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1

The Most Frequent Psychiatric Disorders Registered at Day Hospital of Psychiatric Clinic in Sarajevo During 2006-2007  

PubMed Central

CONFLICT OF INTEREST: NONE DECLARED Day Hospital is an alternative to inpatient treatment as a transition from hospital to outpatient type of treatment, especially for those patients who cannot quickly return to the family, and patients who are unable to leave the usual social contacts so to them the hospitalization will pose a great mental risk. The aim of the research is to determine the structure of psychiatric morbidity, as well as demographic features and duration of hospitalization in patients treated at a Day Hospital of Psychiatric Clinic in Sarajevo during the period 2006-2007. The survey is conducted at the Psychiatric Clinic, Clinical Center of Sarajevo University as retrospective, based on observations of certain variables (gender, age, hospitalization duration), and the number of diagnosis. The results of the research show that the total number of registered patients in the observed period is 400. During the two year study there were more female (61.3%) than male patients (38.7%). Also, during the two years of research, most of those were with one diagnosis. The average hospitalization duration was 45 days, and the most often hospitalization duration was from 1 to 3 months. During both years, mostly present was the population in age group 46 to 65 years, followed by age group 26 to 44 years. Leading diseases during both years of research were from the group F30-F39, and the most common co-morbid diseases from groups: F30-F39, F40-F49 and F60-F69. We can conclude that Day Hospital has great significance in the mental health prevention. Daily structured program provides hospital diagnosis, treatment and rehabilitation of persons of both genders from different age groups and with diverse psychopathology.

Licanin, Ifeta; Masic, Izet; Tandir, Lejla

2009-01-01

2

[Day hospital and night dispensary as intermediate links in the system of psychiatric services].  

PubMed

The author considers the peculiarities of day and night hospitals as centers of partial hospitalization which have independent functions in the differentiated system of psychiatric service and along with this permits to solve tasks more effectively which are raised by comprehensive practice before the system as a whole. The general principles of the organization of day and night hospital activities are formulated and advantages of their use in the treatment of early prepsychotic manifestations of schizophrenia and the initial forms of mental diseases are substantiated. PMID:596041

Volovik, V M

1977-01-01

3

Day hospital care  

Microsoft Academic Search

Over the past 50 years, day hospitals have emerged and developed in Western psychiatric services in the process of deinstitutionalization. There is now great diversity in the aims and uses of services that fit under the umbrella term of ‘day hospital care’. The research literature has identified four models of day hospitals, varying from acute or crisis services as an

Jane Briscoe; Stefan Priebe

2007-01-01

4

Study on an Innovation in Military Psychiatry: Application of the Concepts of Combat Psychiatry to the Fort Hood Psychiatric Day Hospital.  

National Technical Information Service (NTIS)

A psychiatric day hospital was opened with a goal of optimizing the treatment of soldiers by applying the principles of combat psychiatry. This is the first time a psychiatric day hospital has been operational at Fort Hood. The operation of one psychiatri...

T. S. Donough D. D. Zepecki A. E. Norwood

1987-01-01

5

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

6

Day hospital care  

Microsoft Academic Search

Within the context of the deinstitutionalization of psychiatric services across Europe in the last 40 years, day hospitals have emerged as a more flexible treatment model. There is great diversity in the uses and aims of day hospitals, with some functioning as an alternative to acute in-patient care, and others for the rehabilitation and support of patients with chronic needs,

Jane Briscoe; Stefan Priebe

2004-01-01

7

The effect of menstruation on psychiatric hospitalization.  

PubMed

This study evaluated the effect of menstruation on psychiatric hospitalization. We conducted a retrospective chart review of the medical records of 177 women who met the eligibility criteria. Data collected included demographic details, primary and secondary diagnoses, date of last menstrual period (LMP), medication adherence, psychiatric hospitalization length of stay, previous psychiatric admissions (including those related to menstruation), discharge referrals, and readmissions. The majority of women were admitted for major depression, were single, Caucasian, and had a mean age of 34. A disproportionate percentage (37%) of women had their LMP within 5 days of psychiatric hospitalization (p = 0.0006). The overall average length of stay was 4.37 days, and 48.3% had a previous psychiatric admission. Medication adherence was routinely not documented (77.4%). Psychiatric hospitalizations for women are significantly greater within 5 days of their LMP. Nursing education and improved documentation are warranted to decrease the potential for readmission. PMID:22694781

Weston, Jaclyn; Speroni, Karen Gabel; Ellis, Terri; Daniel, Marlon G

2012-07-01

8

[Day Hospital: history and conceptualization].  

PubMed

The appearance of Day Hospitals operated as a model to inspire the different ways of partial time psychiatric care (night hospitals, weekend hospitals, long hour activities in hospitalization services or general hospitals, etc.) and came to complement or replace complete hospitalization in classic psychiatric hospitals. This article presents the history and origins of Day Hospitals and their initial propagation in different countries, and especially in Argentina. Social and political conditions that set their emergence as a therapeutic resource in psychiatry, their models of functioning and variants of application according to the diagnoses of patients admitted, age groups, etc., the theories put into play to report their effects, several studies and technical results, and ideological views related to mental disorders and their treatment in the society are also being studied. PMID:23139920

Stagnaro, Juan C

2012-01-01

9

[The future of psychiatric hospitals].  

PubMed

We are of the opinion that it is less important whether a large mental hospital is regionalized or not, but whether it is possible to realize the principle of universal psychiatric protection as a "unity of responsibilities of all subjects who take part in the protection of mental health and the society in the whole" by improvement and advancement of the existing system. We accept the opinion that the internal organization of mental hospitals has to be changed by organizing hospitals wards with 30-50 beds. We consider that in a perspective organization of psychiatric protection of all institutions (large hospitals, clinic, psychiatric wards of general hospitals, dispensaries and health centers) have their role and that the achieved level of the protection greatly depends on socio-economic level and possibilities. PMID:8692079

Beslin, M; Mihajlovski, L

1996-01-01

10

Psychiatric Hospitalization and Academic Performance  

ERIC Educational Resources Information Center

Studies of college students hospitalized for psychiatric disturbances revealed that diagnosis did not significantly affect academic performance, nor did leave of absence following hospitalization ensure better re-entry adjustment. It is recommended that students be evaluated individually and be allowed to re-enter as soon as the acute illness…

Ganz, Varda Peller; Pao, Jane

1978-01-01

11

A CBT Approach to Inpatient Psychiatric Hospitalization  

ERIC Educational Resources Information Center

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

Masters, Kim J.

2005-01-01

12

Antidepressant adherence after psychiatric hospitalization  

PubMed Central

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

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

2010-01-01

13

Inpatient Suicide in a Chinese Psychiatric Hospital  

ERIC Educational Resources Information Center

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

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

2008-01-01

14

The closure of a major psychiatric hospital  

Microsoft Academic Search

A political decision to decentralize psychiatric care in a county in Sweden was arrived at in October 1984. This will lead to the closure of the only large psychiatric hospital in the area, which will be replaced by three smaller units. The long-term care in the hospital will cease completely and be replaced by district-based psychiatric services. All patients in

Karina Dencker; C.-G. Gottfries

1991-01-01

15

Psychiatric emergencies in a tertiary care hospital.  

PubMed

People with psychiatric problems often visit a general hospital. Many of them require emergency service. B P Koirala Institute of Health Sciences (BPKIHS) is one of the few health institutes in Nepal providing comprehensive 24-hour psychiatric emergency service. This study aims to document the pattern of psychiatric emergencies in a tertiary care hospital of Eastern Nepal. All psychiatric emergencies referred from different departments in 30 random days during a six-month period were enrolled. This is a descriptive study with convenience sampling method where the diagnoses were made based on the'International Classification of Disease and Infirmity' (ICD-10). One hundred twenty-nine cases were referred in the study period. The M:F ratio was 1.3:1. The service users were predominantly young adults. The majority of cases were seen in the emergency department and medical ward. The most common causes for the consultation were behavioral problems (39%), altered consciousness (32%) and somatic complaints (17%). Approximately 83% received the diagnosis of Category F of the ICD-10. Mental and behavioral disorder due to substance use (F10-19) was the most common disorder (30%), followed by mood/affective disorders (23%) and neurotic, stress-related anxiety disorders (16%). Roughly 46% had co-morbid physical illnesses and 8% received only a physical diagnosis. About 20% had attempted suicide using different means, poisoning being the most common. Emergency psychiatric consultation for mental problems is sought by almost all departments of a general hospital. These consultations are most commonly sought for substance use, mood or anxiety disorders. PMID:18552889

Shakya, D R; Shyangwa, P M; Shakya, R

2008-01-01

16

The Emergency Evacuation of a Psychiatric Hospital  

Microsoft Academic Search

As a result of imminent flood conditions expected from a hurricane, South Beach Psychiatric Center implemented emergency procedures and evacuated 200 psychiatric inpatients to a state developmental center five miles away. Following the evacuation, it was decided that a study of the experience would provide valuable management information regarding staff and patient behavior and hospital emergency procedures. The study, based

Lawrence Sporty; Linda Breslin; Patricia Lizza

1979-01-01

17

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

Code of Federal Regulations, 2013 CFR

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

2013-10-01

18

Understanding those who seek frequent psychiatric hospitalizations  

Microsoft Academic Search

In the period after deinstitutionalization, there has been a rise in hospital readmission rates. It is estimated that the readmission rate for individuals who are frequent users of psychiatric inpatient services is approximately 40% to 50% within 1 year of hospital discharge. Attempts to determine predictors of recidivism have identified multiple variables, some of which are mutually contradictory. Furthermore, comparison

Phyllis Montgomery; Helen Kirkpatrick

2002-01-01

19

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

PubMed

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

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

1991-06-01

20

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

21

Nurses as psychiatric consultants in a general hospital emergency room  

Microsoft Academic Search

Psychiatric nurses' experience in milieu therapy, home treatment, community aftercare, and psychotherapy can be the basis for new roles in mental health. This study used psychiatric nurses as consultants to general physicians in a general hospital emergency room. Psychiatric nurses successfully managed 66% of the psychiatric referrals in the emergency room and required only telephone consultation in a majority of

Nelda K. Severin; Robert E. Becker

1974-01-01

22

[Patterns of psychiatric follow-up care outside the psychiatric hospital (author's transl)].  

PubMed

This study was devoted to collecting information from 57 psychiatric hospitals in the Federal Republic of Germany with regard to the quality of the care afforded to chronic psychiatric patients. The study took place during 1977/1978, and concerned the therapeutic and general quality of transitional hostels, homes for long-term follow-up care, and homes for the aged and multiple-handicapped patients. At the same time, the present-day effectivity of sociolegal rehabilitation aid measures was compared with the results of corresponding opinions polls conducted in 1973/1974. The following conclusions were drawn: 1. "Non-clinical" mental health care of chronic psychiatric patients (mentally handicapped persons) requires specific pedagogico-therapeutic programmes specially adapted to the requirements of these patients. These requirements differ considerably from the conventional style of "ward care" which has developed in psychiatric hospitals. Regional fusion or co-operation of these homes is strongly recommended. 2. The effectivity of sociolegal rehabilitation aids for the mentally handicapped continues to be very low. This is partly due to the poor level of training and knowledge of the therapeutic personnel. Hence it is absolutely imperative to arrange for knowledge of this admittedly rather dry sociolegal subject matter, by means of suitable training and instruction. PMID:6255503

Kitzig, P

1980-11-01

23

Cost effectiveness of day and inpatient psychiatric treatment: results of a randomised controlled trial.  

PubMed Central

OBJECTIVE: To compare direct and indirect costs of day and inpatient treatment of acute psychiatric illness. DESIGN: Randomised controlled trial with outcome and costs assessed over 12 months after the date of admission. SETTING: Teaching hospital in an inner city area. SUBJECTS: 179 patients with acute psychiatric illness referred for admission who were suitable for random allocation to day hospital or inpatient treatment. 77 (43%) patients had schizophrenia. INTERVENTIONS: Routine inpatient or day hospital treatment. MAIN OUTCOME MEASURES: Direct and indirect costs over 12 months, clinical symptoms, social functioning, and burden on relatives over the follow up period. RESULTS: Clinical and social outcomes were similar at 12 months, except that inpatients improved significantly faster than day patients and burden on relatives was significantly less in the day hospital group at one year. Median direct costs to the hospital were 1923 pounds (95% confidence interval 750 pounds to 3174 pounds) per patient less for day hospital treatment than inpatient treatment. Indirect costs were greater for day patients; when these were included, overall day hospital treatment was 2165 pounds cheaper than inpatient treatment (95% confidence interval of median difference 737 pounds to 3593 pounds). Including costs to informants when appropriate meant that day hospital treatment was 1994 pounds per patient cheaper (95% confidence interval 600 pounds to 3543 pounds). CONCLUSIONS: Day patient treatment is cheaper for the 30-40% of potential admissions that can be treated in this way. Carers of day hospital patients may bear additional costs. Carers of all patients with acute psychiatric illness are often themselves severely distressed at the time of admission, but day hospital treatment leads to less burden on carers in the long term.

Creed, F.; Mbaya, P.; Lancashire, S.; Tomenson, B.; Williams, B.; Holme, S.

1997-01-01

24

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

25

Elements of Successful School Reentry after Psychiatric Hospitalization  

ERIC Educational Resources Information Center

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

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

2011-01-01

26

Orientation intervention for parents of adolescents after psychiatric hospitalization.  

PubMed

An orientation class has been devised to address the fears, uncertainties, and vulnerabilities of parents admitting their children to an adolescent psychiatric unit. This orientation class offers support and information to parents of adolescents admitted to Charter Rivers Hospital, a private psychiatric inpatient facility in Columbia, South Carolina, and is held during the first week of the adolescent's hospitalization. PMID:8366492

Walsh, S M

1993-07-01

27

Management of psychiatric problems in a Kenyan mission hospital.  

PubMed Central

Many psychiatric conditions are found in the rural general hospital in Kenya and are recognisable and manageable along standard Western lines. An essential element in management is the training of the nursing staff. The psychiatric patient should be actively managed and can benefit from the unsophisticated treatment possible at the mission hospital.

McEvoy, P J; McEvoy, H F

1976-01-01

28

An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy  

PubMed Central

Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs). Information was focused on diagnosis (DSM-IV), reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS), the Modified Overt Aggression Scale (MOAS) and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30). Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs) completed both admission and discharge visits. A severe psychotic episode with (19.1%) or without (47.7%) aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge) and depression (12.9% at admission and 14.7% at discharge) were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD) total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0%) patients had episodes of aggressiveness at admission and 8 (1.7%) at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%), 686 (94.2%) and 676 (92.9%). The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%), typical anti-psychotics (48.3%, 57.0%, 49.6%), atypical anti-psychotics (35.6%, 41.8%, 39.8%) and antidepressants (40.9%, 48.8%, 43.2%). Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20.6% and 26.6% with two drugs, and 53.2%, 57.8% and 59.0% with > two drugs. Benzodiazepines were the most common drugs both at admission (60.0%) and during hospitalisation (85.7%), and 69.5% were prescribed at discharge. Conclusion patients with psychiatric diseases in acute phase experienced a satisfactory outcome following intensified therapeutic interventions during hospitalisation.

Ballerini, Andrea; Boccalon, Roberto; Boncompagni, Giancarlo; Casacchia, Massimo; Margari, Francesco; Minervini, Lina; Righi, Roberto; Russo, Federico; Salteri, Andrea

2007-01-01

29

Day patient versus in-patient: factors determining selection of acutely ill patients for hospital treatment.  

PubMed

In a prospective study the criteria and characteristics associated with the admission of acutely ill psychiatric patients to in-patient or day hospital care were examined. Over a four-month period, 54 patients were admitted to hospital and 43 to a day hospital. There was significantly more schizophrenics in the hospital. Day hospital patients were significantly younger, had shorter psychiatric histories, were considered less severely ill and had more insight into their illness. Hospital patients had poorer employment histories, and perceived their families as less supportive; admission had more often been requested by them or their families. PMID:6882981

Bowman, E P; Shelley, R K; Sheehy-Skeffington, A; Sinanan, K

1983-06-01

30

Do suicidal ideation and behaviour influence duration of psychiatric hospitalization?  

PubMed

Suicidal ideation and behaviour are sometimes considered to be manipulative, with the intention of escaping from intolerable situations leading to prolonged hospitalization. The present study examined the length of hospitalization of those who had attempted suicide or had suicidal ideation compared to non-suicidal patients, as measured by the Health of the Nation Outcome Scales in two private psychiatric hospitals. Suicidal patients had a significantly shorter length of hospitalization, despite their significantly greater degree of psychiatric morbidity. Results indicated that it is erroneous to preclude inpatient care for those who are suicidal on the assumption that it will promote prolonged hospitalization. PMID:12664452

Smith, David; Fisher, Laura; Goldney, Robert

2002-12-01

31

[Psychiatric Hospital San Juan de Dios. One hundred years later].  

PubMed

Mental health and psychiatric diseases have always attracted people's and health authorities' attention due to its magical approach, the lack of knowledge that surrounds them, and, at the same time, the religious fear they provoke. Both have played an important role in the history of humanity, of public health politics, and of physicians. The places where psychiatric patients were treated are of historical interest, because through the historical knowledge we can identify an approach from the science and the health policies that prevailed in each age. At the beginning of the 20th century, it was developed in México a new model of hospital care attention to psychiatric patients. La Casa de Salud San Juan de Dios para Pacientes Alienados is an example; the concept "alienated patients" suggests a social and cultural perspective. This paper presents a chronological type description of one of the major institutions involved in mental health care in México. Similarly, it shows a review of the events that affected the religious order San Juan de Dios from 1901 to 2012, when the hospitaller order was reinstated in México and established the Casa de Salud San Juan de Dios para Pacientes Alienados in the town of Zapopan, Jalisco, institution that exists up to the present day and keeps participating in the mental health care in the state of Jalisco, with the current name of Servicios de Salud San Juan de Dios. PMID:24878099

Cocula-León, Horacio

2014-01-01

32

Treating adult attention deficit hyperactivity disorder in hospitalized psychiatric patients  

Microsoft Academic Search

ObjectivesWe intend to review the importance of appropriately recognizing and managing attention deficit\\/attention deficit hyperactivity disorder (ADD\\/ADHD) in the acute psychiatric hospital setting.

Ricardo Castaneda; Robert Levy; Charles Hazzi; Stephen Ross; William Roman; Hamada Hamid

2008-01-01

33

Psychiatric Day Treatment Clerkship for Undergraduate Pharmacy Students.  

ERIC Educational Resources Information Center

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

Cardoni, Alex A.; Gunning, Jacqueline

1981-01-01

34

Mortality Among Inpatients of a Psychiatric Hospital: Indian Perspective  

PubMed Central

Objective: The objective of this study is to assess mortality and its correlates among psychiatric inpatients of a tertiary care neuropsychiatric hospital. Given the background that such a study has never been undertaken in India, the findings would have a large bearing on policy making from a mental health-care perspective. Materials and Methods: The medical records of those psychiatric inpatients (n = 333) who died during their stay at the National Institute of Mental Health and Neurosciences in past 26 years (January 1983 to December 2008) constituted the study population. Results: During the 26 years, there were a total of 103,252 psychiatric in-patient admissions, out of which 333 people died during their inpatient stay. Majority (n = 135, 44.6%) of the mortality was seen in the age group of 21-40 years. Most of the subjects were males (n = 202, 67%), married (n = 172, 56.8%) and from urban areas (n = 191, 63%). About, 54% of the subjects had short inpatient stay (<5 days, median for the sample). In 118 (39%) of the subjects, there was a history of physical illness. Leading cause of death were cardiovascular system disorders (n = 132, 43.6%), followed by respiratory system disorders (n = 45, 14.9%), nervous system disorders (n = 30, 9.9%) and infections (n = 31, 10.1%). In 21 (7%), cause of death was suicide. Conclusions: Identifying the factors associated with the death of inpatients is of utmost importance in assessing the care in a neuropsychiatric hospital and in formulating better treatment plan and policy in mental health. The discussion focuses on the analysis of different factors associated with inpatient mortality.

Shinde, Shireesh Shatwaji; Nagarajaiah; Narayanaswamy, Janardhanan C.; Viswanath, Biju; Kumar, Naveen C.; Gangadhar, B. N.; Math, Suresh Bada

2014-01-01

35

[Organic morbidity of a hospitalized psychiatric population].  

PubMed

In order to determine organic morbidity in psychiatry, 140 psychiatric inpatients (aged between 20 and 49) were examined. After various investigations (physical, biological, chest film, EEG, ECG), it was concluded that 52% of the patients suffer from at least one physical disease, and 23% suffer from more than one. The most frequent diseases are digestive (hepatic), respiratory and cardiovascular. The relationship between opiate addiction and stomatological, urogenital and dermatological diseases, and between alcoholism and liver diseases seems clear. It would appear that a medical approach adapted to psychiatric patients is necessary in order better to diagnose these physical diseases, and to reduce psychiatric overmorbidity, which might lead to a decrease in psychiatric excess mortality. PMID:1659088

Dan, B; Grégoire, F; Verbanck, P; Corten, P; Pelc, I

1991-01-01

36

PSYCHIATRIC SERVICES IN GENERAL HOSPITALS--A Report of the Northern California Psychiatric Society's Committee on the Need for Psychiatric Services in General Hospitals  

PubMed Central

A study made by a special committee appointed for the purpose by the Northern California Psychiatric Society found that a real need exists for local psychiatric services in general hospitals of the Northern California area. Such services can be provided readily—and in some communities are already available. A broad segment of the population looks to the general hospital to provide diagnosis and care and so enable the patient's prompt recovery from psychiatric disorders. The study further emphasizes the importance of such factors as a competent psychiatric chief, adequate staff and personnel and good planning in organizing inpatient and outpatient facilities and integrating treatment so that all the functions of the hospital are available to psychiatric patients. Granted these special considerations, the services can be provided more easily than many physicians, including some psychiatrists and administrators, suppose.

Juul, Clement O.

1957-01-01

37

A reduction in repeat falls in a private psychiatric hospital.  

PubMed

Falls are of particular concern in psychiatric hospitals where many patients are taking psychotropic medication that may produce postural hypotension. The research considered falls in a private psychiatric hospital before and after the introduction of a hospital policy to measure blood pressure, both lying and standing, after a patient had fallen. Falls, and the injuries associated with them, occurred predominantly among elderly patients. The results of the study showed that the introduction of the policy resulted in more frequent measurement of blood pressure and was associated with fewer repeat falls. PMID:9807268

Murdock, C; Goldney, R; Fisher, L; Kent, P; Walmsley, S

1998-09-01

38

Geriatric day hospital: who improves the most?  

PubMed

This study compared the changes in some bio-psychosocial variables (functional independence, nutritional risk, pain, balance and walking, grip strength, general well-being, psychiatric profile, perception of social support, leisure satisfaction, and caregivers' feeling of burden) in four categories of clients during their program at a geriatric day hospital (GDH). The study also evaluated whether or not improvements, if any, were maintained 3 months after discharge. One-hundred-and-fifty-one people, categorized by primary reason for admission, were assessed at the GDH with reliable and valid tools, at admission and at discharge. Three months after discharge, they were reassessed with the same tools. Overall, two categories of clients, stroke / neurological diseases and musculoskeletal disorders / amputations, improved the most. For the gait disorders and falls group, only the functional independence score improved, but not at a clinically significant level. Finally, clients in the cognitive function disorders / psychopathologies group improved the most on their well-being scores and caregivers' burden decreased the most. All gains were maintained up to 3 months after discharge, except for leisure satisfaction. With the exception of clients who attended the GDH because of gait disorders and falls, the improvements and maintenance achieved in each category occurred in the domains where improvement had been hoped for, because of the particular disabilities in question and because of the nature of the GDH services offered. PMID:15660296

Desrosiers, Johanne; Hébert, Réjean; Payette, Hélène; Roy, Pierre-Michel; Tousignant, Michel; Côté, Sylvie; Trottier, Lise

2004-01-01

39

Coping Strategies of Hospitalized People with Psychiatric Disabilities in Taiwan  

Microsoft Academic Search

Research has found that people with psychiatric disabilities Taiwan tended to utilize passive and emotional-focused strategies\\u000a to cope with their illness unlike Western studies. A self-reported questionnaire that incorporated categories: socio-demographic\\u000a characteristics, the self-impact of illness, illness adaptation, and coping strategy scale was administrated to 140 persons\\u000a with psychiatric disabilities routinely hospitalized over a long period of time to explore

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

2010-01-01

40

High tuberculosis prevalence in a psychiatric hospital in Vietnam.  

PubMed

Little is known about tuberculosis (TB) prevalence in psychiatric hospitals in Vietnam, but prevalence may be higher than in the general population. We assessed the TB prevalence among in-patients of a psychiatric hospital in 2005 in Danang City, Vietnam. Of 300 in-patients, 70 had an abnormal X-ray or prolonged cough, and underwent sputum smear examinations. The prevalence of smear-positive TB was 0.33% (1/300, 95%CI 0.008-1.9). Twenty-three (7.7%) patients had X-ray lesions suggesting active TB and 22 (7.3%) had a history of TB treatment. TB prevalence was high in this psychiatric hospital, and TB infection control needs strengthening. PMID:18492338

Van Duc, L; Vree, M; Cobelens, F G; Phuc, L T; Sy, D N

2008-06-01

41

Intestinal parasites may not cause nosocomial infections in psychiatric hospitals.  

PubMed

This study was conducted to determine whether nosocomial infections of intestinal parasites occur in psychiatric hospitals. Three fecal specimens were collected from each institutionalized patient in seven psychiatric hospitals of north Taiwan. Saline wet mounts were prepared to examine trophozoites, and the other parasite stages were detected using the formalin-ethyl acetate sedimentation technique. Hospital faculties were asked to complete a questionnaire on the demographic data, health status degree of disability, and recent occurrence of gastrointestinal distress of these patients. Of the 464 patients examined, 8.4% were found to be infected with one or more intestinal parasite species: 6.3% single infections, 1.5% double infections, and 0.6% triple infections. Significantly higher prevalences were found among the males, unmarried patients, those with lower education, institutionalized for more than 3 years, sent by social workers to the hospitals, with non-schizophrenic diseases, and with a higher degree of disability. However, only education, marriage, mode of hospitalization, and type of psychiatric disease were found to be significant determinants in a logistic regression model. The variation in prevalence related to demographic factors implies that nosocomial infections may not occur. The mode of hospitalization indicates that the patients may acquire the infections before hospitalization. PMID:15719259

Cheng, Huey-Shinn; Wang, Lian-Chen

2005-03-01

42

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

43

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

Microsoft Academic Search

BACKGROUND: Patients admitted to a psychiatric hospital with suicidal behavior (SB) are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of

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

2010-01-01

44

Patient satisfaction with in-hospital psychiatric care  

Microsoft Academic Search

Summary Patient satisfaction with in-hospital psychiatric care in a community-oriented care organization was studied by means of a questionnaire mailed to a 1-year population of hospitalized patients. The response rate was 43.5%. The results showed that the level of patient satisfaction was high in some areas and low in others. It was higher with regard to staff-patient relationships, treatment programs

Lars Hansson

1989-01-01

45

Antidepressant adherence after psychiatric hospitalization among VA patients with depression.  

PubMed

Depressed patients discharged from psychiatric hospitalizations face increased risks for adverse outcomes including suicide, yet antidepressant adherence rates during this high-risk period are unknown. Using Veterans Affairs (VA) data, we assessed antidepressant adherence and predictors of poor adherence among depressed veterans following psychiatric hospitalization. We identified VA patients nationwide with depressive disorders who had a psychiatric hospitalization between April 1, 1999 and September 30, 2003, received antidepressant medication, and had an outpatient appointment following discharge. We calculated medication possession ratios (MPRs), a measure of medication adherence, within 3 and 6 months following discharge. We assessed patient factors associated with having lower levels of adherence (MPRs < 0.8) after discharge. The criteria for 3- and 6-month MPRs were met by 20,931 and 23,182 patients respectively. The mean 3 month MPR was 0.79 (SD = 0.37). The mean 6 month MPR was 0.66 (SD = 0.40). Patients with poorer adherence were male, younger, non-white, and had a substance abuse disorder, but were less likely to have PTSD or other anxiety disorders. Poor antidepressant adherence is common among depressed patients after psychiatric hospitalization. Efforts to improve adherence at this time may be critical in improving the outcomes of these high-risk patients. PMID:19609666

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

2009-11-01

46

Therapeutic alliance in forensic psychiatric hospitals: An empirical study  

Microsoft Academic Search

This paper presents the first results of an application of empirical research methods of psychotherapy in forensic psychiatric hospitals in Germany. Data were collected in a study on therapeutic alliance conducted in four forensic facilities in Bavaria, Baden-Württemberg and Hesse in the summer of 1994, comprising 137 patients and their therapists. Quality of therapeutic alliance was rated by therapists and

Martin Krupinski; Claudia Schöchlin; Alfred Fischer; Norbert Nedopil

1997-01-01

47

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

48

Adolescent Discharge Against Medical Advice from a Psychiatric Hospital  

Microsoft Academic Search

This retrospective study examined factors which may help predict an adolescent patient being discharged against medical advice (AMA) from a psychiatric hospital. There were 187 patient's records studied over a three year period with 26 patients found to have been discharged AMA. When compared to controls, factors found to be significant in helping to predict adolescent discharge AMA included a

Mark Siegel; Clint A. Norris; Suzana F. Escobar

1994-01-01

49

Risk factors associated with psychiatric hospitalization among Iranian schizophrenic patients.  

PubMed

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

50

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.

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

2013-01-01

51

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

Microsoft Academic Search

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

Manuela Etter; Jean-François Etter

2007-01-01

52

Examining Outcomes of Acute Psychiatric Hospitalization among Children  

PubMed Central

Within the past two decades, few studies have examined outcomes of acute psychiatric hospitalization among children, demonstrating change in emotional and behavioral functioning. A secondary analysis of pre-test/post-test data collected on 36 children was conducted, using the Target Symptom Rating (TSR). The TSR is a 13-item measure with two subscales – Emotional Problems and Behavioral Problems and was designed for evaluation of outcome among children and adolescents in acute inpatient psychiatric settings. Results of this study, its limitations, and the barriers encountered in the implementation of the TSR scale as part of routine clinical practice are discussed.

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

2013-01-01

53

[Treatment courses and therapeutic effectiveness of a psychogeriatric day hospital].  

PubMed

Since 1976, 37 psychogeriatric day hospitals have been set up in Germany. As only few empirical studies on the effectiveness of this day hospital system are available even 25 years on, the treatment course of 58 patients attending the psychogeriatric day hospital run by the Department of Psychiatry, University of Tübingen was evaluated. The course analysis was based on a series of tests comprising the following questionnaires: Social Situation Scale, Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Munich Quality of Life Dimension List (MLDL), Mini Mental Status (MMS), Hamilton Depression Scale, and Cumulative Illness Rating Scale (CIRS). Women accounted for three-quarters of the sample, and men for one-quarter. The average age was 72 years. The fact that only 16% of the patients had been transferred from psychiatric hospitals and that more than half had been referred directly by their local doctors underlines the acute-psychiatric nature of the institution. More than 80% of the patients were discharged to their previous place of residence. A highly significant improvement in affective state was verified by the Hamilton Depression Scale. Significant improvements were also registered in the following items: general satisfaction with life, state of health, physical and mental performance, and scope for personal development. The quality of life, measured with the Munich Quality of Life Dimension List (MLDL), improved in nine of the nineteen items covered, with correction of the significance level alpha taken into account. The treatment outcomes confirmed the therapeutic effectiveness of this type of psychogeriatric institution from aspects of acute psychiatry too and should encourage the continued expansion of partial hospitalization facilities for the elderly. PMID:11253561

Wormstall, H; Morawetz, C; Adler, G; Schmidt, W; Günthner, A

2001-02-01

54

Discharges of Patients from Public Psychiatric Hospitals in Italy between 1994 and 2000  

Microsoft Academic Search

Background: Psychiatric hospitals in Italy had to be closed under a law dated 1994.Aims: To investigate the discharge of patients from public psychiatric hospitals.Methods: A total of 4492 patients from 22 psychiatric hospitals were described at recruitment and followed during the period 1994-2000. Their characteristics were investigated as determinants of discharge to community residential facilities for psychiatric patients versus other

Barbara DAvanzo; Angelo Barbato; Corrado Barbui; R. Nadia Battino; Graziella Civenti; Lucilla Frattura

2003-01-01

55

Suffering related to dignity among patients at a psychiatric hospital.  

PubMed

This article discusses dignity from a Q-methodological study among patients at a psychiatric hospital. The aim of this study is to gain a deeper understanding of the subjective experiences of patients in a psychiatric hospital with respect to dignity. A Q-sample of 51 statements was developed. A total of 15 participants ranked these statements from those they most agreed with to those they most disagreed with. Post-interviews were also conducted. Principal Component Factor Analysis and varimax rotation followed by hand rotation produced the clearest results. Four different viewpoints emerged: being met as equal human being, experience of dignity despite suffering, suffering due to inferior feelings and suffering and fighting for one's own dignity. There seem to be variations in those with dignity-promoting experiences in Viewpoint 1 and to some extent in Viewpoint 2, to those with dignity-inhibiting experiences in Viewpoints 3 and 4. PMID:24046222

Skorpen, Frode; Thorsen, Arlene A; Forsberg, Christina; Rehnsfeldt, Arne W

2014-03-01

56

[Intervention possibilities in the geronto-psychiatric department of a psychiatric hospital].  

PubMed

There are three possibilities of intervention for the gerontological departments of the great hospitals of mental health. While as a first step the medical and psychiatric first aid is given in the admission departments, special departments for rehabilitation and daycare offer as well programs for social training, such as cooking, shopping, traffic lessons, contact to offices etc., which accelerate the resocialisation of mentally handicapped old people. From the participation of the patient in a list of activities we gain hints to the possible result of rehabilitation. Ambulance and visits of a psychiatric consultant in the institutions of the local care for the aged complete the therapy program in the part of prevention and after treatment. PMID:532255

Kretschmar, J H

1979-01-01

57

[Psychiatric hospitalization for mental illness: past, present and future].  

PubMed

The use of psychiatric hospitalization for mental illness has evolved through Modernity. In the last century, indefinite and involuntary committal was a widespread practice but has now become an extraordinary and short-term therapeutic recourse. Even though law experts, doctors and other mental health professionals agree on the benefits of this shift, in practice there are disagreements rooted in the shortcomings of health service providers. The current medical and legal criteria for hospitalization of patients with mental disorders should move away from the concept of endangerment and embrace therapeutic procedures and social care. New contemporary challenges, such as drugs and violence, require the implementation of a social strategy that is more comprehensive than medical treatment. This article presents a series of case studies describing the circumstances that led to the hospitalization of mental health patients, mostly in the city of Buenos Aires. PMID:22091456

Martínez Ferretti, José María

2011-01-01

58

Relationship between psychiatric nurse work environments and nurse burnout in acute care general hospitals.  

PubMed

Following deinstitutionalization, inpatient psychiatric services moved from state institutions to general hospitals. Despite the magnitude of these changes, evaluations of the quality of inpatient care environments in general hospitals are limited. This study examined the extent to which organizational factors of the inpatient psychiatric environments are associated with psychiatric nurse burnout. Organizational factors were measured by an instrument endorsed by the National Quality Forum. Robust clustered regression analysis was used to examine the relationship between organizational factors in 67 hospitals and levels of burnout for 353 psychiatric nurses. Lower levels of psychiatric nurse burnout was significantly associated with inpatient environments that had better overall quality work environments, more effective managers, strong nurse-physician relationships, and higher psychiatric nurse-to-patient staffing ratios. These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses' capacity to sustain safe and effective patient care environments. PMID:20144031

Hanrahan, Nancy P; Aiken, Linda H; McClaine, Lakeetra; Hanlon, Alexandra L

2010-03-01

59

Relationship between Psychiatric Nurse Work Environments and Nurse Burnout in Acute Care General Hospitals  

PubMed Central

Following deinstitutionalization, inpatient psychiatric services moved from state institutions to general hospitals. Despite the magnitude of these changes, evaluations of the quality of inpatient care environments in general hospitals are limited. This study examined the extent to which organizational factors of the inpatient psychiatric environments are associated with psychiatric nurse burnout. Organizational factors were measured by an instrument endorsed by the National Quality Forum. Robust clustered regression analysis was used to examine the relationship between organizational factors in 67 hospitals and levels of burnout for 353 psychiatric nurses. Lower levels of psychiatric nurse burnout was significantly associated with inpatient environments that had better overall quality work environments, more effective managers, strong nurse-physician relationships, and higher psychiatric nurse-to-patient staffing ratios. These results suggest that adjustments in organizational management of inpatient psychiatric environments could have a positive effect on psychiatric nurses’ capacity to sustain safe and effective patient care environments.

Hanrahan, Nancy P.; Aiken, Linda H.; McClaine, Lakeetra; Hanlon, Alexandra L

2010-01-01

60

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

PubMed Central

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

2010-01-01

61

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

62

Basava Day Clinic  

Microsoft Academic Search

Psychiatric day hospitalization is an evolving and innovative alternative to inpatient psychiatric hospitalization. While the deinstitutionalization of some psychiatric patients is therapeutically and financially advantageous, treatment or rehabilitation programs have not effectively kept pace. Many acute and chronic patients do not require in-hospital supervision, but they do require intensive interdisciplinary care. The Basava Day Clinic in Richmind, Virginia, was developed

Rebecca L. Gusich; A. Lynne Silverman

1991-01-01

63

Utilization of local jails and general hospitals by state psychiatric center patients  

Microsoft Academic Search

The idea that the deinstitutionalization of state psychiatric centers has resulted in increased utilization of general hospitals and correctional facilities by people with severe and persistent mental illness is widely held. This hypothesis of transinstitutionalization was tested by examining hospitalization and incarceration rates of people who had been or would be institutionalized in state psychiatric centers in 16 upstate New

Steven M. Banks; James L. Stone; John A. Pandiani; Judith F. Cox; Pamela C. Morschauser

2000-01-01

64

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

ERIC Educational Resources Information Center

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

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

2010-01-01

65

Behavioral Assessment, Analysis, and Support in a Psychiatric Partial Hospitalization Program for Adults with Developmental Disabilities  

Microsoft Academic Search

This article describes the objectives and operations of a behavioral psychology service within a partial hospitalization program for adults with psychiatric disorders and developmental disabilities. Partial hospitalization programs are an effective model of psychiatric service delivery but are not common for patients with mental retardation\\/mental illness. Phases of intake behavioral assessment, treatment planning and implementation, and discharge are described with

James K. Luiselli; Kathleen Lisowski; Robin Weiss

1998-01-01

66

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.

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

2011-01-01

67

Characteristics of Psychiatric Visits to the Emergency Department of Rasoul-e-Akram Hospital, Tehran, Iran  

PubMed Central

Background: More psychiatric visits, especially non-emergency ones, to emergency departments (EDs) of general hospitals have been observed in recent years. The aim of this study was to determine the characteristics of psychiatric visits to the ED of Rasoul-e-Akram Hospital, Tehran, Iran. Methods: In this cross-sectional study, during a two-month period, all psychiatric presentations and consultations to the ED of the studied hospital were included. The required data were gathered by psychiatry chief residents and were documented in pre-designed checklists. Results: About 0.01% of all patients presenting to the ED needed the psychiatric visits. Men consisted 50% of the total patients with mean (±SD) age of 36.41 (±14.7) years. About 51% of them had the indication of the emergency psychiatric visit while 47% had the indication of hospitalization in the psychiatric ward. Non-emergency visits were not related to demographic characteristic, previous psychiatric disorders, substance abuse and physical diseases Conclusions: Non-emergency visits take a high percentage of psychiatric visits in ED and regarding limited sources for psychiatric emergencies and Long visiting time, this percentage can hinder the process of giving services to real emergency psychiatric patients.

Ghanbari Jolfaei, Atefeh; Nasr Isfahani, Mehdi; Shoyookhi, Fatemeh

2012-01-01

68

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

PubMed Central

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

2013-01-01

69

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

PubMed Central

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

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

2007-01-01

70

Use of Short-term General Hospitals by Patients with Psychiatric Diagnoses. Hospital Cost and Utilization Project Research Note 8.  

National Technical Information Service (NTIS)

The report describes the case mix and hospital experience of patients with psychiatric diagnoses in a national sample of community hospitals. It is based on 1977 American Hospital Association Survey data for a national sample of 327 short-term general, no...

J. Wallen

1985-01-01

71

[Data on the status of the organizational structures of hospital hygiene in Germany. II--Rehabilitation clinics, psychiatric hospitals].  

PubMed

The results of an inquiry about the personnel and organisation of the hospital hygiene in 657 German rehabilitation centres and psychiatric hospitals demonstrate that 24% of these hospitals have a hospital epidemiologist, 44% have infection control nurses and 74% infection control physicians. Infection control committees are present in 64% of these hospitals. 78% of the hospitals use the guideline of the Federal Public Health Office "On the Identification, Prevention and Control of Hospital Infections" as a basis for all decisions on hospital hygiene. PMID:8358188

Zastrow, K D; Schöneberg, I

1993-06-01

72

Hospital admissions for self harm after discharge from psychiatric inpatient care: cohort study  

Microsoft Academic Search

Objective To determine the risk of non-fatal self harm in the 12 months after discharge from psychiatric inpatient care.Design Cohort study based on national hospital episode statistics.Setting England.Population Patients aged 16-64 years discharged from psychiatric inpatient care between 1 April 2004 and 31 March 2005 and followed up for one year.Results 75 401 people were discharged from psychiatric inpatient care

David Gunnell; Keith Hawton; Davidson Ho; Jonathan Evans; Susan O’Connor; John Potokar; Jenny Donovan; Nav Kapur

2008-01-01

73

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

74

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

75

The Impact of Deinstitutionalization of Psychiatric Hospitals on Psychological Distress of the Community in Canada  

Microsoft Academic Search

Objective. There has been a plethora of studies that evaluate the impact of deinstitutionalization of psychiatric services, but they have not examined whether this policy has had an impact on the broader community. The present study addresses this gap by evaluating the impact of the deinstitutionalization of psychiatric hospitals on the mental health of the general population in Canada.MethodThis research

Patricia Sealy; Paul C. Whitehead

2006-01-01

76

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

ERIC Educational Resources Information Center

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

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

2004-01-01

77

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

Microsoft Academic Search

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

Franciska A Desplenter; Gert M Laekeman; Steven R Simoens

2009-01-01

78

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

Microsoft Academic Search

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

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

79

The Role of Psychiatric Emergency Services in Aiding Community Alternatives to Hospitalization in an Inner-City Population  

PubMed Central

In the proper political/economic environment, Crisis Intervention Programs can reduce the recidivism rate of patients who suffer from recurrent intermittent acute psychotic episodes. The author seeks to outline such a program and demonstrate its effectiveness in providing an alternative to brief hospitalization. It is believed that this form of management of the psychiatric emergency aids the practice of community psychiatry and supports the use of day treatment facilities, outpatient clinics, emergency housing, family therapy, and other community support systems.

Bell, Carl C.

1978-01-01

80

Rehabilitation of Stroke Patients In A Day Hospital  

PubMed Central

A comprehensive rehabilitation program for stroke patients strives to rectify deficits in communication, cognition, sensation and motor function. Day hospitals can provide diagnostic and remedial therapy services daily or for several hours a week. At the same time, patients can live at home, maintaining their place in the family and community. Day hospitals can also benefit patients who were not introduced to a rehabilitation program soon after suffering a stroke, and provide intermittent upgrading and maintenance therapy for those with recurrent or remote strokes. The day hospital can help the family physician to assess patients' functional status, and assist with caregiving. The experience of a Toronto day hospital is described.

Hajek, V. E.; McCann, T. J.

1985-01-01

81

Return to the Community of Long Term Hospitalized Psychiatric Patients.  

National Technical Information Service (NTIS)

A 1967-1971 study discovered better adjustment in long-term psychiatric patients when placed in a high expectation halfway house rather than the usual, more limited, low expectation services. The high expectation program provided patient autonomy and stru...

H. R. Lamb V. Goertzel

1971-01-01

82

Through the lens of the hospital magazine: Downshire and Holywell psychiatric hospitals in the 1960s and 1970s.  

PubMed

An exploration of the pages of two psychiatric hospital magazines, Speedwell from Holywell Hospital, Antrim, and The Sketch from Downshire Hospital, Downpatrick, reveals the activity-filled lives of patients and staff during the 1960s and 1970s. This was a time of great change in mental health care. It was also a time of political turbulence in Northern Ireland. With large in-patient populations, both hospitals had a range of occupational and sporting activities available to patients and staff. The magazines formed part of the effort to promote the ethos of a therapeutic community. While hospital magazines may be viewed as one aspect of an institutional system that allowed people to cut themselves off from the wider society, they also provided opportunities for budding writers to express their views on life in a hospital from the service-user perspective. As such, they offer some valuable insights into the lives of psychiatric patients. PMID:24573751

Prior, Pauline; McClelland, Gillian

2013-12-01

83

Impediments to Screening for Hazardous Alcohol Use and Dependence in General Hospital Psychiatric Inpatients  

Microsoft Academic Search

Objective: The Alcohol Use Disorders Identification Test (AUDIT) has been developed to screen for hazardous and harmful alcohol consumption. It has been used among a variety of primary care, general population and general hospital populations. However, with the exception of one study undertaken by the author and colleagues, the use of the AUDIT in general hospital psychiatric patients has not

Gary K. Hulse

2001-01-01

84

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.

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

2013-01-01

85

Hospital staff responses to workplace violence in a psychiatric hospital in Taiwan.  

PubMed

We surveyed 222 nurses, nursing assistants, and clerks at a psychiatric hospital in Taiwan on responses to workplace violence, treatment of violent patients, and reporting behavior. Staff reported 78 incidents of physical violence (PV), 113 of verbal abuse (VA), 35 of bullying/ mobbing (BM), 21 of sexual harassment (SH), and 10 of racial harassment (RH) over the course of one year. Among affected staff, only 31% of those experiencing PV and < 10% of those experiencing other categories of violence completed a formal report. Highest levels of reporting to senior staff were among those affected by SH. Patients who were physically violent were more likely to be injected with medication than patients showing other violent behaviors. More VA-affected staff considered the incident not important enough to report. Other reasons for not reporting the incident were fear of negative consequences, especially for BM, and shame for SH. Reliable systems for responding to and reporting patient violence should be developed. PMID:19496484

Chen, Wen-Ching; Hwu, Hai-Gwo; Wang, Jung-Der

2009-01-01

86

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

Microsoft Academic Search

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

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

2007-01-01

87

Hospital Admission in Adolescents with acute Psychiatric Disorder: How Long should it be?  

Microsoft Academic Search

Objective: To determine the length of stay in hospital for youth with acute psychiatric illness, and the treatment outcome.Methods: Diagnostic and Statistical Manual of Mental Disorders(4th edn;DSM-IV) psychiatric diagnosis, clinical outcome and the length of stay were sys-tematically gathered for admissions over an 18month period at the Christchurch Youth Inpatient Unit (YIU). Clinical outcome data were collected at admission,3 weeks

Harith Swadi; Candace Bobier

2005-01-01

88

Four-year retrospective survey of fire incidents in a psychiatric hospital.  

PubMed

This paper describes a four-year retrospective survey of fire incidents in a psychiatric hospital. The results suggest that there were sufficient similarities between a fire incident and a violent incident for the former to be included in a hospital register of violent incidents. The authors recommend that fire incidents should be studied prospectively, and that hospital fire officers should be an integral part of the multidisciplinary team auditing such incidents. PMID:10113883

Barker, A; Forshaw, D; Moxom, T

1991-01-01

89

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

90

Transfer of care between physician teams does not affect length of stay or symptomatic improvement in hospitalized psychiatric patients.  

PubMed

To determine if the length of stay, discharge against medical advice (AMA) or psychiatric symptom severity differs when patients are treated by a single team of physicians versus transfer to a second team all cases (N=1304) admitted to the high intensity psychiatric unit then transferred to a lower intensity unit of a single hospital over 39 months were reviewed. A modified version of the Psychiatric Symptom Assessment Scale (PSAS) was completed on admission and discharge. Statistical analyses including linear and logistic regressions were performed. We found that the length of stay (mean +/-SD) was 18.7+/-10.9 days for transferred patients (N=871) and 18.3+/- 10.6 days for those cared for by only one team (P=.507). Discharge PSAS scores (11.8+/-9.4 for transferred patients and 14.2+/-10.4 for those who kept their physicians), were not different between groups after adjustment for severity on admission. Discharges against medical advice were not different between the groups (P=.207). Although the previous internal medicine literature and single psychiatric study describe a longer length of stay for those patients transferred between physicians, this study shows no differences in terms of length of stay, severity on discharge or AMA discharge rate. PMID:12676421

Kizer, Danielle; Snowden, Mark; Russo, Joan; Roy-Byrne, Peter

2003-01-01

91

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

PubMed

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

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

2009-02-01

92

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.

Kumar, Aparna; Aiken, Linda H.

2010-01-01

93

A crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome.  

PubMed

Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed. PMID:22805906

Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T

2012-07-01

94

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

95

Psychiatric diagnoses among quitters versus continuing smokers 3 years after their quit day  

PubMed Central

Background People with psychiatric disorders are more likely to smoke and smoke more heavily than the general population, and they suffer disproportionally from smoking-related illnesses. However, little is known about how quitting versus continuing to smoke affects mental health and the likelihood of developing a psychiatric diagnosis. This study used data from a large prospective clinical trial to examine the relations of smoking cessation success with psychiatric diagnoses 1 and 3 years after the target quit day. Methods This study enrolled 1504 smokers (83.9% white; 58.2% female) in a cessation trial that involved the completion of the Composite International Diagnostic Interview to assess psychiatric diagnoses and biochemical confirmation of point-prevalence abstinence at Baseline and Years 1 and 3. Results Regression analyses showed that, after controlling for pre-quit (past-year) diagnoses, participants who were smoking at the Year 3 follow-up were more likely to have developed and maintained a substance use or major depressive disorder by that time than were individuals who were abstinent at Year 3. Conclusions Quitting smoking does not appear to negatively influence mental health in the long-term and may be protective with respect to depression and substance use diagnoses; this should encourage smokers to make quit attempts and encourage clinicians to provide cessation treatment.

Piper, Megan E.; Rodock, Matthew; Cook, Jessica W.; Schlam, Tanya R.; Fiore, Michael C; Baker, Timothy B.

2013-01-01

96

Factors Associated with Readmission of Patients at a University Hospital Psychiatric Ward in Iran  

PubMed Central

Objectives. Readmission has a major role in the reduction of the quality of life and the increase in the years of lost life. The main objectives of this study were to answer to the following research questions. (a) What was the readmission rate? (b) What were the social, demographic, and clinical characteristics of patients admitted to the Psychiatric Emergency Service at Nour University Hospital, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran? (c) What were the effective factors on readmission? Method. This cross-sectional study was conducted on a total number of 3935 patients who were admitted to Isfahan University Hospital Psychiatric Ward in Isfahan, Iran, from 2004 to 2010. Gender, age, marital status, education, self-report history of previous admission, type of psychiatric disorder, substance misuse, suicide, and the length of the current psychiatric disorder were collected from the registered medical files of patients. The data were analysed using the negative binomial regression model. Results. We found that factors such as psychiatric anxiety disorder, bipolar I, bipolar II, psychotic disorder, depression, and self report history of previous admission were statistically significant in the number of readmissions using the negative binomial model. Conclusion. Readmission to the psychiatric ward is mainly predictable by the type of diagnosis and psychosocial supports.

Barekatain, Majid; Maracy, Mohammad Reza; Hassannejad, Razeyeh; Hosseini, Reihane

2013-01-01

97

Analytic and Special Studies Reports; Utilization of Psychiatric Facilities by Children: Current Status, Trends, Implications. Mental Health Statistics, Series B, Number 1.  

ERIC Educational Resources Information Center

Data are presented concerning the total number of children served in psychiatric facilities and the utilization of specific facilities, including outpatient psychiatric clinics, state and county mental hospitals, private mental hospitals, inpatient psychiatric services of general hospitals, psychiatric day-night services, private psychiatric

Rosen, Beatrice M.; And Others

98

Comparison of Hospital Risk-Standardized Mortality Rates using In-hospital and 30-Day Models: Implications for Hospital Profiling  

PubMed Central

Background In-hospital mortality measures, which are widely used to assess hospital quality, are not based on a standardized follow-up period and may systematically favor hospitals with shorter lengths of stay (LOS). Objective To assess the agreement between performance measures of U.S. hospitals using risk-standardized in-hospital and 30-day mortality rates. Design Observational study. Setting U.S. acute care non-federal hospitals with at least 30 admissions for acute myocardial infarction (AMI), heart failure (HF) and pneumonia in 2004–2006. Patients Medicare fee-for-service patients admitted for AMI, HF, and pneumonia from 2004–2006. Measurements The primary outcomes are in-hospital and 30-day risk-standardized mortality rates. Results There were 718,508 AMI admissions to 3,135 hospitals, 1,315,845 HF admissions to 4,209 hospitals, and 1,415,237 pneumonia admissions to 4,498 hospitals. The hospital-level mean patient LOS in days varied across hospitals for each condition, ranging (min-max) for AMI, HF and pneumonia from 2–13, 3–11, and 3–14 days, respectively. The mean risk-standardized mortality rate differences (30-day minus inhospital) were 5.3% (SD=1.3) for AMI, 6.0% (SD=1.3) for HF, and 5.7% (SD=1.4) for pneumonia, with wide distributions across hospitals. Hospital performance classifications differed between in-hospital and 30-day models for 257 hospitals (8.2%) for AMI, 456 (10.8%) for HF, and 662 (14.7%) for pneumonia. Hospital mean LOS was positively correlated with in-hospital RSMR for all three conditions. Limitations Our study uses Medicare claims data for risk adjustment. Conclusions In-hospital mortality measures provide a different assessment of hospital performance than 30-day mortality and are biased in favor of hospitals with shorter LOS.

Drye, Elizabeth; Normand, Sharon-Lise T.; Wang, Yun; Ross, Joseph S.; Schreiner, Geoffrey C.; Han, Lein; Rapp, Michael; Krumholz, Harlan M.

2012-01-01

99

Discharge Outcomes in Seniors Hospitalized for More than 30 Days  

ERIC Educational Resources Information Center

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

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

2005-01-01

100

HIV RELATED ADMISSIONS IN A PSYCHIATRIC HOSPITAL A FIVE YEAR PROFILE  

PubMed Central

Recent reports have indicated an increasing prevalence of HIV infection in the mentally ill. Reports have also emphasised the etiological role of HIV infection in psychiatric illness. The aim of this study was to assess the clinical and risk profile of psychiatric inpatients found seropositive for HIV infection. All psychiatric inpatients from a psychiatric hospital who tested positive for HI V infection over a five year period were assessed. The assessments included a detailed clinical history, psychiatric assessment and risk behaviour evaluation. Of the 2283 psychiatric patients tested, 51 were found to be seropositive. 43 patients were included in the study. 30 (69.7%) had a diagnosis of alcohol dependence, of which, 11 patients had comorbid psychiatnc diagnosis in the form of affective disorders (23%) and psychosis (14%). Personality disorders were seen in 9 patients. In 19% the clinical manifestation was considered to be etiologically related to HIV infection. The predominant risk behaviour was in the form of multiple partner heterosexual contacts. In several patients the risk behaviour had occurred during an episode of mental illness or under the influence of alcohol. The study demonstrates the importance of detecting and describing HIV infection and its manifestation among psychiatric patients.

Chandra, P.S.; Krishna, V.A.S.; Ravi, V.; Desai, A.; Puttaram, S.

1999-01-01

101

Patients refused admission to psychiatric hospitals in the Netherlands  

Microsoft Academic Search

Summary In The Netherlands unforeseen and unwanted effects of the “de jure” policy of the government are outpatient waiting lists and refusal of applications for admission to mental hospitals. A register of applications of six mental hospitals in the northern part of The Netherlands reveals that there are significant differences between admitted and refused patients with regard to juridical status,

O. H. Brook

1990-01-01

102

Psychiatric Hospitalization of Adolescents and Successful Mainstream Reentry.  

ERIC Educational Resources Information Center

Major differences between the recidivist and nonrecidivist patient groups were that, of those who were successful in staying in the mainstream, more returned to school, more had at least one biological parent in the home, fewer had had a significant family member hospitalized, and they had shorter hospitalizations prior to discharge. (Author)

Bloom, Robert B.; Hopewell, Lou Ross

1982-01-01

103

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

104

Preventing Suicidal Behaviour in a General Hospital Psychiatric Service: Priorities for Programming  

Microsoft Academic Search

with suicidal behaviour, 14 articles on the treatment of major psychiatric disorders, 1 article and 1 published abstract on discharge from hospital, and 2 articles on reducing access to means. Conclusions: Based on a review of each category, we make several program and policy recommendations, including regularly updating clinical assessment skills, using guidelines for assessment of patients following a suicide

Paul S Links; Brian Hoffman

2005-01-01

105

Deinstitutionalization meets restructuring: the closure of a psychiatric hospital in New Zealand  

Microsoft Academic Search

This paper examines the impending closure of Tokanui (Psychiatric) Hospital in the Waikato region of New Zealand. We view this event as both a single occurrence in the unfolding narrative of deinstitutionalization and a specific manifestation of restructuring. Following a consideration of the particularities of mental health care deinstitutionalization and health care restructuring in New Zealand and guided by a

Robin A. Kearns

1996-01-01

106

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

107

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

Microsoft Academic Search

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

A. Steven Frankel

1988-01-01

108

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

109

Specific psychiatric morbidity in liver cirrhosis in a Nigerian general hospital setting  

Microsoft Academic Search

The purpose of this investigation was to explore the psychiatric complications of liver cirrhosis in a Nigerian general hospital setting. The mental state of 31 consecutive patients with liver cirrhosis seen in a gastroenterology unit, from July 1996 to August 1998, was assessed using the 30-item General Health Questionnaire (GHQ-30) and Present State Examination (PSE) and compared with those of

Henry S Aghanwa; Dennis Ndububa

2002-01-01

110

Nurses' information retrieval skills in psychiatric hospitals - are the requirements for evidence-based practice fulfilled?  

PubMed

Nursing professionals have long recognized the importance to practice of research and the value of research evidence. Nurses still do not use research findings in practice. The purpose of this paper was to describe nurses' skills in using literature databases and the Internet in psychiatric hospitals and associations of nurses' gender, age, and job position with their information retrieval skills. The study was carried out in 2004 among nursing staff (N=183) on nine acute psychiatric wards in two psychiatric hospitals in Finland (n=180, response rate 98%). The Finnish version of the European Computer Driving Licence test (ECDL) was used as a data collection instrument. The study showed that there were clear deficits in information retrieval skills among nurses working in psychiatric hospitals. Thus, nurses' competence does not support the realization of evidence-based practice in the hospitals. Therefore, it is important to increase nurses' information retrieval skills by tailoring continuing education modules. It would be also advisable to develop centralized systems for the internal dissemination of research findings for the use of nursing staff. PMID:19386551

Koivunen, Marita; Välimäki, Maritta; Hätönen, Heli

2010-01-01

111

Cognitive Predictors of Suicide Risk among Hospitalized Psychiatric Patients: A Prospective Study.  

ERIC Educational Resources Information Center

Examined utility of cognitive variables (pessimism, perceived and actual problem-solving ability, polarized thinking, self-negativity, construct system constriction and differentiation) as predictors of suicide risk among 79 hospitalized psychiatric patients. Results indicated that hopelessness, self-negativity, and poor problem-solving…

Hughes, Steven L.; Neimeyer, Robert A.

1993-01-01

112

Frequency of delayed sleep phase syndrome among hospitalized adolescent psychiatric patients  

Microsoft Academic Search

Previous research seems to indicate that a substantial percentage of patients with delayed sleep phase syndrome (DSPS) also suffer from personality disorders. In the present study, we attempted to ascertain whether, in a population of hospitalized psychiatric patients, we would find a greater frequency of DSPS among patients suffering from personality disorders than among patients suffering from any of the

Y. Dagan; D. Stein; M. Steinbock; I. Yovel; D. Hallis

1998-01-01

113

Relationship between aggression, interpersonal style, and therapeutic alliance during short-term psychiatric hospitalization.  

PubMed

Aggression during psychiatric hospitalization is frequent, problematic, and a major challenge for nurses and mental health services more generally. The strength of the therapeutic alliance between nursing staff and patients has been posited as an important protective factor that can limit the likelihood of aggression. This study examined the relationship between interpersonal style, perceived coercion, and psychiatric symptoms on the therapeutic alliance between patients and staff, and how each, in turn, is related to aggression. Participants in this study were 79 patients admitted to an acute psychiatric hospital. Each participant was interviewed to determine perceived coercion, symptoms of psychiatric illness, interpersonal style, and therapeutic alliance. Incidents of aggression were recorded at discharge through a review of incident forms, file review, and interviews with unit nursing staff. The results showed that a hostile-dominant interpersonal style and symptoms of paranoia predicted poor therapeutic alliance, contributing 14% of the variance in therapeutic alliance scores. A dominant interpersonal style predicted aggression towards staff. Therapeutic alliance, perceived coercion, and symptoms of psychiatric illness did not predict aggression. Implications for engagement in treatment and the prevention of aggression are discussed. PMID:21819511

Cookson, Amy; Daffern, Michael; Foley, Fiona

2012-02-01

114

A comparison of olanzapine and risperidone on the risk of psychiatric hospitalization in the naturalistic treatment of patients with schizophrenia  

Microsoft Academic Search

BACKGROUND: Decreasing hospital admissions is important for improving outcomes for people with schizophrenia and for reducing cost of hospitalization, the largest expenditure in treating this persistent and severe mental illness. This prospective observational study compared olanzapine and risperidone on one-year psychiatric hospitalization rate, duration, and time to hospitalization in the treatment of patients with schizophrenia in usual care. METHODS: We

Haya Ascher-Svanum; Baojin Zhu; Douglas Faries; Frank R Ernst

2004-01-01

115

[Comparison of sexual murderers in forensic psychiatric hospitals and in prison].  

PubMed

Empirical data are lacking that answer the question of how sexual murderers detained in forensic mental hospitals can be differentiated from those sentenced to prison. Psychiatric court reports and national criminal records on sexual murderers detained in a forensic mental hospital (n=45) were compared with those of prisoners (n=89) regarding diagnostic, criminologic, and prognostic characteristics and criminal recidivism rates after detention. Sexual murderers detained in forensic mental hospitals were characterized by higher psychiatric morbidity and slightly higher risk of future sexual and nonsexual violence. They were released from incarceration less often than the prison inmates but did not show higher sexual or nonsexual violence recidivism rates than those from the prison group. PMID:18210041

Ujeyl, M; Habermann, N; Briken, P; Berner, W; Hill, A

2008-05-01

116

The state psychiatric center as an academically affiliated tertiary care hospital.  

PubMed

Conventional wisdom views state psychiatric hospitals as a problem as much as a solution in the fight against mental illness. The legacy of the historic shortcomings of these hospitals--overcrowding, dreary environment, ineffective treatments, understaffing--frames the discussions of their future. The authors argue that a positive, constructive mission and vision for state hospitals is emerging in New York. This vision calls for fewer, smaller, specialized centers redefined as academically affiliated, community based, consumer oriented, tertiary care centers. To transform these centers, a major reengineering is proposed, including centralized treatment, patient and family participation, continuing education for all staff, outcome research, specialization, multi-service campuses, and technology transfer programs. With this transformation, State Psychiatric Centers become partners in efforts to improve the quality of life for people with mental illness throughout society. PMID:7568531

Bopp, J H; Fisher, W A

1995-01-01

117

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

Microsoft Academic Search

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

A. Strebel; M. Stacey; N. Msomi

1999-01-01

118

[Profile of psychiatric emergencies in general hospital wards].  

PubMed

Statistical study, using objective variables, was carried out to draw the profile of psycho-social cases at the emergency unit of Publics hospitals. The study analyses the attitude of the nursing and medical staff. This paper looks the problem throw three parameters: the symptoms, the diagnosis and the final destination. The most important conclusion is: staff seems to see his work with emergencies cases like a shunting problem and not like a beginning of therapeutical work. PMID:6524416

Corten, P; Pelc, I

1984-01-01

119

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

PubMed

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

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

2014-05-01

120

Violent behaviour in a forensic psychiatric hospital in Finland: an analysis of violence incident reports.  

PubMed

The aim of this paper was to explore the frequency and provocation of physically violent incidents in a Finnish forensic psychiatric hospital. Three years (2007-2009) of violent incident reports were analysed retrospectively. The data were analysed by content analysis, and statistically by Poisson regression analysis. During the study period a total of 840 incidents of physical violence occurred. Six main categories were found to describe the provocation of violence where three of these categories seemed to be without a specified reason (61%), and three represented a reaction to something (36%). The risk for violent behaviour was highest for the civil patients (RR = 11.96; CI 95% 9.43-15.18; P < 0.001), compared to criminal patients (RR = 1). The civil patients represented 36.7% of the patients, and in 43.6% of the studied patient days, they caused 89.8% of the reported violence incidents. Patients undergoing a forensic mental examination did not frequently behave aggressively (RR = 1.97; CI 95% 0.91-4.28). These results can be used in the reorganization of health-care practices and the allocation of resources. PMID:23634912

Kuivalainen, S; Vehviläinen-Julkunen, K; Putkonen, A; Louheranta, O; Tiihonen, J

2014-04-01

121

Changing trends in inpatient care for psychiatrically hospitalized youth: 1991-2008.  

PubMed

Research has focused on changes in the psychiatric treatment of youth in outpatient settings, but less is known about trends in inpatient care. This study documents changes in the lengths of stay (LOS), clinical profiles of youth, and medication use within an inpatient setting in Massachusetts between 1991 and 2008. A chart review of 233 medical records of psychiatrically hospitalized youth was conducted at three points in time (1991, 1998, and 2008). Sample includes youth between ages 4 and 18. Clinical data, including LOS, diagnoses and other clinical variables, and number and type of medications prescribed were compared across sample years. Findings indicate a significant decrease in the LOS coupled with a concurrent increase in psychotropic medication use between each successive sample year. The prescription of anti-psychotic medications, in particular, increased significantly. On clinical indices, findings show that there was an increase in the diagnosis of bipolar spectrum disorders and a concurrent decrease in unipolar diagnoses in the 2008 sample. Attention-deficit and developmental disorders showed little change. Trauma-related disorders were significantly less frequently diagnosed in 2008. Children hospitalized in 1998 and 2008 had more prior hospitalizations and presented with greater acuity than those in the 1991 sample. Results highlight important changes that have occurred in child/adolescent inpatient settings over the past two decades. Data suggest that these changes have not resulted in decreased rates of inpatient hospitalization for youth with more severe psychiatric disorders. PMID:22855261

Meagher, Susan M; Rajan, Anjana; Wyshak, Grace; Goldstein, Joel

2013-06-01

122

Emotional reactions to involuntary psychiatric hospitalization and stigma-related stress among people with mental illness.  

PubMed

Compulsory admission to psychiatric inpatient treatment can be experienced as disempowering and stigmatizing by people with serious mental illness. However, quantitative studies of stigma-related emotional and cognitive reactions to involuntary hospitalization and their impact on people with mental illness are scarce. Among 186 individuals with serious mental illness and a history of recent involuntary hospitalization, shame and self-contempt as emotional reactions to involuntary hospitalization, the cognitive appraisal of stigma as a stressor, self-stigma, empowerment as well as quality of life and self-esteem were assessed by self-report. Psychiatric symptoms were rated by the Brief Psychiatric Rating Scale. In multiple linear regressions, more self-stigma was predicted independently by higher levels of shame, self-contempt and stigma stress. A greater sense of empowerment was related to lower levels of stigma stress and self-contempt. These findings remained significant after controlling for psychiatric symptoms, diagnosis, age, gender and the number of lifetime involuntary hospitalizations. Increased self-stigma and reduced empowerment in turn predicted poorer quality of life and reduced self-esteem. The negative effect of emotional reactions and stigma stress on quality of life and self-esteem was largely mediated by increased self-stigma and reduced empowerment. Shame and self-contempt as reactions to involuntary hospitalization as well as stigma stress may lead to self-stigma, reduced empowerment and poor quality of life. Emotional and cognitive reactions to coercion may determine its impact more than the quantity of coercive experiences. Interventions to reduce the negative effects of compulsory admissions should address emotional reactions and stigma as a stressor. PMID:23689838

Rüsch, Nicolas; Müller, Mario; Lay, Barbara; Corrigan, Patrick W; Zahn, Roland; Schönenberger, Thekla; Bleiker, Marco; Lengler, Silke; Blank, Christina; Rössler, Wulf

2014-02-01

123

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

Microsoft Academic Search

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

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

1996-01-01

124

Transfer of care between physician teams does not affect length of stay or symptomatic improvement in hospitalized psychiatric patients  

Microsoft Academic Search

To determine if the length of stay, discharge against medical advice (AMA) or psychiatric symptom severity differs when patients are treated by a single team of physicians versus transfer to a second team all cases (N=1304) admitted to the high intensity psychiatric unit then transferred to a lower intensity unit of a single hospital over 39 months were reviewed. A

Danielle Kizer; Mark Snowden; Joan Russo; Peter Roy-Byrne

2003-01-01

125

Reliability, diagnostic efficiency, and validity of the Millon adolescent clinical inventory: examination of selected scales in psychiatrically hospitalized adolescents  

Microsoft Academic Search

This study examined the internal consistency, diagnostic efficiency, and validity of selected scales of the Millon adolescent clinical inventory (MACI; Millon et al., Manual for the Millon Adolescent Clinical Inventory, National Computer Systems, Minneapolis, MN, 1993). 241 psychiatrically hospitalized adolescents were administered the MACI and a battery of established self-report measures and a multidisciplinary team independently assigned DSM-IV psychiatric diagnoses

Michelle Pinto; Carlos M. Grilo

2004-01-01

126

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

ERIC Educational Resources Information Center

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

Elbaz-Haddad, Merav; Savaya, Riki

2011-01-01

127

A survey of the off-label use of mood stabilizers in a large psychiatric hospital  

Microsoft Academic Search

The term ‘off-label’ prescribing refers to the use of a drug outside the terms of its Marketing Authorization, including prescribing for an unlicensed indication. The aims of the study were to determine the frequency of off-label prescriptions for mood stabilizers (lithium and antiepileptics) among inpatients of a large psychiatric hospital, the nature of the off-label clinical indications in use and

Camilla Haw; Jean Stubbs

2005-01-01

128

A study of patient assault-related injuries in state psychiatric hospitals  

Microsoft Academic Search

We surveyed nurses and mental health workers (MHWs) working in six state psychiatric hospitals to identify factors that predict the risk of patient assault-related injuries to staff. We assessed workers' perceptions of ward performance, ward safety climate, and recall of patient assault-related injuries over a one-year period. Fifteen percent of participants experienced a major to severe patient assault. The results

Karen S Calabro

2007-01-01

129

Psychiatric Patients' Competency to Collude With Hospital Police in “Sting” Operations: A Case Report and Practice Implications  

Microsoft Academic Search

This article describes the case of a hospitalized psychiatric patient who colluded with hospital police in a “sting” operation designed to catch a hospital employee selling drugs. The patient had failed a drug test and was told that he could avoid criminal charges by cooperating in the “sting.” We argue that the patient was asked to enter into a contract

Marcus T. Boccaccini; Patricia A. Zapf; Stanley L. Brodsky

2002-01-01

130

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

PubMed

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

Sørlie, Tore; Nergård, Jens-Ivar

2005-06-01

131

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

PubMed Central

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

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

2007-01-01

132

Respiratory day hospital: a novel approach to acute respiratory care  

PubMed Central

IN 1996 WE ESTABLISHED A DAY HOSPITAL DEDICATED to acute respiratory care, as an alternative to emergency department and inpatient treatment. The unit is staffed by respirologists, family physicians and specialized nurses; patients have access to all standard inpatient treatments and services. Between 1996/97 and 1998/99 the annual number of admissions to the day hospital increased from 658 to 922. By 1998/99 more than 75% of patients were referred for acute treatment, with a mean stay of 2.3 days. The most common diagnoses were asthma and chronic obstructive pulmonary disease, which accounted for 58% and 32% respectively of treatment-related admissions. Treatment most often involved intravenous corticosteroid therapy and inhaled bronchodilator therapy. Between 1996/97 and 1998/9 the proportion of patients requiring transfer to overnight care decreased from 22% to 14%; complications and unscheduled return visits were rare. We believe that a respiratory day hospital provides a useful alternative to emergency department and inpatient care.

Schwartzman, Kevin; Duquette, Guylaine; Zaoude, May; Dion, Marie-Josee; Lagace, Marie-Annie; Poitras, Jacinthe; Cosio, Manuel G.

2001-01-01

133

Intentional self-harm seen in psychiatric referrals in a tertiary care hospital  

PubMed Central

Background: Intentional self-harm is common, through out the world; however, there is scanty data from India. Aims: To study the sociodemographic and clinical profile of subjects with “intentional self-harm” referred to consultation-liaison psychiatric services for evaluation in a tertiary care hospital. Design: Retrospective chart review. Materials and Methods: For this study, the consultation-liaison register of Department of Psychiatry was screened to obtain data of all patients who were referred to psychiatry referral services and were diagnosed as “intentional self-harm” while they were admitted in Nehru Hospital, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh during the period of 2000-2005. The case notes of these patients were reviewed for obtaining the sociodemographic profile and clinical profile for the current study. Results: Majority of the subjects were married (61%), educated beyond matriculation (75%), were employed or retired (53.6%), belonged to Hindu (87%), nuclear family (64.5%) of middle socioeconomic status (85%) and came from urban background (53%). Most common reasons/precipitating events prior to intentional self-harm were interpersonal problems with family members (39.2%), followed by interpersonal problems with spouse (16.9%). The most common method of intentional self-harm used was consumption of insecticides (44.6%), followed by use of corrosives (17.5%). Half of the sample (48.2%) did not fulfill criteria for any axis-1 or axis-2 psychiatric diagnosis at the time of assessment and most common psychiatric diagnosis was depression (30.7 %). Conclusions: Nearly half of the subjects who present to a tertiary care hospital with intentional self-harm do not have diagnosable psychiatric illness.

Das, Partha Pratim; Grover, Sandeep; Avasthi, Ajit; Chakrabarti, Subho; Malhotra, Savita; Kumar, Suresh

2008-01-01

134

Measures in the day hospital. II. The interpersonal behavior survey.  

PubMed

This study explored the use of the Interpersonal Behavior Survey (IBS) with a day hospital population. The patients completed the IBS in such a way as to suggest potential deficits in a variety of assertiveness skills and potential excesses in two areas of aggressiveness. Moreover, the IBS was correlated with measures of psychological distress, suggesting the relevance for training in social skills for this population. PMID:10120294

Dufton, B D; Siddique, C M

1992-06-01

135

Adoption of an Internet-based patient education programme in psychiatric hospitals.  

PubMed

Internet-based patient support systems are widely assumed to predict a future trend in patient education. Coherent information is still lacking on how patient education is adopted in psychiatric hospitals and how information technology is used in it. Our aim was to describe nurses' adoption of an Internet-based patient education programme and the variables explaining it. The study was based on Rogers' model of the diffusion of innovation. The Internet-based patient education sessions were carried out by nurses on nine acute psychiatric inpatient wards in two Finnish hospitals. They were evaluated with reports and analysed statistically. Out of 100 nurses, 83 adopted the programme during the study period. The nurses fell into Rogers' groups, late majority (72%), laggards (17%), early majority (7%), early adopters (3%) and innovators (1%). Three groups were formed according to their activity: laggards, late majority, adopters (including early majority, early adopters, innovators). There was a statistical difference between the nurses' programme adoption between the two hospitals (P= 0.045): more laggards (65% vs. 35%) and adopters (73% vs. 27%) in the same hospital. The findings help to provide insight into the contexts and settings when adopting information technology programmes in the area of mental health care. PMID:22070578

Anttila, M; Välimäki, M; Koivunen, M; Luukkaala, T; Kaila, M; Pitkänen, A; Kontio, R

2011-12-01

136

HIV Risk Behavior in Persons with Severe Mental Disorders in a Psychiatric Hospital in Ogun, Nigeria  

PubMed Central

Background: Few studies in Nigeria have investigated HIV risk behavior among persons with severe mental disorders. This study examined HIV risk behavior and associated factors among patients receiving treatment at a Nigerian psychiatric hospital. Aim: To determine the HIV risk behavior in persons with severe mental disorders in a psychiatric hospital. Subjects and Methods: This was a cross-sectional survey involving 102 persons with serious mental disorders receiving treatment at a major psychiatric facility in Southwestern Nigeria. HIV risk screening instrument was self-administered to assess HIV risk behavior. A questionnaire was used to elicit socio-demographic variables while alcohol use was assessed with the alcohol use disorder identification test. Differences in HIV risk levels were examined for statistical significance using Chi square test. Results: Forty eight percent of the respondents engaged in HIV risk behavior. This study revealed that 10.8% (11/102) gave a history of sexually transmitted disease, 5.9% (6/102) reported sex trading and no reports of intravenous drug use was obtained. A single risk factor was reported by 19.6% (20/102), 12.7% (13/102) reported two risk factors and 15.7% (16/102) reported three or more risk factors. HIV risk behavior was significantly related to alcohol use (P = 0.03). Conclusion: Mental health services provide an important context for HIV/AIDS interventions in resource-constrained countries like Nigeria.

Abayomi, O; Adelufosi, A; Adebayo, P; Ighoroje, M; Ajogbon, D; Ogunwale, A

2013-01-01

137

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

138

[Nursing care to patients with comorbidity clinical and psychiatric in hospital emergency service].  

PubMed

Qualitative descriptive, exploratory research developed in 2009, in the emergency service of a general hospital in Curitiba, Paraná, Brazil. It aims to investigate how nurses take care of patients with clinical and psychiatric comorbidity. Six nurses, seven nursing technicians and 14 nursing assistants participated. We obtained data through semi-structured interviews and submitted to analysis of thematic content. The categories that emerged from the data were: Care is technical and without specificity; Safety and protection of patient; and Physical and chemical restraint as protective measures. The study revealed that nursing care of patients with clinical and psychiatric comorbidity does not have any specificity, with emphasis on basic care, physical and chemical restraint. We concluded that it is necessary to establish local training in mental health and make nurses aware of the care needs of this clientele. PMID:21500507

Paes, Marcio Roberto; Maftum, Mariluci Alves; Mantovani, Maria de Fátima

2010-06-01

139

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

140

Value of the general health questionnaire in detecting psychiatric morbidity in a general hospital out-patient population.  

PubMed

On administering the General Health Questionnaire (GHQ) in English, Gujarati and Marathi, to 500 non-acutely ill adult patients selected randomly from a General Hospital Out-patient Department, it was found that 57% scored high (12 and above), indicating the possibility of psychiatric morbidity in this group. On subjecting 50 of these patients to blind psychiatric evaluation a misclassification rate of 30% was observed with respect to the G. H. Q. 96% of the psychiatrically ill scored high on GHQ, 37% of those scoring high on G. H. Q. were psychiatrically normal. If this misclassification rate is lowered by suitable modifications such as reducing items pertaining to Group A of the G. H. Q., then this test will be very useful as a simple tool to detect psychiatric morbidity. PMID:21927123

Bagadia, V N; Ayyar, K S; Lakdawala, P D; Susainathan, U; Pradhan, P V

1985-10-01

141

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

PubMed

To investigate the specific behavioural and cognitive characteristics which may account for academic deficits in children with psychiatric disorders, 50 children admitted to a day treatment and school program were assessed using behaviour questionnaires for parents and teachers, and tests assessing intelligence (WISC-R), language (CELF-R) and academic performance (Kaufman Test of Educational Achievement). The academic measures Reading Decoding, Reading Comprehension and Spelling formed the dependent variables. Behaviour and cognitive measures which distinguished the sample from normative data constituted the independent variables. Hierarchical multiple regression analyses were performed in order to identify behaviour and cognitive measures accounting for the academic deficits. In the analyses, three measures (Digit Span, Sentence Assembly, Recalling Sentences), probably assessing overlapping cognitive/linguistic functions, accounted for a large proportion of variance for Reading Decoding (0.47), Reading Comprehension (0.63) and Spelling (0.29). None of the behaviour measures accounted for any variance of the academic variables. It is argued that linguistic dysfunction is a primary deficit which underlies problems in academic learning. PMID:8814414

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

1996-06-01

142

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

PubMed Central

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

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

2013-01-01

143

[Psychotropic drugs used in a psychiatric hospital (pharmaco-epidemiologic aspects)].  

PubMed

The aim of the study was to optimize psychopharmacotherapy in a big psychiatric hospital. It was conducted in Moscow Alekseev psychiatric hospital No 1, using a method of comparison of standard psychotropic treatment and medication strategy suggested by the expert group. An analysis of the treatment of 966 patients with different mental disorders revealed that 78.3% were in need of neuroleptic assignment that was in line with routine practice. The expert's conclusions were postulated as follows: a need in phenothyazines is significantly lower than that observed in practice. Xantens and tyoxantens (chlorprothixene, flupentixol, zuclopenthixol, zuclopenthixol decanoate, zuclopenthixol acetate), benzamides (sulpiride) and such atypical antipsychotics as risperidone, olanzapine and quentiapine are underused in the treatment. Comparing to usual practice, more patients (35.8%) need antidepressants treatment. Thymoleptics should be assigned in greater daily doses. Selective inhibitors of serotonin reuptake (paroxetine, fluoxetine, citalopram, sertraline), reversible MAO A inhibitors (pyrazidolum), "double-action" drugs (mirtazapine, milnacipran) are recommended for wider usage. Less patients (33.4%) are in need of tranquilizers, though a number of medications used is consistent with a recommended one. Normothymics may be assigned to essentially less part of the patients and 18% of them need nootropics that is consistent with routine practice. PMID:14681962

Kozyrev, V N; Smulevich, A B; Drobizhev, M Iu; Kraeva, G K; Kubrakov, M A

2003-01-01

144

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

PubMed

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

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

2014-01-01

145

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

PubMed Central

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

Seo, Mi Kyung; Kim, Seung Hyun

2011-01-01

146

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

Code of Federal Regulations, 2010 CFR

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

2010-10-01

147

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

Code of Federal Regulations, 2011 CFR

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

2011-10-01

148

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

Code of Federal Regulations, 2012 CFR

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

2012-10-01

149

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.

Loch, Alexandre Andrade

2014-01-01

150

42 CFR 409.62 - Lifetime maximum on inpatient psychiatric care.  

Code of Federal Regulations, 2013 CFR

...2013-10-01 2013-10-01 false Lifetime maximum on inpatient psychiatric care...Hospital Insurance Benefits § 409.62 Lifetime maximum on inpatient psychiatric care. There is a lifetime maximum of 190 days on inpatient...

2013-10-01

151

The High Secure Psychiatric Hospitals’ Nursing Staff Stress Survey 3: Identifying stress resistance resources in the stress process of physical assault  

Microsoft Academic Search

The present paper forms part of the High Secure Psychiatric Hospitals’ Nursing Staff Stress Survey and explores the causal role of generalized and specific stress resistance resources (SRRs) in the stress process following physical assault. Confidential self-report questionnaires were administered to all nurses working in English and Scottish High Secure Psychiatric Hospitals. A total of 636 nurses responded to questionnaires

Ulrich Reininghaus; Tom Craig; Kevin Gournay; Patrick Hopkinson; Jerome Carson

2007-01-01

152

Changes in Object Relations in Long-Term Mentally Ill Patients Treated in a Psychiatric Day-Care Unit  

Microsoft Academic Search

The treatment outcome of a psychiatric day-care unit for long-term mentally ill patients was studied. The aim was to investigate internal representations of object relations among the patients at admission and at a one-year follow up. Another aim was to compare the pattern of, and change in, internal object relations with external events, behaviors, social relationships, and overt change. Twenty

Mona Eklund; Alf Nilsson

1999-01-01

153

From hospital to the community: the influence of deinstitutionalization on discharged long-stay psychiatric patients.  

PubMed

The aim of the present study is to clarify the influence of deinstitutionalization on discharged long-stay patients based on a review of recently published literature. English-language studies were searched from PubMed and Embase for the years 2000-2012, with the terms 'long-stay' or 'chronic mentally ill' and 'deinstitutionalis(z)ation' or 'community' or 'discharged' in the title and/or abstract. The present study defined long-stay as hospitalization >6 months. A total of 14 articles were identified. The majority of the participants suffered from schizophrenia. The most frequently assessed outcomes were social functioning, psychiatric symptoms and quality of life (QOL)/participant attitudes towards the environment. For social functioning, most of the studies found favorable changes. As regards psychiatric symptoms, stability or at least some improvements were detected. For QOL/participant attitudes towards the environment, positive changes, at least at some time-points, were noted. Significant deterioration was rare in all of the three outcomes. The majority of the participants showed enhancements in social functioning despite the fact that functional impairment is common in persons with schizophrenia, which indicates that even long-stay patients could achieve better functioning by deinstitutionalization. Although the stability in symptoms might be due to continuous schizophrenia course, moving to the community may also lead to improvement. The favorable changes in QOL/participants' attitudes towards the environment are in line with other studies. PMID:23890091

Kunitoh, Namino

2013-09-01

154

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

PubMed

Guidelines on the prescription of benzodiazepines recommend their use be limited to the short-term relief of severe anxiety or insomnia. However, clinical experience suggests that in psychiatry these drugs may be being prescribed more widely. The aim of this survey was to investigate benzodiazepine prescribing in a specialist UK psychiatric hospital using a structured interview with consultant psychiatrists. Prescribers were also asked their views on the UK CSM guidance on benzodiazepines (1988). Of 412 inpatients, 77 (18.7%) were receiving 90 benzodiazepine prescriptions for psychiatric indications. Most prescriptions were for anxiety (45/90; 50.0%), aggression (23/90; 25.6%) and agitation (13/90; 14.4%). Use was commonest for acquired brain injury, schizophrenia and personality disorders. Much usage was chronic (only 4/90 (4.4%) prescriptions had been initiated within the previous 4 weeks) and off-label (85/90; 94.4%). Prescribers were concerned about the addictive nature of benzodiazepines for these patients and to a lesser extent about their abuse potential. Most consultants believed the UK CSM guidance was too restrictive in relation to their clinical practice and needed modification to encompass new indications, for example rapid tranquillization, and specialist prescribing. In psychiatry benzodiazepines are quite frequently used in the management of a number of groups of difficult-to-treat patients. Although largely not evidence based, some psychiatrists report a favourable risk-benefit ratio for benzodiazepines in the treatment of certain patients. PMID:17092967

Haw, Camilla; Stubbs, Jean

2007-08-01

155

A Geriatric Day Hospital: Who Improves the Most?  

ERIC Educational Resources Information Center

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

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

2004-01-01

156

75 FR 50041 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...  

Federal Register 2010, 2011, 2012, 2013

...Medicaid Providers of Inpatient Psychiatric Services...hospitals and hospitals with inpatient psychiatric programs. Hospitals with inpatient psychiatric programs...psychiatric rehabilitation treatment facilities, which we are not...

2010-08-16

157

[Evaluation of suicide risk factors based on a survey of suicides and suicidal attempts at psychiatric hospitals in Aichi Prefecture].  

PubMed

This investigation examined cases of suicide, suicidal attempts, and risk factors in 41 psychiatric hospitals of Aichi Prefecture. As a result, some characteristics of psychiatric wards considered to be effective in suicide prevention were shown. In addition, as for measures to resolve risk factors and the state of the patients, there were many which were effective in the prevention of suicide attempts. Regarding measures to reduce risk factors for symptoms and treat patients, there were many techniques which were effective in the prevention of suicidal attempts, but, for cases which did not respond to treatment, suicide was frequent. In addition, a "suicide preventive manual in a psychiatric hospital" produced based on these results was distributed. PMID:23346815

Mori, Takao

2012-01-01

158

The influence of psychiatric hospital and community residence labels on social rejection of the mentally ill.  

PubMed

In order to identify some of the variables influencing public level of acceptance and attitudes towards people with a mental illness, a social distance scale accompanying a case vignette was sent to 488 postal respondents. The vignette contained systematically varied residence labels (psychiatric hospital/community) and behaviours (disturbed/control). There was a 43 per cent response rate. The results showed that social rejection was influenced by the behaviour described in the vignette, the respondents' judgement about the behaviour, and the respondents' previous contact with people with mental illness. The given residence label had an impact on only one component of social rejection and only for those presented with the control vignette. The findings are discussed in relation to current community care policies. PMID:8889077

Ingamells, S; Goodwin, A M; John, C

1996-09-01

159

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

PubMed

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

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

2009-01-01

160

Cognitive predictors of suicide risk among hospitalized psychiatric patients: a prospective study.  

PubMed

This prospective study examined the utility of several cognitive variables as predictors of suicide risk among 79 hospitalized psychiatric patients. These variables included pessimism (measured by the Hopelessness Scale), perceived and actual problem-solving ability (indexed by the Problem-Solving Inventory and Means-End Problem-Solving test, respectively), and polarized thinking, self-negativity, and construct system constriction and differentiation (derived from a repertory grid). Suicide risk was operationalized in terms of subsequent self-report of suicide ideation and staff records of time spent on suicide precautions. Results indicated that hopelessness, self-negativity, and poor problem-solving performance functioned as reliable predictors of suicide risk, whereas self-evaluated problem-solving ability did not. Interestingly, constriction emerged as a significant inverse predictor across. PMID:10124914

Hughes, S L; Neimeyer, R A

1993-01-01

161

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

Microsoft Academic Search

Background Psychotic illness following childbirth is a relatively rare but severe condition with unexplained etiology. The aim of this study was to investigate the impact of maternal background characteristics and obstetric factors on the risk of postpartum psychosis, specifically among mothers with no previous psychiatric hospitalizations.

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

2009-01-01

162

The quality of life of chronic in-patients of a traditional psychiatric hospital in the late 1900s  

Microsoft Academic Search

In the period prior to a major attempt to deinstitutionalize services for a region, the quality of life of most residents of a traditional-type psychiatric hospital was studied. Quality of life was measured by staff-rated observable behavior [the REHAB measure of Baker & Hall (1984)] and in terms of the residents' own perceptions of how contented they were with various

John F. O'Mahony; Maurice Ward

1995-01-01

163

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

164

Characteristics Of Children And Adolescents With Serious Emotional Disturbance In Systems Of Care. Part IPartial Hospitalization And Inpatient Psychiatric Services  

Microsoft Academic Search

This is the first of a series of investigations designed to study the characteristics of children and adolescents with serious emotional disturbance (SED) who are currently being served in various systems of care, ranging from community-based services to psychiatric hospitalization and residential placement. The sociodemographic, medical, psychological, and educational records of all children and adolescents admitted to a child and

Nirbhay N. Singh; Cynthia R. Ellis; Timothy J. Landrum; Lucia S. Donatelli; Christianne Hampton

1994-01-01

165

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

166

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

ERIC Educational Resources Information Center

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

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

2012-01-01

167

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.

2014-01-01

168

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

169

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

PubMed

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

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

2009-03-01

170

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

PubMed

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

Creswell, Laryssa M

2014-04-01

171

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

PubMed

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

Eklund, Mona; Sandlund, Mikael

2014-09-01

172

[Interventions with a patient in a psychologic or social crisis in the hospital of the psychiatric district].  

PubMed

Three questions have been analysed in the study on patients in a state of psychosocial crisis : Who is coming? Who is intervening? Where are they sent? Three epidemiological studies have been taken into account : one study on 16 medical surgical centers in Brussels, the second study on two public emergency services linked to psychiatric services and the third one on a psychiatric district of a popular suburb in Brussels. The study stresses the importance of alcoholism and analyses the differences in population, intervention and response brought by the hospital or the district. PMID:7180556

Corten, P; Pelc, I; Vermeylen, J

1982-01-01

173

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

PubMed Central

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

Valdimarsdottir, Unnur; Hultman, Christina M; Harlow, Bernard; Cnattingius, Sven; Sparen, Par

2009-01-01

174

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

PubMed Central

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

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

1990-01-01

175

Changes in patterns of psychiatric referral in a German general hospital: results of a comparison of two 1-year surveys 8 years apart  

Microsoft Academic Search

The aim of this study was to investigate the issues of changes in patterns of referral and interventions and of consistency of psychiatric diagnoses assigned by a psychiatric consultation-liaison service in a general hospital over an 8-year period. We compared two 1-year surveys 8 years apart. Survey A comprised 713 referrals in 1990, and Survey B included 1025 consecutive new

Hans-Bernd Rothenhäusler; Sigrid Ehrentraut; Hans-Peter Kapfhammer

2001-01-01

176

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

Microsoft Academic Search

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

Laura A. Baker

1986-01-01

177

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

Microsoft Academic Search

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

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

2001-01-01

178

The impact of interpersonal style and perceived coercion on aggression and self-harm in personality-disordered patients admitted to a secure psychiatric hospital  

Microsoft Academic Search

Recent research on aggressive behaviour in psychiatric hospitals has emphasised the importance of the interaction between characteristics of patients and the hospital environment. Interpersonal style, a key component of personality and personality disorder, has emerged as a potentially important characteristic that may be relevant to a patient's interactions with the hospital environment. Interpersonal style affects how patients relate to others

Michael Daffern; Matthew Tonkin; Kevin Howells; Gopi Krishnan; Geoffrey Ijomah; John Milton

2010-01-01

179

United States Department of Justice findings letters in psychiatric hospital CRIPA cases: an aid or a distraction?  

PubMed

The Civil Rights of Institutionalized Persons Act (CRIPA) of 1980 allows the United States Department of Justice (DOJ) to investigate and file lawsuits against certain institutions, including state and county psychiatric hospitals, where individuals within may face unconstitutional conditions. Subsequent to an investigation and before negotiations or litigation, the state is provided a Findings Letter generated by the DOJ that generally contains recommended remedial measures. It has never been determined to what extent a Findings Letter provides a state with a recommendation specific to the institution for corrective action before the state enters into negotiations with the DOJ. Three study groups were derived from a sample of 15 Findings Letters written to states concerning their psychiatric hospitals between 2003 and 2009. The individual recommended remedial measures, labeled texts of interest (TOI), were identified, and the degree of overlap among the Findings Letters was determined. To a surprising degree, TOIs overlapped to various extents, from exact copies of text to paraphrased versions, in Findings Letters written between 2003 and 2009 to different states and for multiple state hospitals in the same state. The recommended remedial measures provided in the DOJ's Findings Letters are not specific to each state hospital's deficiencies. The Findings Letters offer limited guidance to the state on how to remedy the deficiencies before negotiating with the DOJ. This lack of specificity causes inefficient and delayed remediation of unconstitutional conditions and other deficiencies in care and treatment in psychiatric hospitals. While the current process most often leads to improvements in state hospitals, it is a costly, inefficient remedy, despite the possibility of alternative remedial processes of less expensive and equal or greater effectiveness. PMID:23771930

Geller, Jeffrey; Lee, Leilani

2013-01-01

180

Spaces for smoking in a psychiatric hospital: social capital, resistance to control, and significance for 'therapeutic landscapes'.  

PubMed

This paper reports on research framed by theories of therapeutic landscapes and the ways that the social, physical and symbolic dimensions of landscapes relate to wellbeing and healing. We focus especially on the question of how attributes of therapeutic landscapes are constructed in different ways according to the variable perspectives of individuals and groups. Through an ethnographic case study in a psychiatric hospital in the North of England we explore the perceived significance for wellbeing of 'smoking spaces' (where tobacco smoking is practiced in ways that may, or may not be officially sanctioned). We interpret our findings in light of literature on how smoking spaces are linked to the socio-geographical power relations that determine how smoking is organised within the hospital and how this is understood by different groups using the hospital building. We draw on qualitative research findings from discussion groups, observations, and interviews with patients, carers and staff. These focused on their views about the building design and setting of the new psychiatric hospital in relation to their wellbeing, and issues relating to smoking spaces emerged as important for many participants. Creating and managing smoking spaces as a public health measure in psychiatric hospitals is shown to be a controversial issue involving conflicting aims for health and wellbeing of patients and staff. Our findings indicate that although from a physical health perspective, smoking is detrimental, the spaces in which patients and staff smoke have social and psychological significance, providing a forum for the creation of social capital and resistance to institutional control. While the findings relate to one case study setting, the paper illustrates issues of wider relevance and contributes to an international literature concerning the tensions between perceived psychological and psychosocial benefits of smoking vs. physical harm that smoking is likely to cause. We consider the implications for hospital design and the model of care. PMID:24161095

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

2013-11-01

181

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

Microsoft Academic Search

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

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

2009-01-01

182

Factors associated with non-adherence among psychiatric patients at a tertiary care hospital, Karachi, Pakistan: a questionnaire based cross-sectional study  

Microsoft Academic Search

OBJECTIVE: To elucidate predictors of non-adherence among psychiatric patients presenting at a tertiary care hospital of Pakistan, for follow-up with consultant psychiatrist.\\u000aMETHODS: A convenient sampleof psychiatric patients from Aga Khan University Hospital was enrolled between April and May, 2005. An interviewer assisted, standardized questionnaire was used for data collection. Patients with cognitive deficit or psychosis and those presenting for

Fawad Taj; Mansoor Tanwir; Zarmeneh Aly; Ameer Ali Khowajah; Asma Tariq; Fahd Khalid Syed; Fahd Waqar; Khezar Shahzada

2008-01-01

183

THE DISCHARGED PSYCHIATRIC PATIENT: POST-HOSPITAL ADJUSTMENT AND FACTORS AFFECTING REHOSPITALIZATION  

Microsoft Academic Search

Discharged psychiatric patients were studied six months post-discharge to determine those demographic, social and clinical characteristics affecting positive or negative adjustment and the degree to which the use of mental health services and medication compliance mediated the effects. With the exception of those with primary or secondary diagnoses of OBS, substance abuse or mental retardation, sixty-three psychiatric subjects between the

CLAIRE BANKER WINGERTER

1982-01-01

184

Attitudes towards disciplinary measures among managers and workers in Bophelong Psychiatric Hospital, Mafikeng.  

PubMed

This study examines the attitudes towards disciplinary measures among managers and workers at the Bophelong psychiatric hospital, Mafikeng. This is based on the fact that undisciplined workforce may lead to disorder in the workplace and eventually to an organisation's failure to reach its objectives. From a population of four hundred workers and one hundred managers, a simple random sampling technique was used to select sixty workers and forty managers. Data was collected through a structured questionnaire made up of six different sections and analysed using SPSS. Frequency counts, mean and standard deviations were used to describe the data. The results of the study show that 47 percent of the workers and 35 percent of managers are between 30 to 40 years. About 69 percent of workers are female while 70 percent of managers are male. The common educational level among workers is the matric while managers had Diploma and BSc degree. In terms of attitude to disciplinary measure, 73% and 75% agreed that disciplinary measures are legal at BPH by workers and managers respectively. In terms of knowledge of disciplinary measures, sixty six percent of workers at BPH are aware of written warning and Employee Assistance Programmes as disciplinary techniques. Results on implementation of disciplinary measures show that seventy percent of workers mostly had verbal warnings and fifty six percent of managers had withholding all privileges. Common constraints to the implementation of discipline as indicated by workers head office taking too long, unions being too defensive, unqualified managers. The study concludes by advocating the need to review and enforce discipline at the work place if service delivery has to improve. PMID:24498676

Segwai, P E; Oladele, O I

2013-11-01

185

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

PubMed

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

Moses, Tally

2014-05-01

186

A hospital-based day camp for children with diabetes.  

PubMed

This paper describes the planning and implementation of a one-day program of recreation and education for children with diabetes that offers the same sort of fun, peer interaction, and education that the children would get in a summer day camp. The program's curriculum is based on the intrinsic nature of 6- to 11-year-old children--present-oriented thinking, increasing independence, and greater time spent with peers. Consideration is given to the sequence of activities, safety and liability issues, promotion of the camp, and cost. Such one-day camps offer children with diabetes a better understanding of their disease, along with valuable peer interaction and good fun. PMID:2627868

Dorman, P M

1989-01-01

187

Psychiatric Discharge Process  

PubMed Central

Background. Integration of research evidence into clinical nursing practice is essential for the delivery of high-quality nursing care. Discharge planning is an essential process in psychiatric nursing field, in order to prevent recurrent readmission to psychiatric units. Objective. The purpose of this paper is to perform literature overview on psychiatric discharge planning, in order to develop evidence-based practice guideline of psychiatric discharge plan. Methods. A search of electronic databases was conducted. The search process aimed to locate different levels of evidence. Inclusion criteria were studies including outcomes related to prevention of readmission as stability in the community, studies investigating the discharge planning process in acute psychiatric wards, and studies that included factors that impede discharge planning and factors that aid timely discharge. On the other hand, exclusion criteria were studies in which discharge planning was discussed as part of a multi faceted intervention and was not the main focus of the review. Result. Studies met inclusion criteria were mainly literature reviews, consensus statements, and descriptive studies. All of these studies are considered at the lower levels of evidence. Conclusion. This review demonstrated that discharge planning based on general principles (evidence based principles) should be applied during psychiatric discharge planning to make this discharge more effective. Depending on this review, it could be concluded that effective discharge planning includes main three stages; initial discharge meeting, regular discharge meeting(s), and leaving from hospital and discharge day. Each stage of them has requirements should be accomplished be go to the next stage.

Alghzawi, Hamzah M.

2012-01-01

188

Teaching literacy and mathematics skills to adult psychiatric inpatients: an evaluation of the adult literacy program at Hawaii State Hospital.  

PubMed

The Adult Literacy Program at Hawaii State Hospital utilized techniques drawn from the Morningside Model of Generative Instruction. In a study involving psychiatric inpatients, participants were taught reading, mathematics, or both over a 6- to 8-month time span. Using the Woodcock-Johnson Psychoeducational Battery-Revised, it was determined that nearly half of the participants demonstrated academic gains during the study period. Further, a behavioral observation system indicated that participants were on-task 80% of the observation time and staff engaged in positive interactions nearly 20% of the observation time. This study is the first of its kind to document any efficacy for academic instruction with a psychiatric inpatient population. PMID:15690738

Schirmer, Todd N; Meyer, Kim A; Samarasinghe, Roshani

2005-01-01

189

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

190

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

191

Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics  

PubMed Central

Objectives To assess the association between mortality and the day of elective surgical procedure. Design Retrospective analysis of national hospital administrative data. Setting All acute and specialist English hospitals carrying out elective surgery over three financial years, from 2008-09 to 2010-11. Participants Patients undergoing elective surgery in English public hospitals. Main outcome measure Death in or out of hospital within 30 days of the procedure. Results There were 27?582 deaths within 30 days after 4?133?346 inpatient admissions for elective operating room procedures (overall crude mortality rate 6.7 per 1000). The number of weekday and weekend procedures decreased over the three years (by 4.5% and 26.8%, respectively). The adjusted odds of death were 44% and 82% higher, respectively, if the procedures were carried out on Friday (odds ratio 1.44, 95% confidence interval 1.39 to 1.50) or a weekend (1.82, 1.71 to 1.94) compared with Monday. Conclusions The study suggests a higher risk of death for patients who have elective surgical procedures carried out later in the working week and at the weekend.

2013-01-01

192

75 FR 23851 - Medicare Program; Proposed Changes to the Hospital Inpatient Prospective Payment Systems for...  

Federal Register 2010, 2011, 2012, 2013

...Medicaid Providers of Inpatient Psychiatric Services...hospitals and hospitals with inpatient psychiatric programs. Hospitals with inpatient psychiatric programs...psychiatric rehabilitation treatment facilities would be afforded...

2010-05-04

193

Medicaid Financing of State and County Psychiatric Hospitals. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration  

Microsoft Academic Search

Despite the perception that few people are served by public psychiatric hospitals, they play a critical role in the continuum of care for people with mental illness. Although the capacity of these hospitals has diminished as a result of deinstitutionalization, they continue to serve people with severe and chronic mental illness who do not have the resources to seek care

Debra Draper; Megan McHugh; Lori Achman; Sylvia Kuo

2003-01-01

194

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.

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

1997-01-01

195

Measures in the day hospital. I. The global assessment of functioning scale.  

PubMed

This clinical study explored the use of the Global Assessment of Functioning Scale (GAF Scale) in a day hospital setting. In general, the GAF Scale was found to be of use in categorizing patients and in detecting change from admission to discharge. However, changes in GAF Scale scores may lack clinical significance, and moreover, there was little evidence of concurrent validity. Implications for the use of the GAF Scale in day hospitals were discussed. PMID:10120293

Dufton, B D; Siddique, C M

1992-06-01

196

Study of psychiatric consequences of closed head injury at the Kenyatta National Hospital.  

PubMed

This was a study to compare the psychiatric consequences of closed head injury (CHI) in 37 patients with 39 demographically similar patients with fractured lower limb injury (FLLI), aged 16-55 years. The outcome measures were the Clinical Interview Schedule-Revised, the Bender Gestalt Test and the WHO AUDIT Core for alcohol abuse. The final diagnoses were made according to DSM-III-R diagnostic criteria. The findings indicated that CHI patients suffered more psychiatric consequences than FLLI controls (OR = 4.07; 95% CI = 1.30:13.14; p = 0.013). Depression and anxiety disorders were the most common problems encountered in these subjects. PMID:9803614

Sebit, M B; Siziya, S; Ndetei, D M; Sande, G M

1998-06-01

197

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

PubMed Central

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

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

2000-01-01

198

[Decentralization of psychiatric health service].  

PubMed

The article discusses two stages of de-centralization of psychiatric hospitals: the first consists in further division into sub-districts, the second one includes successive establishment of psychiatric wards in general hospitals. With the growth of their number these wards are to take over more and more general psychiatric tasks from the specialized psychiatric hospitals. These wards will not substitute psychiatric hospitals completely. The hospitals, though decreasing in size and number, will be a necessary element of the de-centralized and versatile psychiatric care for a long time to come. PMID:8975255

Dabrowski, S

1996-01-01

199

Psychiatric consultations and therapy recommendations following a suicide attempt in a general hospital and their associations with selected parameters in a 1-year period.  

PubMed

Abstract Objective. Our study aims to determine the frequency and distribution of suicide attempts according to the patients' characteristics and type of suicide attempt as well as the method of treatment proposed by the consultation-liaison service in a general hospital. Methods. This retrospective naturalistic study covers a 1-year period (2012), during which 51 suicide attempters were hospitalised in the Charité Berlin, Campus Benjamin Franklin, Germany. The following data were analysed: method of suicide, account of prior psychiatric history and medication, as well as the acute psychiatric diagnosis and treatment - including pharmacotherapy. Results. Most of the patients were diagnosed with a psychiatric illness. Major depressive disorder was the most frequent diagnosis in consultation. Treatment recommendations more often entailed further psychiatric treatment than medication. In the cases where medication was indeed given, benzodiazepines were the most frequently prescribed. Conclusions. Most of the suicide attempters needed further therapy in psychiatric hospitals. A specialised pharmacotherapy (antidepressants, mood stabilisers) was rarely recommended by the psychiatric consultation service. The psychiatric consultation and therapy recommendations are important in guiding future acute treatment procedures. PMID:24236906

Tauch, Deborah; Winkel, Susanne; Quante, Arnim

2014-06-01

200

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

Microsoft Academic Search

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

Mona Eklund

1999-01-01

201

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

202

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

PubMed Central

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

2013-01-01

203

Identity formation in adolescence: Case study of gender identity disorder and treatment through an intermediate-care day hospital  

Microsoft Academic Search

A review of the literature on gender identity disorders is integrated with a case study presentation of a psychiatrically\\u000a disturbed nineteen-year-old transvestite youth. Accommodations and interventions made both with this patient and in the day\\u000a care program for psychiatrically disturbed youths that allowed him to live at home and be maintained despite severe pathology\\u000a are discussed.

Susan Babinski; Amaro Reyes

1994-01-01

204

30-day hospital readmission of older adults using care transitions after hospitalization: a pilot prospective cohort study  

PubMed Central

Purpose Patients leaving the hospital are at increased risk of functional decline and hospital readmission. The Employee and Community Health service at Mayo Clinic in Rochester developed a care transition program (CTP) to provide home-based care services for medically complex patients. The study objective was to determine the relationship between CTP use, 30-day hospital readmission, and Emergency Room (ER) visits for adults over 60 years with high Elder Risk Assessment scores. Patients and methods This was a pilot prospective cohort study that included 20 patients that used the CTP and 20 patients discharged from the hospital without using the CTP. The medically complex study patients were drawn from the department of Employee and Community Health population between October 14, 2011 and September 27, 2012. The primary outcomes were 30-day hospital readmission or ER visit after discharge from the hospital. The secondary outcomes were within-group changes in grip strength, gait speed, and quality of life (QOL). Patients underwent two study visits, one at baseline and one at 30 days postbaseline. The primary analysis included time-to-event from baseline to rehospitalization or ER visit. Paired t-tests were used for secondary outcomes, with continuous scores. Results Of the 40 patients enrolled, 36 completed all study visits. The 30-day hospital readmission rates for usual care patients were 10.5% compared with no readmissions for CTP patients. There were 31.6% ER visits in the UC group and 11.8% in the CTP group (P = 0.37). The secondary analysis showed some improvement in physical QOL scores (pre: 32.7; post: 39.4) for the CTP participants (P < 0.01) and no differences in gait speed or grip strength. Conclusion Based on this pilot study of care transition, we found nonsignificant lower hospital and ER utilization rates and improved physical QOL scores for patients in the CTP group. However, the data leads us to recommend future studies with larger sample sizes (N = 250).

Takahashi, Paul Y; Haas, Lindsey R; Quigg, Stephanie M; Croghan, Ivana T; Naessens, James M; Shah, Nilay D; Hanson, Gregory J

2013-01-01

205

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.

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

206

Leaving Against Medical Advice (AMA): Risk of 30Day Mortality and Hospital Readmission  

Microsoft Academic Search

Background  With 1–2% of patients leaving the hospital against medical advice (AMA), the potential for these patients to suffer adverse\\u000a health outcomes is of major concern.\\u000a \\u000a \\u000a \\u000a \\u000a Objective  To examine 30-day hospital readmission and mortality rates for medical patients who left the hospital AMA and identify independent\\u000a risk factors associated with these outcomes.\\u000a \\u000a \\u000a \\u000a \\u000a Design  A 5-year retrospective cohort of all patients discharged from a

Justin M. Glasgow; Mary Vaughn-Sarrazin; Peter J. Kaboli

2010-01-01

207

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.

Zemore, Sarah E.; Kaskutas, Lee Ann

2008-01-01

208

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

209

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

210

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

PubMed

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

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

2013-10-01

211

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

PubMed

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

Gandi, Joshua C; Wai, Paul S

2010-10-01

212

Geriatric Out-Patients with Psychiatric Illnesses in A Teaching hospital setting - A Retrospective Study  

PubMed Central

The number of geropsychiatric outpatients is on an increase in North India.Such patients visit many clinics for treatment of their problems. Not much research has been done in this part of the country in assessing the clinical profiles of such patients. As such the present study was undertaken to assess the sociodemographic characteristics and the pattern of psychiatric and physical disorders in the elderly outpatients. A single institutional retrospective study of 3 years was designed. Data was collected year wise and reconfirmation of diagnoses was done using ICD-10 criteria. A total of 181 completed case records of elderly outpatients aged 60 years and over were included in this study. The case records had a printed, semi-structured format; complete and reliable information was available in all the records.Data obtained was analysed using frequency distribution. Results showed that Mood disorders(48.07%), Neurotic, stress-related and somatoform disorders (15.47%) and Organic,including symptomatic, mental disorders (14.36%) were the most common psychiatric disorders in these patients. Medical comorbidity was a significant finding of this study as physical diagnosis was present in most of these patients (56.35%). Conclusion on the results reaffirm that there is a high prevalence of Mood disorders and Neurotic, stress-related and somatoform disorders in elderly outpatients. Adequate measures to detect these psychiatric disorders and medical comorbidity in elderly outpatients by specialized geropsychiatric services are needed. Planning of mental health services for the aged is the demand of the current scenario in our country.

Singh, Gurvinder Pal; Chavan, B.S.; Arun, Priti; Lobraj; Sidana, Ajeet

2004-01-01

213

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

PubMed Central

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

Zeller, Scott; Calma, Nicole; Stone, Ashley

2014-01-01

214

Hospital's comic book promotes benefits of good eating habits. Grocery chain joins campaign with "Cancer Day" promotion. Parkview Hospital, Fort Wayne, IN.  

PubMed

For the past seven years, Parkview Hospital has provided the educational component of Cancer Day. The hospital has distributed pamphlets that educate about different forms of cancer. Last year, the marketing department undertook the subject of colon cancer. PMID:10177638

Herreria, J

1998-01-01

215

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

Microsoft Academic Search

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

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

2000-01-01

216

Family Caregivers' Experiences of Involuntary Psychiatric Hospital Admissions of Their Relatives -- a Qualitative Study  

Microsoft Academic Search

BackgroundFamily caregivers of people with mental disorders are frequently involved in involuntary hospital admissions of their relatives.ObjectiveTo explore family caregivers' experience of involuntary admission of their relative.Method30 in-depth interviews were conducted with family caregivers of 29 patients who had been involuntarily admitted to 12 hospitals across England. Interviews were analysed using thematic analysis.ResultsFour major themes of experiences were identified: relief

Jelena Jankovic; Ksenija Yeeles; Christina Katsakou; Tim Amos; Richard Morriss; Diana Rose; Peter Nichol; Rosemarie McCabe; Stefan Priebe; Ben J. Harrison

2011-01-01

217

Two iniencephaly cases born the same day in the same hospital of Cali, Colombia. Iniencephaly cluster?  

PubMed

Two patients with short and hyperextended neck, cervical meningocele and other birth defects, were born the same day at the same hospital, both died. The autopsy report and X-rays show iniencephaly's classic findings. Revision of clinical histories did not show consanguinity between the parents, or exposure to environmental factors. PMID:24810450

Saldarriaga, Wilmar; Isaza De Lourido, Carolina; Ruiz Murcia, Fabian Andres

2014-01-01

218

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

219

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

NASA Astrophysics Data System (ADS)

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

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

2013-07-01

220

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

PubMed

Several studies have noted seasonal variations in admission rates of patients with psychotic illnesses. However, the changeable daily meteorological patterns within seasons have never been examined in any great depth in the context of admission rates. A handful of small studies have posed interesting questions regarding a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (especially heat waves) and sunshine. In this study, we used simple non-parametric testing and more complex ARIMA and time-series regression analysis to examine whether daily meteorological patterns (wind speed and direction, barometric pressure, rainfall, sunshine, sunlight and temperature) exert an influence on admission rates for psychotic disorders across 12 regions in Ireland. Although there were some weak but interesting trends for temperature, barometric pressure and sunshine, the meteorological patterns ultimately did not exert a clinically significant influence over admissions for psychosis. Further analysis is needed. PMID:22855350

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

2013-07-01

221

Investor-owned psychiatric hospitals and universities: can their marriage succeed?  

PubMed

Economic and competitive pressures have spurred a growing number of affiliations between university medical centers and for-profit health care corporations. University facilities can benefit from such partnerships through strengthened financial support, increased marketing and administrative expertise, and economies of scale. The university connection gives the investor-owned hospital enhanced status, sends a message of clinical excellence, and involves the hospital in educational and research programs that aid in physician recruitment and further enhance its reputation. However, the university's goals of education, research, and public service are not always compatible with the investor-owned hospital's goal of maximizing profits. The authors review the benefits and problems that result from affiliations between university medical centers and investor-owned corporations and discuss principles to be considered in structuring such partnerships. PMID:8514300

Riba, M; Tasman, A

1993-06-01

222

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.

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

2014-01-01

223

Psychiatric Consultation Within a Community of Sick Children - Lessons from a Children's Hospital.  

ERIC Educational Resources Information Center

Delivery of health care services is under close national scrutiny -- and rightly so! This report examines one facet of those traditional services, inpatient specialty consultation, in the form of 100 consecutive initial requests for child psychiatry consultative assistance in the clinical setting of a large children's hospital. Analysis of the…

Bolian, George C.

224

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

Code of Federal Regulations, 2013 CFR

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

2013-10-01

225

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

Microsoft Academic Search

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

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

226

An analysis of patient rights violations in psychiatric hospitals in Japan after the enactment of the Mental Health Act of 1987.  

PubMed

The Mental Health Act in Japan was enacted in 1987. This study aims to determine whether the act has been effective in protecting patient rights by delineating the content and trends of patient rights violations at psychiatric hospitals through an analysis of newspaper reports. An analysis of 924 newspaper articles found 39 hospitals involved in patient rights violations. The results show that violations of patient rights have continued to occur after the implementation of the act. The reasons: for-profit policy of hospitals, a defective oversight system, and a lack of knowledge about the act by medical staff. PMID:19052946

Ohnishi, Kayoko; Hayama, Yumiko; Kosugi, Shinji

2008-12-01

227

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.

2014-01-01

228

Awareness and perceptions of electroconvulsive therapy among psychiatric patients: a cross-sectional survey from teaching hospitals in Karachi, Pakistan  

PubMed Central

Background Electroconvulsive therapy (ECT) is shown to be effective in many psychiatric illnesses, but its distorted projection by the Pakistani media and its unregulated use by many physicians across the country have adversely affected its acceptability. Given this situation we aimed to assess the awareness and perceptions regarding ECT as a treatment modality among the psychiatric patients. Methods This was a questionnaire based cross-sectional study carried out at 2 tertiary care hospitals in Karachi, Pakistan. Results We interviewed 190 patients of which 140 were aware of ECT. The study showed that the level of education had a significant impact on the awareness of ECT (p = 0.009). The most common source of awareness was electronic and print media (38%), followed by relatives (24%) and doctors (23%). Physical injuries (42%) and neurological (12%) and cognitive disturbances (11%) were the commonly feared side effects. The most popular belief about ECT was that it was a treatment of last resort (56%). Thirty-nine percent thought that ECT could lead to severe mental and physical illness and 37% considered it inhumane. Patients' willingness to receive ECT was dependant on whether or not they were convinced of its safety (p = 0.001) and efficacy (p = 0.0001). Conclusion We identified a serious lack of dissemination of information regarding ECT by the psychiatrists and the mental health care providers. This may be the result of an inadequate postgraduate training in Pakistan or just a lack of concern about the mentally ill patients. The media seemed to be the major source of information for our patients. We also saw the prevalence of a variety of myths regarding ECT in our society, which we feel may be responsible for the patients' adverse attitudes. Given the widespread applicability of ECT there is a dire need to dispel these misconceptions and improve its acceptability.

Arshad, Mehreen; Arham, Ahmad Zafir; Arif, Mansoor; Bano, Maria; Bashir, Ayisha; Bokutz, Munira; Choudhary, Maria Maqbool; Naqvi, Haider; Khan, Murad Moosa

2007-01-01

229

Institution specific risk factors for 30 day readmission at a community hospital: a retrospective observational study  

PubMed Central

Background As of October 1, 2012, hospitals in the United States with excess readmissions based on the Centers for Medicare and Medicaid Services (CMS) risk-adjusted ratio began being penalized. Given the impact of high readmission rates to hospitals nationally, it is important for individual hospitals to identify which patients may be at highest risk of readmission. The objective of this study was to assess the association of institution specific factors with 30-day readmission. Methods The study is a retrospective observational study using administrative data from January 1, 2009 through December 31, 2010 conducted at a 257 bed community hospital in Massachusetts. The patients included inpatient medical discharges from the hospitalist service with the primary diagnoses of congestive heart failure, pneumonia or chronic obstructive pulmonary disease. The outcome was 30-day readmission rates. After adjusting for known factors that impact readmission, provider associated factors (i.e. hours worked and census on the day of discharge) and hospital associated factors (i.e. floor of discharge, season) were compared. Results Over the study time period, there were 3774 discharges by hospitalists, with 637 30-day readmissions (17% readmission rate). By condition, readmission rates were 19.6% (448/2284) for congestive heart failure, 13.0% (141/1083) for pneumonia, and 14.7% (200/1358) for chronic obstructive lung disease. After adjusting for known risk factors (gender, age, length of stay, Elixhauser sum score, admission in the previous year, insurance, disposition, primary diagnosis), we found that patients discharged in the winter remained significantly more likely to be readmitted compared to the summer (OR 1.54, p?=?0.0008). Patients discharged from the cardiac floor had a trend toward decreased readmission compared a medical/oncology floor (OR 0.85, p?=?0.08). Hospitalist work flow factors (census and hours on the day of discharge) were not associated with readmission. Conclusions We found that 30 day hospital readmissions may be associated with institution specific risk factors, even after adjustment for patient factors. These institution specific risk factors may be targets for interventions to prevent readmissions.

2014-01-01

230

[Physical activities, psychiatric care and mental health].  

PubMed

At Ville-Evrard psychiatric hospital, sports activities are used as one of several therapeutic tools. The day-long multi-sport sessions, led notably by a nurse, form part of the care programme. Sport not only enables the patients to exert themselves, it is above all a form of therapeutic mediation which encourages verbal and non-verbal communication. PMID:24654330

Davanture, Olivier

2014-02-01

231

Patients' perspective on their relatives' involvement in treatment during a short-term psychiatric hospitalization  

Microsoft Academic Search

With the growing interest in the patient's perspective regarding mental health services, several instruments have been developed\\u000a for this area of research. However, despite the availability of multidimensional questionnaires, the dimensions evaluated\\u000a have rarely addressed the issue of the involvement of relatives in treatment. The present study aimed at documenting the preferences\\u000a and level of satisfaction of 92 patients hospitalized

M. Perreault; G. Paquin; S. Kennedy; J. Desmarais; H. Tardif

1999-01-01

232

Evaluating Psychiatric Hospital Admission Decisions for Children in Foster Care: An Optimal Classification Tree Analysis  

Microsoft Academic Search

This study explored clinical and nonclinical predictors of inpatient hospital admission decisions across a sample of children in foster care over 4 years (N = 13,245). Forty-eight percent of participants were female and the mean age was 13.4 (SD = 3.5 years). Optimal data analysis (Yarnold & Soltysik, 2005) was used to construct a nonlinear classification tree model for predicting

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

2007-01-01

233

Co-morbidities and 90-day outcomes in hospitalized COPD exacerbations.  

PubMed

COPD exacerbations resulting in hospitalization are accompanied by high mortality and morbidity. The contribution of specific co-morbidities to acute outcomes is not known in detail: existing studies have used either administrative data or small clinical cohorts and have provided conflicting results. Identification of co-existent diseases that affect outcomes provides opportunities to address these conditions proactively and improve overall COPD care. Cases were identified prospectively on admission then underwent retrospective case note audit to collect data including co-morbidities on up to 60 unselected consecutive acute COPD admissions between March and May in each hospital participating in the 2008 UK National COPD audit. Outcomes recorded were death in hospital, length of stay, and death and readmission at 90 days after index admission. 232 hospitals collected data on 9716 patients, mean age 73, 50% male, mean FEV1 42% predicted. Prevalence of co-morbidities were associated with increased age but better FEV1 and ex-smoker status and with worse outcomes for all four measures. Hospital mortality risk was increased with cor pulmonale, left ventricular failure, neurological conditions and non-respiratory malignancies whilst 90 day death was also increased by lung cancer and arrhythmias. Ischaemic and other heart diseases were important factors in readmission. This study demonstrates that co-morbidities adversely affect a range of short-term patient outcomes related to acute admission to hospital with exacerbations of COPD. Recognition of relevant accompanying diseases at admission provides an opportunity for specific interventions that may improve short-term prognosis. PMID:21864116

Roberts, Christopher M; Stone, Robert A; Lowe, Derek; Pursey, Nancy A; Buckingham, Rhona J

2011-10-01

234

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.

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

2013-01-01

235

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

PubMed Central

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

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

2012-01-01

236

[Hospitalisation profile in a psychiatric service within a general hospital (author's transl)].  

PubMed

The first part of the study indicates that this small unit has a rapid turnover, that the population is young and that there are fresh cases. The main reason for admission in males are first alcoholism and secondly schizophrenia, and for women first depression and neurotic troubles and secondly endogenous depressions. The second part of this study deals with length of stays and shows that it behaves like random variables of Pascal, with a mean stay of 34 days and a peak within the three first days of hospitalisation. PMID:554445

Corten, P

1979-01-01

237

ASSOCIATION OF SELF-REPORTED HOSPITAL DISCHARGE HANDOFFS WITH 30-DAY READMISSIONS  

PubMed Central

Background Poor provider communication across health care settings may lead to adverse outcomes. We sought to determine the frequency with which inpatient providers report communicating directly with outpatient providers and whether direct communication was associated with 30-day readmissions. Methods We included the initial hospitalization for consecutive patients discharged from the Medicine service at a large, academic medical center from September, 2010 to December, 2011. Self-reported communication was captured from a mandatory electronic discharge worksheet field. Thirty day readmissions, length of stay (LOS), and demographics were obtained from administrative databases. We used multivariable logistic regression models to examine, first, the association between direct communication and patient age, sex, LOS, race, payer, expected 30-day readmission rate based on diagnosis and illness severity, and physician type and, second, the association between 30-day readmission and direct communication, adjusting for patient and physician-level factors. Results Of 13,954 hospitalizations, 6,635 met inclusion criteria. Successful direct communication occurred in 2,438 (36.7%). The most frequently reported reason for lack of direct communication was the provider’s perception that the discharge summary was adequate. Predictors of direct communication, adjusting for all other variables, included patients cared for by hospitalists without house-staff (OR = 1.81; 95% CI 1.59-2.08), high expected 30-day readmission rate (OR = 1.18, 1.10-1.28 per 10%), and insurance by Medicare (OR = 1.35; 95% CI 1.16-1.56) and private insurance companies (OR = 1.35; 95% CI 1.18-1.56) compared to Medicaid. Direct communication with the outpatient provider was not associated with readmissions (OR = 1.08, 0.92-1.26) in adjusted analysis. Conclusions Self-reported direct communication between inpatient and outpatient providers occurred at a low rate, but was not associated with readmissions. This suggests that enhancing inter-provider communication at hospital discharge may not, in isolation, prevent readmissions.

Oduyebo, Ibironke; Lehmann, Christoph U.; Pollack, Craig Evan; Durkin, Nowella; Miller, Jason D.; Mandell, Steven; Ardolino, Margaret; Deutschendorf, Amy; Brotman, Daniel J.

2013-01-01

238

Structure and process factors that influence patients' perception of inpatient psychiatric nursing care at Mathari Hospital, Nairobi.  

PubMed

To explore structure and process factors which influence patients' perception of quality inpatient psychiatric nursing care at Mathari hospital. This was a cross-sectional study of 236 inpatients selected by stratified random sampling. Competence to give consent was determined by a minimum score of 24 on Mini Mental State Examination. Patients were interviewed using a semi-structured questionnaire. Differences in proportions of variables were determined by calculating confidence interval and summary chi-squared statistics. P-values of < or =0.05 were considered significant. Majority of patients (87%) were aged 20-49 years with 43% having stayed in the ward for over a month. Structure factors related to patients' perception of care included physical environment, being happy with the way the ward looked was significantly related to satisfaction with care (chi(2) = 5.506, P = 0002). Process factors significantly related to patients' satisfaction with care included nurses providing patients with information on prescribed medicines (chi(2) = 10.50, P = 00012). Satisfaction with care was positively related to ability to recommend someone for admission in the same ward (chi(2) = 20.2, P = 00001). Structure and process factors identified as influencing patients' perception of care were physical environment and nurses' qualities that fit within the characteristics of Peplau's Interpersonal Relations Theory. PMID:18307654

Wagoro, M C A; Othieno, C J; Musandu, J; Karani, A

2008-04-01

239

Ear, Nose and Throat Day-Case Surgery at a District General Hospital  

PubMed Central

INTRODUCTION In 2000, The NHS Plan in the UK set a target of 75% for all surgical activity to be performed as day-cases. We aim to assess day-case turnover for ENT procedures and, in particular, day-case rates for adult and paediatric otological procedures together with re-admissions within 72 h as a proxy measure of safety. PATIENTS AND METHODS Retrospective collection of data (procedure and length of stay) from the computerised theatre system (Galaxy) and Patient Information Management System (PIMS) of all elective patients operated over one calendar year. The setting was a district general hospital ENT department in South East England. All ENT operations are performed with the exception of oncological head and neck procedures and complex skull-base surgery. RESULTS Overall, 2538 elective operations were performed during the study period. A total of 1535 elective adult procedures were performed with 74% (1137 of 1535) performed as day-cases. Of 1003 paediatric operations, 73% (730 of 1003) were day-cases. Concerning otological procedures, 93.4% (311 of 333) of paediatric procedures were day-cases. For adults, we divided the procedures into major and minor, achieving day-case rates of 88% (93 of 101) and 91% (85 of 93), respectively. The overall day-case rate for otological procedures was 91% (528 of 580). Re-admission rates overall were 0.7% (11 of 1535) for adults and 0.9% (9 of 1003) for paediatric procedures. The most common procedure for re-admission was tonsillectomy accounting for 56% of all adult re-admissions and 78% of paediatric re-admissions. The were no deaths following day-case procedures. DISCUSSION ENT surgery is well-suited to a day-case approach. UK Government targets are attainable when considering routine ENT surgery. Day-case rates for otology in excess of targets are possible even when considering major ear surgery.

Pezier, T; Stimpson, P; Kanegaonkar, RG; Bowdler, DA

2009-01-01

240

Psychiatric morbidity among medical in-patients: a standardized assessment (GHQ12 and CIS-R) using ‘lay’ interviewers in a Brazilian hospital  

Microsoft Academic Search

The 12-item General Health Questionnaire (GHQ-12) and the revised Clinical Interview Schedule (CIS-R) were used to estimate the prevalence of psychiatric morbidity among 78 consecutive admissions to a general medical ward in a Brazilian university hospital (43 males and 35 females; mean age=43.2 years). The CIS-R was administered by three 5th-year medical students after a brief training. A prevalence rate

N. J. Botega; W. A. B. Pereira; M. R. Bio; C. Garcia Jr; M. A. Zomignani

1995-01-01

241

The first four years' experience of day case orthopaedic surgery in a district general hospital.  

PubMed Central

Clinical data were obtained for 2838 consecutive patients admitted to a new day case unit in a district general hospital by four consultant surgeons between 1 October 1981 and 30 September 1985. Surgical procedures under general anaesthesia: on 2581 patients were analysed in detail. Intra-articular arthroscopic surgery was performed on 60% of knees. A fifth of patients had manipulation and intra-articular infection of a joint. Surgical operations involving the hands and forearm were required by 17%. Toe surgery was performed on 11% of patients of whom 21% had a distal metatarsal osteotomy. Overnight admission was necessary for 6% of patients because of postanaesthetic difficulties, the operation occurring too late in the day or proving more extensive. The use of day case facilities was an economic saving, pleased 98% of patients and reduced waiting list time significantly, except for patients with serious chronic joint disorders. The waiting list for total hip and knee replacements increased in the four year period.

Older, J.

1988-01-01

242

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.

243

It takes a team: creating a hematology/hematopoietic cell therapy day hospital.  

PubMed

It is anticipated that by the year 2020, the United States will double the number of hematopoietic cell therapy transplants completed in this country. As a freestanding cancer hospital with one of the largest hematopoietic cell therapy transplant programs in the country, City of Hope embarked on an innovative strategy to address current capacity issues and prospectively plan for future expansion of transplant volumes. This article describes the planning process that was undertaken using various content-specific focused teams to address all components of designing and opening an outpatient day hospital suitable for management of patients undergoing transplant in an ambulatory setting. The deliverables of the 11 teams that drove this planning process are addressed. PMID:24896573

Johnson, Shirley

2014-01-01

244

Awareness and perceptions of electroconvulsive therapy among psychiatric patients: a cross-sectional survey from teaching hospitals in Karachi, Pakistan  

Microsoft Academic Search

BACKGROUND: Electroconvulsive therapy (ECT) is shown to be effective in many psychiatric illnesses, but its distorted projection by the Pakistani media and its unregulated use by many physicians across the country have adversely affected its acceptability. Given this situation we aimed to assess the awareness and perceptions regarding ECT as a treatment modality among the psychiatric patients. METHODS: This was

Mehreen Arshad; Ahmad Zafir Arham; Mansoor Arif; Maria Bano; Ayisha Bashir; Munira Bokutz; Maria Maqbool Choudhary; Haider Naqvi; Murad Moosa Khan

2007-01-01

245

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

246

[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

247

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.

Benaiges, D; Chillaron, 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

248

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

ERIC Educational Resources Information Center

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

Leibson, Cynthia; And Others

1990-01-01

249

Telephone support: a descriptive study in an Italian oncological Day-Hospital ward.  

PubMed

The past decade has been seen widespread use of telephone and computer technologies to provide a broad array of health behaviours intervention and health services. The purpose of this study is to explore the frequency and the reasons about telephone using in an Italian Day Hospital oncological ward. The study was conducted in 2008 throughout a questionnaire filled by nurses that receive patients telephone calls. We analyzed 100 hours of nurses' work corresponding to about 13 days. The mean of daily calls was 30.5 (SD=6.4). 72.2% were calls effectuated on the morning, the others in the afternoon. Nurses spent 13% of their shiftwork time on telephone: 6.97 hours for calls regards directly patients and 5.8 hours for service calls. General information and information on tests results were the more frequent motivations of patients' calls. The study stress major workload for nurses in telephone answers. A significant patient demand emerged that should be addressed also identifying specific hours during the day. PMID:21135903

Quattrin, R; Zanini, A; Di Vora, S; Piller Roner, S; Palese, A; Brusaferro, S

2010-01-01

250

The importance of relationships in mental health care: A qualitative study of service users' experiences of psychiatric hospital admission in the UK  

PubMed Central

Background While a number of studies have looked at life on service users' experiences of life on psychiatric wards, no research exists that have approached these experiences from the user perspective since the introduction of community care. Methods This user-led study uses a participatory approach to develop an understanding of the processes and themes which define the user experience of hospitalisation. Nineteen service users who had all had inpatient stays in psychiatric hospitals in London were interviewed in the community. Results Relationships formed the core of service users' experiences. Three further codes, treatment, freedom and environment defined the role of hospital and its physical aspects. Themes of communication, safety, trust, coercion, and cultural competency contributed to the concept of relationships. Conclusion Relationships with an individual which comprised effective communication, cultural sensitivity, and the absence of coercion resulted in that person being attributed with a sense of trust. This resulted in the patient experiencing the hospital as a place of safety in terms of risk from other patients and staff. Barriers to positive relationships included ineffective and negative communication, a lack of trust, a lack of safety in terms of staff as ineffective in preventing violence, and as perpetrators themselves, and the use of coercion by staff. This unique perspective both acts as a source of triangulation with previous studies and highlights the importance of the therapeutic relationship in providing a safe and therapeutic milieu for the treatment of people with acute mental health problems.

Gilburt, Helen; Rose, Diana; Slade, Mike

2008-01-01

251

Medical marijuana study in San Francisco: pays $1000, 25 days in hospital.  

PubMed

A new study on medical marijuana, funded by the National Institutes of Health (NIH), is recruiting volunteers. Volunteers will be paid $1,000, and the study design requires participants to spend 25 days in San Francisco General Hospital's research ward, without leaving and without receiving visitors. Volunteers will be randomly selected to smoke marijuana, take dronabinol, or take placebo capsules. The goal is to find out what is safe and effective for HIV/AIDS patients. The study will look at the nausea-relieving qualities of the drug and its impact on viral load, testosterone levels, energy intake, and body composition. Eligibility requirements are specified, and contact information is included. PMID:11365468

1998-06-01

252

[Psychiatric emergencies].  

PubMed

Psychiatric emergencies must not just be seen as catastrophies. They invariably represent the nadir of a development which has not been given enough attention while it arose. In contrast to a typical medical emergency situation the doctor is usually not particularly welcome by the disturbed psychiatric patient and his family. This may represent some hardship for the good doctor. When arriving at the scene of a psychiatric emergency, an accurate differential diagnosis will be of primary importance. Suicidality, disturbances of consciousness, states of excitement, dyskinesias and affective crises are the most frequent findings. In contrast to a somatic crisis where rapid intervention may be life-saving, it is advisable, to take your time and make sure you took everything into account, before making a decision. Sometimes the use of medication can dramatically change the scene from drama to dialogue. Basically, one has to determine if a hospitalization is necessary or not. Two primary concerns have to be looked into here: suicidal risk and dangerousness to others. It is good to be aware of those situations and diagnoses well known for their high suicidal potential. The question which - if any - compulsive measures have to be taken has to be answered and acted upon. Unpopular as they may be, they can resolve an extremely difficult situation within minutes. Unnecessary hesitation is not asked here for the sake of the patient as well as his family. The best way to deal with psychiatric emergencies is to avoid them. Looking out for signs and symptoms of a beginning psychotic development or suicidal ideation and acting upon it, for instance with medication and/or intensifying contacts with the patient are the primary means to prevent a crisis. Stopping medication, by patient or doctor, is one of the main reasons for psychiatric emergencies. After a psychiatric emergency has evolved, it pays out, to carefully analyse its development, the way it was handled and how it finally ended. Thus a crisis may, like the Chinese symbol for it with its double meaning, evolve to a chance for the patient. PMID:8999491

Laemmel, K

1996-12-10

253

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

PubMed

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

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

2014-03-01

254

Prediction of Hospital Acute Myocardial Infarction and Heart Failure 30-Day Mortality Rates Using Publicly Reported Performance Measures  

PubMed Central

Objective To identify an approach to summarizing publicly reported hospital performance data for acute myocardial infarction (AMI) or heart failure (HF) that best predicts current year hospital mortality rates. Setting A total of 1,868 U.S. hospitals reporting process and outcome measures for AMI and HF to the Centers for Medicare and Medicaid Services (CMS) from July 2005 to June 2006 (Year 0) and July 2006 to June 2007 (Year 1). Design Observational cohort study measuring the percentage variation in Year 1 hospital 30-day risk-adjusted mortality rate explained by denominator-based weighted composite scores summarizing hospital Year 0 performance. Data Collection Data were prospectively collected from hospitalcompare.gov. Results Percentage variation in Year 1 mortality was best explained by mortality rate alone in Year 0 over other composites including process performance. If only Year 0 mortality rates were reported, and consumers using hospitals in the highest decile of mortality instead chose hospitals in the lowest decile of mortality rate, the number of deaths at 30 days that potentially could have been avoided was 1.31 per 100 patients for AMI and 2.12 for HF (p < .001). Conclusion Public reports focused on 30-day risk-adjusted mortality rate may more directly address policymakers’ goals of facilitating consumer identification of hospitals with better outcomes.

Aaronson, David S.; Bardach, Naomi S.; Lin, Grace A.; Chattopadhyay, Arpita; Goldman, L. Elizabeth; Dudley, R. Adams

2014-01-01

255

Alternatives to Hospitalization -- A Utilization and Follow Up Study of Day Treatment, Halfway House, and Crisis Day Treatment Clients.  

National Technical Information Service (NTIS)

The types of persons receiving services in three alternative programs of the Palm Beach, Fla., Comprehensive Community Mental Health Center and the outcomes achieved in the program are assessed. The programs encompass structured day treatment in problemso...

A. R. Fiester

1976-01-01

256

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

257

Problem-Oriented System. The Weed Method of Medical Record Keeping and Its Use in a Psychiatric Hospital.  

National Technical Information Service (NTIS)

The problem-oriented medical record (POMR) and its adaptation to a psychiatric setting are the focus of 10 articles which first appeared in 1972 - 1973. The topics include the rationale of the POMR system, its advantages as compared with the traditional s...

W. P. Mazur

1974-01-01

258

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

PubMed

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

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

2014-01-01

259

Does Inclusion of Stroke Severity in a 30-day Mortality Model Change Standardized Mortality Rates at VA Hospitals?  

PubMed Central

Background The Centers for Medicare and Medicaid Services is considering developing a 30-day ischemic stroke hospital-level mortality model using administrative data. We examined whether inclusion of the NIH Stroke Scale (NIHSS), a measure of stroke severity not included in administrative data, would alter 30-day mortality rates in the Veterans Health Administration (VHA). Methods 2562 veterans admitted with ischemic stroke to 64 VHA Hospitals in fiscal year 2007 were included. First, we examined the distribution of unadjusted mortality rates across the VHA. Second, we estimated 30-day-all-cause-risk standardized-mortality rates (RSMR) for each hospital by adjusting for age, gender and comorbid conditions using hierarchical models with and without inclusion of the NIHSS. Finally, we examined whether adjustment for the NIHSS significantly changed RSMRs for each hospital compared to other hospitals. Results The median unadjusted mortality rate was 3.6%. The RSMR inter-quartile range without the NIHSS ranged from 5.1% to 5.6%. Adjustment with the NIHSS did not change the RSMR inter-quartile range (5.1% to 5.6%). Among veterans ? 65 years, the RSMR inter-quartile range without the NIHSS ranged from 9.2% to 10.3%. With adjustment for the NIHSS, the RSMR inter-quartile range changed to 9.4% to 10.0%. The plot of 30-day RSMRs estimated with and without the inclusion of the NIHSS in the model demonstrated overlapping 95% confidence intervals across all hospitals, with no hospital significantly below or above the mean unadjusted 30-day mortality rate. The 30-day mortality measure did not discriminate well among hospitals. Conclusions The impact of the NIHSS on RSMRs was limited. The small number of stroke admissions and the narrow range of 30-day stroke mortality rates at the facility level in the VHA cast doubt on the value of using 30-day RSMRs as a means of identifying outlier hospitals based on their stroke care quality.

Keyhani, Salomeh; Cheng, Eric; Arling, Greg; Li, Xinli; Myers, Laura; Ofner, Susan; Williams, Linda S.; Phipps, Michael; Ordin, Diana; Bravata, Dawn M.

2012-01-01

260

Clinical Characteristics of Patients Deemed to Require Long-Term Hospitalization in a Civil or Forensic Psychiatric Setting  

Microsoft Academic Search

This study aimed to examine the specific characteristics of inpatients deemed by their psychiatrist to require ongoing care in a civil or forensic hospital setting compared to those who could benefit from care in a residential setting. The male participants (n = 178) involved in this study came from two such hospital settings. The results show that current hospitalization in

Mathieu Dumont; Alexandre Dumais; Catherine Briand; Gilles Côté; Alain Lesage; Jean-Luc Dubreucq

2012-01-01

261

Decreased Length of Stay and Cumulative Hospitalized Days Despite Increased Patient Admissions and Readmissions in an Area of Urban Poverty  

PubMed Central

Background Length of stay at US acute care hospitals has been steadily decreasing since 1960, and there is ongoing concern that increasing financial pressures on hospitals with high proportions of Medicaid patients may be causing unduly short lengths of stay. Objective To study temporal trends in hospital utilization on internal medicine services at Temple University Hospital, which has the highest percentage of Medicaid and uninsured patients in the state of Pennsylvania. Design Examination of temporal changes in hospital practice over three time periods spanning 13 years. Measurements Numbers of discharges, 1- and 12-month re-admission rates, and lengths of stay. US census data from 1990 to 2000 were examined for the eight major zip codes in which hospitalized patients live. Main Results The number of internal medicine admissions increased from 1991 (117/month) to 2004 (455/month); p?days; p?days; p?=?0.031). Compared to all US hospitals, our hospital had a greater increase in admissions and a greater decrease in length of stay. During this time period, in surrounding zip codes, there were decreases in total population and total number of persons living in poverty, but also multiple closures of area hospitals that served poor patients. Conclusion During the 13-year study period, despite increased readmission rates, the overall number of hospitalized days per year on the internal medicine inpatient service decreased. As local hospitals serving this inner city low income area have closed, our hospital had atypically high increases in numbers of admissions and decreases in length of stay. This raises questions about current adequacy of hospital care in inner city areas of poverty.

Kalra, Amit D.; Fisher, Robert S.

2010-01-01

262

42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.  

Code of Federal Regulations, 2013 CFR

...Definitions § 440.160 Inpatient psychiatric services...under age 21. âInpatient psychiatric services...a hospital with an inpatient psychiatric program...2) A psychiatric facility which is accredited...on Accreditation of Rehabilitation Facilities, or...

2013-10-01

263

Duration of bed occupancy as calculated at a random chosen day in an acute care ward. Implications for the use of scarce resources in psychiatric care  

Microsoft Academic Search

BACKGROUND: Psychiatric acute wards are obliged to admit patients without delay according to the Act on Compulsive Psychiatric Care. Residential long term treatment facilities and rehabilitation facilities may use a waiting list. Patients, who may not be discharged from the acute ward or should not wait there, then occupy acute ward beds. MATERIALS AND METHODS: Bed occupancy in one acute

John E Berg; Asbjørn Restan

2005-01-01

264

Understanding psychiatric institutionalization: a conceptual review  

PubMed Central

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

2013-01-01

265

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

ERIC Educational Resources Information Center

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

Francis, Greta; Radka, Dale F.

266

Relationship between two-year mortality and 30 day to the Hospital Readmission from the Nursing Home  

PubMed Central

Introduction/Objective Hospital readmission from the nursing home is often a concerning development for nursing home residents who have recently been dismissed from the hospital. Clinicians and family often consider the potential prognosis when residents return to the hospital. The objective was to determine the relationship between two-year mortality and 30-day hospital readmission status from the nursing home. Design/Methodology This was a retrospective cohort study of all adult patients over 60 living within the nursing home in Olmsted County , MN. All residents were impaneled within a primary care practice. Of this initial nursing home cohort, the residents was then divided into those residents who were readmitted to the hospital within 30 days and those who were not readmitted. The primary outcome was mortality within 2 years of 1/1/05. Data analysis involved Pearson's chi square analysis for the proportional variables. Results There were 12,650 patients within the initial panel of which 2261 were admitted to the nursing home. Of this 2261 cohort, 347 residents (15.3%) were readmitted to the hospital within 30 days. Of the 347 readmitted, 106 residents died within 2 years (31%) versus 293 (15%) in the group that was not readmitted to the hospital (p <0.001) with a hazard ratio of 2.43 [95% CI 1.88–3.16]. Conclusion/Discussion Older adults who are admitted to the nursing home are at significant risk of 2-year mortality with 2.5 times the odds of mortality in 2 years compared to those residents who are not readmitted. Those patients who are readmitted are older which could explain some of this difference or they could have significant comorbid illness which explains the higher mortality. When faced with residents who have multiple hospital admissions, the provider should consider potential discussion of end of life issues and advanced directives given the prognosis.

Hussain, Syed W.; Cha, Stephen S.; Takahashi, Paul Y.

2014-01-01

267

Alternate Level of Care Patients in Public General Hospital Psychiatry.  

ERIC Educational Resources Information Center

Analyzes the interaction between psychiatric services in public general hospitals and in other institutional settings. A one-day census of patients in a New York general hospital showed the hospital was providing care to a large number of patients in need of other, less intensive institutional settings. (BH)

Marcos, Luis R.; Gil, Rosa M.

1984-01-01

268

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

PubMed

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

Henckes, Nicolas

2009-02-01

269

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

270

The Effect of Psychiatric Rehabilitation on the Activity and Participation Level of Clients with Long-Term Psychiatric Disabilities  

Microsoft Academic Search

During the last decades of the 20th century, many psychiatric hospitals changed the living environments of their clients with long-term psychiatric disabilities. We investigated the effect of this environmental psychiatric rehabilitation and normalization process on the activity and participation level of such clients residing in one Dutch psychiatric hospital. The seven years of panel research demonstrated that more normal living

Tom van Wel; Albert Felling; Jean Persoon

2003-01-01

271

Appropriateness of admission and days of stay in pediatric hospital in Ancona, Italy  

Microsoft Academic Search

Background  In Italy, hospital admission costs account for nearly 42% of total health expenditure; in the Marche region, this share exceeds\\u000a 50%. High costs of hospitalization, however, can be partly explained by inappropriate use. The aim of this research was to\\u000a assess the risk factors associated with inappropriate hospital admissions and stay for acute pediatric patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Clinical records of children from

Daniela Vincitorio; Giacomina Chiaradia; Chiara de Waure; Jerome Mastaki Kambale; Giuseppe La Torre; Francesco Di Stanislao

2010-01-01

272

[Changes of the psychogeriatric inpatient care at the university psychiatric hospitals in basel following the constitution of an outpatient care service for the elderly].  

PubMed

Objective: 10-year follow-up of the psychogeriatric inpatient care at the University Psychiatric Hospitals Basel following the establishment of an outpatient care service for the elderly (ADA). Method: Standardized chart review of a random sample of psychogeriatric cases (??65?y) of the years 1997 and 2007 (n?=?100 each) in terms of socio-demographic, diagnostic, therapeutic und administrative data. Results: The number of patients with contact to both inpatient and outpatient services prior to admission increased. There was no change regarding the amount of unvoluntary admissions. As expected more complex cases were treated. The case management showed changes towards greater guideline conformity. Conclusion: The 10-year follow-up shows a better outpatient treatment and the provision of inpatient facilities for complex multimorbid and emergency patients. PMID:23943077

Eren, Gökhan; Hiss, Barbara; Maeck, Lienhard; Stoppe, Gabriela

2014-05-01

273

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”.

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

2008-01-01

274

The Day Reagan Was Shot: How a University Hospital PR Staff Handled the Crisis.  

ERIC Educational Resources Information Center

The experiences of George Washington University Hospital's public relations staff when it handled the crisis of the shooting of President Reagan is described. Security, choice of a spokesperson, relations with the news media, dealing with VIPs, etc., are discussed. (MLW)

Turk, Emily R.; And Others

1981-01-01

275

Introducing Spirituality into Psychiatric Care  

Microsoft Academic Search

Spirituality is important to many psychiatric patients, and these patients may be moved toward recovery more effectively if\\u000a their spiritual needs are addressed in treatment. This, however, is rarely given expression in the psychiatric services of\\u000a teaching hospitals. In order to develop this potential area of improved care, we (1) evaluated the differential attitudes\\u000a of patients and psychiatric trainees toward

Marc Galanter; Helen Dermatis; Nancy Talbot; Caitlin McMahon; Mary Jane Alexander

2011-01-01

276

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.

Baur, Nicole

2013-01-01

277

Incidence and Predictors of 30-Day Hospital Re-Admission Rate Following Percutaneous Coronary Intervention (From the National Heart, Lung, and Blood Institute Dynamic Registry)  

PubMed Central

Post-discharge outcomes following percutaneous coronary intervention (PCI) are important measures of quality of care and complement in-hospital measures. We sought to assess in-hospital and post-discharge PCI outcomes to 1) better understand the relationship between acute and 30 day outcomes, 2) identify predictors of 30-day hospital re-admission, and 3) determine the prognostic significance of 30-day hospital readmission. We analyzed in-hospital death and length of stay (LOS) and non-elective cardiac-related re-hospitalization following discharge in 10,965 patients following PCI in the Dynamic Registry. From 1999–2006, in-hospital death rate and LOS declined. The 30-day cardiac re-admission rate was 4.6%, with considerable variability over time and among hospitals. The risk of re-hospitalization was greater in women, those with CHF, unstable angina, multiple lesions and emergency PCI. Conversely, a lower risk of re-hospitalization was associated with a higher number of treated lesions. Patients re-admitted within 30 days had higher one-year mortality than those free from hospital readmission. In conclusion, while in-hospital mortality and LOS following PCI have decreased over time, the observed 30 day cardiac re-admission rate was highly variable and the risk of re-admission was more closely associated with underlying patient characteristics than procedural characteristics.

Ricciardi, Mark J.; Selzer, Faith; Marroquin, Oscar C.; Holper, Elizabeth M.; Venkitachalam, Lakshmi; Williams, David O.; Kelsey, Sheryl F.; Laskey, Warren K.

2012-01-01

278

Experiences of clients who have made the transition from the psychiatric hospital to community service provision: a phenomenological approach  

Microsoft Academic Search

Deinstitutionalization, the replacement of long-stay hospitals with community-based alternatives, can have favourable outcomes for people experiencing mental health problems. However, in many cases the community services needed for comprehensive care are not available. This raises the question as to whether the move from the long-stay hospital has been positive or not for health of clients. Therefore, it is important to

Patricia Mannix-McNamara; Elizabeth Carew Eichholz; Agatha Vitale; Didier Jourdan

2012-01-01

279

Determining the Number of State Psychiatric Hospital Beds by Measuring Quality of Care with Artificial Neural Networks  

Microsoft Academic Search

This study uses a new paradigm to calculate the min imum and the optimum number of involuntary psychi atric beds at a state hospital in Maine with 5538 admissions over a 7-year period. The method measures quality of care (Q) based upon the accuracy of predic tion of length-of-stay for the hospital, and of commu nity length-of-stay for the community,

George E. Davis; Walter E. Lowell; Geoffrey L. Davis

1998-01-01

280

Consultation-liaison Service in a Regional Hospital in Hong Kong.  

PubMed

OBJECTIVE. To examine consultation-liaison psychiatric services in a general hospital in Hong Kong. METHODS. All records of Tseung Kwan O Hospital psychiatric consultations from 1 July 2012 to 30 June 2013 were extracted from the database. Patients' demographic data, sources and reasons of referral, psychiatric and suicidal histories, current suicidal attempt, psychiatric diagnoses, psychiatric outcomes, as well as waiting times were analysed accordingly. RESULTS. A total of 1392 psychiatric consultations were received, of which 82% were attended to within the same working day when the referral was received, and 99% were attended to by the end of the next working day. The commonest reasons of consultation were unstable emotion followed by suicidal / deliberate self-harm and aggression. There were 246 consultations with actual suicidal attempt. Overall, 270 (19%) patients who received consultation-liaison psychiatric services were admitted to the psychiatric wards. Follow-up in the psychiatric outpatient department was arranged for 691 (50%) patients while 57 (4%) required referral to the community psychiatric nursing service in addition to outpatient department arrangement. CONCLUSIONS. Management of suicidal attempters and provision of risk assessment continue to be the major tasks of consultation-liaison psychiatrists and nurses. A readily available on-site consultation-liaison psychiatric service is an essential component of services provided in acute general hospitals. PMID:24986199

Wong, M Mc; Yiu, M Gc

2014-06-01

281

Hospital Nursing and 30-Day Readmissions among Medicare Patients with Heart Failure, Acute Myocardial Infarction, and Pneumonia  

PubMed Central

Background Provisions of the Affordable Care Act that increase hospitals’ financial accountability for preventable readmissions have heightened interest in identifying system-level interventions to reduce readmissions. Objectives To determine the relationship between hospital nursing; i.e. nurse work environment, nurse staffing levels, and nurse education, and 30-day readmissions among Medicare patients with heart failure, acute myocardial infarction, and pneumonia. Method and Design Analysis of linked data from California, New Jersey, and Pennsylvania that included information on the organization of hospital nursing (i.e., work environment, patient-to-nurse ratios, and proportion of nurses holding a BSN degree) from a survey of nurses, as well as patient discharge data, and American Hospital Association Annual Survey data. Robust logistic regression was used to estimate the relationship between nursing factors and 30-day readmission. Results Nearly one-quarter of heart failure index admissions (23.3% [n=39,954]); 19.1% (n=12,131) of myocardial infarction admissions; and 17.8% (n=25,169) of pneumonia admissions were readmitted within 30-days. Each additional patient per nurse in the average nurse’s workload was associated with a 7% higher odds of readmission for heart failure (OR=1.07, [1.05–1.09]), 6% for pneumonia patients (OR=1.06, [1.03–1.09]), and 9% for myocardial infarction patients (OR=1.09, [1.05–1.13]). Care in a hospital with a good versus poor work environment was associated with odds of readmission that were 7% lower for heart failure (OR = 0.93, [0.89–0.97]); 6% lower for myocardial infarction (OR = 0.94, [0.88–0.98]); and 10% lower for pneumonia (OR = 0.90, [0.85–0.96]) patients. Conclusions Improving nurses’ work environments and staffing may be effective interventions for preventing readmissions.

McHugh, Matthew D.; Ma, Chenjuan

2013-01-01

282

International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: Analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan.  

PubMed

The purpose of the present study was to review the prescription patterns of antidepressants in different countries in East Asia. The survey was conducted in China, Japan, Korea, Singapore and Taiwan from October 2003 to March 2004 using the unified research protocol and questionnaire. Twenty teaching hospitals and major psychiatric hospitals participated and a total of 1898 patients receiving antidepressants were analyzed. The survey provided a number of interesting characteristics on the prescription patterns of antidepressant in East Asia. Out of 56 antidepressants listed in the Anatomical Therapeutic Chemical Classification (ATC) index by the World Health Organization (WHO) Collaborating Center for Drug Statistics Methodology (Oslo), only 26 antidepressants were prescribed in participating countries in East Asia. On average 38.4% of prescriptions of antidepressants were for patients with diagnoses other than depressive disorders. The availability and commonly prescribed antidepressants varied greatly by country. The selective serotonin re-uptake inhibitors (SSRI) and other newer antidepressants were prescribed in approximately 77.0% of all cases. At the time of the survey, only two SSRI medications were available in Japan. However, five types of SSRI were available and were often prescribed in Korea. PMID:17875031

Uchida, Naoki; Chong, Mian-Yoon; Tan, Chay Hoon; Nagai, Hiroshi; Tanaka, Mariko; Lee, Min-Soo; Fujii, Senta; Yang, Shu-Yu; Si, Tainmei; Sim, Kang; Wei, Hao; Ling, He Yan; Nishimura, Ryoji; Kawaguchi, Yoshichika; Edwards, Glen; Sartorius, Norman; Shinfuku, Naotaka

2007-10-01

283

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.

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

2013-01-01

284

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.

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

1983-01-01

285

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

PubMed

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

Madsen, Flemming; Ladelund, Steen; Linneberg, Allan

2014-07-01

286

Hospital discharges and 30-day case fatality for drug poisoning: a Danish population-based study from 1979 to 2002 with special emphasis on paracetamol  

Microsoft Academic Search

Objective To examine the number of hospital discharges and 30-day case fatalities due to drug poisoning based on data from a Danish County Hospital Discharge Registry from 1979 to 2002. Methods All patients with a hospital discharge diagnosis of drug poisoning were identified and separated into groups taking: (1) opioid analgesics; (2) non-opioid analgesics; (3) anxiolytics; (4) antidepressants; (5) antipsychotics;

LeneRuge Møller; GunnarLauge Nielsen; MetteLena Olsen; AneMarie Thulstrup; JensTølbøll Mortensen; HenrikToft Sørensen

2004-01-01

287

PSYCHIATRIC COMPLICATIONS OF CHLOROQUINE  

PubMed Central

Sixty patients with chloroquine induced psychiatric complications are reported in the present series. Psychosis was the most common complication followed by anxiety state and seizures. The maximum number of patients were between the ages of 6 and 10 years and females (70.0%) outnumbered the males (30.0%). Headache and sleeplessness were found to be more common amongpatients developing psychiatric complications of chloroquine. The symptoms disappeared within 2 to 21 days after the discontinuation of chloroquine.

Bhatia, M.S.; Malik, S.C.

1994-01-01

288

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

Microsoft Academic Search

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

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

2006-01-01

289

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

PubMed

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

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

2014-04-01

290

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

PubMed Central

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

Warnke, Ingeborg; Nordt, Carlos; Moock, Jorn; Kawohl, Wolfram; Rossler, Wulf

2014-01-01

291

The influence of the day of the week of hospital admission on the prognosis of stroke patients.  

PubMed

This study aimed to evaluate the weekday and weekend distribution of stroke case hospital admissions and their respective prognosis based on a sample from the Estudo de Mortalidade e Morbidade do Acidente Vascular Cerebral (EMMA), a cohort of stroke patients admitted to a community hospital in the city of São Paulo, Brazil. We ascertained all consecutive cases of first-time strokes between April 2006 and December 2008 and performed a subsequent one-year follow-up. No association was found between frequency of hospital admissions due to ischemic and hemorrhagic strokes and the specific day of the week on which the admission occurred. However, ten-day and twelve-month case-fatality was higher in hemorrhagic stroke patients admitted at the weekend. We also found that intracerebral hemorrhage patients admitted on weekends had a worse survival rate (50%) compared with those admitted during weekdays (25.6%, P log-rank = 0.03). We found a multivariate hazard ratio of 2.49 (95%CI: 1.10-5.81, P trend = 0.03) for risk of death at the weekend compared to weekdays for intracerebral hemorrhage cases. No difference in survival was observed with respect to the overall sample of stroke or ischemic stroke patients. PMID:23568306

Barros, Juliana B; Goulart, Alessandra Carvalho; Alencar, Airlane P; Lotufo, Paulo A; Bensenor, Isabela M

2013-04-01

292

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

293

The pregnant psychiatric inpatient: a missed opportunity.  

PubMed

The authors describe a group of pregnant psychiatric patients admitted to a psychiatric service in an urban hospital. A high rate of involuntary admission (44%), homelessness (36%), and substance abuse (64%) was noted. In this group of high-risk obstetric patients, we identified risk factors associated with noncompliance with ongoing prenatal care. Brief psychiatric hospitalization can be an important aspect in improving obstetric outcome by providing an opportunity to collect obstetric information and promote ongoing prenatal care. PMID:2245921

Miller, W H; Resnick, M P; Williams, M H; Bloom, J D

1990-11-01

294

A review of violent incidents in a multilevel secure forensic psychiatric hospital: is there a seasonal variation?  

PubMed

There have been several attempts made to reduce the occurrence of violence in hospital settings, with most professional organizations taking a stance. The impact of violent incidence on the therapeutic environment and the cost in human terms led to the declaration by the World Health Organization that violence is a public health problem. There are strategies for reducing violence that flow out of known trends. We sought to examine the trends in institutional violence in a contextual sense. We reviewed the records of all incidents of violence, categorized by severity, victims and trends over five years in a multilevel secure forensic hospital in Canada. The rate of violence perpetrated by female patients was significantly higher than for male patients. Higher occurrence of violence was recorded in the winter months compared with any other season and was related to unstructured activities. There is a window of opportunity to develop some engaging programmes during the long winter months and improve supervision at all times of unstructured activity. The reasons for increased women perpetration and the winter peak of violence require further investigation. PMID:23362235

Peluola, Akin; Mela, Mansfield; Adelugba, Olajide O

2013-04-01

295

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.

Banerjee, Sohini

2013-01-01

296

The incidence, hospital expenditure, and, 30 day and 1 year mortality rates of spontaneous intracerebral hemorrhage in Taiwan.  

PubMed

The risks of morbidity and mortality are high in patients with spontaneous intracerebral hemorrhage (sICH). The medical care resources associated with sICH are also substantial. This study aimed to evaluate the medical expenditure for sICH patients in Taiwan. We analyzed the National Health Insurance Research Database from 2005 to 2010. The inclusion criterion was first-event sICH; traumatic ICH patients were excluded. Student's t-test, multiple linear regression and the chi-squared test were employed as the statistical methods. Our results showed that the incidence of sICH was 40.77 patients per 100,000 of population per year in Taiwan. The incidence increased with age and was greater in men than women. The mean hospital length of stay (LOS) of first-event sICH patients was 31.8 days; the mean LOS in the intensive care unit was 7.9 days; and the mean survival time was 60.4 months. The mortality rate within 30 days and within 1 year was 19.8 and 29.6%, respectively. The mean hospital expenditure of first-event sICH patients was USD $7572, and was highly correlated with LOS. In conclusion, the incidence of sICH in Taiwan is higher than that in white and black populations of northern America and some European countries and lower than that in the Asian populations of Japan and China. The features of male and female sICH patients differ. Our findings suggest that the hospital expenditure and mortality rate of sICH patients in Taiwan are comparable with those of other countries. PMID:24090518

Chan, Chien-Lung; Ting, Hsien-Wei; Huang, Hsin-Tsung

2014-01-01

297

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

PubMed Central

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

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

2014-01-01

298

Postnatal depression and psychosis--a mother and baby unit in a general hospital.  

PubMed

The experience of a Mother and Baby Unit in a General Hospital Psychiatry Department in managing postnatal depression and puerperal psychosis over a 2-year period is reviewed. In our community severe depressive illness will more often be referred to a Public General Hospital with a psychiatric service. The mean admission duration of 26 days for depressive illness was significantly lower than that previously reported by a Psychiatric Hospital. A significant delay in presentation appeared in half the cases, which could be reduced by attention to the family and past psychiatric history, especially the patient's relationship to her own mother indicating risk of puerperal mental disturbance. PMID:3233082

Kissane, D; Ball, J R

1988-08-01

299

Association of meteorological and day-of-the-week factors with emergency hospital admissions in Fukuoka, Japan  

NASA Astrophysics Data System (ADS)

We carried out a statistical study of the influence of meteorological and day-of-the-week factors on the intrinsic emergency patients transported to hospitals by ambulance. Multiple piecewise linear regression analysis was performed on data from 6,081 emergency admissions for 1 year between April 1997 and March 1998 in Fukuoka, Japan. The response variable was the daily number of emergency patients admitted with three types of disease: cerebrovascular, respiratory and digestive diseases. The results showed that the number of emergency patients admitted daily with cerebrovascular disease was significantly associated with temperature on the day of admission and whether the day was Sunday. As it became colder than 12 °C, emergency admissions of patients with cerebrovascular disease increased drastically, reaching a plateau at 4 °C. On the 3rd and 7th days after the temperature fell below 10 °C, the daily admission of patients with respiratory disease significantly increased. We also observed a weak association between emergency admissions of patients suffering from digestive disease and rising barometric pressure on the day of admission.

Makie, Toshio; Harada, Muneaki; Kinukawa, Naoko; Toyoshiba, Hiroyoshi; Yamanaka, Takeharu; Nakamura, Tsuyoshi; Sakamoto, Masako; Nose, Yoshiaki

2002-02-01

300

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

301

A Public-Private Partnership Develops and Externally Validates a 30-Day Hospital Readmission Risk Prediction Model  

PubMed Central

Introduction: Preventing the occurrence of hospital readmissions is needed to improve quality of care and foster population health across the care continuum. Hospitals are being held accountable for improving transitions of care to avert unnecessary readmissions. Advocate Health Care in Chicago and Cerner (ACC) collaborated to develop all-cause, 30-day hospital readmission risk prediction models to identify patients that need interventional resources. Ideally, prediction models should encompass several qualities: they should have high predictive ability; use reliable and clinically relevant data; use vigorous performance metrics to assess the models; be validated in populations where they are applied; and be scalable in heterogeneous populations. However, a systematic review of prediction models for hospital readmission risk determined that most performed poorly (average C-statistic of 0.66) and efforts to improve their performance are needed for widespread usage. Methods: The ACC team incorporated electronic health record data, utilized a mixed-method approach to evaluate risk factors, and externally validated their prediction models for generalizability. Inclusion and exclusion criteria were applied on the patient cohort and then split for derivation and internal validation. Stepwise logistic regression was performed to develop two predictive models: one for admission and one for discharge. The prediction models were assessed for discrimination ability, calibration, overall performance, and then externally validated. Results: The ACC Admission and Discharge Models demonstrated modest discrimination ability during derivation, internal and external validation post-recalibration (C-statistic of 0.76 and 0.78, respectively), and reasonable model fit during external validation for utility in heterogeneous populations. Conclusions: The ACC Admission and Discharge Models embody the design qualities of ideal prediction models. The ACC plans to continue its partnership to further improve and develop valuable clinical models.

Choudhry, Shahid A.; Li, Jing; Davis, Darcy; Erdmann, Cole; Sikka, Rishi; Sutariya, Bharat

2013-01-01

302

Goal attainment scaling in a geriatric day hospital. Team and program benefits.  

PubMed Central

PROBLEM BEING ADDRESSED: The Geriatric Day Program (GDP) of the Capital Health Region in Victoria, BC, is concerned with effective team processes, accountability for health service outcomes, and improving the quality of programs. The GDP identified a need to improve its interdisciplinary processes and generate useful patient outcome data. OBJECTIVE OF PROGRAM: To determine whether Goal Attainment Scaling (GAS) could be introduced to facilitate interdisciplinary processes and to generate useful health outcome data. MAIN COMPONENTS OF PROGRAM: The GAS procedures were incorporated into clinical routines based on published guidelines. The authors determined GAS outcome scores for patients who completed the program and developed outcome scores for specific geriatric problem areas requiring intervention. Outcome scores were made available to the clinical care team and to program managers for continuous quality improvement purposes. CONCLUSIONS: The GAS process was successfully implemented and was acceptable to clinicians and managers at the GDP. Team processes were thought to be improved by focusing on patient goals in a structured way. The GAS provided data on both patient outcomes and outcomes of interventions in specific problem areas. Accountability for patient care increased. Goal Attainment Scaling provided indicators of care for which clinicians could develop program quality improvements.

Evans, D. J.; Oakey, S.; Almdahl, S.; Davoren, B.

1999-01-01

303

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.

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

2014-01-01

304

Introducing spirituality into psychiatric care.  

PubMed

Spirituality is important to many psychiatric patients, and these patients may be moved toward recovery more effectively if their spiritual needs are addressed in treatment. This, however, is rarely given expression in the psychiatric services of teaching hospitals. In order to develop this potential area of improved care, we (1) evaluated the differential attitudes of patients and psychiatric trainees toward the value of spirituality in the recovery process, (2) established a program of group meetings conducted by psychiatric residents and staff where patients can discuss how to draw on their spirituality in coping with their problems, and (3) established related training experiences for psychiatric residents. The results and implications of these three initiatives are presented. PMID:19728095

Galanter, Marc; Dermatis, Helen; Talbot, Nancy; McMahon, Caitlin; Alexander, Mary Jane

2011-03-01

305

Perceptions and needs of parents during a young adult's first psychiatric hospitalization: "we're all on this little island and we're going to drown real soon".  

PubMed

A young person's first psychiatric hospitalization can present a crisis for the family. This initial contact with the mental health care system and health care providers, whether positive or negative, has the potential to set the foundation for all future interactions. The purpose of this study was to examine the impact of a young person's first hospitalization on his or her parents and to determine the parents' perspectives on their own emotional and practical support needs. Ten parents (nine mothers and one father) of a young person aged 18 to 25 were recruited through local support groups and by snowball sampling. Based on Aguilera and Messick's (1986) crisis theory, participants were asked about their perception of the event, coping methods they used, and support systems they engaged while their adult child was hospitalized. Six themes were identified: feeling relief about receiving a diagnosis; shock and disbelief associated with the diagnosis of a mental illness; isolation associated with the stigma of mental illness; feeling excluded during the discharge process; and grieving for the loss associated with an altered future. The results revealed that participants received their support from family, friends, and support groups and did not find mental health care providers to be helpful or supportive. The participants provided recommendations for those who work with families experiencing the crisis of a first psychiatric hospitalization. PMID:20218767

Clarke, Diana; Winsor, Joanne

2010-04-01

306

Regional variations in medical expenditure and hospitalization days for heart attack patients in Japan: evidence from the Tokai Acute Myocardial Study (TAMIS).  

PubMed

In Japan, the use of percutaneous transluminal coronary angioplasty (PTCA) for the treatment of acute myocardial infarction (AMI) is extraordinarily frequent, resulting in large medical expenditure. Using chart-based data and exploiting regional variations, we explore what factors explain the frequent use of PTCA, employing propensity score matching to estimate the average treatment effects on hospital expenditure and hospital days. We find that the probability of receiving PTCA is affected by the density of medical resources in a region. Moreover, expenditure is higher for treated patients while there are no significant differences in hospitalization days, implying that the frequent use of PTCA is economically motivated. PMID:18204898

Noguchi, Haruko; Shimizutani, Satoshi; Masuda, Yuichiro

2008-06-01

307

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

308

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.

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

1999-01-01

309

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

PubMed Central

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

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

2014-01-01

310

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.

2012-01-01

311

Review of Medicare Acute Care Inpatient Same-Day Readmissions at University of Pittsburgh Medical Center Presbyterian Shadyside Hospital.  

National Technical Information Service (NTIS)

Section 1886(d) of the Act established the prospective payment system (PPS) for inpatient hospital services. Under the PPS, CMS pays hospital costs at predetermined rates for patient discharges. The rates vary according to the diagnosis-related group (DRG...

2012-01-01

312

Epidemiology and treatment of mood disorders in a day hospital setting from 1996 to 2007: an Italian study  

PubMed Central

Background: The present study aimed: to assess prescribing patterns in the treatment of major depression, bipolar disorder type I, cyclothymia, and dysthymia from 1996 to 2007 in a day hospital setting; to evaluate the prevalence of the above-mentioned mood disorders and gender distribution; and to relate familiality, comorbidity, and marital status to each diagnosis. Methods: Medical records for 777 day hospital patients with a diagnosis of major depression, bipolar disorder type I, cyclothymia, or dysthymia were grouped into two 6-year periods so as to compare the prescribing patterns of tricyclic antidepressants, selective serotonin reuptake inhibitors, noradrenergic reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, noradrenergic and specific serotonergic antidepressants, first-generation antipsychotics, second-generation antipsychotics, and mood stabilizers. Gender, prevalence, familiality, comorbidity, and marital status were related to each diagnosis. Results: The most common mood disorder, with a female preponderance, was major depression, regardless of marital status. High percentages of familiality and comorbidity were found for major depression, while a reduction was found in the utilization of tricyclic antidepressants. There was no statistically significant difference in rates of prescription of selective serotonin reuptake inhibitors and noradrenergic reuptake inhibitors, but some irregularities were found upon evaluating each diagnosis (eg, increased utilization of these agents in dysthymia and major depression, respectively). There was an increase in prescriptions for serotonin and norepinephrine reuptake inhibitors, but no marked differences in utilization of noradrenergic and specific serotonergic antidepressants, which remained basically low. There was no significant difference in prescribing of first-generation antipsychotic agents, although a reduction was found. There was a significant increase in utilization of second-generation antipsychotics and mood stabilizers. Conclusion: Our epidemiological findings are consistent with data reported in the literature regarding the high prevalence of major depression among the mood disorders, as well as the impact of familiality and comorbidity. Analysis of prescribing patterns for antidepressants, antipsychotics, and mood stabilizers in the treatment of mood disorders shows a shift from older to newer drugs, and wider use of mood stabilizers.

Luca, Maria; Prossimo, Giuseppa; Messina, Vincenzo; Luca, Antonina; Romeo, Salvatore; Calandra, Carmela

2013-01-01

313

Manual for the Development and Day to Day Operation of an In Hospital Health Education Library: A Model Implemented by Volunteers. Sarah K. Davidson Family-Patient Library.  

ERIC Educational Resources Information Center

This manual presents the policies and procedures of the Sarah K. Davidson Family-Patient library, which provides information on children's health problems for pediatric inpatients and their families at the Strong Memorial Hospital of the University of Rochester, New York. The development of the library, and its classification, library use,…

Weber, Sandra, Ed.

314

Deinstitutionalization and the Infirm Chronic Psychiatric Patient  

Microsoft Academic Search

In the Netherlands a tight network of mainly intramural psychogeriatric nursing facilities exists. A discussion is going on whether these beds may substitute beds for elderly infirm inpatients of psychiatric hospitals, which are more expensive. The move towards community psychiatry may lead to insufficient planning of services for patients with combined chronic mental and somatic conditions. Elderly patients in psychiatric

J. A. C. Bleeker; R. De Reus; W. R. A. Duurkoop

1991-01-01

315

Computerized Psychiatric Diagnostic Interview  

PubMed Central

A computerized psychiatric diagnostic interview was developed and administered to 121 adult acute psychiatric inpatients. Data on the 100 completers was evaluated for sensitivity and specificity of the computer diagnostic evaluation relative to the hospital discharge diagnosis and revealed sensitivity greater than 70% for major depression, alcohol/substance abuse, adjustment disorder, bipolar/mania, dependent personaltiy disorder, and histrionic personality disorder. Specificity was greater than 70% for schizophrania, alcohol/substance abuse, and borderline personality disorder. Meen interview time was 51 minutes. Eighty-two percent of patients evaluated the computerized interview as interesting and 78% rated it as thorough. The mouse input, large screen letters, and user-friendliness of the Macintosh computer make this ideal for patient-computer interaction.

Zetin, Mark; Warren, Stacey; Lanssens, Ed; Tominaga, Doris

1987-01-01

316

Irrational determinants of the place of psychiatric treatment.  

PubMed

Observations of 392 women admitted to a psychiatric hospital indicated that 24 were well suited to treatment in a day center and that 208 could feasibly be treated there. However, only 59, or 28 per cent of those for whom day care was feasible, were able to take advantage of that alternative. The others were excluded by financial limitations, refusal to accept the day center option, administrative delays, and inaccurate classification of treatment setting. The authors believe that underuse of the day center was due as much to doctors' inexperience, personal biases, and unfamiliarity with the facilities as it was to psychopathology and financial realities. They found that many clinicians were not aware of the factors that affect their decisions about the use of a partial hospitalization setting. PMID:1278853

Washburn, S L; Vannicelli, M; Scheff, B J

1976-03-01

317

[Actual problems of inpatient psychiatric care in Russia].  

PubMed

A comparative evaluation of inpatient psychiatric care in Russia and some other countries is presented. A systematic analysis of the performance of psychiatric hospitals is conducted. The process of the deinstitutionalization in Russian psychiatry is highlighted. A range of problems hindering a reform of inpatient psychiatric service of the country is singled out. PMID:24300798

Iastrebov, V S; Mitikhin, V G; Solokhina, T A; Shevchenko, L S; Tvorogova, N A

2013-01-01

318

Police referrals to an urban psychiatric emergency room in Israel  

Microsoft Academic Search

The movement toward community psychiatric care brought greater involvement of policemen in incidents involving subjects suffering from psychiatric disorders. The psychiatric emergency room (PER) has become a meeting-point of the police and the mental health system. The object of the study was to characterize subjects brought to Israel's largest PER by policemen and to assess their hospital stay. All referrals

Robert Kimhi; Moshe Zohar; Yoram Barak; Israel Barak

1996-01-01

319

Use of mobile assessment technologies in inpatient psychiatric settings.  

PubMed

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

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

2014-08-01

320

An Administrative Claims Measure Suitable for Profiling Hospital Performance Based on 30-Day All-Cause Readmission Rates Among Patients With Acute Myocardial Infarction  

PubMed Central

Background National attention has increasingly focused on readmission as a target for quality improvement. We present the development and validation of a model approved by the National Quality Forum and used by the Centers for Medicare & Medicaid Services for hospital-level public reporting of risk-standardized readmission rates for patients discharged from the hospital after an acute myocardial infarction. Methods and Results We developed a hierarchical logistic regression model to calculate hospital risk-standardized 30-day all-cause readmission rates for patients hospitalized with acute myocardial infarction. The model was derived using Medicare claims data for a 2006 cohort and validated using claims and medical record data. The unadjusted readmission rate was 18.9%. The final model included 31 variables and had discrimination ranging from 8% observed 30-day readmission rate in the lowest predictive decile to 32% in the highest decile and a C statistic of 0.63. The 25th and 75th percentiles of the risk-standardized readmission rates across 3890 hospitals were 18.6% and 19.1%, with fifth and 95th percentiles of 18.0% and 19.9%, respectively. The odds of all-cause readmission for a hospital 1 SD above average were 1.35 times that of a hospital 1 SD below average. Hospital-level adjusted readmission rates developed using the claims model were similar to rates produced for the same cohort using a medical record model (correlation, 0.98; median difference, 0.02 percentage points). Conclusions This claims-based model of hospital risk-standardized readmission rates for patients with acute myocardial infarction produces estimates that are excellent surrogates for those produced from a medical record model.

Krumholz, Harlan M.; Lin, Zhenqiu; Drye, Elizabeth E.; Desai, Mayur M.; Han, Lein F.; Rapp, Michael T.; Mattera, Jennifer A.; Normand, Sharon-Lise T.

2012-01-01

321

Hospitalization rate and 30-day mortality among patients with status asthmaticus in Denmark: a 16-year nationwide population-based cohort study  

PubMed Central

Objective Current data on hospitalization and prognosis of acute asthma and status asthmaticus are inconclusive. We aim to analyze the rate of first-time hospitalizations for status asthmaticus among patients of all ages, the proportion admitted to intensive care units (ICU), and the 30-day mortality over a 16-year period. Methods In this population-based cohort study, we used medical registries to identify all first-time status asthmaticus hospitalizations in Denmark from 1996 through 2011. Data on comorbidities were also obtained. We computed yearly hospitalization rates overall and by gender and age groups, and estimated the proportion requiring ICU admission. We estimated 30-day age- and gender-standardized mortality. We examined potential misclassification from acute exacerbation of chronic obstructive pulmonary disease (COPD) by excluding patients with preexisting or concurrent COPD. Results Of the 5,001 patients identified with a first-time status asthmaticus hospitalization, 50.5% were male, 40.3% were <15 years old, and 12.4% had comorbidity. The hospitalization rate increased from 48.0 per 1,000,000 person-years (PY) (95% confidence interval [CI]: 45.1–51.1 PY) during 1996–1999 to 70.1 per 1,000,000 PY (95% CI: 66.7–73.7 PY) during 2008–2011. This may be explained by an increased hospitalization rate of children. The standardized 30-day mortality risk declined from 3.3% (95% CI: 2.5%–4.1%) in 1996–1999 to 1.5% (95% CI: 0.9%–2.1%) in 2008–2011. During 2005–2011, 10.1% of status asthmaticus patients were admitted to the ICU. Hospitalization rates and mortality risk decreased by excluding 939 patients also registered with COPD, but overall temporal changes did not change. Conclusion From 1996 to 2011, status asthmaticus hospitalization rate increased but remained below 100 hospitalizations per 1,000,000 PY. Thirty-day mortality risk was halved to less than 2%.

Strid, Jennie Maria Christin; Gammelager, Henrik; Johansen, Martin Berg; T?nnesen, Else; Christian, Fynbo Christiansen

2013-01-01

322

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

PubMed Central

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

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

2010-01-01

323

Psychiatric manifestations in cerebrotendinous xanthomatosis.  

PubMed

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

324

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

Code of Federal Regulations, 2013 CFR

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

2013-10-01

325

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

PubMed

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

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

2014-05-01

326

Brain Tumours Simulating Psychiatric Disease  

PubMed Central

Brain tumours may present with symptoms indistinguishable from psychiatric disease. The impression of most psychiatrists is that individuals suffering from brain tumour rarely appear among their patients. A priori reasoning based on evidence from neurological, neurosurgical and pathological sources suggests the contrary. The present study is a frequency analysis of cases of previously undiagnosed brain tumours admitted to either an open psychoneurotic ward or a mental hospital over a period of 15 years. The results support the impression held by psychiatrists that brain tumours are uncommon among psychiatric patients.

Hobbs, G. E.

1963-01-01

327

Psychiatric disorders among patients admitted to a French medical emergency service  

Microsoft Academic Search

ObjectiveThe authors assessed the prevalence of psychiatric disorders among a population of patients examined in the emergency service of a French general hospital. They compared patients with and without psychiatric disorders. They also compared patients where the primary motive of emergency was psychiatric to those whose psychiatric disorders were secondarily diagnosed by a systematic assessment.

Veronique Saliou; Anika Fichelle; Mary McLoughlin; Isabelle Thauvin; Michel Lejoyeux

2005-01-01

328

Literature Review: Psychiatric Boarding.  

National Technical Information Service (NTIS)

This literature review will explore the relevant literature on several key questions regarding boarding of psychiatric patients in the ED. Is psychiatric boarding a problem. What are the reasons for boarding psychiatric patients. What kind of care is rece...

D. Bender M. Ludwig N. Pande

2008-01-01

329

Post-inpatient attrition from care "as usual" in veterans with multiple psychiatric admissions.  

PubMed

Disengagement from outpatient care following psychiatric hospitalization is common in high-utilizing psychiatric patients and contributes to intensive care utilization. To investigate variables related to treatment attrition, a range of demographic, diagnostic, cognitive, social, and behavioral variables were collected from 233 veterans receiving inpatient psychiatric services who were then monitored over the following 2 years. During the follow-up period, 88.0 % (n = 202) of patients disengaged from post-inpatient care. Attrition was associated with male gender, younger age, increased expectations of stigma, less short-term participation in group therapy, and poorer medication adherence. Of those who left care, earlier attrition was predicted by fewer prior-year inpatient psychiatric days, fewer lifetime psychiatric hospitalizations, increased perceived treatment support from family, and less short-term attendance at psychiatrist appointments. Survival analyses were used to analyze the rate of attrition of the entire sample as well as the sample split by short-term group therapy attendance. Implications are discussed. PMID:23086009

Bowersox, Nicholas W; Saunders, Stephen M; Berger, Bertrand

2013-12-01

330

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

331

Neuropathological research at the "Deutsche Forschungsanstalt fuer Psychiatrie" (German Institute for Psychiatric Research) in Munich (Kaiser-Wilhelm-Institute). Scientific utilization of children's organs from the "Kinderfachabteilungen" (Children's Special Departments) at Bavarian State Hospitals.  

PubMed

During National Socialism, the politically motivated interest in psychiatric genetic research lead to the founding of research departments specialized in pathological-anatomical brain research, the two Kaiser Wilhelm-Institutes (KWI) in Berlin and Munich. The latter was indirectly provided with brain material by Bavarian State Hospitals, to three of which "Kinderfachabteilungen" (Special Pediatric Units) were affiliated. As children became victims of the systematically conducted child "euthanasia" in these Special Pediatric Units, this paper will address the question whether and to which extent the organs from victims of child "euthanasia" were used for (neuro-) pathological research at the KWI in Munich. By means of case studies and medical histories (with focus on the situation in Kaufbeuren-Irsee), I will argue that pediatric departments on a regular base delivered slide preparations, that the child "euthanasia" conduced in these departments systematically contributed to neuropathological research and that slide preparations from victims of child "euthanasia" were used in scientific publications after 1945. PMID:16887759

Steger, Florian

2006-09-01

332

The role of everyday emotion regulation on pain in hospitalized elderly: Insights from a prospective within-day assessment  

Microsoft Academic Search

Pain management is still an unresolved issue among the general elderly patient population in institutions. It is proposed that everyday emotion regulation (i.e. self-supporting maintenance or change in positive and negative emotions) performed by hospitalized elderly can help reduce pain intensity. This argument is based on (1) robust evidence in life span research of elderly's high ability for emotion regulation

Catherine Paquet; Marie-Jeanne Kergoat; Laurette Dubé

2005-01-01

333

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

334

Organizational models of emergency psychiatric intervention: state of the art.  

PubMed

Authors outline the differences between medical and psychiatric definition of emergency and analyze different organizational models of psychiatric intervention in Emergency Room. The historical evolution changed these models, and the relation with services for acute and subacute patients in hospital and community services. The Italian reform model is compared with the slow deinstitutionalization of psychiatry in other countries. Critical points in Italian emergency organization after the Psychiatric Reform are pointed out: low number of beds for acute patients, difficulties and delays in transfer from Emergency Room to GHPW (General Hospital Psychiatric Ward), waiting lists for voluntary treatments. To overcome some of these problems, the Authors propose that even in hospitals without psychiatric ward, a small unit of short psychiatric observation be implemented, for voluntary treatments, before transfer to other institutions. PMID:18062351

Barra, A; Daini, S; Tonioni, F; Bria, P

2007-01-01

335

Oppositional defiant disorder symptoms in relation to psychopathic traits and aggression among psychiatrically hospitalized children: ADHD symptoms as a potential moderator.  

PubMed

Oppositional defiant disorder (ODD) is associated with elevated rates of psychopathic traits and aggression. However, it remains unclear if attention-deficit/hyperactivity disorder (ADHD) symptoms exacerbate these relations, particularly in samples of children who are severely clinically distressed. The purpose of the present study was to test ADHD symptoms as a potential moderator of the relations of ODD symptoms to psychopathic traits (i.e., callous-unemotional [CU] traits, narcissism) and to aggressive subtypes (i.e., proactive, reactive aggression) in a large sample of children in an acute psychiatric inpatient facility (n = 699; ages 6-12). Multiple regression analyses indicated that, after controlling for child demographic variables, ADHD symptoms marginally exacerbated the relation between ODD symptoms and CU traits. Both ODD and ADHD symptoms had an additive, but not a multiplicative effect, in predicting narcissism. In addition, for a subset of the full sample for whom data were available (n =351), ADHD symptoms exacerbated the relation between ODD symptoms and both reactive and proactive aggression. These results suggest that ADHD symptoms tend to have a negative effect on the relation between ODD symptoms and markers of antisociality among children receiving acute psychiatric care. PMID:23436456

Becker, Stephen P; Luebbe, Aaron M; Fite, Paula J; Greening, Leilani; Stoppelbein, Laura

2013-01-01

336

Day-case surgery in children under 2 years of age: experience in a district general hospital and survey of parental satisfaction.  

PubMed

One surgeon's experience of day-case paediatric surgery in a population aged less than 2 years at a district general hospital is reported. During a 6-year period from 1989 to 1994, 82 day-case operations were performed in 79 infants and young children. All children were managed by a multidisciplinary team including surgeon, paediatric anaesthetist and paediatric nurses. There was no mortality and minimal morbidity. A telephone survey of parents enquiring into satisfaction with all aspects of pre-, peri-, and post-operative care revealed that the procedures are well-accepted. The survey also showed that there was no increased utilization of primary health care professionals when day-case surgery is performed in this young age group. We conclude that paediatric day-case surgery is safe and well-tolerated by both infants and parents and is suitable for performance in non-specialist centres provided a team approach is adopted. PMID:8997032

Stiff, G; Haray, P N; Chilcott, M; Williams, I; Watkins, G; Foster, M E

1996-12-01

337

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

338

Excess mortality of psychiatric inpatients in Taiwan  

Microsoft Academic Search

The 6-year mortality rate of a nation-wide cohort of Taiwanese psychiatric inpatients admitted during the 1-year period from 1987 to 1988 was examined via record linkage. The psychiatric care system in Taiwan is mainly hospital-based. Of the 13 385 patients studied (9309 men and 4076 women), 2039 (1720 men and 319 women) had died by the nd of 1993. The

Wei J. Chen; Yu-Jing Huang; Ling-Ling Yeh; Hsien Rin; Hai-Gwo Hwu

1996-01-01

339

CCPP-Copenhagen Community Psychiatric Project  

Microsoft Academic Search

Deinstitutionalization of psychiatry in Denmark has been extensive and the number of psychiatric beds per 1,000 inhabitants is among the lowest in Europe. The effect of supplementing hospital treatment with treatment in community mental health centres was evaluated in a quasi-experimental design. The patient group examined consisted of patients with long-term contact with psychiatric services. When development in intervention and

M. Nordentoft; B. Welcher; H. C. Knudsen; A. Krasnik; B. Jessen-Petersen; P. Treufeldt; H. Sælan

1996-01-01

340

Implications of psychiatric comorbidity among combat veterans.  

PubMed

Limited research exists regarding the rates of and outcomes associated with psychiatric comorbidity among active duty military personnel. This study investigated the rates of comorbid psychiatric diagnoses among 81,720 U.S. Marines, and assessed the relationships between preexisting comorbid disorders and risk of psychiatric hospitalizations and attrition from service. The study used medical, deployment, and personnel records for all Marines who enlisted between 2002 and 2005. The baseline rate of comorbidity was 1.3% for Marines who deployed during the first term of service, and 6.3% for Marines who did not deploy. The most common baseline comorbidity among deployed Marines was mood disorders with anxiety disorders, and mood and adjustment disorders among nondeployed Marines. Logistic regression analyses revealed Marines with comorbid diagnoses before deployment were over three times more likely to attrite (odds ratio = 3.4, p < 0.001) and over five times more likely to be hospitalized for psychiatric symptoms (odds ratio = 5.1, p < 0.001) following deployment than those with no diagnoses. Similar patterns emerged among nondeployers. Outcomes associated with comorbid conditions were substantially worse than outcomes for single conditions. These findings demonstrate that Marines with a history of comorbid psychiatric diagnoses are at a much greater risk for adverse outcomes, specifically attrition from the military and psychiatric hospitalization. PMID:24083917

Schmied, Emily A; Highfill-McRoy, Robyn M; Crain, Jenny A; Larson, Gerald E

2013-10-01

341

Psychiatric morbidity at secondary level health facility in Ballabgarh, Haryana  

PubMed Central

Background: There is dearth of information about psychiatric morbidity at secondary level health facility in India. Aim: To study psychiatric morbidity amongst patients attending psychiatry clinic in secondary level health facility. Settings and Design: Present study is based on hospital record review of psychiatry clinic at secondary care hospital in Ballabgarh, Haryana. Materials and Methods: Service record of psychiatry clinic at civil hospital Ballabgarh was reviewed. Diagnosis of psychiatric morbidity was done according to DSM IV and ICD 10 classification. Statistical Analysis: Descriptive analysis of data was carried out. Results: A total of 724 (0.7%) new OPD patients consulted psychiatry clinic. Common Mental Disorders comprising of mood disorders, neurotic stress –related and somatoform disorders were the most commonly diagnosed disorders (60.5%) amongst reported psychiatric morbidity in the hospital. Conclusion: Substantial burden of psychiatry morbidity highlights necessity of psychiatry clinic at secondary care hospital in India.

Salve, Harshal; Kharya, Pradip; Misra, Puneet; Rai, Sanjay K.; Kant, Shashi

2013-01-01

342

Prescribing at the hospital-general practice interface. I: Hospital outpatient dispensing policies in England.  

PubMed Central

OBJECTIVE--To describe the outpatient dispensing policies of major acute hospitals in England. DESIGN--Postal questionnaire survey in November 1990. SETTING--All (278) major acute hospitals in England with more than 250 beds, excluding maternity, paediatric, or psychiatric hospitals; nine hospitals declined. PARTICIPANTS--Hospital chief pharmacists. MAIN OUTCOME MEASURES--Current dispensing policy and exceptions to it; when the policy was formed; and who was involved in its formation. RESULTS--Completed questionnaires were received from 200 (72%) of the hospitals approached. The quantities of drugs dispensed to outpatients ranged from zero in 12 hospitals to unlimited amounts in nine; nearly half (92) dispensed a 14 days' supply of drugs. The greater the restriction on outpatient dispensing, the more recently the policy had been introduced (chi 2 for trend = 7.15; df = 1; p less than 0.01). Permissible exceptions to the policy included the consultant's specific request (134 hospitals), difficulty in obtaining drugs in the community (102), urgent need for start of treatment (49), and certain types of patients (41) or drugs or their regimens (104). Groups who were neither represented on the hospital committee concerned with policy formation nor consulted before policy changes included regional health authorities in 122 hospitals, district health authorities in 101 hospitals, and general practitioners in 32 hospitals. CONCLUSIONS--Outpatient dispensing policies varied considerably among the hospitals surveyed, but they seemed to be moving towards greater restrictions on the supply of drugs given to outpatients.

Wilkie, P.; Sibbald, B.; Raftery, J.; Anderson, S.; Freeling, P.

1992-01-01

343

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.

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

344

Treatment needs of prisoners with psychiatric disorders.  

PubMed Central

OBJECTIVE--To describe the prevalence of psychiatric disorder and the treatment needs of sentenced prisoners in England and Wales. DESIGN--Population survey based on a 5% sample of men serving prison sentences. SETTING--Sixteen prisons for adult males and nine institutions for male young offenders representative of all prisons in prison type, security levels, and length of sentences. SUBJECTS--406 young offenders and 1478 adult men, 404 and 1365 of whom agreed to be interviewed. MAIN OUTCOME MEASURES--History of psychiatric disorder, clinical diagnosis of psychiatrist, and required treatment. RESULTS--652 (37%) men had psychiatric disorders diagnosed, of whom 15 (0.8%) had organic disorders, 34 (2%) psychosis, 105 (6%) neurosis, 177 (10%) personality disorder, and 407 (23%) substance misuse. 52 (3%) were judged to require transfer to hospital for psychiatric treatment, 96 (5%) required treatment in a therapeutic community setting, and a further 176 (10%) required further psychiatric assessment or treatment within prison. CONCLUSIONS--By extrapolation the sentenced prison population includes over 700 men with psychosis, and around 1100 who would warrant transfer to hospital for psychiatric treatment. Provision of secure treatment facilities, particularly long term medium secure units, needs to be improved. Services for people with personality, sexual, and substance misuse disorders should be developed in both prisons and the health service.

Gunn, J; Maden, A; Swinton, M

1991-01-01

345

Comprehensive Psychiatric Evaluation  

MedlinePLUS

... and print a PDF version of this document . Evaluation by a child and adolescent psychiatrist is appropriate ... emotional and behavioral problems need a comprehensive psychiatric evaluation. Comprehensive psychiatric evaluations usually require several hours over ...

346

Psychiatric disorders in neurology.  

PubMed

Psychiatric disorders (PDs) in neurology are more frequent then it verified in routine exam, not only in the less developed but also in large and very developed neurological departments. Furthermore, psychiatric symptoms (PSs) in neurological disorders (NDs) among primary health care physicians and other specialties are often neglected. Anxiety and depression are most common, but hallucinations, delusions, obsessive-compulsive disorder and delirium or confusional state are also frequent comorbidity in many neurological conditions such as stroke, epilepsy, multiple sclerosis (MS), Parkinson disease (PD). Depression and NDs also have a bidirectional relationship, as not only are patients, for example with stroke at greater risk of developing depression, but patients with depression have a two-fold greater risk of developing a stroke, even after controlling for other risk factors. Dementia or cognitive impairment are part of clinical picture of PD, stroke patients, patients with MS, Huntington disease etc. The prototype of dementia in PD and other NDs is a dysexecutive syndrome with impaired attention, executive functions and secondarily impaired memory. So-called "functional" (or psychogenic or hysterical/conversion) symptoms are relatively infrequent in "neurological" conditions, but very often unrecognized and not properly treated. Treatment of PSs in neurology, basically are not different then treatment of these symptoms in psychiatry and should be include pharmacotherapy and psychiatry. This presentation gives an overview of frequency and type of PSs underlying necessity to recognize these disorders in every day routine exam and properly treatment. PMID:23114812

Sinanovi?, Osman

2012-10-01

347

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.

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

2014-01-01

348

Psychiatric Adjustment in the Year after Meningococcal Disease in Childhood  

ERIC Educational Resources Information Center

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

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

2007-01-01

349

Developing Attitudes: The Role of Psychiatric Rehabilitation Education  

Microsoft Academic Search

This article examines the development of Psychiatric Rehabilitation (PsyR) beliefs, goals, and practices among students from different academic programs within the same university. Undergraduate and graduate students were studied. Students educated and working at psychiatric hospitals were compared to those on college campuses and in the community. The relationship of these attitudes to both affective and career commitment was examined.

KENNETH J. GILL; ANN MURPHY; JOSEPH BIRKMANN

2005-01-01

350

Psychiatric Illness and Family Support in Children and Adolescents With Diabetic Ketoacidosis: A Controlled Study  

Microsoft Academic Search

ObjectiveTo compare compliance, psychiatric disorders, and family support in children with insulin-dependent diabetes mellitus (IDDM) hospitalized with diabetic ketoacidosis (DKA) and clinic controls.

DEANNA S. LISS; DAVID A. WALLER; BETSY D. KENNARD; DONALD McINTIRE; PATRICIA CAPRA; JACQUALENE STEPHENS

1998-01-01

351

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

ERIC Educational Resources Information Center

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

Milazzo-Sayre, Laura J.; And Others

352

Outpatient compliance of psychiatric emergency room patients by presenting problems  

Microsoft Academic Search

In the present study, a cohort of patients who came to a psychiatric emergency room in a general hospital, and were not referred for hospitalization, were analyzed in regard to the amount and rate of subsequent contact with community mental health and substance abuse agencies. Patterns of service receipt and the differential impact of service use on hospitalization and\\/or return

Phyllis Solomon; Barry Gordon

1988-01-01

353

Remote Psychiatric and Psychological Services via the Communications Technology Satellite (CTS).  

ERIC Educational Resources Information Center

To provide remote psychiatric services to a population in Moose Factory, Ontario, via satellite, digital data links will be used to provide 24-hour access to the psychiatric medical file system and the psychiatric patient register at University Hospital, London, Ontario, and to permit scoring and interpretation of standard psychological tests. The…

Covvey, H. Dominic; And Others

354

Psychiatric Comorbidity in Methadone Maintained Patients  

Microsoft Academic Search

Diagnosing comorbid psychiatric disorders in metha-done maintained patients may help to identify subgroups with different outcomes and needs for treatment. In this study, 75 methadone maintenance clinic patients in treatment longer than 30 days were assessed with the Addiction Severity Index, Global Assessment Scale and Mini-Mental Status Exam, and were interviewed for DSM-III-R psychiatric diagnosis using the computerized Diagnostic Interview

B. J. Mason; J. H. Kocsis; D. Melia; E. T. Khuri; J. Sweeney; A. Wells; L. Borg; R. B. Millman; M. J. Kreek

1998-01-01

355

Sleep Disturbance Immediately Prior to Trauma Predicts Subsequent Psychiatric Disorder  

PubMed Central

Study Objectives: This study investigated the extent to which sleep disturbance in the period immediately prior to a traumatic event predicted development of subsequent psychiatric disorder. Design: Prospective design cohort study Setting: Four major trauma hospitals across Australia Patients: A total of 1033 traumatically injured patients were initially assessed during hospital admission and followed up at 3 months (898) after injury Measures: Lifetime psychiatric disorder was assessed in hospital with the Mini-International Neuropsychiatric Interview. Sleep disturbance in the 2 weeks prior to injury was also assessed using the Sleep Impairment Index. The prevalence of psychiatric disorder was assessed 3 months after traumatic injury. Results: There were 255 (28%) patients with a psychiatric disorder at 3 months. Patients who displayed sleep disturbance prior to the injury were more likely to develop a psychiatric disorder at 3 months (odds ratio: 2.44, 95% CI: 1.62–3.69). In terms of patients who had never experienced a prior disorder (n = 324), 96 patients (30%) had a psychiatric disorder at 3 months, and these patients were more likely to develop disorder if they displayed prior sleep disturbance (odds ratio: 3.16, 95% CI: 1.59–4.75). Conclusions: These findings provide evidence that sleep disturbance prior to a traumatic event is a risk factor for development of posttraumatic psychiatric disorder. Citation: Bryant RA; Creamer M; O'Donnell M; Silove D; McFarlane AC. Sleep disturbance immediately prior to trauma predicts subsequent psychiatric disorder. SLEEP 2010;33(1):69-74.

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

2010-01-01

356

Patient rights and law: tobacco smoking in psychiatric wards and the Israeli Prevention of Smoking Act.  

PubMed

In August 2001, the Israeli Ministry of Health issued its Limitation of Smoking in Public Places Order, categorically forbidding smoking in hospitals. This forced the mental health system to cope with the issue of smoking inside psychiatric hospitals. The main problem was smoking by compulsorily hospitalized psychiatric patients in closed wards. An attempt by a psychiatric hospital to implement the tobacco smoking restraint instruction by banning the sale of cigarettes inside the hospital led to the development of a black market and cases of patient exploitation in return for cigarettes. This article surveys the literature dealing with smoking among psychiatric patients, the role of smoking in patients and the moral dilemmas of taking steps to prevent smoking in psychiatric hospitals. It addresses the need for public discussion on professional caregivers' dilemmas between their commitment to uphold the law and their duty to act as advocates for their patients' rights and welfare. PMID:15362356

Kagan, Ilya; Kigli-Shemesh, Ronit; Tabak, Nili; Abramowitz, Moshe Z; Margolin, Jacob

2004-09-01

357

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.

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

2013-01-01

358

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.

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

2011-01-01

359

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.

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

2009-01-01

360

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.

Jones, Robert O.

1965-01-01

361

Effect of psychiatric clinical learning site on nursing students' attitudes toward mental illness and psychiatric nursing.  

PubMed

As a component of an undergraduate nursing program evaluation, the purpose of this study was to investigate the effect of the psychiatric clinical learning site on students' attitudes toward mental illness and psychiatric nursing. A pretest-posttest quasi-experimental design was utilized. The dependent measures included an Environmental Rating Scale, an Attitude Toward Mental Illness Scale, and an Attitude Toward Psychiatric Nursing Scale. The non-probability sample of convenience included 45 students enrolled in the senior level psychiatric nursing module of a baccalaureate nursing program at a midwest, metropolitan liberal arts college. The subjects were randomly assigned to a Veterans Administration (VA) Medical Center and a private hospital. The results indicated that after controlling for students' attitudes toward mental illness and psychiatric nursing prior to the psychiatric nursing module, clinical site location did not account for any significant variance in students' attitudes after the module. However, correlation analysis of the specific components of the Environmental Rating Scale did demonstrate statistically significant associations with a decrease in authoritative, restrictive attitudes toward mental illness, and an increase in the milieu therapy and community mental health orientations to psychiatric nursing. PMID:2156976

Slimmer, L W; Wendt, A; Martinkus, D

1990-03-01

362

Cooperation and contention in psychiatric work.  

PubMed

This article discusses the social organization of psychiatric work in the psychiatric emergency department of a public general hospital located in New York City, based on ethnographic research conducted from 1999 to 2001. Case studies of the care of two patients with ambiguous symptoms are discussed. The analysis applies the ''differences approach'' developed by Mol and colleagues which focuses on the way different professions provide divergent explanations and ontologies for symptoms and illness. The cases illustrate the ways in which social structural constraints are compelling psychiatry to become a multidisciplinary specialty. PMID:21742953

Messinger, Seth D

2011-07-01

363

Do the psychiatric patients reject themselves?  

PubMed

Five statements measuring social distance from and prejudice against the ex-mentally ill were read to 137 psychiatric patients and relatives from urban background. Their agreement and disagreement with the five statements was analysed and compared with controls from an orthopaedic clinic.Maximum social distance was found on statements about establishing marital relationship with an ex-mental patient. The social distance was found less frequently in working in a mental hospital; sharing same house, falling in love and working with an ex-mental patient respectively. The psychiatric patients and their relatives are more rejecting than the controls. PMID:22058514

Malhotra, H K; Inam, A S; Chopra, H D

1981-01-01

364

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

365

The effects of a psychiatric patient education to medication program on post-discharge compliance  

Microsoft Academic Search

The effect of a structured program of education on subsequent psychiatric patient compliance with medication-taking was investigated. The subjects consisted of 150 hospitalized patients housed on four acute-care receiving wards and ready for discharge from Fallsview Psychiatric Hospital in Ohio. They were randomly assigned to one of three groups. Results indicated that subjects who received written information with verbal reinforcement

Gary L. Robinson; Alan D. Gilbertson; Lawrence Litwack

1986-01-01

366

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

PubMed Central

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

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

2013-01-01

367

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

PubMed

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

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

1997-01-01

368

spinal discharge processes have not kept up with the magnitude of change that has occurred over the years A study by Bueno Ross and Wang 2010 showed that of 7 million Medicare CDF patients admitted to the hospital between1993 to 2006 the mean Levels of Stay LOS decreased from 88 days to 63 days  

EPA Pesticide Factsheets

Did you mean: spinal discharge processes have not kept up with the magnitude of change that has occurred over the years A study by Bueno Ross and Wang 2010 showed that of 7 million Medicare CDF patients admitted to the hospital between1993 to 2006 the mean Levels of Stay LOS decreased from 88 days to 63 days ?

369

Substance Abusers in an Acute Psychiatric Facility: A Diagnostic and Logistic Challenge  

PubMed Central

Acute resident psychiatric facilities in Norway usually get their patients after referral from a medical doctor. Acute psychiatric wards are the only places accepting persons in need of emergency hospitalisation when emergency units in somatic hospitals do not accept the patient. Resident patients at one random chosen day were scrutinized in an acute psychiatric facility with 36 beds serving a catchment area of 165?000. Twenty-five patients were resident in the facility at that particular day. Eight of 25 resident patients (32.0%) in the acute wards were referred for a substance-induced psychosis (SIP). Another patient may also have had a SIP, but the differential diagnostic work was not finished. A main primary diagnosis of substance use was given in the medical reports in only 12.9% of patients during the last year. Given that the chosen day was representative of the year, a majority of patients with substance abuse problems were given other diagnoses. There seems to be a reluctance to declare the primary reason for an acute stay in a third of resident stays. Lack of specialized emergency detoxification facilities may have contributed to the results.

Berg, John E.; Restan, Asbj?rn

2013-01-01

370

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

PubMed

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

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

2011-12-01

371

Psychiatric Leave Policies  

Microsoft Academic Search

College counseling centers and administrations have long been concerned about the ability of students needing time away from campus for psychiatric reasons to reenter and successfully copmlete academic endeavors. A survey of 28 colleges and universities finds a variety of policies defining procedures for reentry following an absence for psychiatric reasons. A significant proportion of colleges surveyed requires a stipulated

Frances L Hoffmann; Xavior Mastrianni

1992-01-01

372

Decline in hospitalization risk and health care cost after initiation of depot antipsychotics in the treatment of schizophrenia  

PubMed Central

Purpose: To assess change in hospitalization and cost of care from 6 months pre- to 6 months post-initiation on any depot antipsychotic among schizophrenia patients. Patients and methods: Using a large United States commercial claims and encounters database, patients younger than 65 years diagnosed with schizophrenia were identified. Patients initiated on a depot antipsychotic were studied in a mirror-image design to assess change in hospitalization rates, mean duration hospitalized, and hospitalization cost. McNemar’s test and paired t-tests compared the proportions of patients hospitalized and the mean duration. Paired t-test and bootstrapping methods compared costs. Results: In these patients (n = 147), psychiatric hospitalizations declined from 49.7% pre-initiation to 22.4% post-initiation (P < 0.001), and the mean hospitalized duration for psychiatric purposes numerically declined from 7.3 to 4.7 days (P = 0.05). Total health care costs declined from $11,111 to $7884 (P < 0.05) driven by reduction in costs for psychiatric hospitalizations from $5384 to $2538 (P < 0.05). Conclusion: Initiation of depot antipsychotic therapy appeared to be associated with a decline in hospitalization rates and costs. Current findings suggest that treatment with depot antipsychotics may be a cost-effective option for a subgroup of patients with schizophrenia who are at high risk of nonadherence with their oral antipsychotic medication regimen.

Peng, Xiaomei; Ascher-Svanum, Haya; Faries, Douglas; Conley, Robert R; Schuh, Kory J

2011-01-01

373

Psychiatric comorbidity in veterans with psychogenic seizures.  

PubMed

Psychogenic non-epileptic seizures (PNES) are frequently encountered in epilepsy monitoring units (EMU) at Veterans Affairs Medical Centers (VAMCs) and cause significant long-term disability. An understanding of psychiatric factors associated with PNES could aid in earlier diagnosis and treatment. We studied 50 consecutive veterans diagnosed with PNES and 37 veterans diagnosed with epileptic seizures (ES), evaluated at a VAMC EMU. We reviewed all available mental health evaluations prior to EMU evaluation. Univariate comparisons included axis I diagnoses, axis II diagnoses, and psychiatric hospitalizations. Predictive models of seizure classification were evaluated by logistic regression. A diagnosis of post-traumatic stress disorder (PTSD) preceded the diagnosis of PNES in 58% of patients and the diagnosis of ES in 13.5% (p<0.001). On logistic regression, PTSD was the only significant psychiatric diagnosis (odds ratio 9.2). Major depression and alcohol abuse were common diagnoses but did not differentiate PNES and ES groups. PMID:23103308

Salinsky, Martin; Evrard, Collette; Storzbach, Daniel; Pugh, Mary Jo

2012-11-01

374

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.

Cooley, Janet

2013-01-01

375

Wireless physiological monitoring system for psychiatric patients.  

PubMed

Patients in psychiatric hospitals that are sedated or secluded are at risk of death or injury if they are not continuously monitored. Some psychiatric patients are restless and aggressive, and hence the monitoring device should be robust and must transmit the data wirelessly. Two devices, a glove that measures oxygen saturation and a dorsally-mounted device that measures heart rate, skin temperature and respiratory rate were designed and tested. Both devices connect to one central monitoring station using two separate Bluetooth connections, ensuring a completely wireless setup. A Matlab graphical user interface (GUI) was developed for signal processing and monitoring of the vital signs of the psychiatric patient. Detection algorithms were implemented to detect ECG arrhythmias such as premature ventricular contraction and atrial fibrillation. The prototypes were manufactured and tested in a laboratory setting on healthy volunteers. PMID:19965038

Rademeyer, A J; Blanckenberg, M M; Scheffer, C

2009-01-01

376

Indexing civil commitment in psychiatric emergency rooms.  

PubMed

A reliable prototype index, Three Ratings of Involuntary Admissibility (TRIAD), was developed to reflect the way psychiatric emergency room clinicians apply legal criteria for involuntary commitment. The interrater reliability coefficients--Pearson's r--of the TRIAD system for rating patients are 0.94, danger-to-self score; 0.89, danger-to-other score; 0.77, grave-disability score; and 0.89, total-admissibility score. TRIAD scores accounted for 82 percent of 89 disposition decisions in two metropolitan county hospital psychiatric emergency rooms. Study results indicate that (1) psychiatric emergency room clinicians shared constructs of danger to self, danger to others, and grave disability; (2) these constructs are reliably applied in actual cases; (3) TRIAD is a valid reflection of these constructs; and (4) case disposition is predictable from the severity of the patient's status with regard to these criteria. PMID:10276575

Segal, S P; Watson, M A; Nelson, L S

1986-03-01

377

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 ...

378

Early diagnosis of anti-N-methyl-D-aspartate receptor encephalitis in a young woman with psychiatric symptoms.  

PubMed

A previously healthy 21-year-old woman, transported to our medical emergency center for excluding organic brain disease, had undergone medical examination 9 days before for trembling in her left hand, which was caused by stress. The patient exhibited fever and strange behaviors, e.g., wandering around, babbling, and making smoking gestures; hence, psychiatric examination was performed. The patient's Glasgow Coma Scale score was 4-3-5, and involuntary movement was observed. Cerebrospinal fluid examination revealed increased cell count; hence, we suspected anti-N-methyl-d-aspartate (NMDA) receptor encephalitis. We conducted an abdominal CT scan, which revealed a neoplastic lesion with calcification in the right ovary. Early steroid pulse therapy was started. On hospital day 25, she tested positive for anti-NMDA receptor antibodies; hence, anti-NMDA receptor encephalitis and concomitant ovarian teratoma was diagnosid. She underwent right adnexectomy; subsequently, immunotherapy was performed. The patient recovered and was discharged on hospital day 105. Anti-NMDA receptor encephalitis is not uncommon; however, this disease must be considered for young encephalitis patients exhibiting psychiatric symptoms. If patients (aged ? 30 years) presents with encephalitis of uncertain etiology, psychiatric symptoms, seizures, movement disorders, or psychosis, clinicians should consider anti-NMDA encephalitis as a possible diagnosis. Clinical diagnosis should be waged early to ensure timely treatment. PMID:23032251

Aoki, Hiromichi; Morita, Seiji; Miura, Naoya; Tsuji, Tomoatsu; Ohnuki, Youichi; Nakagawa, Yoshihide; Yamamoto, Isotoshi; Takahashi, Hirohide; Inokuchi, Sadaki

2012-09-01

379

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

380

[Foreign citizens as patients at a psychiatric clinic].  

PubMed

On 98 hospitalizations of foreign patients admitted to psychopathic wards of the mental hospital of Karl-Marx-Stadt from 1983 to 1987 is reported. Basing upon whose course of the disease and under consideration of special literature of medicine, selected questions concerning boundary-exceeding psychiatry are discussed. The proceeding practical importance of questions regarding intercultural psychiatric problems is mentioned. PMID:2772073

Postrach, F

1989-07-01

381

[Early pediatric-psychiatric management of suicide attempts in adolescents].  

PubMed

The authors describe an experience of early intervention by child psychiatrists in adolescents attending an emergency care pediatrics unit for suicide attempts. The two main aspects of this intervention are: 1) a former interview between the child psychiatrist and the suicidal adolescent taking place within the emergency care pediatrics unit; 2) a systematic few days hospitalization of the suicidal adolescent in a child-adolescent psychiatric unit allowing early therapy for both the adolescent and his/her parents. Based on preliminary results the authors believe that early child psychiatrist intervention provides an improvement in the care of suicidal adolescents, especially to prevent recurrent suicide attempts, as compared with conventional care with delayed child psychiatrist participation. PMID:7842077

Laurent, A; Foussard, N; Boucharlat, J; Bost, M

1994-10-01

382

Suicide Prevention in the Psychiatric Hospital  

ERIC Educational Resources Information Center

It is currently impossible to distinguish between patients with depression who will make a suicide attempt and those who will not. Prevention, therefore, must be based on the assumption that any patient with more than mild symptoms of depression is at risk of suicide, and can only be effective if it is applicable to all patients with moderate to…

Matakas, Frank; Rohrbach, Elisabeth

2007-01-01

383

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.

384

Psychiatric events in epilepsy.  

PubMed

Psychiatric events are thought to be more frequent in people with epileptic seizures than in the general population. However, inter-ictal psychiatric events attributable to epilepsy remain controversial. The aim of the present study was to evaluate the occurrence of psychiatric events in a population of fairly unselected patients with epilepsy and in the general population, and the correlation between psychiatric complaints and selected demographic and disease characteristics. The survey was part of a multicentre prospective cohort study of everyday life risks conducted in eight European countries and comparing referral children and adults with epilepsy referred to secondary/tertiary centers to age- and sex-matched non-epileptic controls. Nine hundred and fifty-one patients with epilepsy and 909 controls were studied. Each patient and his/her control received a diary to record any accident or illness, with severity, circumstances, causes, consequences, and (for the cases) the possible relation to a seizure. The follow-up period ranged between 1 and 2 years. Fifty-eight psychiatric events occurred in 25 patients (2.6%) and 88 in 19 controls (2.1%). Housewives (9.3%) and unemployed persons (4.1%) were mostly affected. No correlation was found between psychiatric events, demographic and disease characteristics. Our results suggest that people with epilepsy if unselected are not at higher risk for psychiatric disorders than the general population. PMID:17544705

Cornaggia, Cesare Maria; Beghi, Massimiliano; Beghi, Ettore

2007-10-01

385

Characteristics and cost of staff injuries in a forensic hospital.  

PubMed

At a maximum-security forensic hospital over a three-year period, 79 patients (35 percent of all patients) were involved in 157 staff injuries. Staff members' average postinjury absence from work was 85 days, at a cost equivalent to about 2 percent of the hospital's budget. Nursing staff, particularly psychiatric technicians, had the highest injury rate. Male staff were about twice as likely to be injured as female staff. More injuries occurred on the second shift. Patients who injured staff were younger than those who did not. Florid psychotic behavior, nonpsychotic agitation, and the recent use of restraints were the most common prodromal signs. PMID:8890345

Hillbrand, M; Foster, H G; Spitz, R T

1996-10-01

386

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

PubMed Central

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

2013-01-01

387

Neuromodulation in psychiatric disorders.  

PubMed

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

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

2012-01-01

388

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 ...

389

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.

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

2012-01-01

390

Psychiatric comorbidity in fibromyalgia  

Microsoft Academic Search

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

Laurence A. Bradley

2005-01-01

391

Diabetes and psychiatric disorders  

PubMed Central

Interface of diabetes and psychiatry has fascinated both endocrinologists and mental health professionals for years. Diabetes and psychiatric disorders share a bidirectional association -- both influencing each other in multiple ways. The current article addresses different aspects of this interface. The interaction of diabetes and psychiatric disorders has been discussed with regard to aetio-pathogenesis, clinical presentation, and management. In spite of a multifaceted interaction between the two the issue remains largely unstudied in India.

Balhara, Yatan Pal Singh

2011-01-01

392

Psychiatric aspects of railway fatalities.  

PubMed

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

Symonds, R L

1985-08-01

393

Psychiatric morbidity in prisoners  

PubMed Central

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

Kumar, Vinod; Daria, Usha

2013-01-01

394

Psychiatric morbidity among prisoners  

PubMed Central

Background: There is a considerable lack of scientific estimate of psychiatric morbidity among Indian prisoners. Objective: The objective of the following study is to study the prevalence of psychiatric morbidity among prisoners. Settings and Design: A cross-sectional study at District Jail, Kozhikode, Kerala. Materials and Methods: A total of 255 prisoners who were inmates during the period from mid-April to mid-July 2011 participated in the study. The study subjects included both male and female remand or convict prisoners. Socio-demographic data, clinical history and criminological history were collected from each individual. Psychiatric morbidity was assessed using MINI-Plus. Statistical Analysis: Done by using SPSS version 16 (SPSS Inc, Chicago, USA). Results: A total of 175 subjects (68.6%) had a current mental illness. Substance use disorder was the most common diagnosis (47.1%). Antisocial personality disorder was diagnosed in 19.2%, adjustment disorder in 13.7%, mood disorder in 4.3% and psychosis in another 6.3% of prisoners. A high rate of a current psychiatric disorder was seen in male (69.7%) prisoners. A significant association was noticed for the different nature of crimes with psychiatric diagnoses and previous imprisonment. Nearly 4% of prisoners reported a moderate to high suicide risk. Conclusion: Mental health problems among prisoners were quite high. Mentally ill prisoners are at high risk for repeated incarceration. The increased rate of psychiatric disorders should be a concern for mental health professionals and the policy makers.

Ayirolimeethal, Anithakumari; Ragesh, G.; Ramanujam, Jayanthi M.; George, Biju

2014-01-01

395

Income Taxation--A Pauper a Day Keeps the Taxman Away: Qualifications of Hospitals as Charitable Institutions Under Section 501 (c) (3) of the IRC of 1954  

ERIC Educational Resources Information Center

Qualifications that a hospital must meet to be tax exempt are outlined and discussed. Focus is on organizational and operational characteristics, public vs. private benefit, and prohibition of political activity. (LBH)

Mercer, Henry Marvin

1976-01-01

396

Organic Brain Dysfunction and Child Psychiatric Disorder  

PubMed Central

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

Graham, Philip; Rutter, Michael

1968-01-01

397

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

PubMed Central

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

2014-01-01

398

General hospital psychiatry in the 1980's  

Microsoft Academic Search

There has been an increasing amount of attention being given to the role of community hospital based inpatient psychiatric\\u000a services in the face of changing utilization patterns, state hospital deinstitutionalization and cutbacks in community support\\u000a programs. These trends have converged over recent years to reshape the nature of psychiatric practice in the general hospital\\u000a setting. It is likely that these

Donald Seidemann

1984-01-01

399

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

400

Pathway to psychiatric care in Japan: A multicenter observational study  

PubMed Central

Background This study examines pathways to psychiatric care in Japan using the same method as the collaborative study carried out in 1991 under the auspices of the World Health Organization. Methods Thirteen psychiatric facilities in Japan were involved. Of the 228 patients who contacted psychiatric facilities with any psychiatric illness, eighty four visiting psychiatric facilities for the first time were enrolled. Pathways to psychiatric care, delays from the onset of illness to treatment prior to reaching psychiatrists were surveyed. Results Thirty three patients (39.4%) directly accessed mental health professionals, 32 patients (38.1%) reached them via general hospital, and 13 patients (15.5%) via private practitioners. The patients who consulted mental health professionals as their first carers took a longer time before consulting psychiatrists than the patients who consulted non-mental health professionals as their first carers. The patients who presented somatic symptoms as their main problem experienced longer delay from the onset of illness to psychiatric care than the patients who complained about depressive or anxiety symptoms. Prior to the visit to mental health professionals, patients were rarely informed about their diagnosis and did not receive appropriate treatments from their physicians. Private practitioners were more likely to prescribe psychotropics than physicians in general hospitals, but were less likely to inform their patients of their diagnosis. Conclusion This first pathway to psychiatric care study in Japan demonstrated that referral pathway in Japan heavily relies on medical resources. The study indicates possible fields and gives indications, underlining the importance of improving skills and knowledge that will facilitate the recognition of psychiatric disorders presenting with somatic and depressive symptoms in the general health care system and by private practitioners.

Fujisawa, Daisuke; Hashimoto, Naoki; Masamune-Koizumi, Yayoi; Otsuka, Kotaro; Tateno, Masaru; Okugawa, Gaku; Nakagawa, Atsuo; Sato, Ryoko; Kikuchi, Toshiaki; Tonai, Eita; Yoshida, Kosuke; Mori, Takatoshi; Takahashi, Hidehiko; Sato, Soichiro; Igimi, Hiroyasu; Waseda, Yoshibumi; Ueno, Takefumi; Morokuma, Ippei; Takahashi, Katsuyoshi; Sartorius, Norman

2008-01-01

401

Nurses' attitudes toward ethical issues in psychiatric inpatient settings.  

PubMed

Background: Nursing is an occupation that deals with humans and relies upon human relationships. Nursing care, which is an important component of these relationships, involves protection, forbearance, attention, and worry. Objectives: The aim of this study is to evaluate the ethical beliefs of psychiatric nurses and ethical problems encountered. Research Design: The study design was descriptive and cross-sectional. Research context: Methods comprised of a questionnaire administered to psychiatric nurses (n?=?202) from five psychiatric hospitals in Istanbul, Turkey, instruction in psychiatric nursing ethics, discussion of reported ethical problems by nursing focus groups, and analysis of questionnaires and reports by academicians with clinical experience. Participants: Participants consist of the nurses who volunteered to take part in the study from the five psychiatric hospitals (n?=?202), which were selected with cluster sampling method. Ethical considerations: Written informed consent of each participant was taken prior to the study. Findings: The results indicated that nurses needed additional education in psychiatric ethics. Insufficient personnel, excessive workload, working conditions, lack of supervision, and in-service training were identified as leading to unethical behaviors. Ethical code or nursing care -related problems included (a) neglect, (b) rude/careless behavior, (c) disrespect of patient rights and human dignity, (d) bystander apathy, (e) lack of proper communication, (f) stigmatization, (g) authoritarian attitude/intimidation, (h) physical interventions during restraint, (i) manipulation by reactive emotions, (j) not asking for permission, (k) disrespect of privacy, (l) dishonesty or lack of clarity, (m) exposure to unhealthy physical conditions, and (n) violation of confidence. Discussion: The results indicate that ethical codes of nursing in psychiatric inpatient units are inadequate and standards of care are poor. Conclusion: In order to address those issues, large-scale research needs to be conducted in psychiatric nursing with a focus on case studies and criteria for evaluation of service, and competency and responsibility needs to be established in psychiatric nursing education and practice. PMID:24091350

Eren, Nurhan

2014-05-01

402

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

403

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

404

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.

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

2012-01-01

405

Clients with intellectual disabilities on psychiatric units: care coordination for positive outcomes.  

PubMed

The transition from residential facilities to and from the psychiatric hospital setting is difficult for individuals with intellectual disabilities (ID). In the U.S.A., specialized psychiatric units for individuals with ID are uncommon and this population is usually served in generalized services. Nevertheless, providers of mental health services in the U.S.A. receive little training in their specific needs. Best practices call for coordination of plans between psychiatric units and community agencies, multidisciplinary care plans, staff education and comprehensive discharge planning in order to improve outcomes of psychiatric hospitalization. An inner city psychiatric unit in a major academic medical centre and a community agency providing residential care for individuals with ID cooperated to provide a plan of care for a client with ID both for hospitalization and for discharge leading to improved outcomes. PMID:22070102

Krch-Cole, E L; Lynch, P; Ailey, S H

2012-04-01

406

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

NASA Astrophysics Data System (ADS)

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

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

1993-06-01

407

Establishing a psychiatric library.  

PubMed

The amount of information in the psychiatric field has increased to such an extent that a specialized library is an essential part of the mental health facility. Guidelines are presented for establishing a psychiatric library, including staffing, budgeting, physical layout, and selection and handling of books, reference materials, journals and annuals, microfilm and microfiche, and audiovisuals. The expertise of the librarian is the single most important factor in determining the quality of the collection and the services provided, the author believes. Because of escalating costs, developing a cooperative library network of small, specialized mental health collections may be the most productive course for the future. PMID:6852794

Rubinton, P

1983-05-01

408

Psychiatric Nurse as Therapist  

PubMed Central

Under supervision five nurse-therapists have treated phobic patients as successfully as have psychiatrists and psychologists using similar psychological treatments in comparable psychiatric populations. Nurses have also had good results in other neurotic disorders. Intensive training is required. Nurse-therapists find their work rewarding, but the present Salmon gradings make no provision for their advancement should they retain their clinical function. Results suggest that the use of selected psychiatric nurses as skilled therapists can ease the current critical shortage of treatment personnel in psychiatry.

Marks, I. M.; Connolly, J.; Hallam, R. S.

1973-01-01

409

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".

Kang, Seong-Kyu

2010-01-01

410

Psychiatric screening for headache patients.  

PubMed

There are numerous reasons to consider psychiatric screening for migraine patients, as well as valid objections to screening. Although psychiatric comorbidity has been consistently described for migraine patients, there is no evidence that treatment of psychiatric comorbidity influences headache outcomes. The author presents his perspectives on psychiatric screening, offers insight into currently available screening instruments, as well as some clinical pearls for screening. PMID:22540202

Maizels, Morris

2012-05-01

411

Attitudes of nursing and rest home administrators toward deinstitutionalized elders with psychiatric disorders  

Microsoft Academic Search

The administrators of 92 nursing homes and rest homes in western Massachusetts were surveyed on their experiences with elderly residents, with a history of psychiatric hospitalization and their willingness to admit such individuals in the future. A majority of those who had admitted deinstitutionalized elders with chronic psychiatric disorders reported having experienced severe problems with them. Most of the problems

Pearl M. Mosher-Ashley; Barbara F. Turner; Darcy O'Neill

1991-01-01

412

residential placement for the chronic psychiatric patient: a review and evaluation of the literature  

Microsoft Academic Search

Informed opinion during the last two decades has held that psychiatric hospitals are bad places for psychiatric patients and are to be avoided except in the most dire circumstances; patients should be returned to the community as rapidly as possible and relabeled \\

Mary D. Carpenter

1978-01-01

413

Interrelationship of Hypochondriacal, Paranoid, Depressive, and Suicidal Symptoms in Chinese Psychiatric Patients  

Microsoft Academic Search

Data concerning 150 consecutive adult psychiatric patients treated by the authors in a general hospital psychiatric unit were analyzed. All patients with predominant hypochondriacal or paranoid symptoms were selected. The presence of depressed mood and suicidal ideas and their impact on prognosis were investigated. Finally, characteristics of patients with both hypochondriacal and paranoid symptoms were studied. We found that: (a)

Leo P. W. Chiu; Ranan Rimón

1988-01-01

414

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

415

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

Microsoft Academic Search

The presence of dating violence victimization as well as its relation to psychiatric diagnosis and cognitive processes was examined in a sample of 155 adolescents hospitalized in a psychiatric facility. Participants and their parents completed semistructured diagnostic interviews. Participants also completed self-report measures of dating violence victimization and cognitive functioning. Seventy-seven percent of adolescents who had initiated dating reported psychological,

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

2010-01-01

416

The Clerkenwell scheme: assessing efficacy and cost of a psychiatric liaison service to a magistrates' court  

Microsoft Academic Search

OBJECTIVE--To determine the efficacy of psychiatric liaison schemes to magistrates' courts in shortening the period that mentally ill accused people spend in custody between arrest, the provision of psychiatric reports, and admission to hospital under the Mental Health Act 1983 and to establish the direct costs of setting up such schemes. DESIGN--A nine month prospective study of court referrals and

D V James; L W Hamilton

1991-01-01

417

Taking it to the Street: A Psychiatric Outreach Service in Canada  

Microsoft Academic Search

This paper describes a model of flexible psychiatric outreach service in Canada designed to meet the needs of persons who are homeless or marginally housed and have mental illness. The activities of the Psychiatric Outreach Team of the Royal Ottawa Hospital for individual clients and the community agencies who serve them are profiled, followed by a demographic and mental and

Susan J. Farrell; James Huff; Sue-Ann MacDonald; Alison Middlebro; Steven Walsh

2005-01-01

418

Shrinking inpatient psychiatric capacity: cause for celebration or concern?  

PubMed

This issue brief examines reported capacity constraints in inpatient psychiatric services and describes how these services fit within the continuum of care for mental health treatment. The paper summarizes the type and range of acute care services used to intervene in mental health crises, including both traditional hospital-based services and alternative crisis interventions, such as mobile response teams. It reviews historical trends in the supply of inpatient psychiatric beds and explores the anticipated influence of prospective payment for inpatient psychiatric services under Medicare. The paper also considers other forces that may affect the need for and supply of acute mental health services, including key factors that could improve the quality and efficiency of inpatient psychiatric care. PMID:17679175

Salinsky, Eileen; Loftis, Christopher

2007-08-01

419

Psychiatric conditions in palliative medicine  

Microsoft Academic Search

Psychiatric conditions are common among patients with advanced illness who are referred to palliative care services. Psychiatric illness can cause considerable distress to both patients and their families. In order to improve end-of-life care for patients, it is necessary to diagnose psychiatric conditions and treat them appropriately. This review considers delirium, dementia, depression, anxiety, and suicidal ideation. It considers the

Damien J. McMullan; Emma Lundy; Clare White; Neil Jackson

2011-01-01