, failure of marriage, not-homelessness, and quality insurance were found to be associated with a diagnosis of affective disorders. Conclusion Our results show that these demographic factors, including ethnicity, have effects on diagnoses in psychiatric inpatients. Furthermore, these variables may help prediction of psychiatric diagnoses. PMID:22993517

Choi, Mal Rye; Eun, Hun-Jeong; Yoo, Tai P.; Yun, Youngmi; Wood, Christopher; Kase, Michael; Park, Jong-Il

2012-01-01

321

Prevalence of psychiatric morbidities in acute coronary heart disease.  

PubMed

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

Shoja Shafti, Saeed

2014-01-01

322

Factors associated with involuntary admission to psychiatric facilities in Newfoundland.  

PubMed Central

To assess what factors determine the involuntary status of psychiatric patients, we reviewed the case records of 5729 patients consecutively admitted to one of four inpatient psychiatric facilities, including a mental hospital, in St. John's between October 1975 and October 1978. Of the 5729 patients 5005 (87.4%) were voluntary and 724 (12.6%) involuntary. Involuntary patients were more likely than voluntary patients to be male, single and unemployed and to have been referred by police or transferred from another facility to the mental hospital, where most of the involuntary admissions occurred. They had higher rates of previous admissions to a psychiatric facility and of suicidal and violent behaviour, were more likely to have a diagnosis of schizophrenia or mania and were less likely to be suffering from depression or a neurotic disorder. In correspondence with differences in diagnosis, involuntary patients stayed in hospital more than twice as long as voluntary patients, were less likely to receive electroconvulsive therapy, minor tranquillizers and antidepressants, and were more likely to receive neuroleptics and lithium carbonate. Stepwise logistic regression analysis revealed that only the source of referral and a diagnosis of neurotic disorder had an independent effect on admission status. The findings are discussed in the context of the controversy over the parens patriae approach v. the legal approach to involuntary admission of psychiatric patients. PMID:3567777

Malla, A; Norman, R M; Helmes, E

1987-01-01

323

The Oregon Psychiatric Security Review Board: 1978-2012.  

PubMed

This commentary describes the functioning of the Oregon Psychiatric Security Review Board (PSRB) from 1978 through 2011, when the Oregon Legislature altered the authority of the PSRB in regard to certain hospitalized insanity acquittees. Following the Hinckley verdict, the American Psychiatric Association recognized the PSRB as a possible future model for the management and treatment of insanity acquittees. The commentary provides an overview of the board from administrative and empirical viewpoints over this 34-year period and discusses the changes made in PSRB statutes in 2012 and the implication of these changes for the future management of insanity acquittees in Oregon. PMID:24335330

Bloom, Joseph D; Buckley, Mary Claire

2013-01-01

324

The certified psychiatric nurse practitioner: advanced practice psychiatric nursing reclaimed  

Microsoft Academic Search

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

Pamela Bjorklund

2003-01-01

325

Accountability and psychiatric disorders: How do forensic psychiatric professionals think?  

Microsoft Academic Search

Swedish penal law does not exculpate on the grounds of diminished accountability; persons judged to suffer from severe mental disorder are sentenced to forensic psychiatric care instead of prison. Re-introduction of accountability as a condition for legal responsibility has been advocated, not least by forensic psychiatric professionals. To investigate how professionals in forensic psychiatry would assess degree of accountability based

Pontus Höglund; Sten Levander; Henrik Anckarsäter; Susanna Radovic

2009-01-01

326

Predictors of Length of Stay Among Youths Hospitalized in State Hospitals in Illinois  

Microsoft Academic Search

Using data from the Integrated Database on Children and Family Services in Illinois, we examined factors associated with the length of psychiatric hospitalization of youths in state hospitals between July 1, 1987 and June 30, 1992. Univariate analysis indicated that those diagnosed with attention deficit, psychotic, and conduct disorder experienced longer hospitalizations. In contrast, youths diagnosed with depressive disorders, drug

Thomas W. Pavkov; Robert M. Goerge; John G. Czapkowicz

1997-01-01

327

Assessment of Serum Progesterone Level on the Day of hCG Injection in Infertile Polycystic Ovarian Syndrome Patients Referred to Women's Hospital, Tehran, 2009  

PubMed Central

Background Polycystic ovarian syndrome (PCOS) is one of the most common causes of endocrine disorders and main reasons for infertility due to unovulation and recurrent abortions. There is no consensus on effect of serum progesterone level on the day of human chorionic gonadotropin (hCG) injection. This study aims to evaluate the effect of plasma levels of progesterone on the day of hCG injection on the rate of pregnancy in in vitro fertilization (IVF) cycles of PCOS cases. Materials and Methods A stratified cohort study was conducted over a period of one year (2009) on 38 infertile women with PCOS who were suitable candidates for the IVF program. Patients were evaluated for other causes of infertility with hysterosalpingography (HSG), laparoscopy and normal sperm analysis. Patients were placed on the long protocol, followed by oocyte pick up, and finally IVF-embryo transfer (ET). Study patients were grouped according to progesterone levels of greater or less than 1.2 ng/ml on the day of hCG injection. Pregnancy rates were defined in each group. Levels on day of hCG day clinical pregnancy outcome were assessed. Experimental data were then compared against Fisher’s exact test in SPSS version 18. Results The overall pregnancy rate in this study was 26.3%. In the group with progesterone levels more than 1.2 ng/ml on the day of hCG injection, the clinical pregnancy rate was 4 (21.1%) and chemical pregnancy rate was 3(15.8%). In the group with progesterone levels less than 1.2 ng/ml, the clinical pregnancy rate was 1(5.3%) and chemical pregnancy rate was 2(10. 5%). Conclusion This study showed that PCOS patients with progesterone levels more than 1.2 ng/ml on the day of hCG injection resulted in higher chemical and clinical pregnancy rates. However, no significant statistical differences were found between the two groups. For further verification, we recommend additional studies with larger numbers of subjects. PMID:25210608

Rezaee, Zahra; Ghaseminejad, Azizeh; Forootan, Mitra; Hosseinipoor, Taraneh; Forghani, Forough

2012-01-01

328

Psychiatric Aide II. Instructor's Guide.  

ERIC Educational Resources Information Center

This instructor's guide is for a Psychiatric Aide II course intended to provide Psychiatric Aids Is who have demonstrated expertise in giving basic nursing care to the mentally ill with more advanced nursing interventions and techniques. (It is assumed that all nursing care the aides provide is under the direction of a Registered Nurse.)…

Heimericks, Belinda K.

329

Occupational Psychiatric Disorders in Korea  

PubMed Central

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

Kang, Seong-Kyu

2010-01-01

330

Psychiatric Emergencies In Family Medicine  

PubMed Central

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

Smith, V. A.; Goluboff, S.

1975-01-01

331

New Frontiers in Psychiatric Technology.  

ERIC Educational Resources Information Center

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

Fuzessery, Zoltan, Ed.

332

College Students with Psychiatric Disabilities  

ERIC Educational Resources Information Center

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…

Singh, Delar K.

2011-01-01

333

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

PubMed Central

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

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

334

National Hospital Discharge Survey  

Cancer.gov

The National Hospital Discharge Survey (NHDS), which has been conducted annually since 1965, collects data from a sample of approximately 270,000 inpatient records acquired from a national sample of about 500 hospitals. Only hospitals with an average length of stay of fewer than 30 days for all patients, general hospitals, or children's general hospitals are included in the survey. Information collected includes diagnoses, surgical and nonsurgical procedures, prescription and over-the-counter drugs, immunizations, allergy shots, anesthetics, and dietary supplements.

335

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

ERIC Educational Resources Information Center

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…

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

2010-01-01

336

Treatment Characteristics of Patients With Dementia: Comparing Two Different Psychiatric Inpatient Settings  

Microsoft Academic Search

Objective: Patients with dementia in 2 German community psychiatric hospitals with different treatment settings were investigated prospectively and treatment variables compared. Method: In each of the hospitals, which differ in treatment settings (Gütersloh specialized vs. Detmold integrated), 50 patients with dementia consecutively admitted were screened and compared according to personal data, clinical instruments, medication, and diagnosis. Results: No relevant differences

Volker Haude; Monika Lüdeke; Heike Dohse; Sabine Reiswig; Anette Liebler; Hans-Joerg Assion; Miriam Basilowski; Ingrid Börner

2009-01-01

337

Hospital acquired rotavirus infections: burden in Canadian paediatric hospitals  

Microsoft Academic Search

Rotavirus infections are one of the most common hospital acquired infections in pediatric hospitals. Laboratory confirmed hospital acquired rotavirus infections from 12 pediatric hospitals in Canada were documented for a 3 year period, 2005-7. Overall, hospital acquired infections represented one quarter of all rotavirus hospitalizations for an annual rate of 0.45 per 1000 hospital days with a peak of 0.68

Nicole Le Saux; Julie Bettinger; Scott Halperin; Wendy Vaudry; David Scheifele

2011-01-01

338

Cutaneous factitia in elderly patients: alarm signal for psychiatric disorders  

PubMed Central

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

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

2014-01-01

339

Exorcism: a psychiatric viewpoint.  

PubMed Central

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

Trethowan, W. H.

1976-01-01

340

Previously diagnosed psychiatric illness among inhabitants of common lodging houses.  

PubMed Central

STUDY OBJECTIVE: The aim of the study was to determine the characteristics of the homeless population and their previously diagnosed psychiatric illnesses in a well defined inner city area. DESIGN: The study involved a one in 10 sequential sample collected over three years. SETTING: Hostels and day care centres for the homeless in Manchester. PARTICIPANTS: 420 homeless people were interviewed; 17 were excluded because of lack of rapport. RESULTS: The majority were single middle aged catholic males who left school early and were unemployed; 48.7% had a history of alcoholism, 38.5% of diagnosed psychiatric illness, and 22.6% of psychiatric inpatient treatment. Only 21% of those with psychiatric diagnoses were being treated or followed up at the time of study. There was a strong association between criminal behaviour and previous admission to a psychiatric unit. CONCLUSIONS: There is a high incidence of psychiatric illness among the homeless, particularly among those originating from the locality studied. They tend to be geographically stable and therefore accessible to the provision of facilities for continuing care. PMID:2614329

Shanks, N J

1989-01-01

341

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

Microsoft Academic Search

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

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

2010-01-01

342

Screening instruments for psychiatric morbidity in chronic fatigue syndrome.  

PubMed Central

Physicians require a screening instrument to detect psychiatric disorders in patients with chronic fatigue syndrome (CFS). Different threshold scores on the Hospital Anxiety and Depression scale (HAD) and the mental health scale of the Medical Outcome Survey (MOS) were compared with two gold standards for the presence or absence of psychiatric disorder, standard diagnostic criteria (DSM-III-R) and a threshold score for the number of psychiatric symptoms at a standardized psychiatric interview (Revised Clinical Interview Schedule total cut-off score of 11/12). They were compared by use of validating coefficients and receiver operating characteristics in 136 consecutive CFS medical outpatients. The HAD scale at cut-off of 9/10 was a valid and efficient screening instrument for anxiety and depression by comparison with both gold standards. The MOS mental health scale at its recommended cut-off score of 67/68 yielded too many false-positives to be recommended as a psychiatric screening instrument in CFS patients. PMID:9771495

Morriss, R K; Wearden, A J

1998-01-01

343

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

PubMed

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

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

2007-12-01

344

Psychiatric Diagnoses and Psychiatric Treatment Among Bariatric Surgery Candidates  

Microsoft Academic Search

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

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

345

Mexican hospitals.  

PubMed

In order to understand current medical and hospital care in Mexico, we need to know first their past and then compare that past to their present situation. We can attempt to glimpse into what their future should be. The evolution of Mexican health services from the time of the Spanish Conquest until the the post-revolutionary period involved the creation of hospitals for both the poor and the rich. This continues to be the present goal. Public and private medical institutions evolved in part along with the legal reforms that were enacted through the passage of the Reform Laws in 1937. The Public Assistance Secretariat was established, which was dedicated to assist hospitals, nurseries, asylums and orphanages. In 1943, this Public Assistance Secretariat joined with the Public Health Department, forming what today is the actual Secretary of Health. The formation of private social health care for major medical needs together with governmental Social Security Health Care brought about a radical improvement in medical and hospital care; however, it is insufficient, overpopulated and outdated. It will be necessary during the coming decades that other alternatives to the models of hospitals and medical care that exist today in Mexico be enacted. The present models have not been able to satisfy the medical and hospital demands for present-day needs of the population. PMID:20433794

Loyo-Varela, Mauro; Díaz-Chazaro, Horacio

2009-01-01

346

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

PubMed

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

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

2014-01-01

347

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

PubMed

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

1992-03-01

348

Circadian Rhythms and Psychiatric Illness  

PubMed Central

Purpose of review The present review provides a conceptual introduction to sleep and circadian research in psychiatric illness, and discusses recent experimental and intervention findings in this area. Recent Findings In this review, studies published since January 2011 on circadian disturbance and psychiatric illness have been summarized. Summary Exciting new results have increasingly utilized objective and validated instruments to measure the circadian system in experimental studies. Since 2011, treatment research has still predominantly utilized self-report measures as outcome variables. However, research in the treatment domain for sleep/circadian disturbances comorbid with psychiatric illness has advanced the field in its work to broaden the validation of existing sleep treatments to additional patient populations with comorbid sleep/circadian disruptions, address how to increase access to and affordability of treatment for sleep and circadian dysfunction for patients with psychiatric disorders, and how to combine psychosocial treatments with psychopharmacology to optimize treatment outcomes. PMID:24060916

Asarnow, Lauren D.; Soehner, Adriane M.; Harvey, Allison G.

2014-01-01

349

The Role of Personal Social Networks in Risk Assessment and Management of Forensic Psychiatric Patients  

Microsoft Academic Search

Social network factors are usually not accounted for in the clinical practice of risk assessment\\/management.This article introduces a social network analysis as an instrument to systematically chart the relationships and personal networks of forensic psychiatric patients. During the period 2005 to 2007, the so-called Forensic Social Network Analysis (FSNA) was developed in a Dutch forensic psychiatric hospital. A case study

Lydia Pomp; Marinus Spreen; Stefan Bogaerts; Beate Völker

2010-01-01

350

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

PubMed Central

Background Is the nature of decision-making capacity (DMC) for treatment significantly different in medical and psychiatric patients? Aims To compare the abilities relevant to DMC for treatment in medical and psychiatric patients who are able to communicate a treatment choice. Method A secondary analysis of two cross-sectional studies of consecutive admissions: 125 to a psychiatric hospital and 164 to a medical hospital. The MacArthur Competence Assessment Tool - Treatment and a clinical interview were used to assess decision-making abilities (understanding, appreciating and reasoning) and judgements of DMC. We limited analysis to patients able to express a choice about treatment and stratified the analysis by low and high understanding ability. Results Most people scoring low on understanding were judged to lack DMC and there was no difference by hospital (P = 0.14). In both hospitals there were patients who were able to understand yet lacked DMC (39% psychiatric v. 13% medical in-patients, P<0.001). Appreciation was a better ‘test’ of DMC in the psychiatric hospital (where psychotic and severe affective disorders predominated) (P<0.001), whereas reasoning was a better test of DMC in the medical hospital (where cognitive impairment was common) (P = 0.02). Conclusions Among those with good understanding, the appreciation ability had more salience to DMC for treatment in a psychiatric setting and the reasoning ability had more salience in a medical setting. PMID:23969482

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

2013-01-01

351

Secondary Psychiatric Schools: Characteristics and Approaches to Curriculum  

ERIC Educational Resources Information Center

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…

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

2011-01-01

352

Road rage: a psychiatric phenomenon?  

Microsoft Academic Search

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

G. Fong; D. Frost; S. Stansfeld

2001-01-01

353

Mobile apps for psychiatric nurses.  

PubMed

Many health care professionals, including psychiatric nurses, are faced with increasing questions from patients about mobile applications (apps). The purpose of this article is to give psychiatric-mental health nurses (PMHNs) an overview of the world of mobile health and medical apps to answer their own questions as well as those of their patients. Mobile apps will continue to evolve; thus, this article will serve as a base for PMHNs to build knowledge and understanding to help their patients. PMID:24305909

Elias, Beth L; Fogger, Susanne A; McGuinness, Teena M; D'Alessandro, Katherine R

2014-04-01

354

Economical Framework of Psychiatric Care  

Microsoft Academic Search

\\u000a In Medicine, autonomy of the patient, beneficence of the physician, Non-maleficence of the physician and justice are four\\u000a leading ethical principles and several Medical Associations as well as Psychiatric Associations published a Code of Ethics\\u000a in which the physician–patient relationship is considered to be at the heart of medical and psychiatric practice. In the economical\\u000a framework, the principle of equity

Christina M. van der Feltz-Cornelis

2010-01-01

355

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

Microsoft Academic Search

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

Ellen Kjelsberg

2004-01-01

356

[The psychiatric revolution in Quebec, 1950-1962. From asylum to community psychiatry and the open door].  

PubMed

Psychiatry opens to the world at a time when the very basis of psychiatric practice, namely the asylum, is called into question. Studies appear in Quebec and Canadian journals concurrent to the introduction of new formulas for care, such as the delivery of psychiatric services in general hospitals and clinics, that allow patients to be treated outside the walls of psychiatric hospitals. In addition, postwar psychiatry takes an optimistic view toward the future of children with impairments through the creation of specialized schools and workshops. From the mid-20th century onward, the thinking in psychiatry centres on the open door. PMID:22518889

Duprey, Catherine

2011-01-01

357

Psychiatric emergencies (part I): psychiatric disorders causing organic symptoms.  

PubMed

Psychiatric emergencies are conditions that mostly destabilize the already frenetic activity of the Emergency Department. Sometimes the emergency is clearly referable to primitive psychiatric illness. Other times, psychiatric and organic symptoms can independently coexist (comorbidity), or develop together in different conditions of substance abuse, including alcohol and prescription drugs. Differentiating between substance induced and pre-existing psychiatric disorder (dual diagnosis) may be difficult, other than controversial issue. Finally, an organic disease can hide behind a psychiatric disorder (pseudopsychiatric emergency). In this review (part I), psychiatric disorders that occur with organic symptoms are discussed. They include: (1) anxiety, conversion and psychosomatic disorders, and (2) simulated diseases. The physiologic mechanisms of the stress reaction, divided into a dual neuro-hormonal response, are reviewed in this section: (1) activation of the sympathetic nervous system and adrenal medulla with catecholamine production (rapid response), and (2) activation of the hypothalamic-pituitary-adrenal axis with cortisol production (slow response). The concept of the fight-or-flight response, its adaptive significance and the potential evolution in paralyzing response, well showing by Yerkes-Dodson curve, is explained. Abnormal short- and long-term reactions to stress evolving toward well codified cluster of trauma and stressor-related disorders, including acute stress disorder, adjustment disorder and post-traumatic stress disorder, are examined. A brief review of major psychiatric disorder and related behaviour abnormalities, vegetative symptoms and cognitive impairment, according to DMS IV-TR classification, are described. Finally, the reactive psychic symptoms and behavioral responses to acute or chronic organic disease, so called "somatopsychic disorders", commonly occurring in elderly and pediatric patients, are presented. The specific conditions of post-operative and intensive care unit patients, and cancer and HIV positive population are emphasized. PMID:23436668

Testa, A; Giannuzzi, R; Sollazzo, F; Petrongolo, L; Bernardini, L; Daini, S

2013-02-01

358

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

PubMed Central

Background In May 2011 an outbreak of Shiga toxin-producing enterohaemorrhagic E. coli (STEC) O104:H4 in Northern Germany led to a high number of in-patients, suffering from post-enteritis haemolytic-uraemic syndrome (HUS) and often severe affection of the central nervous system. To our knowledge so far only neurological manifestations have been described systematically in literature. Aim To examine psychiatric symptoms over time and search for specific symptom clusters in affected patients. Methods 31 in-patients suffering from E. coli O104:H4 associated HUS, were examined and followed up a week during the acute hospital stay. Psychopathology was assessed by clinical interview based on the AMDP Scale, the Brief Symptom Inventory and the Clinical Global Impressions Scale. Results At baseline mental disorder due to known physiological condition (ICD-10 F06.8) was present in 58% of the examined patients. Patients suffered from various manifestations of cognitive impairment (n?=?27) and hallucinations (n?=?4). Disturbances of affect (n?=?28) included severe panic attacks (n?=?9). Psychiatric disorder was significantly associated with higher age (p<0.0001), higher levels of C-reactive protein (p<0.05), and positive family history of heart disease (p<0.05). Even within the acute hospital stay with a median follow up of 7 days, symptoms improved markedly over time (p <0.0001). Conclusions Aside from severe neurological symptoms the pathology in E.coli O104:H4 associated HUS frequently includes particular psychiatric disturbances. Long term follow up has to clarify whether or not these symptoms subside. PMID:25007072

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

2014-01-01

359

Psychiatric disorder does not preclude adequate continuous positive airway pressure titration.  

PubMed

Obstructive sleep apnea (OSA) is a highly prevalent disorder associated with significant morbidity and multiple complications. A large proportion of patients with OSA also have a coexisting primary psychiatric disorder. The effect of psychiatric disorders on the ability to tolerate continuous positive airway pressure (CPAP) titration is not known. In this study, whether the presence of psychiatric disorders precludes the patients' ability to tolerate CPAP titration for OSA was investigated. A retrospective chart review on a sample of 284 patients who underwent sleep studies in a single-center, university-based Veterans Affairs hospital was performed. A total of 143 patients with OSA who underwent titration of CPAP therapy were identified. The prevalence of psychiatric disorders between patients who tolerated titration and those who did not tolerate it was compared using the ?² test. The percentages of patients with psychiatric disorders who tolerated and did not tolerate CPAP were 33.6% and 33.3%, respectively. No statistically significant difference between the 2 groups (?² = 0.051 with 1 degree of freedom; P = 0.82) was found. The predominantly male patient population, exclusion of mild OSA, lack of data about the level of control of the psychiatric symptoms and the sleep technicians not being blinded to the patients' psychiatric diagnoses were some of the limitations of this study. No significant difference existed in the prevalence of psychiatric disorders between patients intolerant to CPAP titration and those who tolerated CPAP for OSA. PMID:23138124

Manjunath, Skantha K; Sarva, Siva T; Yataco, Jose C; Murillo, Luis C; Avecillas, Jaime F; Freire, Amado X

2013-08-01

360

Examining Psychiatric Disorder as a Risk Factor for Cancer in a Prospective Cohort Study of 1,165,039 Swedish Men: Different Analytical Strategies Reveal Different Findings  

PubMed Central

Background Associations between psychiatric disorders and cancer incidence are inconsistent, with studies reporting cancer rates in psychiatric patients that are higher, similar, or lower than the general population. Exploration of these associations is complicated by difficulties in establishing the timing of onset of psychiatric disorders and cancer, and the associated possibility of reverse causality. Some studies have dealt with this problem by excluding patients with cancers pre-dating their psychiatric illness; others have not considered the issue. Methods We examined associations between psychiatric hospitalization and cancer incidence in a cohort of 1,165,039 Swedish men, and explored the impact of different analytical strategies on these associations using real and simulated data. Results Relative to men without psychiatric hospitalization, we observed consistent increases in smoking-related cancers in those with psychiatric hospitalizations, regardless of analytical approach (for example, hazard ratio (95% confidence interval): 1.73 (1.52, 1.96)). However, associations with nonsmoking-related cancers were highly dependent on analytical strategy. In analyses based on the full cohort, we observed no association or a modest increase in cancer incidence in those with psychiatric hospitalizations (1.14 (1.07, 1.22)). In contrast, analyses excluding men whose cancer predated their psychiatric hospitalizations, resulted in a reduction in future cancer incidence in psychiatric patients (0.72; 0.67, 0.78). Results from simulated data suggest that even modest exclusions of this type can lead to strong artefactual associations. Conclusions Psychiatric disorder-cancer incidence associations are complex and influenced by analytical strategy. A greater understanding of the temporal relationship between psychiatric disorder and cancer incidence is required. PMID:22488410

Whitley, Elise; Batty, G. David; Mulheran, Paul A.; Gale, Catharine R.; Osborn, David P.; Tynelius, Per; Rasmussen, Finn

2014-01-01

361

The Chinese hospital.  

PubMed

The Chinese hospital serves three separate but overlapping functions. Like Western hospitals, the Chinese hospital provides patient care in a wide range of settings and with various levels of facilities. The Chinese hospital is also a danwei or work unit, that employs not only health care personnel, but also day-care teachers, builders, drivers, repairmen, and other auxiliary personnel. The third function is political and organizational. Hospital leaders act as local representatives of the Chinese Communist Party and the state, with jurisdiction over personal, professional, legal, and political activities of the workers in the hospital. PMID:6625391

Cohen, M S; Henderson, G E

1983-10-01

362

Vocational rehabilitation for psychiatric inpatient Vietnam combat veterans.  

PubMed

A Department of Veterans Affairs (DVA) inpatient psychiatry program treating Vietnam veterans for symptoms of posttraumatic stress disorder provided day and evening treatment programs. The evening program, besides treating psychiatric trauma, incorporated the DVA mission of assisting patients with vocational rehabilitation and work force reentry. Although initially opposed to employment, Vietnam veterans accepted a treatment program with an emphasis on working and job training. Both programs were compared using the Ward Atmosphere Scale (WAS). No significant differences between the two programs were found. The results support the DVA's position that employment is a valuable component of psychiatric treatment. PMID:2119020

Pendorf, J E

1990-08-01

363

Infant psychiatric disorders.  

PubMed

Infant mental health problems include difficulties to regulate emotions or attention, crying, sleeping or feeding problems as well as aggressive behavior. Early identifications of these problems help to change developmental trajectories and improve developmental outcomes. Psychiatric assessment and classification have to take into account the rapid processes of development as well as the inseparable linkage between symptoms of the infant, psychosocial risks in the family environment, and parent-child relations. The proposed DSM-5 classification system presents a systematic description of mental health disorders which are relevant for infant psychiatry. However, the proposal has provided rather limited attention to developmental differences and parent-infant relations. Therefore, additional classification systems, like the Zero-to-Three (DC: 0-3R), are strongly recommended. In terms of assessment and in accordance with the guidelines of the American Academy of Child and Adolescent Psychiatry, infant psychiatrists have to consider the close relation between somatic and mental health and the interplay between behaviors of the caregiver and the infant. Therefore, the assessment has to be multidisciplinary and relationship based. A standard assessment in infancy includes a clinical interview, behavior observations, caregiver questionnaires, and a pediatric screening. All assessments should pay attention to motor, cognitive, language, and social-emotional development. Because infant development is embedded in the family context, socio-economic factors, parents' mental problems, including drug abuse, domestic violence, and trauma history should be assessed. The treatment has to be oriented toward symptoms and development and has to address underlying medical conditions. The focus should be on parent-child interactions. Evidence-based interventions are based on attachment theory, use social-learning perspectives, and behavioral approaches. PMID:23229140

Bolten, Margarete I

2013-02-01

364

THE UNIVERSITY OF CONNECTICUT HEALTH CENTER JOHN DEMPSEY HOSPITAL  

E-print Network

Observation/Constant Observation, and or alternative measures to maintain safety of the patient and othersTHE UNIVERSITY OF CONNECTICUT HEALTH CENTER JOHN DEMPSEY HOSPITAL ADMINISTRATIVE MANUAL SECTION: PATIENT CARE NUMBER: 08-006 SUBJECT: CARE OF PSYCHIATRIC PATIENT PAGE: 1 of 1 IN A NON-PSYCHIATRIC UNIT

Oliver, Douglas L.

365

Housing outcomes for hospitalized homeless veterans.  

PubMed

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

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

2006-05-01

366

Psychiatric comorbidity in forensic psychiatry.  

PubMed

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

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

2009-09-01

367

Effectiveness of Partial Hospitalization in the Treatment of Borderline Personality Disorder: A Randomized Controlled Trial  

Microsoft Academic Search

Objective: This study compared the effectiveness of psychoanalytically oriented partial hospitalization with standard psychiatric care for patients with borderline personality disor- der. Method: Thirty-eight patients with borderline personality disorder, diagnosed accord- ing to standardized criteria, were allocated either to a partially hospitalized group or to a standard psychiatric care (control) group in a randomized controlled design. Treatment, which included individual

Anthony Bateman; Peter Fonagy

1999-01-01

368

Hospitality in hospitals?  

Microsoft Academic Search

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

Denver Severt; Taryn Aiello; Shannon Elswick; Cheryl Cyr

2008-01-01

369

Culturally competent psychiatric nursing care.  

PubMed

Evidence-based descriptions of culturally competent psychiatric nursing care are scarce. This study explored the perceptions of clients with mental illness regarding the overall effectiveness of psychiatric nursing care in meeting their cultural needs, and psychiatric nurses' perceptions of how and to what extent they provided culturally competent psychiatric mental health nursing care to diverse client populations. This descriptive study employed a qualitative research design using a multi-method data collection approach consisting of in-depth individual client interviews and a self-administered nurse questionnaire. Client participants tended to minimize the importance of receiving care related to their cultural needs. They described (1) encouraging and reassuring me; (2) speaking up for me; and (3) praying a lot as essential to their care. Nurse participants perceived their psychiatric nursing care to be culturally competent; however, few described specific strategies for incorporating cultural beliefs and practices into nursing care. Client participant lacked awareness of their cultural needs and had difficulty identifying and describing specific nursing interventions that contributed to positive mental health outcomes. Nurses perceived that they provided culturally competent care but actually lacked specific knowledge and skills to do so effectively. PMID:21050338

Wilson, D W

2010-10-01

370

Undergraduate college students' perceptions of psychiatric nurses.  

PubMed

We surveyed undergraduate students' perceptions of psychiatric nurses' effectiveness and analyzed other sources of data. Students reported that psychiatric nurses' strengths include helping in situations that involve psychiatric symptoms, mental health evaluation, and drug abuse. Psychiatric nurses also were said to be effective when helping an individual with psychiatric symptoms, such as delusions and hallucinations. Friends or associates, common knowledge, school and education, and movies are some sources by which students learn about psychiatric nurses. Sources that provided less influential information include insurance carriers, newspapers, and personal experience. PMID:23146011

Wantz, Richard A; Firmin, Michael W; Stolzfus, Melissa J; Ray, Brigitte N; Holmes, Hannah J; Geib, Ellen F

2012-11-01

371

An earthquake disaster in Turkey: an overview of the experience of the Israeli Defence Forces Field Hospital in Adapazari.  

PubMed

On 17 August 1999 at 3:04 a.m., an earthquake of 7.4 magnitude (Richter scale) struck the Marmara region in Turkey. The city of Adapazari suffered 2,680 fatalities with approximately 5,300 injured. The Israeli Defence Forces (IDF) field hospital arrived at Adapazari, on day four after the quake. The team consisted of 102 personnel. The field hospital acted as a secondary referral centre. A total of 1,205 patients were treated in the field hospital between day four and day 14 of the earthquake. The frequency distribution of the medical problems seen in the field hospital was 32 per cent internal medicine, 13 per cent general surgery including plastic, 21 per cent orthopaedic surgery, 23 per cent paediatric disease, 10 per cent obstetrics and gynaecology and 1 per cent major psychiatric disorders. A mean number of 35 patients per day were hospitalised in the field hospital for between 24 hours to one week. The rapid establishment of the field hospital enabled the local medical facilities to 'buy time' in order to organise and restore surgical and hospitalisation abilities in this disastrous situation. PMID:11026159

Bar-Dayan, Y; Beard, P; Mankuta, D; Finestone, A; Wolf, Y; Gruzman, C; Levy, Y; Benedek, P; VanRooyen, M; Martonovits, G

2000-09-01

372

Psychiatric Nurses' Perceptions about Physical Restraint; A Qualitative Study  

PubMed Central

Background: The use of physical restraint as an intervention in the care of psychiatric patients dates back to the beginning of psychiatry. Although it is a challenging question, it is still one of the common procedures in psychiatry. Considering that very little research has been done in Iran in relation to physical restraint, this qualitative study aimed to investigate the experiences of  nurses working in psychiatric wards regarding physical restraint. Methods: This qualitative study was done on 14 nurses working in the psychiatric hospitals of Ahvaz city, southern Iran, during 2011-2012. The participants were selected by purposive sampling. Semi-structured interviews were used for data collection, which were continued until data saturation and emergence of themes. Inductive content analysis was used to analyze the data. Results: Four categories emerged: (1) Restraint as a multi-purpose procedure, (2) Processing of physical restraint, (3) Restraint as a challenging subject and (4) The effects of restraint on the spectrum. Each category has several different sub-categories. Conclusion: The participants described using physical restraint as one of the main strategies to control psychiatric patients, and despite having negative consequences, it is extensively used. Given the risks and challenges of using physical restraint, nursing education should find alternative methods.

Fereidooni Moghadam, Malek; Fallahi Khoshknab, Masoud; Pazargadi, Mehrnoosh

2014-01-01

373

Home treatment for children and adolescents with psychiatric disorders.  

PubMed

The study examines the effectiveness of home treatment in 70 children and adolescents (aged 6-17 years) with heterogeneous psychiatric disorders. Home treatment was offered to parents/children as an alternative to inpatient treatment (no randomized group assignment). Interventions were carried out by psychiatric nurses (n = 38) and medical students (n = 32) under the supervision of experienced child psychiatrists. Assessment of treatment effects was based on a structured parent interview and parents', children's and therapists' ratings of various aspects of psychosocial functioning. Pre- or post-treatment comparisons indicate significant improvement of psychiatric symptoms, severity of the disorder, and psychosocial adjustment after three months of home-based interventions. Outcome of behavioral interventions carried out by experienced nurses was superior, compared to treatment effects achieved by advanced medical students. Post-treatment comparison of home-based (n = 70) and inpatient-based (n = 35) treatment effects suggests that inpatient treatment all in all was more effective. At one-year follow-up, however, the effects of home treatment were maintained in a higher number of patients, compared to the stability of effects seen after psychiatric hospitalization. Thus, home treatment appears to be an effective treatment setting. Motivation and compliance of patient and parents, and high skills of the therapists are key ingredients for the success of a home-based treatment program. PMID:16604436

Schmidt, Martin H; Lay, Barbara; Göpel, Christopher; Naab, Silke; Blanz, Bernd

2006-08-01

374

Quinolones: review of psychiatric and neurological adverse reactions.  

PubMed

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

Tomé, Ana M; Filipe, Augusto

2011-06-01

375

Work and common psychiatric disorders.  

PubMed

Psychiatric disorders are now the most common reason for long-term sickness absence. The associated loss in productivity and the payment of disability benefits places a substantial burden on the economies of many developed countries. The occupational dysfunction associated with psychiatric disorders can also lead to poverty and social isolation. As a result the area of work and psychiatric disorders is a high priority for policymakers. There are two main agendas: for many researchers and clinicians the focus is on the need to overcome stigma and ensure people with severe psychiatric disorders have meaningful work; however the public health agenda predominantly relates to the more common disorders such as depression and anxiety, which contribute a greater burden of disability benefits and pensions. In this review we attempt to address this second agenda. The relatively sparse evidence available reveals a complex field with significant interplay between medical, psychological social and cultural factors. Sick leave can be a 'process' as well as an 'event'. In this review we propose a staged model where different risk and protective factors contribute to the onset of psychiatric disorders in the working population, the onset of short-term sickness absence, and the transition from short- to long-term absence. We also examine strategies to manage psychiatric disorder in the workforce with a view towards returning the employee to work. Our aim in this review is to highlight the complexity of the area, to stimulate debate and to identify important gaps in knowledge where further research might benefit both patients and wider society. PMID:21558098

Henderson, M; Harvey, S B; Overland, S; Mykletun, A; Hotopf, M

2011-05-01

376

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

PubMed Central

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

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

2014-01-01

377

Psychiatric Morbidity in Pediatric Critical Illness Survivors: A Comprehensive Review of the Literature  

PubMed Central

Objective To review the prevalence of psychiatric syndromes in pediatric critical illness survivors as well as to summarize data on vulnerabilities and pediatric intensive care unit (PICU) exposures that may increase risk of developing these syndromes. Data Sources Medline (1966–2009), the Cochrane Library (2009, Issue 3), and PsycInfo (1967–2009) as of August 9, 2009. Study Selection Case-control, cross-sectional, prospective cohort and retrospective cohort studies, as well as randomized-controlled trials. Main Exposures Hospitalization for the treatment of a critical illness. Main Outcome Measures Assessments of psychiatric symptoms/disorders at least once after discharge. Results Seventeen studies were eligible. The most commonly assessed psychiatric disorders were posttraumatic stress disorder (PTSD) and major depression. The point prevalence of clinically significant PTSD symptoms ranged from 10%–28% (5 studies). The point prevalence of clinically significant depressive symptoms ranged from 7%–13% (3 studies). Pre-illness psychiatric and/or developmental problems and parental psychopathology were associated with vulnerability to psychiatric morbidity. Neither a child’s age nor gender consistently increased vulnerability to post-illness psychopathology. Exposure to increased severity of medical illness and PICU service-delivery characteristics (e.g., invasive procedures) were predictors of psychiatric illness in some, but not all, studies. Early post-illness psychiatric symptoms were predictors of later psychiatric morbidity. Conclusions Psychiatric morbidity appears to be a substantial problem for pediatric critical illness survivors. Future research should include more in-depth assessment of post-critical illness depressive, anxiety and psychotic symptoms, validate existing psychiatric instruments, and clarify how vulnerability factors, PICU service-delivery characteristics and severity of critical illnesses are associated with subsequent psychopathology. PMID:20368492

Davydow, Dimitry S.; Richardson, Laura P.; Zatzick, Douglas F.; Katon, Wayne J.

2010-01-01

378

Teaching Psychodynamics to Psychiatric Residents through Psychiatric Outpatient Interviews  

ERIC Educational Resources Information Center

Objective: This study evaluates whether a course that was designed for first-year psychiatric residents and that specifically addressed psychodynamic principles fostered residents' progress in knowledge, skills, and attitudes regarding these concepts. Methods: The course was given in the 2005 academic year to all residents (N=18) in their first…

Cardoso Zoppe, Eva Helena C.; Schoueri, Patricia; Castro, Monica; Neto, Francisco Lotufo

2009-01-01

379

[Nurturance of children during inpatient psychiatric treatment of their parents].  

PubMed

About a third of all inpatients in psychiatric hospitals are parents of children aged below 18 years. The mental illness of a parent and especially the need of inpatient treatment burdens families. This study was contributed to assess parental stress, behavioural and emotional problems of the children and the needs of psychiatric inpatients for support. Barriers and hindrances as well as positive experience with support for their children were assessed. All psychiatric hospitals in a county with about 1.5 million inhabitants in South-West Germany participated in this study. From 643 inpatients after drop-out 83 (54 female, 29 male) patients with non full aged children were questioned with inventories as the SDQ, the PSS and further assessments. Diagnoses and biographic data were assessed by the documentation of the German Association of psychiatry and psychotherapy. Parents reported about an increased level of stress by parenthood (PSS mean 41.9, SD 9.4). Psychopathology of the children influenced the stress of the mentally ill parents. 40% of the patients are dissatisfied with the care of their children during their inpatient treatment, but 51% have strong resentments against the youth welfare custodies and do not ask for support. Our results prove the high negative attitude of mentally ill parents against youth welfare service which must be reduced by active information policy and offers in collaboration with the treating psychiatrist of the parents. PMID:19143235

Kölch, Michael; Schmid, Marc

2008-01-01

380

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

PubMed Central

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

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

2012-01-01

381

[Challenges for the future of psychiatry and psychiatric medical care].  

PubMed

In addition to the prolonged economic recession and global financial crisis, the Great East Japan Earthquake of March 2011 has caused great fear and devastation in Japan. In the midst of these, Japanese people have felt to lose the traditional values and common sense they used to share, and it has become necessary to build a new consciousness. Engaged in psychiatry and psychiatric care under these circumstances, we have to analyze the challenges we face and to brainstorm on appropriate prescriptions that can be applied to solve the problems. Five points in particular were brought up: [1] The persistently high number of suicides. [2] The increase in depression and overflowing numbers of patients visiting clinics and outpatient departments at hospitals. [3] The absolute shortage of child psychiatrists. [4] Little progress with the transition from hospitalization-centered to community-centered medical care. [5] The disappearance of beds for psychiatry patients from general hospitals. The situations surrounding these five issues were briefly analyzed and problems were pointed out. The following are five problems that psychiatry is facing: 1) A lack of large clinical trials compared to the rest of the world. 2) The drug lag and handling of global trials. 3) The lack of staff involved in education and research (in the field of psychiatry). 4) Following the DSM diagnostic criteria dogmatically, without differentiating therapeutics. 5) Other medical departments, the industry, patients, and their families are demanding objective diagnostic techniques. After analyzing the problems, and discussing to some extent what kind of prescription may be considered to solve the problems, I gave my opinion. (1) The first problem is the deep-rooted prejudice and discrimination against psychiatric disorders that continue to be present among Japanese people. The second problem is the government's policy of low remuneration (fees) for psychiatric services. The third problem, symbolic of the situation, is the fact that the "psychiatry exception" system (unbalanced ratio of staff to psychiatric patients) is still present today. (2) To reach a fundamental solution, the policy of low fees for psychiatric services has to be abolished. (3) Multi-disciplinary medical teams, as practiced in other developed countries, is not yet adequately applied in Japan. From the aspect of medical fees, it is not adequately encouraged either. The only place where team medicine is actually practiced is in the "forced hospitalization" ward, but, as stated in the supplementary resolution of the Japanese diet (national assembly), high-quality medicine should not only be practiced in the "forced hospitalization" ward, but also in general psychiatry. (4) The policy of transition from hospitalization-centered to community-centered medical care, which was initiated a long time ago by the Japanese government, is not proceeding in reality, and it is time that we put our heads together and find ways to overcome this problem. It is significant that "psychiatric disorders" have been included as one of the "five diseases," (a system adopted by the government concerning community health care), and now we have the best opportunity to improve community-centered psychiatric care. PMID:23691798

Higuchi, Teruhiko

2013-01-01

382

Psychiatric disorders in children and adolescents six-to-twelve months after mild traumatic brain injury.  

PubMed

The objective of this study was to understand how novel psychiatric disorders (NPD) in children with mild traumatic brain injury (MTBI) are related to pre-injury variables, injury-related variables, and concurrent neurocognitive outcome. A group of 79 children, ages 5 to 14 years, who had experienced MTBI, were studied from consecutive hospital admissions with semistructured psychiatric interviews soon after injury (baseline); 60 children were reassessed 12 months post-injury. Standardized instruments were used to assess injury severity; lesion characteristics; pre-injury variables, including psychiatric disorder, family psychiatric history, family functioning, socioeconomic status, psychosocial adversity, adaptive functioning, and post-injury neurocognitive and adaptive functioning. NPD occurred in 17 of 60 participants (28%) in the 6-12-month interval after injury, with disorders that were significantly associated with socioeconomic status, psychosocial adversity, estimated pre-injury academic functioning, and concurrent deficits in adaptive functioning, academic performance, processing speed, memory, and expressive language. NPD was not significantly associated with pre-injury adaptive functioning, injury severity, family psychiatric history, pre-injury psychiatric disorder, lesion location, gender, or age at injury. These findings suggest that the short-term psychiatric morbidity associated with MTBI in children occurs more commonly than previously reported and is related to both pre-injury social factors and concurrent neurocognitive functioning. PMID:24247854

Max, Jeffrey E; Pardo, David; Hanten, Gerri; Schachar, Russell J; Saunders, Ann E; Ewing-Cobbs, Linda; Chapman, Sandra B; Dennis, Maureen; Wilde, Elisabeth A; Bigler, Erin D; Thompson, Wesley K; Yang, Tony T; Levin, Harvey S

2013-01-01

383

Examination of Psychiatric Symptoms in Student Athletes  

Microsoft Academic Search

In the present study, the authors examined the severity of psychiatric symptoms in undergraduate recreational (noncompetitive) athletes (n = 64) and National Collegiate Athletic Association (NCAA; competitive) athletes (n = 72). The results indicated that the 2 groups were similar in the severity of psychiatric symptoms. The recreational and NCAA athletes combined (n = 136) showed less severe global psychiatric

Brad Donohue; Tracey Covassin; Kevin Lancer; Yani Dickens; Abby Miller; Adria Hash; Jeff Genet

2004-01-01

384

Psychiatric disorders and traumatic brain injury  

PubMed Central

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

Schwarzbold, Marcelo; Diaz, Alexandre; Martins, Evandro Tostes; Rufino, Armanda; Amante, Lucia Nazareth; Thais, Maria Emilia; Quevedo, Joao; Hohl, Alexandre; Linhares, Marcelo Neves; Walz, Roger

2008-01-01

385

Academic Accommodations for Students with Psychiatric Disabilities.  

ERIC Educational Resources Information Center

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…

Souma, Alfred; Rickerson, Nancy; Burgstahler, Sheryl

386

Psychiatric complications of 'Ecstasy' use  

Microsoft Academic Search

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

Sietske Boeles; Eluned Dorkins; Robert Peveler

1994-01-01

387

The smoking-room as psychiatric patients' sanctuary: a place for resistance.  

PubMed

This article investigates the significance of the smoking-room for psychiatric patients: for their everyday interactions, activities and perceptions of what is meaningful, also for their positioning as agents concerning their own and fellow patients' illnesses and problems. A social constructionist perspective is used as well as concepts anchored in a phenomenology of architecture and local place. This article is a part of ethnographic study of the daily life within a psychiatric ward using participant observation and conversations and interviews with psychiatric inpatient and staff in a psychiatric hospital. Important themes from our analysis were 'smoking-room as patients''panopticon', 'smoking-room as the patients' sanctuary' and 'patient-led treatment'. We discuss these themes within a framework of seeing the smoking-room as an arena for patient and staff resistance. Patients' resistance is analysed as attempts to maintain their civil status identity and feelings of dignity in an otherwise powerless situation. PMID:18844798

Skorpen, A; Anderssen, N; Oeye, C; Bjelland, A K

2008-11-01

388

Serostatus surveillance testing of HIV-I infection among Zimbabwean psychiatric inpatients, in Zimbabwe.  

PubMed

Psychiatric patients, like any other medical patients, are vulnerable to HIV infection and those infected with HIV could transmit the virus to others. Some studies have found that the severely mentally ill as a group are more vulnerable to HIV infection because of comorbidity with substance abuse. Unsafe sexual behavior has also been reported among the severely mentally ill. Blood samples from 87 male and 56 female patients consecutively admitted to Harare Central Hospital's Psychiatric Unit were tested with ELISA and Western blot for infection with HIV. The subjects were 17-70 years old of mean age 32.5 years with a mean 4.21 years of psychiatric illness. 23.8% were infected with HIV and HIV infection was significantly related to high education attainment and being unemployed. Preventive interventions are urgently needed for HIV-infected psychiatric patients in Zimbabwe. PMID:8997817

Acuda, S W; Sebit, M B

1996-09-01

389

[Psychiatric reform, federalism, and the decentralization of the public health in Brazil].  

PubMed

This study examines the relationships between Brazilian psychiatric reform, the adoption of the Centers for Psychosocial Care (CAPS) and the development of the Unified Health System (SUS). The adherence of municipal governments was a variable determinant for the spread of reform, especially due to the continental scale and fragmentation of the Brazilian federation. The article demonstrates the institutional stability of psychiatric reform in Brazil over two decades. The institutional nature of the decision-making process in the public arena has permitted the implementation of new organizational formats through imitation and financial incentives. The psychiatric reform was successful in defending the advantages of CAPS in relation to the asylum and hospital model dominant in past decades. The inductive policies, strengthened and upheld by Law 10.216/2001, transformed the agenda of psychiatric reform, limited to pioneering cities in a national public policy. PMID:22124901

Costa, Nilson do Rosário; Siqueira, Sandra Venâncio; Uhr, Deborah; Silva, Paulo Fagundes da; Molinaro, Alex Alexandre

2011-12-01

390

Consultations for 'maladaptive denial of illness' in patients with cancer: psychiatric disorders that result in noncompliance.  

PubMed

Patients who present with late stages of cancer often have complicated medical and psychiatric problems which are labeled as 'maladaptive delay or denial.' In some of these patients, psychiatric problems have either contributed to the delay in medical presentation for care or have interfered with treatment of the late stage cancer. The authors review some of the factors that contributed to delay and noncompliance in a series of patients with cancer who were evaluated by the psychiatric consultation service of a university hospital. Specifically, psychoses and cognitive impairment played a major role in delay and noncompliance. The authors discuss recommendations for management of such patients, and suggest that clinicians often benefit from the assistance of the psychiatric consultant as part of the treatment team. Multiple resources and multiple types of intervention are needed in order to help such patients negotiate the clinical environment. PMID:9205971

Kunkel, E J; Woods, C M; Rodgers, C; Myers, R E

1997-06-01

391

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

PubMed

Normal pressure hydrocephalus (NPH) is characterized by gait disturbance, dementia and/or urinary incontinence associated with dilation of ventricular system with normal opening cerebrospinal fluid pressure. Wide scientifical evidence confirms association between NPH and psychiatric symptoms. We selected 35 patients with idiopathic normal pressure hydrocephalus from January 2010 to January 2012 in a Brazilian tertiary hospital and performed a formal psychiatric evaluation to identify psychiatric disorders. Psychiatric disorders were present in 71% of these patients, especially anxiety, depression and psychotic syndromes. NPH patients may develop symptoms with frontal dominance, such as personality changes, anxiety, depression, psychotic syndromes, obsessive compulsive disorder, Othello syndrome; shoplifting and mania. Unusual appearances of NPH symptoms may hinder early diagnosis and consequently proper treatment. PMID:24964110

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

2014-06-01

392

Immersion experience in undergraduate psychiatric mental health nursing.  

PubMed

Immersion practica have been used in a variety of nursing settings to help prepare culturally competent nursing students. The psychiatric setting represents a diverse culture that traditionally has not appealed to nursing students when considering career options. This article describes the experiences of baccalaureate nursing students and hospital nursing staff following a brief immersion practicum at a psychiatric facility. Seven students were assigned to one practicum for six consecutive weekdays (45 hours), without the distraction of other classes. Both the students and staff rated the experience as positive. The students believed that their ability to form therapeutic relationships, develop clinical skills, and integrate theory into clinical practice was enhanced. While nursing faculty struggle to produce more graduates, with declining clinical sites and increased competition for these sites, the brief clinical immersion may be a reasonable alternative to a traditional rotation. PMID:21627052

Tratnack, Sheri A; O'Neill, Claudia M; Graham, Pat

2011-09-01

393

What shall we do with untreatable forensic psychiatric patients?  

PubMed

The destiny of untreatable forensic psychiatric patients in many western countries is uncertain, because governments, staff members of forensic psychiatric hospitals, lawyers and other involved groups do not know what to do with this category of patients. The debate concerning this matter, and related cost saving measures, very frequently ignores two important questions. Who is responsible for the untreatability of these patients? What are the criteria for untreatability? These core questions, which are related to each other, must be answered before the debate can go further. An exact definition of untreatability is needed for a) a fair screening of the patients, and b) getting more insight in the precise nature of, and interactions of the factors which play a role in the phenomenon of untreatability. To say that some patients are not (totally) responsible for their untreatability is not justifiable, as they may eventually become the victims of cost saving measures. PMID:11143874

Martens, W

2000-01-01

394

Managing Psychiatric Comorbidity Within Versus Outside of Methadone Treatment Settings: A Randomized and Controlled Evaluation  

PubMed Central

Background and aims Integrating psychiatric services within substance abuse treatment settings is a promising service delivery model, but has not been evaluated using random assignment to psychiatric treatment setting and controlled delivery of psychiatric care. This study evaluates the efficacy of on-site and integrated psychiatric service delivery in an opioid-agonist treatment program on psychiatric and substance use outcomes. Design Participants at the Addiction Treatment Services (ATS) were assigned randomly to receive on-site and integrated substance abuse and psychiatric care (on-site: n=160) versus off-site and non-integrated substance abuse and psychiatric care (off-site: n=156), and observed for 1 year. On-site participants received all psychiatric care within the substance abuse program by the same group of treatment providers. The same type and schedule of psychiatric services were available to off-site participants at a community psychiatry program. Setting All participants received routine methadone maintenance at the ATS program in Baltimore, Maryland, USA. Participants Participants were opioid-dependent men and women with at least one comorbid psychiatric disorder as assessed by the Structured Clinical Interview for DSM-IV and confirmed by expert clinical reappraisal. Measurements Outcomes included psychiatric service utilization and retention, Hopkins Symptom Checklist Global Severity Index (GSI) change scores, and urinalysis test results. Findings On-site participants were more likely to initiate psychiatric care (96.9% vs. 79.5%, p < 0.001), remain in treatment longer (195.9 vs. 101.9 days; p < 0.001), attend more psychiatrist appointments (12.9 vs. 2.7; p < 0.001), and have greater reductions in GSI scores (4.2 vs. 1.7; p = .003) than off-site participants; no differences were observed for drug use. Conclusions On-site and integrated psychiatric and substance misuse services in a methadone treatment setting may improve psychiatric outcomes compared with off-site and non-integrated substance misuse and psychiatric care. However, this might not translate into improved substance misuse outcomes. PMID:23734943

Brooner, Robert K.; Kidorf, Michael S.; King, Van L.; Peirce, Jessica; Neufeld, Karin; Stoller, Ken; Kolodner, Ken

2013-01-01

395

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

ERIC Educational Resources Information Center

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…

Walsh, Joan E.

396

Hospitalization of patients with schizophrenic and affective disorders in Israel in the aftermath of the structural and rehabilitation reforms  

PubMed Central

Background In the last decade (2001–2010) the Ministry of Health implemented two major inter-related reforms: a ’structural reform’ to reduce the number of psychiatric beds and the ’Rehabilitation of the Mentally Disabled in the Community Law’, which allocated funds for a variety of residential and vocational programs in the community for these patients. The objective of the present paper was to examine the impact of the two reforms on the hospitalization of schizophrenic and affective disorder patients by tracking the patterns of their inpatient care during the last decade. Methods Data on all psychiatric admissions during the period 1990–2011 were extracted from the Israel Psychiatric Case Register to examine changes in the rate of admissions, length of hospitalizations, total inpatient days and tenure in the community. The analysis was done separately for first-in-life vs. all admissions and for patients with schizophrenia vs. patients with affective disorders. Results From 2006 onward, with no decrease in the number the beds, the number of inpatient days for first-in-life patients with schizophrenia decreased by 29%, their admission rates dropped by 22%, the proportion of short [< 30 days] first in life episodes went up, while the percentage of those whose first in life episode lasted more than one year went down from 2.5% to 0.5%. The parallel results for patients with affective disorders were much less significant. Conclusions An increasing percentage of patients with schizophrenia are not admitted to psychiatric wards at all and an increasing percentage of those who are admitted are treated during a shorter episode. The change is probably due to the rehabilitation reform which enabled the structural reform (the reduction in beds) to be implemented effectively. PMID:23879855

2013-01-01

397

Effect of predictive value of progesterone level on the day of HCG injection for IVF success in women with infertility due to tubal factor or polycystic ovarian syndrome referred to the women hospital, Tehran, 2009  

PubMed Central

Background: Polycystic ovarian syndrome is one of the most common causes of endocrine disorders and main reason of infertility due to anovulation and recurrent abortions. Progesterone has been shown to have an important role in fertilization of oocyte and fetal implantation. Objective: The purpose of this study was to compare the predictive value of progesterone level on IVF success in women with infertility due to tubal factor or PCOS. Materials and Methods: In a stratified cohort study, we assigned 76 infertile women of 20-38 years old who referred to women hospital into two equal groups with fallopian tube factor infertility and PCOS. We measured the plasma levels of progesterone and estradiol on the day of HCG administration. The patients were divided into two groups based on progesterone level cut off point of 1.2ng/ml. Thereafter the incidence of pregnancy (chemical by ?-HCG measurement and clinical by ultrasonography up to the 6 weeks after fetal transfer) was compared in these groups. Results: Total pregnancy rates were 15.8% in patients with tubal factor infertility and 26.3% in women with PCOS. In women with PCOS, the pregnancy rate was less in patients with progesterone level <1.2 ng/ml. However this difference was not statistically significant. Likewise, we did not observe any significant differences in pregnancy rate in patients with fallopian tube factor infertility. Conclusion: Serum progesterone level on the day of HCG administration is not well predictive of the IVF success in infertile women due to fallopian tube factor or PCOS. To obtain more uniform results, we recommend use of larger samples while the bias variable is taken into account and the ROC curve is used for determination of the unique serum progesterone level. PMID:25246897

Ghaseminejad, Azizeh; Rezaee, Zahra; Forootan, Mitra; Hosseinipoor, Taraneh; Forghani, Forough; Nikuei, Pooneh

2012-01-01

398

Pi Day.  

ERIC Educational Resources Information Center

Presents a day of activities to encourage students to participate in mathematics. Five contests include poster; model; mathematics puzzle; mathematics problem challenge; and essay. Some student entries and the rules for each contest are described. (MKR)

Waldner, Bruce C.

1994-01-01

399

Influence of aeroionotherapy on some psychiatric symptoms  

NASA Astrophysics Data System (ADS)

Negative aeroionotherapy (daily 15 50 min sittings, for 10 30 days) was applied in 112 patients with various psychiatric disorders, especially neuroses, with the aim of ameliorating certain symptoms (target symptoms). Corona and water air ion generators, as well as electro-aerosol generators, were used. The aeroionization (small air ion concentration), at the patient's respiration level, was moderate: n-=10,000 15,000/ml air; n+s?1,000/ml air; q=n+/n-?0.1. In most treated patients a diminution or even the disappearance of the target symptoms was obtained. Those obviously ameliorated under the influence of aeroionotherapy were: asthenia, depressive reactions, anxiety, irascibility, cephalea, insomnia, and general indisposition.

Deleanu, M.; Stamatiu, C.

1985-03-01

400

Evaluating current trends in psychiatric music therapy: a descriptive analysis.  

PubMed

Approximately 21% of music therapists report working in the mental health field, more so than another other specific client population category (AMTA, 2005). The purpose of this study was to descriptively evaluate psychiatric music therapists and their institutions, philosophies, interventions, and clinical objectives. A survey was designed and posted online or mailed to music therapists who did not have email addresses in the 2005 Member Sourcebook (AMTA, 2005). A total of 176 psychiatric music therapists completed various parts of the survey for an overall response rate of 42.9%. Respondents reported working a mean of 11.3 years in the psychiatric setting, being Board-Certified Music Therapists for 13.3 years, and working at their institution for 8.4 years. Most respondents (90.6%) indicated they did not have a music therapist as a supervisor. Group music therapy was the dominant modality in psychiatric institutions for music therapists. Respondents indicated they read music therapy journals (80%) and other types of psychiatric periodicals (57.1%), presented educational sessions at conferences (44.6%), conducted in-services for hospital staff (64.8%), worked with an interdisciplinary treatment team (77.9%), and trained practica students (43.5%) and interns (37.4%). Respondents also indicated that although most were not bilingual (85.7%), they still worked with non-English speaking consumers (58.2%). Participants noted that they enjoyed working with the psychiatric population and felt they had a positive influence on treatment as indicated by Likert-type scales. Respondents reported using primarily behavioral or psychodynamic approaches but considered their primary psychological philosophy as eclectic. Participants predominantly indicated they addressed goal areas such as socialization, communication, self-esteem, coping skills, and stress reduction/management. Participants noted they employed a variety of music therapy techniques such as music assisted relaxation, improvisation, songwriting, lyric analysis, and music and movement to address consumer objectives. Participants indicated they used therapeutic verbal skills and techniques such as humor, redirection, reinforcement, empathy, and affirmation in their clinical practice. Additionally, the results of this survey were compared to the psychiatric portion of a music therapy descriptive study published in 1979. Similarities and differences are discussed. PMID:17997627

Silverman, Michael J

2007-01-01

401

Does experienced seclusion or restraint affect psychiatric patients' subjective quality of life at discharge?  

PubMed Central

Background In Finland major effort has been invested in reducing the use of coercion in psychiatric treatment, and the goal is to diminish the use of coercion by 40% by 2015. Improving patients’ quality of life (QoL) has gained prominence in psychiatric treatment during the past decade. Numerous studies have shown that most secluded or restrained patients (S/R patients) would prefer not to have had this experience. Experience of S/R could affect negatively patients’ QoL, but empirical data on this issue are lacking. Aim The study aimed to explore the effect of experienced S/R on the subjective QoL of psychiatric in-patients. Method This study explored subjective QoL of the S/R patients. At discharge, S/R patients completed the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF). Results We found that S/R patients’ (n?=?36) subjective QoL was significantly better than that of non-S/R patients’ (n?=?228). Most non-S/R patients were diagnosed with mood disorders (mostly depression). Most of S/R patients were diagnosed with schizophrenia, schizotypal and delusional disorders. The mean duration of S/R was 2.3 days, median was one day and mean length of the hospitalization after S/R episode was 2.5 months. Conclusion Our cross-sectional findings suggest that S/R does not considerably influence patients’ QoL or that the influence is short-lived. Because baseline QoL was not measured this remains uncertain. There are also many other factors, such as negative mood, which decrease the patients’ QoL ratings. These factors may either mask the influence of S/R on QoL or modify the experience of QoL to such an extent that no independent association can be found at the time of discharge. PMID:24308388

2013-01-01

402

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

PubMed Central

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

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

2013-01-01

403

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

ERIC Educational Resources Information Center

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

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

2009-01-01

404

Neuroimaging Correlates of Novel Psychiatric Disorders after Pediatric Traumatic Brain Injury  

ERIC Educational Resources Information Center

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

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

2012-01-01

405

Impulsivity as a Correlate of Suicidal Behavior in Adolescent Psychiatric Inpatients  

Microsoft Academic Search

One hundred and eighteen inpatient adolescents in a psychiatric hospital were evaluated to determine the relationship of aggression, self injury, and suicidal behavior to impulsivity. It was hypothesized that all these variables would be significantly and positively correlated with one another. This hypothesis was in part based on the results of psychobiological research that found serotonin dysfunction to be the

Netta Horesh; Doron Gothelf; Hadas Ofek; Tal Weizman; Alan Apter

1999-01-01

406

Psychiatric morbidity and its recognition by doctors in patients with cancer  

Microsoft Academic Search

Psychiatric morbidity in patients with cancer is high and without appropriate treatment unremitting. We assessed the ability of 143 doctors to establish the psychological status of 2297 patients during outpatient consultations in 34 cancer centres and hospitals in the UK. Prior to seeing the doctor, consenting patients completed a short self-report questionnaire (GHQ12), designed for the psychological screening of large

L Fallowfield; D Ratcliffe; V Jenkins; J Saul

2001-01-01

407

Assessing Violence Risk Among Discharged Psychiatric Patients: Toward an Ecological Approach  

Microsoft Academic Search

This paper draws upon data from the Pittsburgh site of the MacArthur Foundation's Risk Assessment Study, a large-scale study of violence risk among persons discharged from psychiatric hospitals, to examine the effect of the neighborhood context on risk of violence. This paper has two purposes: (1) to assess the extent to which the inclusion of neighborhood characteristics enhances violence prediction

Eric Silver; Edward P. Mulvey; John Monahan

1999-01-01

408

Maximum Security Psychiatric PatientsActuarial and Clinical Prediction of Dangerousness  

Microsoft Academic Search

Ratings of the dangerousness of 360 men in a maximum security psychiatric institution were obtained from experienced forensic clinicians. These ratings were well predicted (R = .61) from historical, offense, and in-hospital data. Seriousness of outcome scores based upon an 11-year minimum follow-up time were obtained on 85 additional men released from the same institution; this outcome sample was constructed

VERNON L. QUINSEY; ANNE MAGUIRE

1986-01-01

409

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

ERIC Educational Resources Information Center

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

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

2010-01-01

410

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

ERIC Educational Resources Information Center

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

Lewine, R. J.; And Others

1978-01-01

411

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

ERIC Educational Resources Information Center

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

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

2012-01-01

412

Outcome of psychiatric intervention in factitious illness by proxy (Munchausen's syndrome by proxy)  

Microsoft Academic Search

OBJECTIVETo determine the outcome for children after psychiatric intervention in cases of factitious illness by proxy.METHODSAll 17 children from 16 families, selected for admission to the Park Hospital Oxford family unit 1992–96 were followed up after a mean of 27 months. Information was obtained on the children and their carers from general practitioners, social workers or both; 13 of the

Birgit Berg; David P H Jones

1999-01-01

413

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

PubMed

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

Chapireau, F

2005-01-01

414

Assaults against nurses of general and psychiatric hospitals in Taiwan  

Microsoft Academic Search

Purpose  Nurses are at risk of occupational assaults. However, the incidence and effects have not been documented among nurses in Taiwan.\\u000a We aimed to study the incidence of assaults and their effects, including quality of life and job-related stress among nurses.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A cross-sectional study was conducted to understand the incidence of work-related assaults in nurses. Job content questionnaire\\u000a was used to

Judith Shu-Chu Shiao; Yuntin Tseng; Yueh-Tzu Hsieh; Jui-Yeh Hou; Yawen Cheng; Yueliang Leon Guo

2010-01-01

415

[Ketamine: psychiatric indications and misuses].  

PubMed

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

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

2014-01-01

416

Psychiatric Aspects of Organ Transplantation  

PubMed Central

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

Kalra, G.; Desousa, A.

2011-01-01

417

Social competence and social-emotional isolation and eating disorder psychopathology in female and male adolescent psychiatric inpatients1  

Microsoft Academic Search

The ex post facto study examined the association between interpersonal deficits in peer relations and specific aspects of eating disorder (ED) psychopathology in psychiatrically-hospitalized adolescent girls and boys. Four hundred and ninety-two psychiatric inpatients (286 girls and 206 boys), aged 12 to 19 years, completed self- report instruments that generate assessments of peer relations, ED psychopathology, self-esteem, and depression. Associations

Shannon L. Zaitsoff; Dwain C. Fehon; Carlos M. Grilo

2009-01-01

418

Dinosaur Day!  

NSDL National Science Digital Library

On Dinosaur Day, first-grade students rotated through four dinosaur-related learning stations that integrated science content with art, language arts, math, and history in a fun and time-efficient manner. The event drew parents, teachers, and students together as they helped each other discuss, write, draw, measure, mix, and record at each learning station.

Baptiste, H. P.; Nakamura, Sandra

2006-01-01

419

Day wetting  

Microsoft Academic Search

About 1% of healthy children over the age of 5 years have troublesome daytime wetting. Two-thirds of those who wet by day are reliably dry at night. The problem is more common in girls and is usually the result of urge incontinence. Although the wetting may be exacerbated by giggling and\\/or stress, pure giggle micturition and isolated stress incontinence are

S. R. Meadow

1990-01-01

420

Inspire Day  

ERIC Educational Resources Information Center

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

Bohach, Barbara M.; Meade, Birgitta

2014-01-01