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Sample records for adolescent psychiatric inpatient

  1. Reliability and Validity of the Beck Depression Inventory--II with Adolescent Psychiatric Inpatients

    ERIC Educational Resources Information Center

    Osman, Augustine; Kopper, Beverly A; Barrios, Frank; Gutierrez, Peter M.; Bagge, Courtney L.

    2004-01-01

    This investigation was conducted to validate the Beck Depression Inventory--II (BDI-II; A. T. Beck, R. A. Steer, & G. K. Brown, 1996) in samples of adolescent psychiatric inpatients. The sample in each substudy was primarily Caucasian. In Study 1, expert raters (N=7) and adolescent psychiatric inpatients (N=13) evaluated the BDI-II items to assess…

  2. Characteristics of Dieting and Nondieting Adolescents in a Psychiatric Inpatient Setting

    ERIC Educational Resources Information Center

    Abrantes, Ana M.; Strong, David R.; Ramsey, Susan E.; Lewinsohn, Peter M.; Brown, Richard A.

    2006-01-01

    The clinical and psychosocial characteristics of 239 dieting and nondieting adolescents (61% female; mean age=15.3) recruited from an inpatient psychiatric setting were examined. Dieting adolescents were compared to nondieting adolescents on exercise frequency, weight control behaviors, risky behaviors, psychiatric comorbidity and distress, eating…

  3. Psychiatric Correlates of Nonsuicidal Cutting Behaviors in an Adolescent Inpatient Sample

    ERIC Educational Resources Information Center

    Swenson, Lance P.; Spirito, Anthony; Dyl, Jennifer; Kittler, Jennifer; Hunt, Jeffrey I.

    2008-01-01

    This archival study of 288 adolescent psychiatric inpatients examined the psychiatric correlates of cutting behavior. Participants were categorized into Threshold cutters (n = 61), Subthreshold cutters (n = 43), and Noncutters (n = 184). Groups were compared on psychiatric diagnoses, suicidality, and self-reported impairment. Results demonstrated…

  4. Psychosocial Correlates of Suicidal Ideation in Adolescent Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Kumar, Geetha; Steer, Robert A.

    1995-01-01

    Beck Scale for Suicide Ideation (BSI) was administered to 121 adolescent inpatients. Twelve characteristics found to be associated with adolescent suicide ideation were entered into multiple regression to estimate BSI scores, along with Beck inventories for anxiety, depression (BDI), and hopelessness (BHS), and Youth Self Report. BHS and BDI were…

  5. Utility of the Minnesota Multiphasic Personality Inventory Personality Disorder Scales with Adolescent Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Freiheit, Stacy R.; And Others

    1996-01-01

    The utility of Minnesota Multiphasic Personality Inventory personality disorder scales was studied with 217 male adolescent psychiatric inpatients. Analyses of variance found patterns consistent with research on adult samples in spite of differences in factor structure. These similarities suggest that adolescent assessment may provide information…

  6. Behavioral Management Leads to Reduction in Aggression in a Child and Adolescent Psychiatric Inpatient Unit

    ERIC Educational Resources Information Center

    Dean, Angela J.; Duke, Suzanne G.; George, Michelle; Scott, James

    2007-01-01

    Objective: Aggression is common in children and adolescents admitted to psychiatric inpatient units. Few interventions for reducing aggressive behaviors have been identified. This study aimed to evaluate the impact of a milieu-based behavioral management program on the frequency of aggressive behaviors in a child and adolescent mental health…

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

    PubMed

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

    2014-10-01

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

  8. Overweight in adolescent, psychiatric inpatients: A problem of general or food-specific impulsivity?

    PubMed

    Deux, Natalie; Schlarb, Angelika A; Martin, Franziska; Holtmann, Martin; Hebebrand, Johannes; Legenbauer, Tanja

    2017-05-01

    Adolescent psychiatric patients are vulnerable to weight problems and show an overrepresentation of overweight compared to the healthy population. One potential factor that can contribute to the etiology of overweight is higher impulsivity. As of yet, it is unclear whether it is a general impulse control deficit or weight-related aspects such as lower impulse control in response to food that have an impact on body weight. As this may have therapeutic implications, the current study investigated differences between overweight and non-overweight adolescent psychiatric inpatients (N = 98; aged 12-20) in relation to trait impulsivity and behavioral inhibition performance. The Barratt Impulsiveness Scale and two go/no-go paradigms with neutral and food-related stimulus materials were applied. Results indicated no significant differences concerning trait impulsivity, but revealed that overweight inpatients had significantly more difficulties in inhibition performance (i.e. they reacted more impulsively) in response to both food and neutral stimuli compared to non-overweight inpatients. Furthermore, no specific inhibition deficit for high-caloric vs. low-caloric food cues emerged in overweight inpatients, whereas non-overweight participants showed significantly lower inhibition skills in response to high-caloric than low-caloric food stimuli. The results highlight a rather general, non-food-specific reduced inhibition performance in an overweight adolescent psychiatric population. Further research is necessary to enhance the understanding of the role of impulsivity in terms of body weight status in this high-risk group of adolescent inpatients.

  9. The Multi-Attitude Suicide Tendency Scale: Further Validation with Adolescent Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Osman, Augustine; Gilpin, Andrew R.; Panak, William F.; Kopper, Beverly A.; Barrios, Francisco X.; Gutierrez, Peter M.; Chiros, Christine E.

    2000-01-01

    Examines construct validity and psychometric properties of the Multi-Attitude Suicide Tendency Scale in adolescent psychiatric inpatients. Confirmatory factor analysis provides support for the fit of the 28-item, four-factor model. Results of regression analyses reveal that high scores on the repulsion by life and the attraction to death subscales…

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

    Kjelsberg, Ellen

    2004-01-01

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

  12. Self-harm in Child and Adolescent Psychiatric Inpatients: A Retrospective Study

    PubMed Central

    Zhand, Naista; Matheson, Katherine; Courtney, Darren

    2016-01-01

    Objective This study presents a comprehensive report of children and adolescents who engaged in self-harm during their admission to a psychiatric inpatient unit. Method A chart review was conducted on all admissions to an acute care psychiatric inpatient unit in a Canadian children’s hospital over a one-year period. Details on patients with self-harm behaviour during the admission were recorded, including: demographics, presentation to hospital, self-harm behaviour and outcome. Baseline variables for patients with and without self-harm behaviour during admission were compared. Results Self-harm incidents were reported in 60 of 501 (12%) admissions during the one-year period of the study. Fourteen percent of patients (50 of 351) accounted for total number of 136 self-harm incidents. Half of these incidents (49%) occurred outside of the hospital setting, when patients were on passes. Using the Beck Lethality Scale (0–10), mean severity of the self-injury attempts was 0.33, and there were no serious negative outcomes. Conclusion Self-harm behaviour during inpatient psychiatric admission is a common issue among youth, despite safety strategies in place. While self-harm behaviour is one of the most common reasons for admission to psychiatric inpatient unit, our understanding of nature of these acts during the admission and contributing factors are limited. Further research is required to better understand these factors, and to develop strategies to better support these patients. PMID:27924147

  13. Associations between sleep disturbance and suicidal ideation in adolescents admitted to an inpatient psychiatric unit.

    PubMed

    Kaplan, Sebastian G; Ali, Shahzad K; Simpson, Brittany; Britt, Victoria; McCall, W Vaughn

    2014-01-01

    The goals of our study were to: 1) describe the incidence of disturbances in sleep quality, sleep hygiene, sleep-related cognitions and nightmares; and 2) investigate the association between these sleep-related disturbances and suicidal ideation (SI), in adolescents admitted to a psychiatric inpatient unit. Our sample consisted of 50 adolescents between the ages of 12 and 17 years (32 females and 18 males; 41 Caucasian and nine African American). Our cross-sectional design involved the administration of the Adolescent Sleep Wake Scale (ASWS), the Adolescent Sleep Hygiene Scale (ASHS), the Dysfunctional Beliefs and Attitudes about Sleep-Short version for use with children (DBAS-C10), the Disturbing Dreams and Nightmare Scale (DDNSI), and the Suicidal Ideation Questionnaire Jr (SIQ-JR). Analyses were conducted using Pearson correlations, as well as univariate and multivariate regression. Results indicated that our sample experienced sleep disturbances and SI to a greater degree than non-clinical samples. Sleep quality was correlated with nightmares, while sleep quality and nightmares were each correlated with SI. Sleep quality, dysfunctional beliefs, and nightmares each independently predicted SI. Our study was the first to use the four sleep measures with an adolescent psychiatric inpatient sample. It is important to develop sleep-related assessment tools in high-risk populations given the link between sleep disturbances and suicidality. Furthermore, a better understanding of the relationships between SI and sleep quality, sleep-related cognitions, and nightmares is needed to develop potential prevention and treatment options for suicidality in adolescents.

  14. Association of Family Structure to Later Criminality: A Population-Based Follow-Up Study of Adolescent Psychiatric Inpatients in Northern Finland

    ERIC Educational Resources Information Center

    Ikaheimo, Olli; Laukkanen, Matti; Hakko, Helina; Rasanen, Pirkko

    2013-01-01

    The influence of family structure on criminality in adolescents is well acknowledged in population based studies of delinquents, but not regarding adolescent psychiatric inpatients. The association of family structure to criminality was examined among 508 adolescents receiving psychiatric inpatient treatment between 2001 and 2006. Family structure…

  15. Is Exposure to Domestic Violence and Violent Crime Associated with Bullying Behaviour among Underage Adolescent Psychiatric Inpatients?

    ERIC Educational Resources Information Center

    Mustanoja, Susanna; Luukkonen, Anu-Helmi; Hakko, Helina; Rasanen, Pirkko; Saavala, Hannu; Riala, Kaisa

    2011-01-01

    We examined the relationship of exposure to domestic violence and violence occurring outside home to bullying behaviour in a sample (508; 40.9% males, 59.1% females) of underage psychiatric inpatient adolescents. Participants were interviewed using K-SADS-PL to assess DSM-IV psychiatric diagnoses and to gather information about domestic and other…

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

    PubMed Central

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

    2010-01-01

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

  17. Tripartite structure of positive and negative affect, depression, and anxiety in child and adolescent psychiatric inpatients.

    PubMed

    Joiner, T E; Catanzaro, S J; Laurent, J

    1996-08-01

    The tripartite model of depression and anxiety suggests that depression and anxiety have shared (generalized negative affect) and specific (anhedonia and physiological hyperarousal) components. In one of the 1st studies to examine the structure of mood-related symptoms in youngsters, this model was tested among 116 child and adolescent psychiatric inpatients, ages 8-16 (M = 12.46; SD = 2.33). Consistent with the tripartite model, a 3-factor (Depression, Anxiety, and Negative Affect) model represented the observed data well. Follow-up analyses suggested that a nonhierarchical arrangement of the 3 factors may be preferable to a hierarchical one.

  18. Music listening preferences and preadmission dysfunctional psychosocial behaviors of adolescents hospitalized on an in-patient psychiatric unit.

    PubMed

    Weidinger, C K; Demi, A S

    1991-01-01

    This study investigated the relationship between music listening preferences and preadmission, dysfunctional psychosocial behaviors (PDPB) of 60 adolescents who were hospitalized on an in-patient psychiatric unit. Findings were that hospitalized adolescents who primarily listened to music with negative lyrics/themes had a history of more PDPB than hospitalized adolescents who primarily listened to music that did not contain negative lyrics/themes; and hospitalized adolescents who primarily listened to heavy metal music had a history of more PDPB than hospitalized adolescents who primarily listened to other types of music.

  19. Universal parent training as a supplement to inpatient psychiatric treatment for children and adolescents.

    PubMed

    Schwenck, Christina; Schneider, Wolfgang; Reichert, Andreas

    2016-08-01

    Parent trainings constitute an effective method to target aspects of parenting in child and adolescent psychiatric and psychotherapeutic care. Past research has mainly been conducted in outpatient contexts, with parents of children with externalizing disorders and often included only small sample sizes. The aim of the current study was first to assess the effectiveness of a novel parent training which is characterized by a universal approach, an open group concept, and short duration, and second to identify variables that have an influence on the effectiveness. A sample of n = 151 parent-child dyads treated in an inpatient clinic was included in the study and randomly assigned to a treatment group and a waiting-list control group. As dependent measures served child behavior problems, dysfunctional parenting, parental mental health, and parental self-efficacy measured with parent-rated questionnaires prior to the training, post training and 3 months after discharge of the clinic. Additionally, a parent-child-interaction observation was conducted and rated by blind raters. Results indicated a general inpatient treatment effect on all dependent measures assessed with questionnaires. An additional effect of the parent training was only shown for parenting and parental mental health with the treatment group revealing better outcomes post training and at follow-up. No effects were found for the measures assessed by interaction observation. Out of a number of variables, only a low monthly income was associated with a higher reduction of dysfunctional parenting. Results indicate that parent training does not contribute additionally to standard inpatient care with respect to child behavior, but does have an influence on parental well-being, which might have a positive effect on the long run.

  20. The Involuntary Treatment of Adolescent Psychiatric Inpatients--A Nation-Wide Survey from Finland

    ERIC Educational Resources Information Center

    Ellila, Heikki Toivo; Sourander, Andre; Valimaki, Maritta; Warne, Tony; Kaivosoja, Matti

    2008-01-01

    This national cross-sectional study investigates the prevalence rates, regional differences and factors associated with the involuntary inpatient treatment of adolescents in Finland on a chosen day in 2000. The proportion of inpatients with involuntary legal status was 29.5% (n=82) giving a prevalence rate of 2.5 per 10,000/12-17 years old…

  1. Stability of Diagnosis: A 20-Year Retrospective Cohort Study of Israeli Psychiatric Adolescent Inpatients.

    ERIC Educational Resources Information Center

    Valevski, Avi; Ratzoni, Gideon; Sever, Jonathan; Apter, Alan; Zalsman, Gil; Shiloh, Roni; Weizman, Abraham; Tyano, Sam

    2001-01-01

    Outcome according to diagnosis and stability of diagnosis were investigated in a follow-back study, with a duration of 15-19 years, of 351 adolescents with various psychiatric disorders hospitalized in a closed psychiatric ward. Findings indicated that transient adolescent psychosis is associated with a relatively good prognosis and should…

  2. Inpatient Opioid Withdrawal Management of Street Children and Adolescents Admitted to Child and Adolescent Psychiatric Ward: A Preliminary Case Series

    PubMed Central

    Firouzkouhi Moghadam, Mahboubeh; Hashemian, Seyed-Sepehr; Pishjoo, Masoud; Ghasemi, Sanaz; Hajebi, Ahmad; Noroozi, Alireza

    2016-01-01

    Background About 10 million children worldwide live or work on the street. International reports estimate the prevalence of substance use among street children to be between 25% - 90%, which is who were referredntal disorders and high-risk behaviors. Objectives The objective of this study was to report the outcomes of assisted withdrawal of opioid-dependent vulnerable children and adolescents who were referred to child and adolescent psychiatric ward of Ali Ebne Abitaleb hospital, an academic hospital in Zahedan city. Methods Clinical chart abstractions were performed on a convenience sample of 40 serial opioid-dependent street children and adolescents (mean age: 11.14 ± 3.6 years) who were referred to child and adolescent psychiatric ward of Ali Ebne Abitaleb treatment and research center from November 2014 to May 2015. The demographic data, drug use history, comorbid physical and psychiatric conditions, symptomatology of opioid withdrawal syndrome, pharmacotherapies and psychosocial services, length of hospital stay, and any adverse events were extracted from the patients’ files using a checklist developed by the authors. Results Twenty-four (60%) patients were male, and 16 (40%) were female. The main drug used by all patients was opioids. Heroin Kerack (which has a street name of crystal in southeast Iran) was the most common (75%) drug of use, followed by opium (10%) and opium residue (7.5%). None of the participants self-reported using injected drugs. The high rate of a lack of eligibility for guardianship was documented among parents (87.5%) mainly due to their use of illegal drugs. Musculoskeletal pain and diarrhea were the most common withdrawal symptoms of the patients upon admission. The mean length of stay was 10.8 (± 7.30) days, and no significant adverse events were reported during the symptomatic treatment of opioid withdrawal syndrome. Conclusions To our knowledge, this is the first study to report on the safety and feasibility of inpatient

  3. Adolescent Dress, Part I: Dress and Body Markings of Psychiatric Outpatients and Inpatients.

    ERIC Educational Resources Information Center

    Michelman, John D.; And Others

    1991-01-01

    Investigated dress and body markings of 100 hospitalized and never-hospitalized adolescent psychiatric patients using in-depth interviews. Found that hospitalized patients had higher incidence of self-scarring, but other individual expressions of appearance did not differentiate two groups. Suggests that dress and appearance observations,…

  4. Bullying behavior in relation to psychiatric disorders and physical health among adolescents: a clinical cohort of 508 underage inpatient adolescents in Northern Finland.

    PubMed

    Luukkonen, Anu-Helmi; Räsänen, Pirkko; Hakko, Helinä; Riala, Kaisa

    2010-06-30

    The aim was to investigate the association of bullying behavior with psychiatric disorders and physical health in a sample of adolescent psychiatric patients, as there have to our knowledge been no previous studies using actual psychiatric diagnoses examining this relationship in boys and girls. We studied 508 Finnish adolescents (age 12-17) admitted to psychiatric inpatient care between April 2001 and March 2006 from the geographically large area of Northern Finland. The Schedule for Affective Disorder and Schizophrenia for School-Age Children, Present and Lifetime (K-SADS-PL) was used to obtain psychiatric diagnoses of adolescents according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and information on bullying behavior. Logistic regression analyses showed that having an externalizing disorder increased the likelihood of being a bully or a bully-victim (i.e. a person who is both a bully and a victim of bullying) among both the boys (odds ratio, OR=14.4, P=0.001) and the girls (OR=10.0, P<0.001). In addition, having an internalizing disorder increased the likelihood of being a victim of bullying among the boys (OR=3.4, P=0.008), but not the girls. Chronic somatic diseases were also significantly associated with being bullied among the boys (OR=2.5, P=0.041). Our results suggest that adolescents who are involved in bullying behavior should be evaluated psychiatrically, as this might be an early marker of psychiatric disorders.

  5. The association of non-suicidal self-injury and suicidal behavior according to DSM-5 in adolescent psychiatric inpatients.

    PubMed

    Groschwitz, Rebecca C; Kaess, Michael; Fischer, Gloria; Ameis, Nina; Schulze, Ulrike M E; Brunner, Romuald; Koelch, Michael; Plener, Paul L

    2015-08-30

    Non-suicidal self-injury (NSSI) and suicidal behaviors frequently occur among adolescent psychiatric patients. Although those behaviors are distinct with regards to intent, NSSI has been shown to be an important risk-factor for suicide attempts. However, the association of NSSI and Suicidal Behavior Disorder (SBD) according to DSM-5 criteria has not yet been investigated. For investigating distinctive features and mutual risk-factors of NSSI-disorder and SBD, adolescent psychiatric inpatients (N=111, aged 12-19 years; 65.8% females) were interviewed using the Self-Injurious-Thoughts-And-Behaviors-Interview-German (SITBI-G). NSSI started significantly earlier in life (M=12.5 years, SD=2.2) than first suicide attempts (M=14.1 years, SD=2.0). Patients meeting NSSI-disorder and/or SBD were significantly more likely to be female and to be diagnosed with an affective disorder. NSSI-disorder and SBD seem to have several distinctive features (i.e. age of onset or frequency), but also seem to share certain mutual risk-factors (i.e. affective disorders, female gender). While both NSSI and SBD seem to be maintained by mainly automatic negative reinforcement, positive automatic and social functions were rated significantly higher for NSSI. Most importantly, NSSI seems to be a strong risk factor for the occurrence of SBD (even when controlling for suicidal ideation) and should therefore always be assessed when dealing with psychiatric adolescent patients.

  6. Relational stressors as predictors for repeat aggressive and self-harming incidents in child and adolescent psychiatric inpatient settings.

    PubMed

    Ulke, Christine; Klein, Annette M; von Klitzing, Kai

    2014-01-01

    This study examined whether relational stressors such as psychosocial stressors, the therapist's absence and a change of therapist are associated with repeat aggressive or self-harming incidents in child and adolescent psychiatric inpatient care. The study data were derived from critical incident reports and chart reviews of 107 inpatients. In multinomial regression analysis, patients with repeat aggressive or self-harming incidents were compared with patients with single incidents. Results suggested that a higher number of psychosocial stressors and a change of therapist, but not the therapist's absence are predictors for repeat aggressive and self-harming incidents. There was a high prevalence of therapist's absence during both, single and repeat, incidents. Repeat aggressive incidents were common in male children and adolescents with disruptive behavior disorders. Repeat self-harming incidents were common in adolescent females with trauma-related disorders. Patients with repeat aggressive or self-harming incidents had a higher number of abnormal intrafamilial relationships and acute life events than patients with single incidents. Interventions to reduce a change of therapist should in particular target children and adolescents with a higher number of psychosocial stressors and/or a known history of traumatic relational experiences. After a first incident, patients should have a psychosocial assessment to evaluate whether additional relational support is needed.

  7. Inpatient Suicide in a Chinese Psychiatric Hospital

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  8. A prospective examination of the interpersonal-psychological theory of suicidal behavior among psychiatric adolescent inpatients.

    PubMed

    Czyz, Ewa K; Berona, Johnny; King, Cheryl A

    2015-04-01

    The challenge of identifying suicide risk in adolescents, and particularly among high-risk subgroups such as adolescent inpatients, calls for further study of models of suicidal behavior that could meaningfully aid in the prediction of risk. This study examined how well the Interpersonal-Psychological Theory of Suicidal Behavior (IPTS)--with its constructs of thwarted belongingness (TB), perceived burdensomeness (PB), and an acquired capability (AC) for lethal self-injury--predicts suicide attempts among adolescents (N = 376) 3 and 12 months after hospitalization. The three-way interaction between PB, TB, and AC, defined as a history of multiple suicide attempts, was not significant. However, there were significant 2-way interaction effects, which varied by sex: girls with low AC and increasing TB, and boys with high AC and increasing PB, were more likely to attempt suicide at 3 months. Only high AC predicted 12-month attempts. Results suggest gender-specific associations between theory components and attempts. The time-limited effects of these associations point to TB and PB being dynamic and modifiable in high-risk populations, whereas the effects of AC are more lasting. The study also fills an important gap in existing research by examining IPTS prospectively.

  9. Associations of the Dopamine D4 Receptor Gene VNTR Polymorphism with Drug Use in Adolescent Psychiatric Inpatients

    PubMed Central

    McGeary, John E.; Esposito-Smythers, Christianne; Spirito, Anthony; Monti, Peter M.

    2007-01-01

    Background The VNTR polymorphism in the Dopamine D4 receptor gene (DRD4) has been associated with differential urge for substances across multiple methodologies ranging from neuroimaging to assessment in the natural environment. It is unclear whether the DRD4 gene is a marker for an underlying propensity for greater urge or whether the DRD4 gene differentially moderates the neuroadaptive effects of extended substance use on urge. Examination of the DRD4 in an adolescent sample may provide evidence of a mechanism of this putative relationship. Method Data from a subset of 77 participants in a larger assessment study characterized adolescents for substance-related behaviors by DRD4 genotype. The psychiatrically admitted adolescents were genotyped for the variable number of tandem repeats polymorphism in the DRD4 gene (L ≥ 7 [n = 25], S = < 7 [n = 52]). Associations of the DRD4 with scores on the SASSI, and ADI were examined as well as selected individual items thought to be most related to the intermediate phenotype of urge. Results The DRD4 gene was not associated with any DSM-IV substance misuse diagnostic classification. Individual items related to urge were also nonsignificantly related to DRD4 status. Carriers of the long variant of the DRD4 polymorphism were more likely to have used hard drugs within the previous 6 months and scored higher on the self-medication subscale of the ADI compared to short variant homozygotes. Discussion Preliminary results provide little evidence for the DRD4 VNTR polymorphism to be related to urge-related phenomena in hospitalized adolescents on a psychiatric inpatient unit. The association of the DRD4 gene with hard drug use may support literature linking this gene to impulsivity. Subscale findings may suggest a role of negative affect in previous DRD4 urge findings. PMID:17175015

  10. Association of family structure to later criminality: a population-based follow-up study of adolescent psychiatric inpatients in Northern Finland.

    PubMed

    Ikäheimo, Olli; Laukkanen, Matti; Hakko, Helinä; Räsänen, Pirkko

    2013-04-01

    The influence of family structure on criminality in adolescents is well acknowledged in population based studies of delinquents, but not regarding adolescent psychiatric inpatients. The association of family structure to criminality was examined among 508 adolescents receiving psychiatric inpatient treatment between 2001 and 2006. Family structure and DSM-IV based psychiatric diagnoses were based on the K-SADS-PL-interview and criminality on criminal records provided by the Finnish Legal Register Centre. After adjusting for socio-demographic, clinical and family factors, the adolescents from single parent families, child welfare placements and those not living with their biological parents showed an increased risk of committing crimes at an earlier age than adolescents from two parent families. Lack of a safe and stable family environment has important implications for adolescents with severe mental disorder. When these adolescents are discharged from hospital, special attention should be focused on organizing stable and long term psychosocial support which compensates for the lack of stable family environment and seeks to prevent future adversities.

  11. Body Dysmorphic Disorder and Other Clinically Significant Body Image Concerns in Adolescent Psychiatric Inpatients: Prevalence and Clinical Characteristics

    ERIC Educational Resources Information Center

    Dyl, Jennifer; Kittler, Jennifer; Phillips, Katharine A.; Hunt, Jeffrey I.

    2006-01-01

    Background: This study assessed prevalence and clinical correlates of body dysmorphic disorder (BDD), eating disorders (ED), and other clinically significant body image concerns in 208 consecutively admitted adolescent inpatients. It was hypothesized that adolescents with BDD would have higher levels of depression, anxiety, and suicidality.…

  12. Problems in Differentiating Sexually from Nonsexually Abused Adolescent Psychiatric Inpatients by Self-Reported Anxiety, Depression, Internalization, and Externalization.

    ERIC Educational Resources Information Center

    Kumar, Geetha; And Others

    1996-01-01

    Several measures of psychopathology were administered to 111 psychiatric inpatients (ages 13 to 17) including 46 patients who reported sexually abusive experiences. None of the scales was correlated with sexual abuse in either sex, and a history of physical abuse was the only characteristic that significantly correlated with sexual abuse for both…

  13. Prosecuting Assaultive Forensic and Psychiatric Inpatients

    ERIC Educational Resources Information Center

    Angus, Kerri C.; Reddon, John R.; Chudleigh, Michele D.

    2008-01-01

    Inpatient assault of forensic and psychiatric staff is a complex and multifaceted issue. Hence, the consequences reported in the literature regarding prosecuting assaultive inpatients are quite variable. In this article, issues pertaining to the prosecution of violent inpatients are reviewed. Illustrative cases, challenges of prosecution,…

  14. [Factors influencing the course and duration of inpatient child and adolescent psychiatric treatment: between empiricism and clinical reality].

    PubMed

    Branik, Emil

    2003-09-01

    In the last two decades considerable changes influenced the scope of inpatient treatment in child and adolescent psychiatry. Proceeding from a literature review dilemmas between available research data and clinical practice will be pointed out. Proposals will be made to take into account the complex developmental processes, the individuality and the social context by psychic impaired children and adolescents requiring hospitalisation. This could improve the transfer of research findings into the clinical practice. It will be argued against a confusion of economical interests with research findings.

  15. A CBT Approach to Inpatient Psychiatric Hospitalization

    ERIC Educational Resources Information Center

    Masters, Kim J.

    2005-01-01

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

  16. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment...

  17. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment...

  18. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment...

  19. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment...

  20. 42 CFR 412.405 - Preadmission services as inpatient operating costs under the inpatient psychiatric facility...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... under the inpatient psychiatric facility prospective payment system. 412.405 Section 412.405 Public... Services of Inpatient Psychiatric Facilities § 412.405 Preadmission services as inpatient operating costs under the inpatient psychiatric facility prospective payment system. The prospective payment...

  1. Borderline personality disorder associates with violent criminality in women: A population based follow-up study of adolescent psychiatric inpatients in Northern Finland.

    PubMed

    Arola, Riikka; Antila, Henna; Riipinen, Pirkko; Hakko, Helinä; Riala, Kaisa; Kantojärvi, Liisa

    2016-09-01

    Various psychiatric problems in adolescence and early adulthood have been shown to associate with criminal behaviour. In this study the association of personality disorders (PDs) with criminal behaviour was examined in adolescents treated in psychiatric hospitals. The study sample consisted of 508 adolescents (age 13-17) admitted to acute psychiatric impatient care between April 2001 and March 2006. Crime data was obtained from the Finnish Legal Register Centre on September 2013. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) was used to assess psychiatric diagnoses in adolescence. The information on PDs in early adulthood was based on follow-up information on psychiatric treatments in either out- or inpatient settings until the end of 2012, and was extracted from the National Care Register for Health Care provided by the Finnish National Institute for Health and Welfare. A total of 22 (39%) of the 57 subjects with PD had committed a crime. In women, the likelihood for violent criminality was significantly increased in those with Borderline PD (OR 6.09, CI 1.24-29.84, p=0.009) and was also associated with conduct disorder (OR 4.26, CI 1.38-13.19, p=0.012), child welfare placement (OR 11.82, CI 3.61-38.76, p<0.001) and parent's substance use disorder (OR 7.74, CI 2.30-26.10, p=0.001). In men, no association was observed between PD and any kind of criminal behaviour. Significant predictors for violent criminality in males were conduct disorder (OR 4.05, CI 1.75-9.38, p=0.001), substance use disorder (OR 2.51, CI 1.22-5.17, p=0.012) and special services at school (OR 2.58, CI 1.16-5.76, p=0.021). Females with Borderline PD showed an increased risk for violent offending. This suggests Borderline PD as a potential explanatory factor for violent assaults by females and highlights the importance of recognizing the risk for violence in young women with a Borderline PD.

  2. Regional Correlates of Psychiatric Inpatient Treatment

    PubMed Central

    Ala-Nikkola, Taina; Pirkola, Sami; Kaila, Minna; Saarni, Samuli I.; Joffe, Grigori; Kontio, Raija; Oranta, Olli; Sadeniemi, Minna; Wahlbeck, Kristian

    2016-01-01

    Current reforms of mental health and substance abuse services (MHS) emphasize community-based care and the downsizing of psychiatric hospitals. Reductions in acute and semi-acute hospital beds are achieved through shortened stays or by avoiding hospitalization. Understanding the factors that drive the current inpatient treatment provision is essential. We investigated how the MHS service structure (diversity of services and balance of personnel resources) and indicators of service need (mental health index, education, single household, and alcohol sales) correlated with acute and semi-acute inpatient treatment provision. The European Service Mapping Schedule-Revised (ESMS-R) tool was used to classify the adult MHS structure in southern Finland (population 1.8 million, 18+ years). The diversity of MHS in terms of range of outpatient and day care services or the overall personnel resourcing in inpatient or outpatient services was not associated with the inpatient treatment provision. In the univariate analyses, sold alcohol was associated with the inpatient treatment provision, while in the multivariate modeling, only a general index for mental health needs was associated with greater hospitalization. In the dehospitalization process, direct resource re-allocation and substituting of inpatient treatment with outpatient care per se is likely insufficient, since inpatient treatment is linked to contextual factors in the population and the health care system. Mental health services reforms require both strategic planning of service system as a whole and detailed understanding of effects of societal components. PMID:27929403

  3. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... psychiatric facilities. (a) Requirements for certification and recertification: General considerations... other hospitals because the care furnished in inpatient psychiatric facilities is often purely...

  4. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... psychiatric facilities. (a) Requirements for certification and recertification: General considerations... other hospitals because the care furnished in inpatient psychiatric facilities is often purely...

  5. Feasibility of Dialectical Behavior Therapy for Suicidal Adolescent Inpatients.

    ERIC Educational Resources Information Center

    Katz, Laurence Y.; Cox, Brian J.; Gunasekara, Shiny; Miller, Alec L.

    2004-01-01

    Objective: To evaluate the feasibility of dialectical behavior therapy (DBT) implementation in a general child and adolescent psychiatric inpatient unit and to provide preliminary effectiveness data on DBT versus treatment as usual (TAU). Method: Sixty-two adolescents with suicide attempts or suicidal ideation were admitted to one of two…

  6. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Certification and Plan Requirements § 424.14 Requirements for inpatient services of inpatient psychiatric... requirements differ from those for other hospitals because the care furnished in psychiatric hospitals is...

  7. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Certification and Plan Requirements § 424.14 Requirements for inpatient services of inpatient psychiatric... requirements differ from those for other hospitals because the care furnished in psychiatric hospitals is...

  8. Spectrum of autoantibodies in Tunisian psychiatric inpatients.

    PubMed

    Sidhom, Oussama; Laadhar, Lilia; Zitouni, Mondher; Ben Alaya, Nissaf; Rafrafi, Rym; Kallel-Sellami, Marayam; Lahmar, Houria; El Hechmi, Zouhair; Makni, Sondes

    2012-01-01

    One hundred and three psychiatric inpatients (74 men) were assessed for a wide spectrum of autoantibodies including antinuclear, antismooth muscle, antimitochondrial, antiDNA, anti-phospholipid, anti-cardiolipin IgG and IgM, antikeratin, rheumatoid factor, antithyroperoxydase, antigliadin IgA and IgG, antitransgutaminase, and antiendomysium antibodies. Four groups of patients were considered separately, including 47 with schizophrenia, 23 with schizoaffective disorder, 16 with bipolar disorder and 17 patients with other different psychiatric diagnosis. Forty one healthy, age- and sex-matched blood donors were used as a control group. There were no significant difference in the prevalence of the different autoantibodies between patients (N = 103) and controls except for antigliadin IgG (30.1 vs 9.8 respectively, p = 0.01). Presence of autoantibodies was influenced by age but not by sex or treatment. As for diagnosis categories, patients with bipolar disorder presented significantly more autoantibodies than the three other categories and controls. These results point out a possible autoimmune activation in at least a subgroup of psychiatric patients especially amongst those suffering from bipolar disorder.

  9. 42 CFR 412.432 - Method of payment under the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Method of payment under the inpatient psychiatric... Psychiatric Facilities § 412.432 Method of payment under the inpatient psychiatric facility prospective... inpatient psychiatric facility receives payment under this subpart for inpatient operating cost and...

  10. 42 CFR 412.432 - Method of payment under the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Method of payment under the inpatient psychiatric... Psychiatric Facilities § 412.432 Method of payment under the inpatient psychiatric facility prospective... inpatient psychiatric facility receives payment under this subpart for inpatient operating cost and...

  11. 42 CFR 412.432 - Method of payment under the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Method of payment under the inpatient psychiatric... Psychiatric Facilities § 412.432 Method of payment under the inpatient psychiatric facility prospective... inpatient psychiatric facility receives payment under this subpart for inpatient operating cost and...

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

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Method of payment under the inpatient psychiatric... Psychiatric Facilities § 412.432 Method of payment under the inpatient psychiatric facility prospective... inpatient psychiatric facility receives payment under this subpart for inpatient operating cost and...

  13. Shrinking inpatient psychiatric capacity: cause for celebration or concern?

    PubMed

    Salinsky, Eileen; Loftis, Christopher

    2007-08-01

    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.

  14. Reducing Psychiatric Inpatient Violence through Solution-Focused Group Therapy.

    ERIC Educational Resources Information Center

    Oxman, Elaine B.; Chambliss, Catherine

    Violent behaviors increasingly provide the basis for psychiatric hospitalization. This study targeted a group of high-risk psychiatric inpatients with a recent history of violence. A solution-focused treatment approach was used in conducting two ongoing weekly therapy groups. Patients were encouraged to reflect upon occasions where they…

  15. Controlling Costs for Inpatient CHAMPUS Psychiatric Care

    DTIC Science & Technology

    1991-12-01

    average length of stay , primiry diagnoses, cost of admission, reimbursement rates, beneficiary category, and occupancy rates. Compare...Inpatient Psych 26 provided, total mental health care costs, average length of stay , average cost per admission, and average cost per day were calculated. A...depressions account for fully 46% of the total government inpatient bill. The average length of stay (LOS) for inpatient mental health for the

  16. 42 CFR 412.434 - Reconsideration and appeals procedures of Inpatient Psychiatric Facilities Quality Reporting...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Psychiatric Facilities Quality Reporting (IPFQR) Program decisions. 412.434 Section 412.434 Public Health... Services of Inpatient Psychiatric Facilities § 412.434 Reconsideration and appeals procedures of Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program decisions. (a) An inpatient psychiatric facility...

  17. 42 CFR 412.428 - Publication of Updates to the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Publication of Updates to the inpatient psychiatric... Psychiatric Facilities § 412.428 Publication of Updates to the inpatient psychiatric facility prospective... inpatient psychiatric facility prospective payment system. This information includes: (a) A description...

  18. 42 CFR 412.428 - Publication of Updates to the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Publication of Updates to the inpatient psychiatric... Psychiatric Facilities § 412.428 Publication of Updates to the inpatient psychiatric facility prospective... inpatient psychiatric facility prospective payment system. This information includes: (a) A description...

  19. 42 CFR 412.434 - Reconsideration and appeals procedures of Inpatient Psychiatric Facilities Quality Reporting...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Psychiatric Facilities Quality Reporting (IPFQR) Program decisions. 412.434 Section 412.434 Public Health... Services of Inpatient Psychiatric Facilities § 412.434 Reconsideration and appeals procedures of Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program decisions. (a) An inpatient psychiatric facility...

  20. 42 CFR 412.428 - Publication of Updates to the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Publication of Updates to the inpatient psychiatric... Psychiatric Facilities § 412.428 Publication of Updates to the inpatient psychiatric facility prospective... inpatient psychiatric facility prospective payment system. This information includes: (a) A description...

  1. 42 CFR 412.434 - Reconsideration and appeals procedures of Inpatient Psychiatric Facilities Quality Reporting...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Psychiatric Facilities Quality Reporting (IPFQR) Program decisions. 412.434 Section 412.434 Public Health... Services of Inpatient Psychiatric Facilities § 412.434 Reconsideration and appeals procedures of Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program decisions. (a) An inpatient psychiatric facility...

  2. 42 CFR 412.428 - Publication of Updates to the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Publication of Updates to the inpatient psychiatric... Psychiatric Facilities § 412.428 Publication of Updates to the inpatient psychiatric facility prospective... inpatient psychiatric facility prospective payment system. This information includes: (a) A description...

  3. Frequency, Characteristics and Management of Adolescent Inpatient Aggression

    PubMed Central

    Baeza, Immaculada; Saito, Ema; Amanbekova, Dinara; Ramani, Meena; Kapoor, Sandeep; Chekuri, Raja; De Hert, Marc; Carbon, Maren

    2013-01-01

    Abstract Background Inpatient aggression is a serious challenge in pediatric psychiatry. Methods A chart review study in adolescent psychiatric inpatients consecutively admitted over 24 months was conducted, to describe aggressive events requiring an intervention (AERI) and to characterize their management. AERIs were identified based on specific institutional event forms and/or documentation of as-needed (STAT/PRN) medication administration for aggression, both recorded by nursing staff. Results Among 408 adolescent inpatients (age: 15.2±1.6 years, 43.9% male), 1349 AERIs were recorded, with ≥1 AERI occurring in 28.4% (n=116; AERI+). However, the frequency of AERIs was highly skewed (median 4, range: 1–258). In a logistical regression model, the primary diagnosis at discharge of disruptive behavior disorders and bipolar disorders, history of previous inpatient treatment, length of hospitalization, and absence of a specific precipitant prior to admission were significantly associated with AERIs (R2=0.32; p<0.0001). The first line treatment of patients with AERIs (AERI+) was pharmacological in nature (95.6%). Seclusion or restraint (SRU) was used at least once in 59.4% of the AERI+ subgroup (i.e., in 16.9% of all patients; median within-group SRU frequency: 3). Treatment and discharge characteristics indicated a poorer prognosis in the AERI+ (discharge to residential care AERI+: 22.8%, AERI−: 5.6%, p<0.001) and a greater need for psychotropic polypharmacy (median number of psychotropic medications AERI+: 2; AERI−: 1, p<0.001). Conclusions Despite high rates of pharmacological interventions, SRU continue to be used in adolescent inpatient care. As both of these approaches lack a clear evidence base, and as adolescents with clinically significant inpatient aggression have increased illness acuity/severity and service needs, structured research into the most appropriate inpatient aggression management is sorely needed. PMID:23647136

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  5. 42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Definitions § 440.160 Inpatient psychiatric services for individuals under age 21. “Inpatient psychiatric... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient psychiatric services for individuals under age 21. 440.160 Section 440.160 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES,...

  6. 42 CFR 412.432 - Method of payment under the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... facility prospective payment system. 412.432 Section 412.432 Public Health CENTERS FOR MEDICARE & MEDICAID... Psychiatric Facilities § 412.432 Method of payment under the inpatient psychiatric facility prospective... inpatient psychiatric facility receives payment under this subpart for inpatient operating cost and...

  7. 42 CFR 409.62 - Lifetime maximum on inpatient psychiatric care.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Lifetime maximum on inpatient psychiatric care. 409....62 Lifetime maximum on inpatient psychiatric care. There is a lifetime maximum of 190 days on inpatient psychiatric hospital services available to any beneficiary. Therefore, once an individual...

  8. 42 CFR 409.62 - Lifetime maximum on inpatient psychiatric care.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Lifetime maximum on inpatient psychiatric care. 409....62 Lifetime maximum on inpatient psychiatric care. There is a lifetime maximum of 190 days on inpatient psychiatric hospital services available to any beneficiary. Therefore, once an individual...

  9. 42 CFR 409.62 - Lifetime maximum on inpatient psychiatric care.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Lifetime maximum on inpatient psychiatric care. 409....62 Lifetime maximum on inpatient psychiatric care. There is a lifetime maximum of 190 days on inpatient psychiatric hospital services available to any beneficiary. Therefore, once an individual...

  10. 42 CFR 409.62 - Lifetime maximum on inpatient psychiatric care.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Lifetime maximum on inpatient psychiatric care. 409....62 Lifetime maximum on inpatient psychiatric care. There is a lifetime maximum of 190 days on inpatient psychiatric hospital services available to any beneficiary. Therefore, once an individual...

  11. 42 CFR 409.62 - Lifetime maximum on inpatient psychiatric care.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Lifetime maximum on inpatient psychiatric care. 409....62 Lifetime maximum on inpatient psychiatric care. There is a lifetime maximum of 190 days on inpatient psychiatric hospital services available to any beneficiary. Therefore, once an individual...

  12. Managing Bipolar Youths in a Psychiatric Inpatient Emergency Service

    ERIC Educational Resources Information Center

    Masi, Gabriele; Mucci, Maria; Pias, Paola; Muratori, Filippo

    2011-01-01

    Among the youths referred to our Psychiatric Inpatient Emergency Service, we focused on bipolar disorder (BD), to explore predictive elements for the outcome. Fifty-one patients (30 males, 21 females, age range 8-18 years, mean age 14.2 plus or minus 3.1 years) received a diagnosis of BD, according to historical information, prolonged…

  13. Proactive and Reactive Aggression in a Child Psychiatric Inpatient Population

    ERIC Educational Resources Information Center

    Fite, Paula J.; Stoppelbein, Laura; Greening, Leilani

    2009-01-01

    This study examined relations between proactive and reactive aggression and indicators of antisocial behavior (callous/unemotional traits and behavioral consequences) and negative affect (depression and suicidal behavior) in a sample of 105 children admitted to an acute child psychiatric inpatient unit. The majority of the children were male (69%)…

  14. Psychiatric Inpatient Admissions of Adults with Intellectual Disabilities: Predictive Factors

    ERIC Educational Resources Information Center

    Cowley, Amy; Newton, Jonathan; Sturmey, Peter; Bouras, Nick; Holt, Geraldine

    2005-01-01

    Information on admission to psychiatric inpatient units is lacking from the literature on contemporary services for people with intellectual disability and mental health needs. Here we report on predictors of admission for a cohort of 752 adults from this population living in community settings; 83 were admitted. We also report on two subsamples…

  15. Sampling the Experience of Chronically Aggressive Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Waite, Bradley M.

    1994-01-01

    Studies the application of the Experience Sampling Method (ESM) to chronically aggressive psychiatric inpatients. ESM allows for the sampling of behavior, thoughts, and feelings of persons across time and situations by signalling subjects to record these aspects using a questionnaire at random times. (JPS)

  16. Ethnic and clinical characteristics of a Portuguese psychiatric inpatient population.

    PubMed

    Alexandre, Joana; Ribeiro, Raquel; Cardoso, Graça

    2010-04-01

    The present study examined the association between ethnicity and clinical characteristics of patients admitted to a psychiatric inpatient unit in Portugal. The only ethnicity-related terms routinely recorded in the medical records were "Black" (mainly from the African Portuguese-speaking countries of Cape Verde, Angola, Guinea, Sao Tome and Mozambique) and "White." Black immigrants appeared to be over-represented, comprising 19.6% of inpatients; and were younger and more frequently male when compared with White inpatients. They were more frequently diagnosed with schizophrenia and acute or transient psychosis, and less frequently diagnosed with delusional and personality disorders than White inpatients. These results are consistent with previous studies in the US and UK, and highlight the need for more culturally sensitive care in mental health services.

  17. An acute in-patient psychiatric service for 16- to 17-year-old adolescents in the UK: a descriptive evaluation

    PubMed Central

    Duddu, Venu; Rhouma, Abdulhakim; Qureshi, Masood; Chaudhry, Imran Bashir; Drake, Terry; Sumra, Altaf; Husain, Nusrat

    2016-01-01

    Aims and method The need for an age-appropriate in-patient service for 16- to 17-year-olds led to the development of a 6-bed acute admissions unit in a non-metropolitan county in the UK. We provide a descriptive evaluation of the first 2 years of its operation. All admissions from April 2010 to March 2012 were reviewed, clinical details systematically recorded and descriptively analysed. Results Ninety-seven young people were admitted during this period (a third were compulsorily detained under the Mental Health Act 1983). The average length of stay was 3–4 weeks. The most common presenting complaints were self-harm and low mood, usually in the context of life events and childhood adversity. Nearly half had substance misuse and other risk-taking behaviours. A third presented with psychotic symptoms. Adjustment and anxiety disorders were most common, followed by alcohol/substance use disorders, depressive illnesses and psychotic illnesses. Comorbidity was the rule rather than the exception. Most patients improved by the time of discharge. Clinical implications The unit provides an accessible and effective age-appropriate service and is likely to constitute an important component of the comprehensive child and adolescent mental health service strategy in the county. PMID:27752345

  18. Suicidal patients as experienced by psychiatric nurses in inpatient care.

    PubMed

    Carlén, Pontus; Bengtsson, Anita

    2007-08-01

    Psychiatric nurses have a major influence on the lives of patients with suicidal behaviour in inpatient care. Despite this, there is a lack of knowledge about how nurses experience patients with suicidal behaviour in a deeper sense. The aim of this study was to investigate how psychiatric nurses experience patients with suicidal behaviour within an inpatient psychiatric context. Semi-structured interviews were carried out with 11 psychiatric nurses, each of whom had more than 5 years of experience caring for patients with suicidal behaviour. Data were analysed using qualitative latent content analysis. Two main themes emerged from the data analysis. These are 'labelled' and 'suffering'. In the nurses' natural attitude, they saw patients as being labelled with different conditions and/or behaviours based on objective signs. These were categorized into different groups or identities such as psychiatric diagnosis, mask wearer, screened-off, or the social, relapsing or determined patient. On reflection, however, the nurses described the patients' suffering in terms related to feelings of hopelessness, meaninglessness, and being out of control. The nurses' experiences of the patients as suffering were based on their subjective reflective experience of the patients. The study gives support to the conclusion that two main logic systems are represented in the care of patients with suicidal behaviour: technical practical and nursing perspectives. In order to ensure that these two logic systems combine, it is necessary for the psychiatric care organization to intervene to support the nurses in reflecting on their everyday work.

  19. The influence of borderline personality features on inpatient adolescent suicide risk.

    PubMed

    Yalch, Matthew M; Hopwood, Christopher J; Fehon, Dwain C; Grilo, Carlos M

    2014-01-01

    Suicide is a leading cause of death among adolescents and suicidal behavior is one of the primary risk factors for youth psychiatric hospitalizations. A number of studies indicate that depression and substance abuse are associated with suicide risk in this population, but less is known about the role of borderline personality features or their incremental influence over other known risk factors in indicating suicidal behavior among adolescents. This study examined whether borderline features were associated with suicide risk when controlling for symptoms of depression and substance abuse in a sample of adolescents hospitalized in an inpatient psychiatric facility. Self-report data from 477 adolescent psychiatric inpatients were used to test hypotheses about the association of borderline features with suicide risk after controlling for other common risk factors. Borderline features were significantly related to suicide risk even after accounting for symptoms of depression and substance abuse. These findings underscore the clinical value of routinely assessing borderline features among adolescents.

  20. [Dual diagnosis in psychiatric inpatients: prevalence and general characteristics].

    PubMed

    Rodríguez-Jiménez, Roberto; Aragüés, María; Jiménez-Arriero, Miguel Angel; Ponce, Guillermo; Muñoz, Antonio; Bagney, Alexandra; Hoenicka, Janet; Palomo, Tomás

    2008-06-01

    Comorbidity between a substance use disorder (SUD) and another psychiatric disorder is known as dual diagnosis. It is of great relevance due to its important clinical consequences and costs of care. There are practically no published studies on dual diagnosis prevalence in patients admitted to psychiatric hospitalization units in general hospitals (PHUGH) in our country. The objectives were to estimate the prevalence of dual diagnosis in psychiatric inpatients admitted consecutively to a Psychiatric Hospitalization Unit (Hospital Universitario 12 de Octubre, Madrid, Spain) in one year, to compare clinical and sociodemographic variables between the dual diagnosis group (DD group) and the group with a psychiatric disorder but no SUD (PD group), and to study the types of substances used. This is a retrospective study, based on the review of the clinical charts of the 257 patients admitted to this PHUGH in one year. The results showed that, excluding nicotine dependence, 24.9% of our inpatients had a SUD as well as another psychiatric disorder. A statistically significant predominance of men was found in the DD group, as well as a younger age at the time of the study, at the beginning of their psychiatric attention and on their first psychiatric admission, and they had received diagnoses of schizophrenia or related psychoses more often than the PD group, who had mostly affective disorders. The substances most frequently used in the DD group were alcohol (78.1%), cannabis (62.5%), and cocaine (51.6%). Due to the high prevalence and repercussions of dual diagnosis, it would be advisable to have specialized therapeutic programs for its treatment.

  1. Effects of music on major depression in psychiatric inpatients.

    PubMed

    Hsu, Wei-Chi; Lai, Hui-Ling

    2004-10-01

    The study was to assess the effectiveness of soft music for treatment of major depressive disorder inpatients in Kaohsiung City, Taiwan. A pretest-posttest with a two-group repeated measures design was used. Patients with major depressive disorder were recruited through referred by the psychiatric physicians. Subjects listened to their choice of music for 2 weeks. Depression was measured with the Zung's Depression Scale before the study and at two weekly posttests. Using repeated measures ANCOVA, music resulted in significantly better depressive scores, as well as significantly better subscores of depression compared with controls. Depression improved weekly, indicating a cumulative dose effect. The findings provide evidence for psychiatric nurses to use soft music as an empirically based intervention for depressed inpatients.

  2. Dissociative disorders in acute psychiatric inpatients in Taiwan.

    PubMed

    Chiu, Chui-De; Meg Tseng, Mei-Chih; Chien, Yi-Ling; Liao, Shih-Cheng; Liu, Chih-Min; Yeh, Yei-Yu; Hwu, Hai-Gwo; Ross, Colin A

    2017-04-01

    Dissociative disorders have been documented to be common psychiatric disorders which can be detected reliably with standardized diagnostic instruments in North American and European psychiatric inpatients and outpatients (20.6% and 18.4%, respectively). However, there are concerns about their cross-cultural manifestations as an apparently low prevalence rate has been reported in East Asian inpatients and outpatients (1.7% and 4.9%, respectively). It is unknown whether the clinical profile of dissociative disorders in terms of their core symptomatic clusters, associated comorbid disorders, and environmental risk factors that has emerged in western clinical populations can also be found in non-western clinical populations. A standardized structured interview for DSM-IV dissociative disorders, post-traumatic stress disorder, and a history of interpersonal victimization was administered in a sample of Taiwanese acute psychiatric inpatients. Our results showed that 19.5% of our participants met criteria for a DSM-IV dissociative disorder, mostly dissociative disorder not otherwise specified. More importantly, the western clinical profile of dissociative disorders also characterized our patients, including a poly-symptomatic presentation and a history of interpersonal trauma in both childhood and adulthood. Our results lend support to the conclusion that cross-cultural manifestations of dissociative pathology in East Asia are similar to those in North America and Europe.

  3. The temporal fluctuations and characteristics of psychiatric inpatient admissions in Ireland: data from the HRB's National Psychiatric In-Patient Reporting System.

    PubMed

    Walsh, D; Daly, A

    2016-11-01

    This paper examines trends in psychiatric inpatient admissions from the 1960s to 2014 and uses data from the National Psychiatric Inpatient Reporting System (NPIRS) to review these trends. In the 1960s the Department of Health began an annual system of reporting on the activities in Irish psychiatric units and hospitals on foot of the recommendations of the Commission of Inquiry on Mental Illness. The National Psychiatric Inpatient Reporting System (NPIRS) was established shortly thereafter and this paper discusses the data from this database contained in these annual activity reports over the last 50 years.

  4. Integrating Smartphone Technology at the Time of Discharge from a Child and Adolescent Inpatient Psychiatry Unit

    PubMed Central

    Gregory, Jonathan M.; Sukhera, Javeed; Taylor-Gates, Melissa

    2017-01-01

    Objective As smartphone technology becomes an increasingly important part of youth mental health, there has been little to no examination of how to effectively integrate smartphone-based safety planning with inpatient care. Our study sought to examine whether or not we could effectively integrate smartphone-based safety planning into the discharge process on a child and adolescent inpatient psychiatry unit. Method Staff members completed a survey to determine the extent of smartphone ownership in a population of admitted child and adolescent inpatients. In addition to quantifying smartphone ownership, the survey also tracked whether youth would integrate their previously-established safety plan with a specific safety planning application on their smartphone (Be Safe) at the time of discharge. Results Sixty-six percent (50/76) of discharged youth owned a smartphone, which is consistent with prior reports of high smartphone ownership in adult psychiatric populations. A minority of youth (18%) downloaded the Be Safe app prior to discharge, with most (68%) suggesting they would download the app after discharge. Notably, all patients who downloaded the app prior to discharge were on their first admission to a psychiatric inpatient unit. Conclusion Child and adolescent psychiatric inpatients have a clear interest in smartphone-based safety planning. Our results suggest that integrating smartphone-related interventions earlier in an admission might improve access before discharge. This highlights the tension between restricting and incorporating smartphone access for child and adolescent inpatients and may inform future study in this area. PMID:28331503

  5. 42 CFR 412.428 - Publication of Updates to the inpatient psychiatric facility prospective payment system.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... facility prospective payment system. 412.428 Section 412.428 Public Health CENTERS FOR MEDICARE & MEDICAID... Psychiatric Facilities § 412.428 Publication of Updates to the inpatient psychiatric facility prospective... inpatient psychiatric facility prospective payment system. This information includes: (a) A description...

  6. Non-Psychiatric Health Problems among Psychiatric Inpatients with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Charlot, L.; Abend, S.; Ravin, P.; Mastis, K.; Hunt, A.; Deutsch, C.

    2011-01-01

    Background: Physical distress resulting from medical problems has been found to cause increased behaviour problems in patients with intellectual disabilities (ID). Despite this fact, little has been documented on the medical problems of individuals with ID admitted for inpatient psychiatric care. We conducted an exploratory investigation based on…

  7. 78 FR 46733 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-01

    ...This notice updates the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs). These changes are applicable to IPF discharges occurring during the fiscal year (FY) beginning October 1, 2013 through September 30,...

  8. 77 FR 47223 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Fiscal...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-07

    ...This notice updates the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs). These changes are applicable to IPF discharges occurring during the fiscal year (FY) beginning October 1, 2012 through September 30,...

  9. Non-psychiatric health problems among psychiatric inpatients with Intellectual Disabilities

    PubMed Central

    Charlot, L.; Abend, S.; Ravin, P.; Mastis, K.; Hunt, A.; Deutsch, C.

    2013-01-01

    Background Physical distress resulting from medical problems has been found to cause increased behavior problems in with Intellectual Disabilities (ID). Despite this fact, little has been documented on the medical problems of individuals with ID admitted for inpatient psychiatric care. We conducted an exploratory investigation based on a retrospective chart review of the medical problems and medications for 198 people with ID who had been admitted to a specialized inpatient psychiatric unit. Most patients were referred for admission because of aggressive, disruptive and self-injurious behaviors. The average length of stay was 17.6 days. Method We tallied the total number of medical problems and medications listed in the patients’ discharge summaries. Because longer stays are disruptive, costly and associated with greater overall impairment, we examined the relationship between length of stay and frequency of discharge medical diagnoses. We also assessed whether or not the number of psychoactive medications correlated with the number of medical diagnoses. The effects of other demographic and diagnostic variables on rates of medical diagnoses and medications were also evaluated, including gender, age group (16–25, 26–45, 46–60, > 60), level of ID (Mild, moderate or severe ID), and diagnosis of an Autism Spectrum Disorder (ASD) or Down syndrome (DS). Results Inpatients with a higher number of medical diagnoses had longer lengths of stay (Spearman r = +.32, p < 0.0001). There was a significant correlation between number of psychoactive medications and number of medical problems (Spearman r = + .32, p < 0.0001). The most frequent medical comorbidity was constipation, reported in 60% of the inpatients (n = 118), while Gastro- Esophageal Reflux Disease (GERD) was identified in 38% (n = 75). Older inpatients had an increased number of medical problems, as might be expected, but a diagnosis of an ASD, gender, and level of ID had no detectible effect on rates of

  10. High prevalence of antineuronal antibodies in Tunisian psychiatric inpatients.

    PubMed

    Laadhar, Lilia; Sidhom, Oussama; Zitouni, Mondher; Sassi, Nadia; Abdelghaffar, Wafa; Lahmar, Houria; Kallel-Sellami, Maryam; El Hechmi, Zouhaier; Makni, Sondes

    2015-01-01

    The authors aimed to determine the prevalence of antineuronal antibodies in 103 psychiatric inpatients and 41 control subjects with no history of malignancies or neurological disorders. All sera were tested by indirect immunofluorescence and positive sera by immunoblot. Using immunofluorescence, antineuronal nuclear autoantibodies were detected in 20 patients and none of the control subjects, and antibodies reacted with the cytoplasm of Purkinje cells in six patients and two control subjects. The immunoblot confirmed well-characterized antineuronal antibodies only in five patients: two had anti-Ri and three had anti-Yo antibodies. After a follow-up of 5 years, none of these patients developed neurological disorder or malignancy.

  11. When should psychiatrists seek criminal prosecution of assaultive psychiatric inpatients?

    PubMed

    Ho, Justin; Ralston, D Christopher; McCullough, Laurence B; Coverdale, John H

    2009-08-01

    This Open Forum commentary reviews the ethical considerations relevant to the question of prosecuting assaultive psychiatric patients, with particular attention to the significance that should be attached to the arguments generated by those considerations. A comprehensive literature search was conducted incorporating the terms "assaultive patients," "ethics," "psychiatric inpatients," and "law." The literature of professional medical ethics was applied to identify relevant domains of ethical argument. Five domains were identified: fiduciary obligations of physicians to assaultive and other patients; obligations to staff members; professional virtues of compassion, self-sacrifice, and self-effacement; retributive justice; and the patient's right to confidentiality. The content of each domain is explained, and guidance is provided on how to assess the relative strengths of ethical argument within each domain. All five domains must be explicitly addressed in order to make ethically disciplined judgments about whether to seek prosecution. A distinctive feature of this ethical analysis is the central importance of the professional virtues.

  12. Alternative comorbidity adjustors for the Medicare inpatient psychiatric facility PPS.

    PubMed

    Drozd, Edward M; Maier, Jan; Hales, Jan F; Thomas, Frederick G

    2008-01-01

    The inpatient psychiatric facility prospective payment system (IPF-PPS), provides per diem payments for psychiatric hospitals and units, including 17 comorbid condition payment adjustors that cover 11 percent of patients. This study identifies an alternative set of 16 adjustors identifying three times as many high-cost patients and evaluates the improved predictive power in log per diem cost regression models. A model using the IPF-PPS adjustors achieved 8.8 percent of the feasible improvement from a no-adjustor baseline, while the alternative adjustors achieved 22.1 percent of the feasible improvement. The current adjustors may therefore be too restrictive, resulting in systematic over- or underpayment for many patients.

  13. A review of token economy treatment programs for psychiatric inpatients.

    PubMed

    Milby, J B

    1975-10-01

    The author has reviewed outcome studies of token economy programs for psychiatric inpatients. Only studies that employed some control procedures in their evaluation were included. Token economies were most effective in modifying inhospital work, personal care, and some psychotic behaviors. Studies that assessed token programs to prepare patients for community living and reduce recidivism generally affirmed the effectiveness of token procedures, but the studies were poorly designed, and they lacked systematic follow-up data. Almost all studies failed to examine possible interactions between chemotherapy and the token economies. The author suggests the need for studies using token economies with psychiatric patients other than chronic schizophrenics, who have been studied almost exclusively to date.

  14. Development of an adolescent inpatient sexual abuse group: application of Lewin's model of change.

    PubMed

    Riddle, C R

    1994-01-01

    The development and implementation of an adolescent sexual abuse group on an inpatient psychiatric unit is described. Steps of Kurt Lewin's model of change are used as a framework for this planned change. Specific issues concerning group procedure and process are detailed. Recommendations for this group and broader use of the Lewin model are included.

  15. Child and Adolescent Inpatient Restraint Reduction: A State Initiative to Promote Strength-Based Care.

    ERIC Educational Resources Information Center

    LeBel, Janice; Stromberg, Nan; Duckworth, Ken; Kerzner, Joan; Goldstein, Robert; Weeks, Michael; Harper, Gordon; LaFlair, Lareina; Sudders, Marylou

    2004-01-01

    Objective: To reduce the use of restraint and seclusion with children and adolescents in psychiatric inpatient units by promoting a preventive, strength-based model of care. Method: The State Mental Health Authority used data analysis, quality improvement strategies, regulatory oversight, and technical assistance to develop and implement system…

  16. Experiential Therapy with Troubled Youth: The Ropes Course for Adolescent Inpatients.

    ERIC Educational Resources Information Center

    Blanchard, Charles W.

    This paper provides information about conducting adventure-based counseling using a ropes course with adolescent psychiatric inpatients. Active learning in the process of therapy is widely accepted, but it is not clear how the complex nature of that relationship works and how programs should be structured to facilitate change. Theoretical…

  17. The MAPI as a Treatment Outcome Measure for Adolescent Inpatients.

    ERIC Educational Resources Information Center

    Piersma, Harry L.; And Others

    1993-01-01

    Administered Millon Adolescent Personality Inventory at admission and discharge to 215 hospitalized adolescent psychiatric patients. Found significant mean score differences for both internalizing (affective disorder) and externalizing (disruptive behavior disorder) adolescents. Internalizing adolescents reported significantly greater distress at…

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

    PubMed Central

    Culhane, D P; Hadley, T R

    1992-01-01

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

  19. 75 FR 23105 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System Payment-Update for...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ...This notice updates the payment rates for the Medicare prospective payment system (PPS) for inpatient psychiatric hospital services provided by inpatient psychiatric facilities (IPFs). These changes are applicable to IPF discharges occurring during the rate year beginning July 1, 2010 through June 30, 2011. We are also responding to comments on the IPF PPS teaching adjustment and the market......

  20. Family Trauma and Dysfunction in Sexually Abused Female Adolescent Psychiatric Control Groups.

    ERIC Educational Resources Information Center

    Wherry, Jeffrey N.; And Others

    1994-01-01

    Differences in family trauma, stressors, and dysfunction among adolescent psychiatric inpatients grouped by sexual abuse self-reports were investigated. Family trauma/dysfunction was determined from a composite score derived from the Traumatic Antecedents Scale. The results indicated that sexually abused adolescents reported more family…

  1. Determining adolescents' suitability for inpatient psychotherapy: utility of the clinician-rated Readiness for Inpatient Psychotherapy Scale with an adolescent inpatient sample.

    PubMed

    Haggerty, Greg; Siefert, Caleb; Stoycheva, Valentina; Sinclair, Samuel Justin; Baity, Matthew; Zodan, Jennifer; Mehra, Ashwin; Chand, Vijay; Blais, Mark A

    2014-01-01

    Growing economic pressure on inpatient services for adolescents has resulted in fewer clinicians to provide individual psychotherapy. As a result, inpatient treatment trends have favored group psychotherapy modalities and psychopharmacological interventions. Currently, no clinician-rated measures exist to assist clinicians in determining who would be able to better utilize individual psychotherapy on inpatient units. The current study sought to demonstrate the utility of the Readiness for Inpatient Psychotherapy Scale with an adolescent inpatient sample. This study also used the RIPS as it is intended to be used in everyday practice. Results from the authors' analyses reveal that the RIPS demonstrates good psychometrics and interrater reliability, as well as construct validity.

  2. The Relationship between Adjustment and Perceived Locus of Control for Female Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Youkilis, Hildreth D.; Bootzin, Richard R.

    1979-01-01

    Examines the longitudinal relationship between internal-external locus of control and adjustment using independent measures within two dissimilar treatment environments: a traditional ward and a token economy ward. Subjects were 65 female psychiatric inpatients. (CM)

  3. The Relationship between Seclusion and Restraint Use and Childhood Abuse among Psychiatric Inpatients

    ERIC Educational Resources Information Center

    Hammer, Joseph H.; Springer, Justin; Beck, Niels C.; Menditto, Anthony; Coleman, James

    2011-01-01

    Seclusion and restraint (S/R) is a controversial topic in the field of psychiatry, due in part to the high rates of childhood physical and sexual abuse found among psychiatric inpatients. The trauma-informed care perspective suggests that the use of S/R with previously abused inpatients may result in retraumatization due to mental associations…

  4. 76 FR 26431 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Rate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-06

    ...This final rule updates the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) for discharges occurring during the rate year (RY) beginning July 1, 2011 through September 30, 2012. The final rule also changes the IPF prospective payment system (PPS) payment rate update period to a RY that coincides with a fiscal year (FY). In......

  5. 76 FR 4997 - Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System-Update for Rate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-27

    ...This proposed rule would update the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) for discharges occurring during the rate year beginning July 1, 2011 through September 30, 2012. The proposed rule would also change the IPF prospective payment system (PPS) payment rate update period to a rate year (RY) that coincides with......

  6. Anhedonia predicts suicidal ideation in a large psychiatric inpatient sample.

    PubMed

    Winer, E Samuel; Nadorff, Michael R; Ellis, Thomas E; Allen, Jon G; Herrera, Steve; Salem, Taban

    2014-08-15

    This study examined the relationship among symptoms of anhedonia and suicidal ideation at baseline, at termination, and over time in 1529 adult psychiatric inpatients. Anhedonia was associated with suicidality cross-sectionally at baseline and at termination. In addition, change in anhedonia from baseline to termination predicted change in suicidality from baseline to termination, as well as level of suicidality at termination; moreover, anhedonia remained a robust predictor of suicidal ideation independent of cognitive/affective symptoms of depression. Symptom-level analyses also revealed that, even after accounting for the physical aspect of anhedonia (e.g., loss of energy), loss of interest and loss of pleasure were independently associated with higher levels of suicidal ideation at baseline, over time, and at discharge. Loss of interest was most highly predictive of suicidal ideation, providing support for recent differential conceptualizations of anhedonia. Taken together, these findings indicate that the manner in which anhedonia is conceptualized is important in predicting suicidal ideation, and that anhedonia symptoms warrant particular clinical attention in the treatment of suicidal patients.

  7. Switch Function and Pathological Dissociation in Acute Psychiatric Inpatients

    PubMed Central

    Chiu, Chui-De; Tseng, Mei-Chih Meg; Chien, Yi-Ling; Liao, Shih-Cheng; Liu, Chih-Min; Yeh, Yei-Yu; Hwu, Hai-Gwo

    2016-01-01

    Swift switching, along with atypical ability on updating and inhibition, has been found in non-clinical dissociators. However, whether swift switching is a cognitive endophenotype that intertwines with traumatisation and pathological dissociation remains unknown. Unspecified acute psychiatric patients were recruited to verify a hypothesis that pathological dissociation is associated with swift switching and traumatisation may explain this relationship. Behavioural measures of intellectual function and three executive functions including updating, switching and inhibition were administered, together with standardised scales to evaluate pathological dissociation and traumatisation. Our results showed superior control ability on switching and updating in inpatients who displayed more symptoms of pathological dissociation. When all three executive functions were entered as predictors, in addition to intellectual quotient and demographic variables to regress upon pathological dissociation, switching rather than updating remained the significant predictor. Importantly, the relationship between pathological dissociation and switching became non-significant when the effect of childhood trauma were controlled. The results support a trauma-related switching hypothesis which postulates swift switching as a cognitive endophenotype of pathological dissociation; traumatisation in childhood may explain the importance of swift switching. PMID:27123578

  8. 42 CFR 409.63 - Reduction of inpatient psychiatric benefit days available in the initial benefit period.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Reduction of inpatient psychiatric benefit days... Hospital Insurance Benefits § 409.63 Reduction of inpatient psychiatric benefit days available in the initial benefit period. (a) Reduction rule. (1) If the individual was an inpatient in a...

  9. 42 CFR 409.63 - Reduction of inpatient psychiatric benefit days available in the initial benefit period.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 2 2012-10-01 2012-10-01 false Reduction of inpatient psychiatric benefit days... Hospital Insurance Benefits § 409.63 Reduction of inpatient psychiatric benefit days available in the initial benefit period. (a) Reduction rule. (1) If the individual was an inpatient in a...

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 2 2014-10-01 2014-10-01 false Reduction of inpatient psychiatric benefit days... Hospital Insurance Benefits § 409.63 Reduction of inpatient psychiatric benefit days available in the initial benefit period. (a) Reduction rule. (1) If the individual was an inpatient in a...

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 2 2013-10-01 2013-10-01 false Reduction of inpatient psychiatric benefit days... Hospital Insurance Benefits § 409.63 Reduction of inpatient psychiatric benefit days available in the initial benefit period. (a) Reduction rule. (1) If the individual was an inpatient in a...

  12. Comprehensive evidence-based program teaching self-management of auditory hallucinations on inpatient psychiatric units.

    PubMed

    Buccheri, Robin Kay; Trygstad, Louise Nigh; Buffum, Martha D; Lyttle, Kathleen; Dowling, Glenna

    2010-03-01

    Patients hearing command hallucinations to harm whose only self-management strategies are to obey these commands, can represent serious safety concerns on inpatient psychiatric units. A comprehensive evidence-based program teaching self-management of auditory hallucinations on inpatient psychiatric units is described that includes five components: suggestions for staff education; patient self-assessment tools; an interview guide and safety protocol; a course to teach strategies for managing distressing voices and commands to harm; suggestions to improve staff communication; and a plan to extend the program from inpatient care settings into the community by sharing materials with community case managers and caregivers when patients are discharged.

  13. Gender Differences in Psychiatric Diagnoses among Inpatients with and without Intellectual Disabilities

    ERIC Educational Resources Information Center

    Lunsky, Yona; Bradley, Elspeth A.; Gracey, Carolyn D.; Durbin, Janet; Koegl, Chris

    2009-01-01

    There are few published studies on the relationship between gender and psychiatric disorders in individuals with intellectual disabilities. Adults (N = 1,971) with and without intellectual disabilities who received inpatient services for psychiatric diagnosis and clinical issues were examined. Among individuals with intellectual disabilities,…

  14. Aggression in Inpatient Adolescents: The Effects of Gender and Depression.

    ERIC Educational Resources Information Center

    Knox, Michele; Carey, Michael; Kim, Wun Jung

    2003-01-01

    Examined differences in aggressive behavior among predominantly white adolescent inpatients with and without depression. Survey data indicated that depression and gender interacted significantly. Depressed females demonstrated more physical aggression than nondepressed females, and depressed males demonstrated less aggression than nondepressed…

  15. Adolescent Inpatient Behavioral Health Clients: Risk Factors and Methods of Preventing an Increase in HIV Infection among Youth.

    ERIC Educational Resources Information Center

    Hackerman, Ann E.

    2002-01-01

    There has been a surge in the rates of adolescents who are becoming infected with HIV. This study of 214 at risk clients being treated on an inpatient psychiatric hospitalization basis examines why such clients continue to engage in high-risk behaviors. Results and suggestions for a psychoeducational curriculum for professionals are included.…

  16. Ayahuasca in adolescence: a preliminary psychiatric assessment.

    PubMed

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

    2005-06-01

    Ayahuasca is believed to be harmless for those (including adolescents) drinking it within a religious setting. Nevertheless controlled studies on the mental/ psychiatric status of ritual hallucinogenic ayahuasca concoction consumers are still lacking. In this study, 40 adolescents from a Brazilian ayahuasca sect were compared with 40 controls matched on sex, age, and educational background for psychiatric symptomatology. Screening scales for depression, anxiety, alcohol consumption patterns (abuse), attentional problems, and body dysmorphic disorders were used. It was found that, compared to controls, considerable lower frequencies of positive scoring for anxiety, body dismorphism, and attentional problems were detected among ayahuasca-using adolescents despite overall similar psychopathological profiles displayed by both study groups. Low frequencies of psychiatric symptoms detected among adolescents consuming ayahuasca within a religious context may reflect a protective effect due to their religious affiliation. However further studies on the possible interference of other variables in the outcome are necessary.

  17. Adolescent inpatient girls׳ report of dependent life events predicts prospective suicide risk.

    PubMed

    Stone, Lindsey B; Liu, Richard T; Yen, Shirley

    2014-09-30

    Adolescents with a history of suicidal behavior are especially vulnerable for future suicide attempts, particularly following discharge from an inpatient psychiatric admission. This study is the first to test whether adolescents׳ tendency to generate stress, or report more dependent events to which they contributed, was predictive of prospective suicide events. Ninety adolescent psychiatric inpatients who were admitted for recent suicide risk, completed diagnostic interviews, assessments of history of suicidal behavior, and a self-report questionnaire of major life events at baseline. Participants were followed over the subsequent 6 months after discharge to assess stability vs. onset of suicide events. Cox proportional hazard regressions were used to predict adolescents׳ time to suicide events. Results supported hypothesis, such that only recent greater dependent events, not independent or overall events, predicted risk for prospective suicide events. This effect was specific to adolescent girls. Importantly, dependent events maintained statistical significance as a predictor of future suicide events after co-varying for the effects of several established risk factors and psychopathology. Results suggest that the tendency to generate dependent events may contribute unique additional prediction for adolescent girls׳ prospective suicide risk, and highlight the need for future work in this area.

  18. The prevalence and psychosocial correlates of suicide attempts among inpatient adolescent offspring of Croatian PTSD male war veterans.

    PubMed

    Boričević Maršanić, Vlatka; Margetić, Branka Aukst; Zečević, Iva; Herceg, Miroslav

    2014-10-01

    Despite evidence that children of male war veterans with combat-related posttraumatic stress disorder (PTSD) are at particularly high risk for behavior problems, very little is currently known about suicidal behaviors in this population of youth. This study aimed to examine the prevalence and psychosocial correlates of suicide attempts among psychiatrically hospitalized adolescent offspring of Croatian male PTSD veterans. Participants were psychiatric inpatients, ages 12-18 years. Self-report questionnaires assessed demographics, suicide attempts, psychopathology, parenting style, and family functioning. The prevalence of suicide attempts was 61.5% (65.2% for girls and 58.0% for boys). Internalizing symptoms, family dysfunction, lower levels of maternal and paternal care, and paternal overcontrol were significantly associated with suicide attempts. Our findings suggest that suicide attempts are common among inpatient adolescent offspring of male PTSD veterans and that interventions targeting both adolescent psychopathology and family relationships are needed for adolescents who have attempted suicide.

  19. Psychiatric illness in inpatients with neurological disorders: patients' views on discussion of emotional problems with neurologists.

    PubMed Central

    Bridges, K W; Goldberg, D P

    1984-01-01

    The prevalence of psychiatric morbidity in inpatients with neurological disorders and the extent to which it is detected by neurologists were measured by using a two stage model of psychiatric assessment and from information recorded in the patients' medical notes. The prevalence of psychiatric morbidity was estimated as 39%, of which 72% was unrecognised by the neurologists. Only a minority of patients with an uncertain physical diagnosis had a psychiatric illness, showing the error in assuming that a patient's physical symptoms arise from a psychological disturbance if an organic aetiology cannot be determined. When the patients were interviewed on their discharge from hospital they were divided on whether they had wished to discuss their mood with neurologists while they were in hospital. The reasons that they gave suggested that interactions between patients and doctors and the lack of ward facilities for private consultations with doctors are important determinants of hidden psychiatric morbidity in medical inpatients. PMID:6434026

  20. Reducing six-month inpatient psychiatric recidivism and costs through case management.

    PubMed

    Kolbasovsky, Andrew; Reich, Leonard; Meyerkopf, Neil

    2010-01-01

    The objective of this study is to determine the reduction in inpatient psychiatric recidivism and costs associated with an intensive case management (ICM) program among high-risk adults with chronic mental health conditions. An intent-to-treat, historical control design was used to examine utilization differences between 306 intervention group (IG) members eligible to receive ICM services and a cohort of 290 baseline group (BG) members over a six-month outcome period. Members were identified retrospectively using identical criteria during one year prior to implementation of the program. The six-month recidivism rate for BG members was 49.67% compared to 22.07% among IG members. Forward stepwise regression results indicated a significant main effect for the ICM intervention on inpatient psychiatric costs. Inpatient psychiatric costs for the six-month outcome period were $4,982.90 lower per member in the IG group. Additional models demonstrated that the ICM intervention was associated with significantly lower inpatient substance abuse costs and psychiatric emergency department costs. There were no statistically significant increases in utilization associated with the ICM intervention. After factoring in program costs, it is estimated that the ICM services contributed to almost $1,500,000 in cost savings over the six-month outcome period. The ICM intervention was associated with significant reductions in inpatient, psychiatric six-month readmission rates and associated costs among adult members who are at elevated risk of inpatient, psychiatric recidivism. The intervention, enrollment process, and measurement strategies can be adapted for use by health plans looking to reduce psychiatric costs.

  1. Hypermentalizing in adolescent inpatients: treatment effects and association with borderline traits.

    PubMed

    Sharp, Carla; Ha, Carolyn; Carbone, Crystal; Kim, Sohye; Perry, Katie; Williams, Laurel; Fonagy, Peter

    2013-02-01

    Sharp et al. (2011) recently demonstrated that in adolescents with borderline traits the loss of mentalization is more apparent in the emergence of unusual alternative strategies (excessive theory of mind or hypermentalizing) than in the loss of the capacity per se (no mentalizing or undermentalizing). This suggests that hypermentalizing could be a worthwhile social-cognitive treatment target in adolescents with borderline traits. The aim of the current study was to examine (1) whether a reduction in excessive theory of mind or hypermentalizing is achieved between admission and discharge for adolescent inpatients; (2) whether the hypothesized reduction is more apparent in adolescents meeting criteria for BPD compared with psychiatric controls; and (3) whether other forms of mentalizing would also be sensitive to and malleable by inpatient treatment in the same way we expected hypermentalizing to be. The "Movie for the Assessment of Social Cognition" Task (Dziobek et al., 2006) was administered to consecutive admissions to an adolescent inpatient setting (n = 164) at admission and discharge, alongside measures of borderline symptomology and interview-based diagnosis of BPD. Results demonstrated that 41% (n = 68) of the sample met full or intermediate criteria for BPD on an interview-based measure of BPD. A relation between borderline traits and hypermentalizing that appears to be independent of internalizing and externalizing problems was demonstrated. Hypermentalizing, but not other forms of social-cognitive reasoning (as measured by the Child Eyes Test, Basic Empathy Scale and the Mentalizing Stories Test for Adolescents), was found to be malleable through a milieu-based inpatient treatment. Clinical implications of the findings for the organization of treatment settings for adolescents are discussed.

  2. The inpatient psychiatric unit as both a safe and unsafe place: implications for absconding.

    PubMed

    Muir-Cochrane, Eimear; Oster, Candice; Grotto, Jessica; Gerace, Adam; Jones, Julia

    2013-08-01

    Absconding from acute psychiatric inpatient units is a significant issue with serious social, economic, and emotional costs. A qualitative study was undertaken to explore the experiences of people (n = 12) who had been held involuntarily under the local mental health act in an Australian inpatient psychiatric unit, and who had absconded (or attempted to abscond) during this time. The aim of the study was to explore why people abscond from psychiatric inpatient units, drawing on published work from health geography on the significance of the person-place encounter, and in particular the concept of 'therapeutic landscapes'. The findings show that the inpatient unit is perceived as a safe or unsafe place, dependent on the dialectical relationship between the physical, individual, social, and symbolic aspects of the unit. Consumers absconded when the unit was perceived as unsafe. Forming a therapeutic relationship with staff, familiarity with the unit, a comfortable environment, and positive experiences with other consumers all supported perceptions that the unit was safe, decreasing the likelihood of absconding. Findings extend existing work on the person-place encounter within psychiatric inpatient units, and bring new knowledge about the reasons why consumers abscond. Implications for practice are discussed.

  3. Bullying involvement in relation to personality disorders: a prospective follow-up of 508 inpatient adolescents.

    PubMed

    Antila, Henna; Arola, Riikka; Hakko, Helinä; Riala, Kaisa; Riipinen, Pirkko; Kantojärvi, Liisa

    2017-01-24

    We examined the association of bullying behavior in adolescence to personality disorder (PD) diagnosed in early adulthood. The study sample consisted of 508 adolescents (300 girls, 208 boys) who were admitted to psychiatric inpatient treatment between April 2001 and March 2006. Data were based on semi-structured K-SADSPL-interviews and hospital treatments extracted from the Care Register for Health Care (CRHC). At the end of 2013, details of psychiatric diagnoses recorded on hospital discharges and outpatient visits were extracted from the CRHC. This study showed that female victims of bullying have an almost fourfold likelihood of developing a PD later in life compared to adolescents with no involvement in bullying behavior. Most of the females had Borderline PD. Female adolescents diagnosed with anxiety disorder during adolescence had an over threefold risk of developing a PD during late adolescence or early adulthood. Conversely, we found no associations between bullying involvement among men in adolescence and subsequent PDs. Bullying victimization may influence the development of PDs among females. Adolescent services should pay particular attention to female victims of bullying and those displaying symptoms of anxiety disorders.

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

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) The reasons for either— (i) Hospitalization of the patient for inpatient medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases... treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for...

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

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) The reasons for either— (i) Hospitalization of the patient for inpatient medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases... treatment in a SNF but no bed is available in a participating SNF. (2) If this is the basis for...

  6. Quality of interactions influences everyday life in psychiatric inpatient care—patients’ perspectives

    PubMed Central

    Molin, Jenny; Graneheim, Ulla H.; Lindgren, Britt-Marie

    2016-01-01

    Everyday life consists of daily activities that are taken for granted. It forms the foundation for human efforts and contains elements of both comfort and boredom. Because everyday life escapes no one, life in a psychiatric ward will become ordinary while staying there. This study aims to explore everyday life in psychiatric inpatient care based on patients’ experiences. We individually interviewed 16 participants with experiences of psychiatric inpatient care and analysed the data in accordance with the methods of grounded theory. Data collection and analysis continued in parallel in accordance with the method. Our results showed that everyday life is linked to the core category quality of interactions influences everyday life, and three constructed categories—staff makes the difference, looking for shelter in a stigmatizing environment, and facing a confusing care content—were related to the core category. Our results highlight the importance of ordinary relationships between staff and patients in psychiatric inpatient care. These results can be used to develop nursing interventions to improve psychiatric inpatient care and might also be used as a basis for reflective dialogues among staff. PMID:26806313

  7. 42 CFR 424.14 - Requirements for inpatient services of inpatient psychiatric facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... psychiatric facilities. 424.14 Section 424.14 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... psychiatric facilities. (a) Content of certification and recertification: General considerations. The content requirements differ from those for other hospitals because the care furnished in psychiatric hospitals is...

  8. Tobacco Smoking in Adolescent Psychiatric Outpatients

    ERIC Educational Resources Information Center

    Ditchburn, K. Marie; Sellman, J. Douglas

    2013-01-01

    Three main aims of this study were to ascertain the prevalence rate of smoking among adolescent psychiatric outpatients; estimate smokers' degree of nicotine dependence; and investigate the relationship between smoking and common mental health disorders. Face-to-face interviews were conducted on 93 patients ages 13-18 presenting to an adolescent…

  9. Psychiatric Comorbidity in Gender Dysphoric Adolescents

    ERIC Educational Resources Information Center

    de Vries, Annelou L. C.; Doreleijers, Theo A. H.; Steensma, Thomas D.; Cohen-Kettenis, Peggy T.

    2011-01-01

    Background: This study examined psychiatric comorbidity in adolescents with a gender identity disorder (GID). We focused on its relation to gender, type of GID diagnosis and eligibility for medical interventions (puberty suppression and cross-sex hormones). Methods: To ascertain DSM-IV diagnoses, the Diagnostic Interview Schedule for Children…

  10. Adolescent inpatient girls’ report of dependent life events predicts prospective suicide risk

    PubMed Central

    Stone, Lindsey Beth; Liu, Richard; Yen, Shirley

    2014-01-01

    Adolescents with a history of suicidal behavior are especially vulnerable for future suicide attempts, particularly following discharge from an inpatient psychiatric admission. This study is the first to test whether adolescents’ tendency to generate stress, or report more dependent events to which they contributed, was predictive of prospective suicide events. Ninety adolescent psychiatric inpatients who were admitted for recent suicide risk, completed diagnostic interviews, assessments of history of suicidal behavior, and a self-report questionnaire of major life events at baseline. Participants were followed over the subsequent 6 months after discharge to assess stability vs. onset of suicide events. Cox proportional hazard regressions were used to predict adolescents’ time to suicide events. Results supported hypothesis, such that only recent greater dependent events, not independent or overall events, predicted risk for prospective suicide events. This effect was specific to adolescent girls. Importantly, dependent events maintained statistical significance as a predictor of future suicide events after co-varying for the effects of several established risk factors and psychopathology. Results suggest that the tendency to generate dependent events may contribute unique additional prediction for adolescent girls’ prospective suicide risk, and highlight the need for future work in this area. PMID:24893759

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

    PubMed Central

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

    2006-01-01

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

  12. The Validation of the Factor Structure of the Brief Psychiatric Rating Scale-Expanded Version (BPRS-E) with Geriatric and Nongeriatric Psychiatric Inpatients

    ERIC Educational Resources Information Center

    Panos, Patrick T.

    2004-01-01

    The Brief Psychiatric Rating Scale-Expanded (BPRS-E) is a widely used outcome measure that assesses change in psychiatric symptoms. The focus of the present study was to clarify and determine the factor structure of the BPRS-E with geriatric and nongeriatric psychiatric inpatients. Two previous studies found different factor structures for the…

  13. Differing Levels of Superstitious Beliefs among Three Groups: Psychiatric Inpatients, Churchgoers, and Students.

    ERIC Educational Resources Information Center

    Robinson, Sheryl L.

    This study investigated the level of superstitious belief among 175 persons in three categories: persons undergoing inpatient psychiatric treatment, churchgoers, and college students. A 50-item inventory consisting of positive and negative common superstitions, including a 5-item invalidity subscale, was administered. Using a 2 (male, female) x 3…

  14. Associations between Relational Aggression, Depression, and Suicidal Ideation in a Child Psychiatric Inpatient Sample

    ERIC Educational Resources Information Center

    Fite, Paula J.; Stoppelbein, Laura; Greening, Leilani; Preddy, Teresa M.

    2011-01-01

    The current study examined relations between relational aggression, depressive symptoms, and suicidal ideation in a child clinical population. Participants included 276 children (M age = 9.55 years; 69% Male) who were admitted to a child psychiatric inpatient facility. Findings suggested that relational aggression was associated with depressive…

  15. Exploring the Sociotropy-Autonomy Dimensions in a Sample of Turkish Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Sahin, Nesrin; And Others

    1993-01-01

    Explored sociotropy and autonomy among 70 Turkish psychiatric inpatients and 189 university students, who were administered Beck Depression Inventory, Dysfunctional Attitudes Scale, Automatic Thoughts Questionnaire, and Sociotropy-Autonomy Scale. Results seem to support relationship of sociotropy with other depression measures in both samples.…

  16. Concurrent Validity of Three WAIS-R Short Forms in Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Benedict, Ralph H. B.; And Others

    1992-01-01

    The concurrent validities of 3 short forms of the Wechsler Adult Intelligence Scale (WAIS) were compared for their prediction of full-scale IQ for 145 male and 159 female psychiatric inpatients. Results support previous research showing better predictive accuracy for L. C. Ward's (1990) seven-subtest short form than the others. (SLD)

  17. On the Distinction of Suicide Ideation versus Attempt in Elderly Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Schmid, Hermann; And Others

    1994-01-01

    Study of selected elderly psychiatric inpatients (n=152) suggests that suicidal ideation may initiate process of smoldering when patient, family, and professionals interact in such a way as to dampen apparent distress. Suicidal thoughts/mood may be masked by affective or cognitive constriction, camouflaged by anxiety and external agitation, and…

  18. Acceptance of Computerized Compared to Paper-and-Pencil Assessment in Psychiatric Inpatients.

    ERIC Educational Resources Information Center

    Weber, Bernhard; Schneider, Barbara; Fritze, Jurgen; Gille, Boris; Hornung, Stefan; Kuhner, Thorsten; Maurer, Konrad

    2003-01-01

    Investigated the acceptance of computerized assessment, particularly compared to conventional paper-and-pencil techniques, in seriously impaired psychiatric inpatients. Describes the development of a self-rating questionnaire (OPQ, Operation and Preference Questionnaire) and reports results that showed computerized assessment was convincingly…

  19. The psychiatric inpatient physical health assessment sheet (PIPHAS): a useful tool to improve the speed, efficiency, and documentation of physical examination in new psychiatric inpatients.

    PubMed

    Pettipher, Alexander; Ovens, Richard

    2015-01-01

    There is increased morbidity and mortality among patients suffering from mental illness. This is believed to be multi-factorial. Poor access to healthcare, the stigma of mental illness, reduced clinic attendance, lifestyle factors, and side effects of medications are cited as possible contributing factors. It is therefore vital to perform a physical examination to identify previously undiagnosed conditions during the admission of a psychiatric inpatient. The Royal College of Psychiatrists recommends that all patients admitted to a psychiatric hospital should receive a full physical examination on admission, or within twenty-four hours of admission. A snapshot audit was carried out at Prospect Park Hospital in Reading, which highlighted that The Royal College of Psychiatrist's recommendation, along with Trust guidelines regarding physical examination were not being met, with only 78 out of 111 patients (70.3%) undergoing an examination during their admission. In addition to this, examinations were often poorly documented and not covering all examination domains. A psychiatric inpatient physical health assessment sheet (PIPHAS) was designed and introduced, providing a quick and standardised approach to the documentation of a physical examination. After the intervention was put into practice, its impact was assessed by performing a retrospective review of the admission clerking notes of the next 100 admissions to Prospect Park Hospital. Following the introduction of the PIPHAS form there was an increase in the number of patients undergoing physical examination on admission to hospital (75 out of 100 patients, 75%). There was also an increase in the thorough documentation of all examination domains (e.g. respiratory examination) for patients that had a completed PIPHAS form scanned within their medical records. This quality improvement project demonstrates that the PIPHAS form is a useful tool to improve the speed, efficiency, and documentation of a thorough physical

  20. Sociodemographic and Clinical Characteristics of Psychiatric Inpatients Hospitalized Involuntarily and Voluntarily in a Mental Health Hospital

    PubMed Central

    GÜLTEKİN, Bülent Kadri; ÇELİK, Seda; TİHAN, Aysu; BEŞKARDEŞ, Ali Fuat; SEZER, Umut

    2013-01-01

    Introduction In this study, we aimed to investigate and compare the sociodemographic and clinical characteristics of psychiatric inpatients hospitalized involuntarily and voluntarily. To our knowledge, there is no study analyzing involuntary psychiatric hospitalization in our country. Method In this retrospective study, we included a total of 504 patients who were involuntarily or voluntarily hospitalized in Bolu Izzet Baysal Mental Health Hospital between 1st of May and 31st October 2010. The data were obtained from the hospital records. Result In the 6-month period, 13.1% of 504 inpatients were hospitalized involuntarily. The number of male patients who were involuntarily hospitalized was higher than the number of female patients. Most of the patients in the involuntary hospitalized group were graduates of primary school, were not married and were not working at the time of hospitalization. Schizophrenia was the most common diagnosis in the involuntarily hospitalized psychiatric patients and these patients needed longer stay in the hospital. The next hospitalization of the involuntarily hospitalized patients was mostly involuntary. Conclusion Most of the involuntarily hospitalized psychiatric inpatients were male, were not working and had the diagnosis of schizophrenia. These general psychiatric risk factors were more important in involuntary hospitalization compared to voluntary hospitalization. We concluded that the high prevalence of involuntary hospitalizations deserved further studies.

  1. The impact of psychiatric comorbidity on Medicare reimbursement for inpatient medical care.

    PubMed

    Goldberg, R J; Daly, J; Golinger, R C

    1994-01-01

    Funding for psychiatric consultation-liaison (C-L) services has been a difficult problem. It has been suggested that the identification of psychiatric co-morbidities in Medicare patients on medical services could generate incremental hospital revenue by moving patients from a lower to a higher paying Diagnostic Related Group (DRG). This increased revenue could be used as a means of supporting the psychiatric C-L service. This study documents the financial impact of screening for and documenting psychiatric co-morbidities on a general acute medical service. We clinically assessed 100 consecutive Medicare admissions and found 25 psychiatric co-morbidities in 20 patients. In only one case did the psychiatric diagnosis result in moving the case to a higher DRG. However, the need for psychiatric consultation remains evident as there was significant lack of recognition and documentation of the psychiatric diagnoses by the medical team. The authors discuss both the financial and clinical implications of screening medical inpatients for psychiatric co-morbidities and propose directions for further studies in this area.

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

    PubMed Central

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

    1997-01-01

    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. PMID:9161310

  3. [Autonomy, care and justice: ethical aspects of the psychiatric treatment of adolescents].

    PubMed

    Höger, Christoph

    2010-11-01

    What is the right and good action in dealing with young patients in child and adolescent psychiatry? To answer this question, we have to consider professional standards, legal rules, and ethical reflections. With reference to the latter, four bioethical principles were proposed by Beauchamp and Childress to identify and to deal with ethical problems and conflicts. On the basis of this scheme we reflect on the legal aspects and discuss the following topics: (1) self-determination of adolescents concerning their own psychiatric treatment, (2) conflicts between autonomy and care, which occur relatively often, whenever restrictions to personal liberty are indicated, and (3) admission of adolescents in adult psychiatric wards. The bioethical principles facilitate a reliable decision-making process in individual cases. The standards of right and good action have to be implemented in the field of distributive justice. We find evidence that prioritization decisions for inpatient admission are already established in German child and adolescent psychiatry.

  4. Predicting Length of Psychiatric Hospital Stay in Children and Adolescents.

    ERIC Educational Resources Information Center

    Leininger, Michele; Stephenson, Laura A.

    Length of stay in psychiatric inpatient units has received increasing attention with the external pressures for treatment cost-effectiveness and evidence that longer hospital stays do not appear to have significant advantages over shorter hospital stays. This study examined the relationship between length of psychiatric hospital stay and…

  5. Tripartite model of depression and anxiety in youth psychiatric inpatients: relations with diagnostic status and future symptoms.

    PubMed

    Joiner, T E; Lonigan, C J

    2000-09-01

    Examined the relation of the depression aspect of the tripartite model of depression and anxiety to the diagnostic status and future symptoms of two samples that included 74 child and adolescent psychiatric inpatients, ages 7 to 17 years (M = 13.57, SD = 2.39), some with either internalizing or externalizing diagnoses. The tripartite model suggests that anhedonia (low positive affect, or PA) differentiates depression from other conditions, whereas generalized negative affect (NA) also characterizes depression but is not specific to it. In this study, differences among children in PA and NA were associated with depressive versus externalizing diagnostic status and with future symptoms of depression. Depressive disorder diagnoses were associated with the combination of low levels of PA and high levels of NA. Changes over time in depression, but not in anxiety, also were associated with the combination of low PA and high NA. Results provide support for the applicability, clinical utility, and extension of the tripartite model with children.

  6. Interpersonal trauma, attachment insecurity and anxiety in an inpatient psychiatric population.

    PubMed

    Wiltgen, Anika; Arbona, Consuelo; Frankel, Leslie; Frueh, B Christopher

    2015-10-01

    Current research suggests that interpersonal trauma has an impact on insecure attachment and anxiety. Some research further suggests that attachment may play a mediating role between traumatic events and psychopathology. The purpose of this study was to examine the relationship between the experience of interpersonal trauma, attachment anxiety, attachment avoidance and clinical anxiety severity among adult psychiatric inpatients who reported having experienced interpersonal trauma after the age of 16. It was hypothesized that attachment anxiety and attachment avoidance would mediate the relationship between interpersonal trauma and clinical anxiety level. This study used archival data on 414 adult psychiatric inpatients in a large city in the Southwest U.S. Results suggest that interpersonal trauma was correlated to attachment avoidance but not to attachment anxiety and that attachment avoidance partially mediated the relation of interpersonal trauma to anxiety. The attachment framework appositely explains how a negative model of other contributes to the relation between experiences of interpersonal trauma and anxiety in adulthood.

  7. Gender differences in psychiatric diagnoses among inpatients with and without intellectual disabilities.

    PubMed

    Lunsky, Yona; Bradley, Elspeth A; Gracey, Carolyn D; Durbin, Janet; Koegl, Chris

    2009-01-01

    There are few published studies on the relationship between gender and psychiatric disorders in individuals with intellectual disabilities. Adults (N = 1,971) with and without intellectual disabilities who received inpatient services for psychiatric diagnosis and clinical issues were examined. Among individuals with intellectual disabilities, women were more likely to have a diagnosis of mood disorder and sexual abuse history; men were more likely to have a substance abuse diagnosis, legal issues, and past destructive behavior. Gender difference patterns found for individuals with intellectual disabilities were similar to those of persons without intellectual disabilities, with the exception of eating disorder and psychotic disorder diagnoses. Gender issues should receive greater attention in intellectual disabilities inpatient care.

  8. [Inpatient and partial hospitalization facilities for child and adolescent psychiatry in the unified Germany, 1991].

    PubMed

    Specht, F; Anton, S

    1992-12-01

    First results of the project "Surveys regarding the structure of psychiatric institutions for children and adolescents in the Federal Republic of Germany" are described. On July 1, 1991 there were 111 in-patient institutions with a total capacity for 6363 children and youths. The contributing shares of each state (Bundesland) vary enormously. The number of accommodations per 100,000 residents is between 2.1 and 19. One reason for this discrepancy lies in the fact that the services of the institutions are called upon without regard to the state borders. More important though is the fact that in the new states the psychiatric institutions for children and youths also treat young patients who are psychologically or mentally handicapped with neuropsychiatric complications to a greater extent than comparable institutions in the old states.

  9. Self-harm and attempted suicide within inpatient psychiatric services: a review of the literature.

    PubMed

    James, Karen; Stewart, Duncan; Bowers, Len

    2012-08-01

    Self harm is a major public health concern, yet there are considerable challenges in providing support for those who self harm within psychiatric inpatient services. This paper presents the first review of research into self harm within inpatient settings. Searches of the main electronic databases were conducted using key words for self harm and inpatient care. There was substantial variation in the rates of self-harm and attempted suicide between studies, but rates were highest on forensic wards. There was no evidence of differences in prevalence of self-harm between men and women; women, however, were at increased risk of attempting suicide. People were more likely to self-harm in private areas of the ward and in the evening hours, and often self-harmed in response to psychological distress, or elements of nursing care that restricted their freedom. Wards used a variety of strategies to prevent self-harm; however, there is little research into their effectiveness.

  10. Trauma and Aggression: Investigating the Mediating Role of Mentalizing in Female and Male Inpatient Adolescents.

    PubMed

    Abate, Anna; Marshall, Kaisa; Sharp, Carla; Venta, Amanda

    2017-02-07

    High rates of posttraumatic stress disorder (PTSD) symptoms and elevated levels of aggression are common among youth in inpatient psychiatric settings. Several models link trauma exposure to aggression through anomalous mental state reasoning. Some theoretical frameworks linking trauma to aggression specify that the over-attribution of hostile mental states contributes to the development of aggressive behavior whereas other theories suggest that an inhibition of mental state reasoning leads to aggressive behavior. Using a sample of inpatient adolescents, the current study examined relations between PTSD symptoms and four forms of aggression, exploring the role of both over- and under-mentalizing (i.e., hypo- and hypermentalizing) as mediators and gender as a moderator. The results suggest that hypermentalizing, but not hypomentalizing, mediates the relation between trauma and aggression, extending prior research related to inpatient adolescents for the first time. Evidence of moderated mediation was noted, such that this mediational relation was evident for females but not males. The current study offers support for differential underlying causes of aggression among males and females with PTSD symptoms.

  11. From ideals to resignation - interprofessional teams perspectives on everyday life processes in psychiatric inpatient care.

    PubMed

    Molin, Jenny; Graneheim, Ulla Hällgren; Ringnér, Anders; Lindgren, Britt-Marie

    2016-11-01

    WHAT IS KNOWN ON THE SUBJECT?: Psychiatric inpatient care has been described by both ward staff and patients as being demanding and disorganized, lacking opportunities for quality interactions in everyday life through joint activities. Qualitative research on interprofessional teams' perspectives on everyday life processes in psychiatric inpatient care is lacking. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Staff have ideals about care and collaboration, but the obstacles they face in everyday life, such as a poor environment, power asymmetry, lacking structure and the demands of managing chaos, mean that they appear to resign and shift focus from the patients' best interests to self-survival. Different professions in general describe the same obstacles in everyday life on the wards but there are also profession-specific perspectives on distancing and feelings of abandonment. To our knowledge, these findings have not been reported in the international evidence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Given these findings we suggest interventions such as Protected Engagement Time as well as reflective dialogues within interprofessional teams. This would help staff to resume their caring role in everyday life in psychiatric inpatient care and put their ideals into practice.

  12. Mental health recovery for psychiatric inpatient services: perceived importance of the elements of recovery.

    PubMed

    Siu, B W M; Ng, B F L; Li, V C K; Yeung, Y M; Lee, M K L; Leung, A Y H

    2012-06-01

    OBJECTIVES. To develop a questionnaire for measuring the perceived importance of the elements of mental health recovery in psychiatric inpatients in Hong Kong and to test the psychometric properties of the questionnaire. METHODS. Thematic content analysis of identified literature on mental health recovery was performed to identify the elements related to mental health recovery. A questionnaire was developed to assess the perceived importance of the identified elements. An expert panel was set up to evaluate the content validity and patient focus group's face validity of the questionnaire. Participants were recruited from medium-stay and rehabilitation wards of Castle Peak Hospital. RESULTS. A total of 101 psychiatric inpatients completed the questionnaire, the majority of whom suffered from schizophrenia (75%). Having meaning in life was rated by 91% of the participants as an important element of recovery, followed by hope (86%) and general health and wellness (85%). Cronbach's alpha for internal consistency was 0.91. Explorative factor analysis yielded 7 factors and intraclass correlation coefficients revealed a fair-to-good test-retest reliability. CONCLUSIONS. The results supported the psychometric properties of the questionnaire for measurement of mental health recovery and serve as a basis for the future development of recovery-oriented services in the psychiatric inpatient settings in this locality.

  13. Demographics, psychiatric diagnoses, and other characteristics of North American Deaf and hard-of-hearing inpatients.

    PubMed

    Black, Patricia A; Glickman, Neil S

    2006-01-01

    This study examined demographic and clinical data from a specialty deaf inpatient unit so as to better understand characteristics of severely and chronically mentally ill deaf people. The study compares deaf and hearing psychiatric inpatients on demographic variables, psychiatric discharge diagnoses, a language assessment measure, a cognitive ability measure, and a measure of psychosocial functioning and risk of harm to self and others. Overall, findings indicate a broader range of diagnoses than in past studies with posttraumatic stress disorder being the most common diagnosis. Compared with hearing patients in the same hospital, deaf patients were less likely to be diagnosed with a psychotic or substance abuse disorder and more likely to be diagnosed with a mood, anxiety, personality, or developmental disorder. Psychosocial functioning of the deaf patients was generally similar to hearing psychiatric patients. Deaf patients presented significantly higher risks than hearing patients in areas of self-harm and risk of sexual offending. Cognitive scores show that both the deaf and hearing inpatient population is skewed toward persons who are lower functioning. An additional surprising finding was that 75% of deaf individuals fell into the nonfluent range of communication in American Sign Language.

  14. Risk Estimates and Risk Factors Related to Psychiatric Inpatient Suicide—An Overview

    PubMed Central

    Madsen, Trine; Erlangsen, Annette; Nordentoft, Merete

    2017-01-01

    People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during admission. Most studies are based on low power, thus compromising quality and generalisability. The few studies with sufficient statistical power mainly identified non-modifiable risk predictors such as male gender, diagnosis, or recent deliberate self-harm. Also, the predictive value of these predictors is low. It would be of great benefit if future studies would be based on large samples while focusing on modifiable predictors over the course of an admission, such as hopelessness, depressive symptoms, and family/social situations. This would improve our chances of developing better risk assessment tools. PMID:28257103

  15. Risk Estimates and Risk Factors Related to Psychiatric Inpatient Suicide-An Overview.

    PubMed

    Madsen, Trine; Erlangsen, Annette; Nordentoft, Merete

    2017-03-02

    People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during admission. Most studies are based on low power, thus compromising quality and generalisability. The few studies with sufficient statistical power mainly identified non-modifiable risk predictors such as male gender, diagnosis, or recent deliberate self-harm. Also, the predictive value of these predictors is low. It would be of great benefit if future studies would be based on large samples while focusing on modifiable predictors over the course of an admission, such as hopelessness, depressive symptoms, and family/social situations. This would improve our chances of developing better risk assessment tools.

  16. Gestational Risks and Psychiatric Disorders Among Indigenous Adolescents

    PubMed Central

    Crawford, Devan M.

    2009-01-01

    This study reports on the effects maternal prenatal binge drinking, cigarette smoking, drug use, and pregnancy and birth complications on meeting criteria for psychiatric disorders at ages 10–12 and 13–15 years among 546 Indigenous adolescents from a single culture in the northern Midwest and Canada. Adolescent DSM-IV psychiatric disorders were assessed with the Diagnostic Interview Schedule for Children-Revised (DISC-R). Results indicate that maternal behaviors when pregnant have significant effects on adolescent psychiatric disorders even when controlling for age and gender of adolescent, family per capita income, living in a single mother household, and adolescent reports of mother’s positive parenting. PMID:18998209

  17. Patterns of psychotropic medication use in inpatient and outpatient psychiatric settings in Saudi Arabia

    PubMed Central

    Alosaimi, Fahad D; Alhabbad, Abdulhadi; Abalhassan, Mohammed F; Fallata, Ebtihaj O; Alzain, Nasser M; Alassiry, Mohammad Zayed; Haddad, Bander Abdullah

    2016-01-01

    Objective To study the pattern of psychotropic medication use and compare this pattern between inpatient and outpatient psychiatric settings in Saudi Arabia. Method This cross-sectional observational study was conducted between July 2012 and June 2014 on patients seeking psychiatric advice at major hospitals in five main regions of Saudi Arabia. Male (n=651) and female (n=594) patients who signed the informed consent form and were currently or had been previously using psychotropic medications, irrespective of the patient’s type of psychiatric diagnosis and duration of the disease, were included. A total of 1,246 patients were found to be suitable in the inclusion criteria of whom 464 were inpatients while 782 were outpatients. Results Several studied demographic factors have shown that compared with outpatients, inpatients were more likely to be male (P=0.004), unmarried (P<0.001), have less number of children (1–3; P=0.002), unemployed (P=0.001), have a lower family income (<3,000 SR; P<0.001), live in rural communities (P<0.001), have a lower body mass index (P=0.001), and are smokers (P<0.001); however, there were no differences with regard to age or educational levels. The current frequency of use of psychotropic medications in overall patients was antipsychotics (76.6%), antidepressants (41.4%), mood stabilizers (27.9%), and antianxiety (6.2%). However, compared to outpatients, the current use of medications for inpatients was more frequent (93.8% vs 89.9%, P=0.019) with inpatients more likely to be treated with multiple medications (2.1 vs 1.8 medications). A similar trend was observed in the case of antipsychotics, high potency first-generation antipsychotics, second-generation antipsychotics, mood stabilizers, and antianxiety medicines where inpatients were more frequently treated with these medications for all psychiatric diagnoses when compared with outpatients. On the contrary, in the case of antidepressant treatment, an opposite trend was observed

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

    ERIC Educational Resources Information Center

    Milazzo-Sayre, Laura J.; And Others

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

  19. A Systematic Review of Music Therapy Practice and Outcomes with Acute Adult Psychiatric In-Patients

    PubMed Central

    Carr, Catherine; Odell-Miller, Helen; Priebe, Stefan

    2013-01-01

    Background and Objectives There is an emerging evidence base for the use of music therapy in the treatment of severe mental illness. Whilst different models of music therapy have been developed in mental health care, none have specifically accounted for the features and context of acute in-patient settings. This review aimed to identify how music therapy is provided for acute adult psychiatric in-patients and what outcomes have been reported. Review Methods A systematic review using medical, psychological and music therapy databases. Papers describing music therapy with acute adult psychiatric in-patients were included. Analysis utilised narrative synthesis. Results 98 papers were identified, of which 35 reported research findings. Open group work and active music making for nonverbal expression alongside verbal reflection was emphasised. Aims were engagement, communication and interpersonal relationships focusing upon immediate areas of need rather than longer term insight. The short stay, patient diversity and institutional structure influenced delivery and resulted in a focus on single sessions, high session frequency, more therapist direction, flexible use of musical activities, predictable musical structures, and clear realistic goals. Outcome studies suggested effectiveness in addressing a range of symptoms, but were limited by methodological shortcomings and small sample sizes. Studies with significant positive effects all used active musical participation with a degree of structure and were delivered in four or more sessions. Conclusions No single clearly defined model exists for music therapy with adults in acute psychiatric in-patient settings, and described models are not conclusive. Greater frequency of therapy, active structured music making with verbal discussion, consistency of contact and boundaries, an emphasis on building a therapeutic relationship and building patient resources may be of particular importance. Further research is required to

  20. Child and Adolescent Psychiatric Epidemiology in India

    PubMed Central

    Bhola, Poornima; Kapur, Malavika

    2003-01-01

    The increasing focus on child mental health in developing countries like India points to the importance of epidemiological data in developing training, service and research paradigms.This review attempts to synthesise and evaluate the available research on the prevalence of child and adolescent psychiatric disorders in India and highlight significant conceptual and methodological trends. It identified 55 epidemiological studies conducted between 1964 and 2002 in the community and school settings. Despite considerable progress, various methodological lacunae continue to limit the value of the epidemiological surveys. These include issues related to sampling, case definition methods, tools, multi-informant data and data analysis. The importance of a socio-culturally relevant research framework has been highlighted. The review suggests directions for future research to guide planning of services that meet the mental health needs of vulnerable children and adolescents PMID:21206860

  1. 42 CFR 409.63 - Reduction of inpatient psychiatric benefit days available in the initial benefit period.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... of the 90 days spent in the general hospital. (3) An individual was admitted to a general hospital... initial benefit period. (a) Reduction rule. (1) If the individual was an inpatient in a psychiatric... participating in Medicare as a psychiatric hospital on the individual's first day of entitlement. (3)...

  2. Inpatient Suicide in a Psychiatric Hospital: A Nested Case–control Study

    PubMed Central

    Khanra, Sourav; Mahintamani, Tathagata; Bose, Swarnali; Khess, Christoday Raja Jayant; Umesh, Shreekantiah; Ram, Daya

    2016-01-01

    Objective: Risk factors for inpatient suicide are different from those in the general population. We examined sociodemographic and clinical variables of patients who committed suicide as an inpatient in a psychiatric hospital in India. Methods: Matched retrospective nested case–control design was adopted. Ten patients who died by suicide as inpatients between 2000 and 2013 were included, along with fifty controls, matched with respect to age, sex, diagnosis, and period of admission. Results: Suicide completers were mostly unskilled in occupation (P = 0.03), had a history of past suicide attempts (P < 0.001), shorter duration of hospital stay (P = 0.001), poorer improvement on psychopathology (P = 0.02), and were having more suicidal ideation (P = 0.02). Significantly more completers were receiving antidepressants (P = 0.04). Conclusion: This study adds to the existing sparse literature on inpatient suicides from Asia. Strength of the study was close matching between case and controls and blindedness. Limitations were retrospective design, and variations in prescription behavior and treatment decisions. PMID:28031595

  3. Effects of a single-session assertiveness music therapy role playing protocol for psychiatric inpatients.

    PubMed

    Silverman, Michael J

    2011-01-01

    The purpose of this study was to implement and measure the effectiveness of a single-session assertiveness music therapy role playing protocol for psychiatric inpatients. Participants (N=133) were randomly assigned by group to one of three conditions: (a) Assertiveness Music Therapy, (b) No Music Assertiveness, or (c) Music No Assertiveness. Participants in both assertiveness conditions role played a number of different commonly occurring scenarios at an inpatient psychiatric facility and in the community. There were no significant between-group differences in posttest quality of life, locus of control, or other subscales. However, participants in both assertiveness conditions tended to have slightly higher internal locus of control and overall quality of life scores than participants in the music no assertiveness condition. Additionally, the assertiveness music therapy condition had higher attendance rates than the other conditions. A higher percentage of participants from both the assertiveness music therapy and music no assertiveness conditions indicated they thought their session was the most helpful/therapeutic group therapy session in which they had participated; this was not the case for the assertiveness no music condition. Future research is warranted to measure the effects of protocols that can help psychiatric patients generalize skills learned in treatment.

  4. Rehabilitation Needs of Chronic Female Inpatients Attending Day-care in a Tertiary Care Psychiatric Hospital

    PubMed Central

    Waghmare, Avinash; Sherine, Linda; Sivakumar, Thanapal; Kumar, C. Naveen; Thirthalli, Jagadisha

    2016-01-01

    Background: Female patients hospitalized for a long duration in psychiatric hospitals are a special population with unique needs. Aims and Objectives: To assess rehabilitation needs of chronic female inpatients attending psychiatric rehabilitation services in a tertiary care psychiatric hospital. Materials and Methods: Rehabilitation needs of nine chronic female inpatients were assessed with an interview schedule developed by expert consensus. The needs were elicited from the patients. Perspectives of nursing staff, vocational instructors, and treating psychiatrists were also sought. Results and Conclusion: Most patients expressed the need for more incentives for working in day-care, variety in food and grooming items. The nursing staff felt many patients could be placed outside, and the family members should come more frequently to meet them. Vocational instructors felt that patients need more incentives, variety in food and work. Treating psychiatrists said that major barriers in discharging and placing them were nonavailability or poor involvement of family members. Services like supported housing, supported education and supported employment are necessary to cater to their complex needs. PMID:27011400

  5. Prevalence of periodontal disease among inpatients in a psychiatric hospital in India.

    PubMed

    Gopalakrishnapillai, Ajithkrishnan Champettil; Iyer, Ramya Radhakrishnan; Kalantharakath, Thanveer

    2012-01-01

    This paper assessed the periodontal status of inpatients at Government Mental Hospital, Vadodara, India, and studied the possible relationship between periodontal status and age, length of hospitalization, type of mental illness, and medication and tobacco use. Information about psychiatric diagnosis, length of hospitalization, and prescribed medication was obtained from hospital records. We interviewed 165 inpatients and recorded their chief dental complaints (if any) and relevant histories. Periodontal status was assessed using the Community Periodontal Index (CPI). Descriptive statistics, nonparametric tests, and multiple logistic regression analyses were used. The most prevalent periodontal condition was shallow pockets (47.27%). Some subjects (10.3%) had loss of attachment (LOA) of 9-11 mm. Age and length of hospitalization were significantly associated with periodontal status. Multiple logistic regression revealed that only age was significantly associated with periodontal pockets. Male gender, age, and tobacco-related habits were significantly associated with LOA of more than 0-3 mm.

  6. Hospice referral after inpatient psychiatric treatment of individuals with advanced dementia from a nursing home.

    PubMed

    Epstein-Lubow, Gary; Fulton, Ana Tuya; Marino, Louis J; Teno, Joan

    2015-06-01

    This report addresses the discharge disposition following inpatient psychiatric treatment for advanced dementia. The total population included 685 305 Medicare fee-for-service decedents with advanced cognitive and functional impairment, with a mean age of 85.9 years who had resided in a nursing home. In the last 90 days of life, 1027 (0.15%) persons received inpatient psychiatry treatment just prior to the place of care where the individual died. Discharge dispositions included 132 (12.9%) persons to a medical hospital, 728 (70.9%) to nursing home without hospice services, 73 (7.1%) to hospice services in a nursing home, 32 (3.1%) to home without hospice services, and 16 (1.6%) to hospice services at home. Overall, the rate of referral to hospice services for advanced dementia was relatively low.

  7. The shift of psychiatric inpatient care from hospitals to jails and prisons.

    PubMed

    Lamb, H Richard; Weinberger, Linda E

    2005-01-01

    Far-reaching structural changes have been made in the mental health system. Many severely mentally ill persons who come to the attention of law enforcement now receive their inpatient treatment in jails and prisons, at least in part, because of a dramatic reduction of psychiatric inpatient beds. While more high-quality community treatment, such as intensive case management and assertive community treatment, is needed, the authors believe that for many, 24-hour structured care is needed in the mental health system for various lengths of time to decrease criminalization. Another central theme of this article is that when a mentally ill individual is arrested, that person now has a computerized criminal record, which is easily accessed by the police and the courts in subsequent encounters. This may influence their decisions and reinforce the tendency to choose the criminal justice system over the mental health system.

  8. Use of novel psychoactive substances by inpatients on general adult psychiatric wards

    PubMed Central

    Stanley, Jack L; Mogford, Daniel V; Lawrence, Rebecca J; Lawrie, Stephen M

    2016-01-01

    Objectives Non-illicit alternatives to controlled drugs, known as novel psychoactive substances (NPS), have recently risen to prominence. They are readily available, with uncertain pharmacology and no widely available assay. Given that psychiatric patients are at risk of comorbid substance abuse, we hypothesised that NPS use would be present in the psychiatric population, and sought to determine its prevalence and investigate the characteristics of those who use these drugs with a retrospective review of discharge letters. Setting General adult inpatient wards of a psychiatric hospital in a Scottish city. Participants All adult inpatients (18–65) discharged from general psychiatric wards between 1 July 2014 and 31 December 2014. Of the 483 admissions identified, 46 were admissions for maintenance electroconvulsive therapy (ECT) and were excluded. Of the remaining 437 admissions, 49 discharge letters were unobtainable, leaving 388 admissions to analyse. Primary outcome measure The mention, or lack thereof, of NPS use in discharge letters was our planned primary outcome measure and was also the primary outcome measure we used in our analysis. Results NPS use was identified in 22.2% of admissions, contributing to psychiatric symptoms in 59.3%. In comparison to non-users, NPS users were younger (p<0.01), male and more likely to have a forensic history ((p<0.001) for both). The diagnosis of drug-induced psychosis was significantly more likely in NPS users (p<0.001, OR 18.7, 95% CI 8.1 to 43.0) and the diagnosis of depression was significantly less likely (p<0.005, OR 0.133, CI 0.031 to 0.558). Use of cannabis was significantly more likely in NPS users (p<0.001, OR 4.2, CI 2.5 to 7.1), as was substitute opiate prescribing (p<0.001, OR 3.7, CI 1.8 to 7.4). Conclusions NPS use was prevalent among young, male psychiatric inpatients, in particular those with drug-induced psychosis and often occurred alongside illicit drug use. PMID:27165643

  9. Multimodal examination of distress tolerance and posttraumatic stress disorder symptoms in acute-care psychiatric inpatients.

    PubMed

    Vujanovic, Anka A; Dutcher, Christina D; Berenz, Erin C

    2016-09-01

    Distress tolerance (DT), the actual or perceived capacity to withstand negative internal states, has received increasing scholarly attention due to its theoretical and clinical relevance to posttraumatic stress disorder (PTSD). Past studies have indicated that lower self-reported - but not behaviorally observed - DT is associated with greater PTSD symptoms; however, studies in racially and socioeconomically diverse clinical samples are lacking. The current study evaluated associations between multiple measures of DT (self-report and behavioral) and PTSD symptoms in an urban, racially and socioeconomically diverse, acute-care psychiatric inpatient sample. It was hypothesized that lower self-reported DT (Distress Tolerance Scale [DTS]), but not behavioral DT (breath-holding task [BH]; mirror-tracing persistence task [MT]), would be associated with greater PTSD symptoms, above and beyond the variance contributed by trauma load, substance use, gender, race/ethnicity, and subjective social status. Participants were 103 (41.7% women, Mage=33.5) acute-care psychiatric inpatients who endorsed exposure to potentially traumatic events consistent with DSM-5 PTSD Criterion A. Results of hierarchical regression analyses indicated that DTS was negatively associated with PTSD symptom severity (PCL-5 Total) as well as with each of the four DSM-5 PTSD symptom clusters (p's<0.001), contributing between 5.0%-11.1% of unique variance in PTSD symptoms across models. BH duration was positively associated with PTSD arousal symptom severity (p<0.05). Covariates contributed between 21.3%-40.0% of significant variance to the models. Associations between DT and PTSD in this sample of acute-care psychiatric inpatients are largely consistent with those observed in community samples.

  10. Psychiatric Disorders in Iranian Children and Adolescents

    PubMed Central

    Mohammadi, Mohammad Reza; Salmanian, Maryam; Asadian-koohestani, Fatemeh; Ghanizadeh, Ahmad; Alavi, Ali; Malek, Ayyoub; Dastgiri, Saeed; Moharreri, Fatemeh; Hebrani, Paria; Arman, Soroor; Khoshhal Dastjerdi, Javad; Motavallian, Ali

    2016-01-01

    Objective: The aim of the present study was to investigate the epidemiology of psychiatric disorders in children and adolescents in five provinces of Iran: Tehran, Shiraz, Isfahan, Tabriz and Mashhad. Method: In the present study, we selected 9,636 children and adolescents aged 6–18 years through multistage cluster random sampling method from Tehran, Shiraz, Isfahan, Tabriz and Mashhad. We instructed the clinical psychologists to complete the Strengths and Difficulties Questionnaire (SDQ) for the participants, andthose who received a high score on SDQ, completed the Persian version of Kiddie-SADS-Present and Lifetime Version (K-SADS-PL). We used descriptive analysis and 95% confidence interval to investigate the relationship between scores of the K-SADS questionnaire and demographic factors. We used one-way ANOVA to test the significant differences among the disorders according to sex, age and province of residence. Results: Based on the results, oppositional defiant disorder (ODD) (4.45%) had the highest prevalence of psychiatric disorders in the five provinces and substance abuse and alcohol abuse (0%) had the lowest prevalence. In addition, attention deficit hyperactivity disorder (ADHD) had the most prevalence in boys (5.03%) and ODD had the most prevalence in girls (4.05%). Among the three age groups, 6 to 9 year olds had the highest rates of ADHD (5.69%); 10 to 14 and 15 to 18 year olds had the highest rates of ODD (4.32% and 4.37% respectively). Among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of ADHD; and Tabriz had the highest rates of social phobia. Conclusion: The current study revealed that the overall frequency of psychiatric disorders based on Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) was higher than a similar study. Moreover, in this study, among the five provinces, Tehran and Mashhad allocated the highest rates of ODD; Isfahan and Shiraz had the highest rates of

  11. Histories of Child Maltreatment and Psychiatric Disorder in Pregnant Adolescents

    ERIC Educational Resources Information Center

    Romano, Elisa; Zoccolillo, Mark; Paquette, Daniel

    2006-01-01

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

  12. Psychiatric nursing as 'different' care: experience of Iranian mental health nurses in inpatient psychiatric wards.

    PubMed

    Zarea, K; Nikbakht-Nasrabadi, A; Abbaszadeh, A; Mohammadpour, A

    2013-03-01

    Patients with mental illness require unique and specific care. The purpose of this study was to explore the experiences of nurses, who provide such care for mentally ill people, within the context of Iranian culture. This hermeneutic phenomenological study was carried out in a university-affiliated hospital in an urban area of Iran. We interviewed 10 mental health nurses to capture in detail their experiences in psychiatric units, and the approach developed by Diekelmann et al. was employed to analyse the data. Four themes and five sub-themes were identified: 'being engaged with patients' (sub-themes: 'struggle for monitor/control', 'safety/security concerns', 'supporting physiological and emotional needs'), 'being competent', 'altruistic care' and 'facing difficulties and challenges' (sub-themes: 'socio-cultural' and 'organizational challenges'). The results provide valuable insights and greater understanding of the professional experiences of psychiatric nurses in Iran, and indicate the need for a stable and responsible organizational structure for those nurses who are expected to manage patient care in psychiatric wards.

  13. Prevalence and denial of sexual abuse in a male psychiatric inpatient population.

    PubMed

    Lab, Damon D; Moore, Estelle

    2005-08-01

    While the link between sexual abuse and psychiatric morbidity is well established, there are only a few studies that have investigated the prevalence of sexual abuse in male psychiatric populations and these studies have typically employed designs that ignore methodological issues specific to male sexual abuse. The present study aims to contribute to this research using as methodologically sound approach as possible. Seventy-four male inpatients were interviewed using a questionnaire (J. N. Briere, 1992) about childhood sexual experiences. Approximately one third reported incidents that met this study's criteria for sexual abuse. Many of these men did not label such experiences as "sexual abuse." The results suggest that mental health professionals need to be aware that many of their male patients may have a history of sexual abuse and that potential minimization or denial of it is a barrier to disclosure.

  14. Profiles of psychiatric symptoms among Amphetamine Type Stimulant and Ketamine using inpatients in Wuhan, China

    PubMed Central

    Zhang, Yao; Xu, Zaifeng; Zhang, Sheng; Desrosiers, Alethea; Schottenfeld, Richard S.; Chawarski, Marek C.

    2014-01-01

    Amphetamine type stimulants (ATS) and ketamine have emerged as major drug problems in China, and chronic extensive exposure to these substances frequently co-occurs with psychiatric symptoms. This study compares the psychiatric symptoms of patients reporting ATS use only, ATS and ketamine use, or ketamine use only who were admitted to an inpatient psychiatry ward in Wuhan, China between 2010 and 2011. Data on 375 study participants collected during their ward admission and extracted from their clinical records included their socio-demographics, scores on the Brief Psychiatric Rating Scale (BPRS), and urine toxicology screens. Results The ketamine-only group had significantly lower total BPRS scores and significantly lower scores on Thinking Disorder, Activity, and Hostility-Suspicion BPRS subscales than the ATS-only and ATS+ketamine groups (p<0.001 for all comparisons). The ketamine-only group also had significantly higher scores on the subscales of Anxiety-Depression and Anergia. The ATS-only group had significantly higher scores on subscales of Thinking Disorder, Activity, and Hostility-Suspicion and significantly lower scores on Anxiety-Depression and Anergia subscales than the ketamine-only and ATS+ketamine groups (p<0.001 for all comparisons). A K-means cluster method identified three distinct clusters of patients based on the similarities of their BPRS subscale profiles, and the identified clusters differed markedly on the proportions of participants reporting different primary drugs of abuse. The study findings suggest that ketamine and ATS users present with different profiles of psychiatric symptoms at admission to inpatient treatment. PMID:24613031

  15. Utilization of psychiatric inpatient care in Greece: a nationwide study (1984-1996).

    PubMed

    Madianos, M G; Zacharakis, C; Tsitsa, C

    2000-01-01

    This report examines the trends in the utilization of psychiatric inpatient care for the period 1984-1996, when the implementation of the psychiatric reform programme was initiated in Greece. Admissions in public mental hospitals declined by 7.2%. However discharges have been increased by 30.6% with a parallel decrease of the length of stay by 53.7% followed by an increase in discharges of patients diagnosed as suffering from schizophrenia and affective psychoses by 61.1% and 123.8% respectively. In the private sector a remarkable reduction in both admissions and discharges was noticed. Admissions in psychiatric departments of general hospitals for the same years have been increased by 1054.1%. It seems that the recent deinstitutionalization process resulted in increasing trends in the discharges of patients suffering from psychoses. Additionally, a substantial increase in the number of extramural psychiatric services and rehabilitation places between 1994-1996 was observed. The demand for the mental health care services expressed as the urbanization index was found to be related with mental health professionals and the extramural units ratios. The higher degree of urbanism is, the greater the number of extramural services exist. The models explained variance reached 50.6%.

  16. A preliminary study of the relation between trauma symptoms and emerging BPD in adolescent inpatients.

    PubMed

    Venta, Amanda; Kenkel-Mikelonis, Robyn; Sharp, Carla

    2012-01-01

    The relation between trauma and borderline personality disorder (BPD) has been studied in great detail with adults, but few studies have examined this link in adolescents. Furthermore, virtually nothing is known about how different aspects of trauma relate to BPD and whether trauma symptoms reflect actual trauma history in adolescents diagnosed with BPD. Using a sample of 147 adolescent psychiatric inpatients, the authors examined the concurrent link between trauma symptoms, trauma history, and BPD. Findings suggest that adolescents with BPD are more likely than their non-BPD counterparts to have a history of sexual trauma and to report sexual concerns. However, the link between BPD and sexual concerns is not completely explained by increased sexual trauma history in the BPD group, indicating that there is some relation between BPD and sexual concerns independent of trauma history. These findings are discussed within an attachment framework. The preliminary nature of this study is noted and used as the basis for encouraging future research in the area.

  17. Adolescents' Perceptions of Their Consent to Psychiatric Mental Health Treatment

    PubMed Central

    Roberson, Anthony James; Kjervik, Diane K.

    2012-01-01

    The purpose of this paper is to present the findings of a small-scale study in which the decision-making process of adolescents who consent to psychiatric mental health treatment was examined. Sixteen (16) adolescents were interviewed about their decisions related to initial and continued treatment, along with their understanding of minor consent laws. Interviews were audio-recorded, and transcripts were analyzed through concept analysis. Findings are presented in the context of the decision-making steps and research questions. Most adolescents did not recognize consequences related to psychiatric mental health treatment and did not assimilate and integrate information provided to them about treatment choices. Adolescents disagreed with current minor consent laws that allow minors to consent to certain healthcare treatments without the required consent of the parent. Further, adolescents reported that a collaborative approach in making decisions about the adolescent's psychiatric mental health treatment was most facilitative of achieving the goals of treatment. PMID:22474581

  18. Psychopathic traits and change on indicators of dynamic risk factors during inpatient forensic psychiatric treatment.

    PubMed

    Hildebrand, Martin; de Ruiter, Corine

    2012-01-01

    The main objective of the present study was to investigate the impact of treatment on forensic psychiatric inpatients, examining changes on 22 indicators of five dynamic risk factors for violence (i.e., egocentrism, hostility, impulsivity, lack of insight, and negative distrustful attitudes), and to relate these potential changes to level of psychopathy assessed with the Hare Psychopathy Checklist - Revised (PCL-R). Also, we studied the relationship between psychopathy and treatment compliance, as indicated by the attendance rate of therapeutic activities. Eighty-seven male patients (due to missing data on at least one measure, sample size varies from 58 to 87; 42 patients have complete datasets) were administered a standardized psychological assessment battery (self-report inventories, performance-based personality test, observer ratings) upon admission (T1) and after on average 20 months of treatment (T2). Upon admission, psychopathy (median split, PCL-R score≥22) was significantly related to a higher score on five of the 22 indicators of dynamic risk. The analyses showed no significant differences between psychopathic and non-psychopathic patients on the indicators of dynamic risk factors during 20 months of inpatient forensic psychiatric treatment. However, psychopaths showed the expected pattern of treatment noncompliance, compared to non-psychopaths. The clinical and research implications of these findings are discussed.

  19. S100B blood levels and childhood trauma in adolescent inpatients

    PubMed Central

    Falcone, Tatiana; Janigro, Damir; Lovell, Rachel; Simon, Barry; Brown, Charles A.; Herrera, Mariela; Myint, Aye Mu; Anand, Amit

    2015-01-01

    Background Serum levels of the astrocytic protein S100B have been reported to indicate disruption of the blood–brain barrier. In this study, we investigated the relationship between S100B levels and childhood trauma in a child psychiatric inpatient unit. Method Levels of S100B were measured in a group of youth with mood disorders or psychosis with and without history of childhood trauma as well as in healthy controls. Study participants were 93 inpatient adolescents admitted with a diagnosis of psychosis (N = 67), or mood disorder (N = 26) and 22 healthy adolescents with no history of trauma or psychiatric illness. Childhood trauma was documented using the Life Events Checklist (LEC) and Adverse Child Experiences (ACE). Results In a multivariate regression model, suicidality scores and trauma were the only two variables which were independently related to serum S100B levels. Patients with greater levels of childhood trauma had significantly higher S100B levels even after controlling for intensity of suicidal ideation. Patients with psychotic diagnoses and mood disorders did not significantly differ in their levels of S100B. Patients exposed to childhood trauma were significantly more likely to have elevated levels of S100B (p < .001) than patients without trauma, and patients with trauma had significantly higher S100B levels (p < .001) when compared to the control group. LEC (p 0.046), and BPRS-C suicidality scores (p = 0.001) significantly predicted S100B levels. Conclusions Childhood trauma can potentially affect the integrity of the blood–brain barrier as indicated by associated increased S100B levels. PMID:25669696

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

    PubMed

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

    2005-01-01

    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.

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

    PubMed Central

    2012-01-01

    Background The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients’ perceived coercion and to increase patient satisfaction, their quality of life and empowerment. Methods/Design This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care

  2. Seroprevalence of selected viral, bacterial and parasitic infections among inpatients of a public psychiatric hospital of Mexico.

    PubMed

    Alvarado-Esquivel, Cosme; Arreola-Valenzuela, Miguel Angel; Rodríguez-Briones, Alfredo; Alanís-Quiñones, Olga Patricia; Estrada-Martínez, Sergio; Luevanos-Becerra, Carlos; Martínez-Saenz, Luis Felipe; Martínez-García, Sergio Arturo; Ramírez-Valles, Eda Guadalupe; Ibarra-Torres, Isaac; González-Verdín, Cesar Arnulfo

    2008-01-01

    We sought to determine the frequency of serological markers of selected infections in a population of psychiatric patients in Durango City, Mexico, and to determine whether there are any epidemiological characteristics of the subjects associated with the infections. One hundred and five inpatients of a public psychiatric hospital of Durango were examined for HBsAg, anti-HCV antibodies, anti-HIV antibodies, anti-Brucella antibodies, rapid plasma reagin and anti-Cysticercus antibodies by commercially available assays. Anti-Cysticercus antibodies were confirmed by Western blot and HBsAg by neutralization assay. Epidemiological data from each participant were also obtained. Seroprevalences of HBsAg, anti-HCV, anti-HIV, anti-Brucella, rapid plasma reagin and anti-Cysticercus antibodies found were 0.0%, 4.8%, 0.9%, 0.0%, 1.9%, and 0.9%, respectively. Overall, 9 (8.6%) inpatients showed seropositivity to any infection marker. We concluded that our psychiatric inpatients have serological evidence of a number of infections. HCV is an important pathogen among our psychiatric inpatients. Health care strategies for prevention and control of infections in Mexican psychiatric patients should be considered.

  3. Educational Functioning and Self-Esteem of Psychiatrically Hospitalized Adolescents.

    ERIC Educational Resources Information Center

    Bley, Georganne R.; And Others

    A topic of much national concern is the mental health of youth. Adolescents often enter psychiatric treatment with poor school performance, having attended numerous schools, and have very negative attitudes toward the school environment. In order to facilitate more effective psychiatric functioning, this study sought to learn more about two groups…

  4. Psychiatric Diagnostic Interviews for Children and Adolescents: A Comparative Study

    ERIC Educational Resources Information Center

    Angold, Adrian; Erkanli, Alaattin; Copeland, William; Goodman, Robert; Fisher, Prudence W.; Costello, E. Jane

    2012-01-01

    Objective: To compare examples of three styles of psychiatric interviews for youth: the Diagnostic Interview Schedule for Children (DISC) ("respondent-based"), the Child and Adolescent Psychiatric Assessment (CAPA) ("interviewer-based"), and the Development and Well-Being Assessment (DAWBA) ("expert judgment"). Method: Roughly equal numbers of…

  5. Adolescents and Dual Diagnosis in a Psychiatric Emergency Service.

    PubMed

    Matali, José Luis; Andión, Oscar; Pardo, Marta; Iniesta, Raquel; Serrano, Eduard; San, Luis

    2016-03-02

    In recent years, both the prevalence of drug use and related child and adolescent psychiatric emergencies have risen sharply. There are few studies about the impact on child and adolescent emergency services. This study has a twofold aim. The first is to describe the prevalence of substance use disorders, mental disorders and dual diagnosis (substance use problems plus mental disorder) in adolescents in psychiatric emergency service. The second is to analyze clinical and healthcare differences between patients with dual diagnosis and patients with a mental disorder without substance use disorder.We retrospectively reviewed 4012 discharge forms for emergencies treated at the psychiatric emergency department during the period 2007-2009. We obtained a sample of 1795 visits. This sample was divided into two groups: the dual diagnosis group (n = 477) and the psychiatric disorder group (n = 1318).The dual diagnosis group accounted for 26.5% of psychiatric emergencies analyzed. Compared to the psychiatric disorder group,the dual diagnosis group had significantly more conduct disorders, social problems, involuntariness in the visit, less hospital admissions and less connection with the healthcare network.Adolescents with a dual diagnosis account for a high percentage of visits at child and adolescent psychiatric emergency services. This patient group requires specialized care both at emergency services and in specific units. Accordingly, these units should play a triple role when handling dual diagnosis: detection, brief treatment and referral to a specialised unit.

  6. Early detection of psychotic disorders in adolescents: specificity of basic symptoms in psychiatric patient samples.

    PubMed

    Resch, F; Koch, E; Möhler, E; Parzer, P; Brunner, R

    2002-01-01

    Based on the results of adult studies that have shown a subgroup of basic symptoms to have a predictive value for later schizophrenic disorder, a cross-sectional study on 36 schizophrenic and 75 nonschizophrenic adolescent psychiatric inpatients was performed to elucidate the specificity of prodromal signs in early age groups. The occurrence of any single basic symptom does not show schizophrenic specificity in adolescents, but the number of basic symptoms in the categories of the Bonn Scale for the Assessment of Basic Symptoms is increased in schizophrenic patients compared with subjects with other diagnoses. The interrelation between minus symptoms and cognitive symptoms exerts a higher amount of cognitive disturbances given a certain level of irritation in schizophrenic adolescents. With the help of odds ratios, the seven most discriminating cognitive items could be elucidated including perception, information processing and action tendency.

  7. [Foreign patients in inpatient treatment in a psychiatric university clinic with community service].

    PubMed

    Holzmann, T H; Volk, S; Georgi, K; Pflug, B

    1994-05-01

    About one third (29.5%) of the population living within the area of Frankfurt, for which the psychiatric university clinic provides psychiatric service, are foreigners. For the better understanding of our foreign psychiatric inpatients treated in our clinic in in 1992, the diagnostic spectrum and the nationalities of these patients were analysed. More than half of them (58%) were raised up in former Yugoslavia, Turkey, Italy, Poland and Marocco. The other foreign patients came from 36 different countries. The diagnostic spectrum comparing german and foreign patients showed marked differences. Paranoid schizophrenia was more common in foreigners (31.5%) compared with german patients (16.8%), as well as female foreigners were admitted to the clinic because of psychoreactive disorders (65.2% of all turkish females) more often. The language barrier limited the treatment in many patients. In addition treatment was also hampered by family induced pressure on our patients. This was mainly due to differences and misunderstanding concerning the nature and treatment strategies. In spite of these difficulties, engagement of the therapeutic teams and treatment outcome did not differ between german and foreign patients. In order to improve treatment modalities, we quote for an increasing number of psychiatrists, who are capable of serbocroatic, turkish, italian, polish or arab language and culture, to work in clinical psychiatry.

  8. Substance Use Disorders in Elderly Admissions to an Academic Psychiatric Inpatient Service over a 10-Year Period

    PubMed Central

    Dombrowski, Dennis; Norrell, Nelly

    2016-01-01

    Objective. There is a paucity of research on substance use disorders (SUDs) in the elderly psychiatric population. This study examines SUDs in a geriatric psychiatry inpatient service over a 10-year period. Methods. Data from 1788 elderly psychiatric inpatients from a ten-year period was collected. Variables collected included psychiatric diagnoses, SUD, number of psychiatric admissions, and length of stay. Those with and without a SUD were compared using Chi-Square or Student's t-test as appropriate using SPSS. Results. 11.7% (N = 210) of patients had a SUD, and the most common substance was alcohol at 73.3% (N = 154) or 8.6% of all admissions. Other SUDs were sedative-hypnotics (11%), opiate (2.9%), cannabis (1%), tobacco (1.4%), and unspecified SUD (38.6%). SUD patients were significantly younger, divorced, male, and less frequently readmitted and had shorter lengths of stay. The most common comorbid diagnoses were major depression (26.1%), bipolar disorder (10.5%), and dementia (17.1%). Conclusions. Over 10% of psychogeriatric admissions were associated with a SUD, with alcohol being the most common. Considering the difficulties in diagnosing SUD in this population and the retrospective study design, the true prevalence in elderly psychiatric inpatients is likely higher. This study adds to sparse literature on SUD in elderly psychiatric patients. PMID:27840765

  9. Religion/Spirituality and Adolescent Psychiatric Symptoms: A Review

    ERIC Educational Resources Information Center

    Dew, Rachel Elizabeth; Daniel, Stephanie S.; Armstrong, Tonya D.; Goldston, David B.; Triplett, Mary Frances; Koenig, Harold G.

    2008-01-01

    The aim of the current article is to review the literature on religion and spirituality as it pertains to adolescent psychiatric symptoms. One hundred and fifteen articles were reviewed that examined relationships between religion/spirituality and adolescent substance use, delinquency, depression, suicidality, and anxiety. Ninety-two percent of…

  10. Psychiatric Comorbidities among Female Adolescents with Anorexia Nervosa

    ERIC Educational Resources Information Center

    Salbach-Andrae, Harriet; Lenz, Klaus; Simmendinger, Nicole; Klinkowski, Nora; Lehmkuhl, Ulrike; Pfeiffer, Ernst

    2008-01-01

    This study investigated current comorbid Axis I diagnoses associated with Anorexia Nervosa (AN) in adolescents. The sample included 101 female adolescents treated at a psychiatric unit for primary DSM-IV diagnoses of AN. 73.3% of the AN patients were diagnosed as having a current comorbidity of at least one comorbid Axis I diagnosis, with no…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  12. Predictors of medication compliance after hospital discharge in adolescent psychiatric patients.

    PubMed

    Lloyd, A; Horan, W; Borgaro, S R; Stokes, J M; Pogge, D L; Harvey, P D

    1998-01-01

    Failure in medication compliance in adult psychiatric patients is often found to be due to side effects or associated with unawareness of illness. Little research has been conducted on medication compliance in adolescent psychiatric patients. In this study, 97 adolescent psychiatric patients, including 46 with substance abuse, were followed up an average of 14 months after their discharge from inpatient psychiatric care. Compliance with prescribed medications was examined and the association between several potential predictors and compliance was examined. The overall rate of medication compliance was only 38% at 14-month follow-up, whereas the rate of patients stopping their medications because of side effects was only 23%. Significant predictors of compliance failures were general noncompliance with the discharge plan, followed by postdischarge substance abuse. Side effects did not contribute any additional variance when these factors were considered. These data suggest that medication compliance may be adversely impacted by general tendencies toward noncompliance with treatment, which may be mediated by several possible factors. Interventions to increase awareness of the need for psychotropic medications as well as careful monitoring for substance abuse relapse in this population are suggested.

  13. Sensory Modulation Treatment on a Psychiatric Inpatient Unit: Results of a Pilot Program.

    PubMed

    Gardner, Jennifer

    2016-04-01

    The purpose of the current pilot program was to measure efficacy of sensory modulation treatment for adults (N = 20) admitted to an inpatient, involuntary psychiatric unit. Efficacy of 1-hour group (n = 10) and 1-hour individual (n = 9) sensory modulation treatment was measured via pre- and postintervention self-rating scales (visual analog scale from 0 to 10, with 0 = low arousal and 10 = high arousal) and post-survey. Results indicated treatment elicited an average self-perceived change in arousal of 1.93. Group treatment elicited an average self-rating change of 1.79, whereas individual treatment elicited an average change of 2.67. For participants who initially rated their arousal level ≥6, group treatment elicited a change of 4.5, whereas individual treatment elicited a change of 7.5. Participants sought materials and activities that were primarily categorized into the olfactory, gustatory, and auditory sensory systems.

  14. Multiple-baseline analysis of a token economy for psychiatric inpatients.

    PubMed Central

    Nelson, G L; Cone, J D

    1979-01-01

    Twelve behaviors selected for reinforcement among 16 chronic psychiatric inpatients were divided into four classes: (a) personal hygiene, (b) personal management, (c) ward work, and (d) social skills. A token economy program was introduced for each class in a sequential, cumulative, multiple-baseline format. Corrections were included for methodological deficiencies frequently enountered in past studies. Treatment variables were systematically monitored, and target behavior rates, levels of global individual functioning, general ward behavior, and off-ward behavior were assessed during baseline, implementation, and probe periods. Results indicated abrupt and substantial increases in performance of most target behaviors, significant improvements in global individual functioning (p less than .025), positive changes in general ward behavior, and increases in social interaction during off-ward activities. The findings provide strong evidence for the efficacy of a token economy and indicate that the multiple-baseline design can be a useful method for evaluating token economy programs. PMID:489481

  15. Ringleader bullying: association with psychopathic narcissism and theory of mind among child psychiatric inpatients.

    PubMed

    Stellwagen, Kurt K; Kerig, Patricia K

    2013-10-01

    This study examined the association of ringleader bullying with psychopathic traits and theory of mind among 100 youth aged 10-15 (62 boys and 38 girls) receiving inpatient psychiatric services at a state facility. Results of hierarchical multiple regression analyses indicated a positive association between ringleader bullying and psychopathic narcissism, and a significant interaction effect between narcissism and theory of mind. More specifically, narcissism moderated the relationship between theory of mind and ringleader bullying such that theory of mind was positively associated with ringleader bullying when levels of narcissism were high, and theory of mind was negatively associated ringleader bullying when levels of narcissism were low. The discussion of these results focuses on the importance of developing effective treatment techniques for youth whose bullying behavior is associated with narcissistic features and social acuity.

  16. Multiple-baseline analysis of a token economy for psychiatric inpatients.

    PubMed

    Nelson, G L; Cone, J D

    1979-01-01

    Twelve behaviors selected for reinforcement among 16 chronic psychiatric inpatients were divided into four classes: (a) personal hygiene, (b) personal management, (c) ward work, and (d) social skills. A token economy program was introduced for each class in a sequential, cumulative, multiple-baseline format. Corrections were included for methodological deficiencies frequently enountered in past studies. Treatment variables were systematically monitored, and target behavior rates, levels of global individual functioning, general ward behavior, and off-ward behavior were assessed during baseline, implementation, and probe periods. Results indicated abrupt and substantial increases in performance of most target behaviors, significant improvements in global individual functioning (p less than .025), positive changes in general ward behavior, and increases in social interaction during off-ward activities. The findings provide strong evidence for the efficacy of a token economy and indicate that the multiple-baseline design can be a useful method for evaluating token economy programs.

  17. Reduced amygdala volume in newly admitted psychiatric in-patients with unipolar major depression.

    PubMed

    Kronenberg, Golo; Tebartz van Elst, Ludger; Regen, Francesca; Deuschle, Michael; Heuser, Isabella; Colla, Michael

    2009-09-01

    Structural neuroimaging studies investigating amygdala volumes in patients suffering from major depression have yielded variable results. Discrepant findings across studies may be attributable in part to heterogeneity with respect to antidepressant medication and to lack of adequate control for the effects of total brain volume and age. Here, 24 unipolar depressed in-patients newly admitted to a psychiatric unit and 14 healthy control participants matched for age, gender, and years of education underwent quantitative magnetic resonance imaging (MRI) toward the end of a one-week washout period. Saliva cortisol was measured at 08.00 and at 16.00h in patients during washout. Absolute amygdala volumes were significantly reduced in the patient group (by 13% in left amygdala and 12% in right amygdala). The effect of reduced amygdala volumes in patients remained significant after correction for brain volume (BV) and age. Furthermore, amygdala volume measurements in the patient sample showed a significant inverse relationship to the number of preceding depressive episodes. In patients, severity of disease (baseline HAMD scores) and baseline cortisol levels were not related to amygdala volume. This study of a sample of unmedicated depressed in-patients adds to the small, yet growing, body of evidence linking untreated major depression to reduced amygdala volume.

  18. The Effect of Violence on the Diagnoses and the Course of Illness Among Female Psychiatric Inpatients

    PubMed Central

    TEMİZ, Meltem; BEŞTEPE, Emrem; YILDIZ, Özlem; KÜÇÜKGÖNCÜ, Suat; YAZICI, Ayla; ÇALIKUŞU, Celal; ERKOÇ, Şahap

    2014-01-01

    Introduction The aim of the study was to determine the rate of exposure to domestic violence among female inpatients at any period of their lives; to investigate the effect of different forms of violence on the diagnoses and the course of the illness. Method The study was conducted on 102 female inpatients treated at Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) was administered and socio-demographic and clinical data was collected. A form designed for the assessment of violence was used to evaluate domestic violence. Results Ninety patients reported that they had been subjected to some kind of violence at some period of their lives. The parents or husbands were the most frequently reported persecutors. Seventy-three patients reported that they had been subjected to violence before the onset of their illness. Seventy-one had been subjected to physical, 79 to verbal, 42 to sexual, 52 to economic violence, and 49 to constraints on social relationship formation. Comorbid diagnosis of post traumatic stress disorder (PTSD) was related to all types of violence. The rate of suicide attempt was found to be significantly related to verbal-emotional violence. Only 12 patients had previously reported being subjected to domestic violence to their psychiatrist. Conclusion Domestic violence, an often overlooked phenomenon, is prevalent among women with psychiatric disorders. Subjection to domestic violence is found to be correlated with PTSD and suicidal attempt.

  19. [Nonfatal suicidal acts in a group of psychiatric inpatients. Situation of Mediterranean immigrants].

    PubMed

    Grube, M

    2004-07-01

    We investigated the correlation of belonging to an ethnic cultural minority and nonfatal suicidal acts (suicide attempts), suicidal ideation, and self-injurious behavior in a group of 494 psychiatric inpatients at the time of admission. The frequency of nonfatal suicidal acts was 15.3% in the group of immigrants ( n=111) and 8.9% in the group of German patients. This difference is significant, but the impact of belonging to the immigration group covaries with the impact of female gender and young age (below 45 years). If all three factors come together the risk of suicide attempts increases threefold. In the immigrant group alone, nonfatal suicidal acts were correlated with "transcultural conflicts". In the group of suicide attempters, we tried to assess the risk of suicide with the help of the "suicide risk list" (Pöldinger) and the suicidal intention with the help of the "suicide intention scale" (Pierce). Additionally, we investigated the method of suicide attempts and categorized them into two groups: "hard" and "weak" methods. We did not find any significant difference between immigrants and German patients concerning suicide risk, suicide intention, and choice of the method. Although there are some methodological shortcomings, we interpret our findings as an indication that immigrant inpatients are more involved in managing the additional stress which results from their immigration. Perhaps nonfatal suicidal behavior represents a risky, but insufficient attempt at "solving" transcultural problems in the immigrant group.

  20. The experience of adolescent inpatient care and the anticipated transition to the community: Young people's perspectives.

    PubMed

    Gill, Freya; Butler, Stephen; Pistrang, Nancy

    2016-01-01

    This study explored adolescents' perspectives of inpatient mental health care, focussing on aspects of the inpatient environment they anticipated would help or hinder their transition back home. Semi-structured interviews were conducted with 12 adolescent inpatients; transcripts were analysed thematically. Participants experienced inpatient treatment as offering a mix of benefits (e.g., supportive relationships) and drawbacks (e.g., living in a "fake world"). They anticipated the transition home as providing opportunities for personal growth and consolidation of new coping skills, but also posing challenges concerning re-entering the "real world" after the experience of being "wrapped in cotton wool". Self-determination theory and attachment theory offer two potential frameworks for understanding these opportunities and challenges. Inpatient care has the potential to foster key mechanisms for adaptive development, creating a platform for developing positive future behaviours. Community teams should work closely with inpatient units to support the generalisation of the young person's newly acquired coping skills.

  1. Combined medical-psychiatric inpatient units: evaluation of the Centre for the Elderly.

    PubMed

    Maier, A B; Wächtler, C; Hofmann, W

    2007-08-01

    Considering the large number of elderly patients in acute hospitals who receive medical as well as psychiatric treatment because of relevant comorbidity, adequate interdisciplinary treatment models have to be developed and applied. The Centre for Elderly, a cooperation project between the departments of geriatric and psychogeriatric medicine in a community hospital in Germany, was founded in 2000. In addition to traditionally structured units, the centre consists of interdisciplinary units. Patient-, staff- and hospital-related characteristics influenced by the reformation of both departments were evaluated by comparing hospital-based registry data records containing age, gender, main and minor diagnoses, length of stay and patient transferrals within the centre. Experts working at the centre were asked to take a stand on the development of the treatment quality, allocation of patients, diagnostic procedures, consultation services and information transmission. The number of admissions to the Centre for the Elderly increased within one year. The distribution of the main diagnose groups remained unchanged, with an overlap between the geriatric and psychogeriatric department consisting of the main diagnoses dementia and depression. The length of stay and the number of transferrals decreased significantly in both departments. The majority of the interviewed employees stated that the treatment quality and the allocation of patients were improved. We conclude that interdisciplinary treatment between the departments of psychiatry and geriatric medicine may contribute to the medical needs of subgroups of elderly inpatients suffering from medical-psychiatric comorbidity.

  2. Comorbid internet addiction in male clients of inpatient addiction rehabilitation centers: psychiatric symptoms and mental comorbidity.

    PubMed

    Wölfling, Klaus; Beutel, Manfred E; Koch, Andreas; Dickenhorst, Ulrike; Müller, Kai W

    2013-11-01

    Addictive Internet use has recently been proposed to be included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Still, little is known about its nosological features, including comorbidity with other mental disorders and disorder-specific psychopathological symptoms. To investigate whether Internet addiction (IA) is an issue in patients in addiction treatment, 1826 clients were surveyed in 15 inpatient rehabilitation centers. Male patients meeting criteria for comorbid IA (n = 71) were compared with a matched control group of male patients treated for alcohol addiction without addictive Internet use (n = 58). The SCL-90-R, the Patient Health Questionnaire, and the seven-item Generalized Anxiety Disorder were used to assess associated psychiatric symptoms and further comorbid disorders. Comorbid IA was associated with higher levels of psychosocial symptoms, especially depression, obsessive-compulsive symptoms, and interpersonal sensitivity. Moreover, the patients with IA more frequently met criteria for additional mental disorders. They display higher rates of psychiatric symptoms, especially depression, and might be in need of additional therapeutic treatment. In rehabilitation centers, a regular screening for IA is recommended to identify patients with this (non-substance-related) addiction and supply them with additional disorder-specific treatment.

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

    PubMed

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

    2014-06-01

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

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

    PubMed Central

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

    2010-01-01

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

  5. Network coordination following discharge from psychiatric inpatient treatment: a study protocol

    PubMed Central

    2013-01-01

    Background Inadequate discharge planning following inpatient stays is a major issue in the provision of a high standard of care for patients who receive psychiatric treatment. Studies have shown that half of patients who had no pre-discharge contact with outpatient services do not keep their first outpatient appointment. Additionally, discharged patients who are not well linked to their outpatient care networks are at twice the risk of re-hospitalization. The aim of this study is to investigate if the Post-Discharge Network Coordination Program at ipw has a demonstrably significant impact on the frequency and duration of patient re-hospitalization. Subjects are randomly assigned to either the treatment group or to the control group. The treatment group participates in the Post-Discharge Network Coordination Program. The control group receives treatment as usual with no additional social support. Further outcome variables include: social support, change in psychiatric symptoms, quality of life, and independence in daily functioning. Methods/design The study is conducted as a randomized controlled trial. Subjects are randomly assigned to either the control group or to the treatment group. Computer generated block randomization is used to assure both groups have the same number of subjects. Stratified block randomization is used for the psychiatric diagnosis of ICD-10, F1. Approximately 160 patients are recruited in two care units at Psychiatrie-Zentrum Hard Embrach and two care units at Klinik Schlosstal Winterthur. Discussion The proposed post-discharge network coordination program intervenes during the critical post-discharge period. It focuses primarily on promoting the integration of the patients into their social networks, and additionally to coordinating outpatient care and addressing concerns of daily life. Trial registration ISRCTN: ISRCTN58280620 PMID:24007198

  6. The Role of Family Variables in the Length of Stay of Psychiatric In-patients

    PubMed Central

    Yoneyama, Satoko; Makita, Yudo; Miyazu, Keiko; Katsukawa, Kazuhiko; Yoneyama, Eiichi; Masuda, Shinji; Nakajima, Yukiko; Kawasaki, Yasuhiro; Miyazu, Kenji

    2016-01-01

    Background: In Japan, the number of beds and average length of stay in a psychiatric ward are greater than in other developed countries. Objective: The present study aimed to investigate the association between family variables and the length of stay of patients with mental and behavioural disorders in a private psychiatric hospital in Japan. Methods: The medical records of patients discharged during a one-year period (n=56: men 50.0% excepting 27 patients discharged due to death were re-examined regarding age, laundry type (self-washing of clothes, family washing or supplier washing), number of family visits per one month while hospitalised, and family structure prior to hospitalisation. A length of stay greater than six months was considered the cut-off point for a long hospital stay. Bivariate logistic regression analyses were conducted to identify factors independently associated with the length of stay, adjusted for sex, age, and mental and/or behavioural disorders according to the criteria of the International Statistical Classification of Diseases and Related Health Problems. Results: The bivariate-adjusted odds ratio (95% confidence intervals) for in-patients hospitalised for more than six months was 0.08 (0.01, 0.48) for those who used family washing (p = 0.006) compared with those who used supplier washing. The number of visits per month and family structures before hospitalisation were not significantly associated. Conclusion: These results suggest that within a private psychiatric hospital in Japan, family washing is associated with shortened stays and frequency of family visits, while family structure is not associated with these factors. PMID:27867414

  7. Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis

    PubMed Central

    Iozzino, Laura; Ferrari, Clarissa; Large, Matthew; Nielssen, Olav; de Girolamo, Giovanni

    2015-01-01

    Background Violence in acute psychiatric wards affects the safety of other patients and the effectiveness of treatment. However, there is a wide variation in reported rates of violence in acute psychiatric wards. Objectives To use meta-analysis to estimate the pooled rate of violence in published studies, and examine the characteristics of the participants, and aspects of the studies themselves that might explain the variation in the reported rates of violence (moderators). Method Systematic meta-analysis of studies published between January 1995 and December 2014, which reported rates of violence in acute psychiatric wards of general or psychiatric hospitals in high-income countries. Results Of the 23,972 inpatients described in 35 studies, the pooled proportion of patients who committed at least one act of violence was 17% (95% confidence interval (CI) 14–20%). Studies with higher proportions of male patients, involuntary patients, patients with schizophrenia and patients with alcohol use disorder reported higher rates of inpatient violence. Conclusion The findings of this study suggest that almost 1 in 5 patients admitted to acute psychiatric units may commit an act of violence. Factors associated with levels of violence in psychiatric units are similar to factors that are associated with violence among individual patients (male gender, diagnosis of schizophrenia, substance use and lifetime history of violence). PMID:26061796

  8. The Differential Relations Between Empathy and Internalizing and Externalizing Symptoms in Inpatient Adolescents.

    PubMed

    Gambin, Malgorzata; Sharp, Carla

    2016-12-01

    Impaired empathy is associated with a variety of psychiatric conditions; however, little is known about the differential relations between certain forms of psychopathology and cognitive and affective empathy in adolescent girls and boys. The aim of this study was to examine the relations between externalizing and internalizing disorders and cognitive and affective empathy, respectively, while controlling for covariance among different forms of psychopathology, separately in girls and boys. A total of 507 inpatient adolescents (319 girls and 188 boys) in the age range of 12-17 years completed the Basic Empathy Scale that measures affective and cognitive empathy. The Youth Self-Report Form and Child Behavior Checklist were used to assess the severity of psychopathological symptoms. Results demonstrated that affective and cognitive empathy were negatively associated with conduct problems only in girls, but not in boys. Affective empathy was positively related to internalizing problems observed by parents and youths and self-reported ADHD symptoms in girls and boys. The clinical implications of these differential relationships for externalizing versus internalizing symptoms and empathy are discussed.

  9. A comparison of adolescent inpatients with and without a history of violence perpetration: impulsivity, PTSD, and violence risk.

    PubMed

    Fehon, Dwain C; Grilo, Carlos M; Lipschitz, Deborah S

    2005-06-01

    How childhood maltreatment and violence victimization contributes to subsequent violent behavior remains an understudied area. We examined 130 psychiatrically hospitalized adolescents and compared those with a history of perpetrating violence to those without a history of violence perpetration. Perpetrators of physical violence were significantly more likely to have been a victim and/or witness to family and community violence and also reported significantly higher levels of a broad range of psychopathology than nonperpetrators. Correlational analyses with the study group of violence perpetrators revealed that higher levels of impulsivity, dissociation, and PTSD were significantly associated with higher levels of violence. Furthermore, multiple regression analysis showed that symptoms of impulsivity and PTSD contributed significantly to the prediction of violence risk. Our findings demonstrate that violence exposure and childhood maltreatment are indeed common negative life events among adolescent inpatients, and that symptoms of PTSD may predispose traumatized youth toward impulsive violent behavior.

  10. Psychiatric Symptoms due to Thyroid Disease in a Female Adolescent

    PubMed Central

    Capetillo-Ventura, Nelly; Baeza, Inmaculada

    2014-01-01

    The hypothalamic-pituitary-thyroid axis is involved in the production of thyroid hormone which is needed to maintain the normal functioning of various organs and systems, including the central nervous system. This study reports a case of hypothyroidism in a fifteen-year-old female adolescent who was attended for psychiatric symptoms. This case reveals the importance of evaluating thyroid function in children and adolescents with neuropsychiatric symptoms. PMID:25436160

  11. Psychotropic medication use in children and adolescents in an inpatient setting.

    PubMed

    Pejovic-Milovancevic, M; Miletic, V; Popovic-Deusic, S; Draganic-Gajic, S; Lecic-Tosevski, D; Marotic, V

    2011-01-01

    Medication can be an effective part of treatment for several psychiatric disorders of childhood and adolescence but its use should be based on a comprehensive psychiatric evaluation and treatment plan. The aim of this study was to evaluate psychotropic medication use for children and adolescents treated as inpatients and to compare it with principles of rational pharmacotherapy, thus identifying possible downsides of current practices and pointing a way towards safer and more efficient practices. This is a descriptive study of prescribing trends at the Clinical Department for Children and Adolescents of the Institute of Mental Health in Belgrade, during the period from September 2009 to September 2010. Analyzed demographic data (age, gender) and the number of hospitalizations were obtained from medical histories, while diagnoses were obtained from discharge notes. Prescribed therapy was copied from medication charts. Drug dosages were analyzed as average daily doses prescribed during the hospitalization. Psychiatric diagnoses were classified according to The International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10). During the examined time period, 264 patients were hospitalized (61.4% males), with an average age of 11.4±5.1 years. We have found that 66.3% of admitted patients were treated with pharmacotherapy in addition to other treatment modalities. There was a highly significant correlation between the age of patients and the prescribed dosage (Spearman's rho=0.360, p<0.001) as well as the number of prescribed drugs (Spearman's rho=0.405, p<0.001). The most commonly diagnosed psychiatric disorders were: autism spectrum disorders (20.8%), conduct disorders(19.7%), mixed developmental disorder (14.8%), adjustment disorder (7.2%), mental retardation (7.2%),acute psychosis (4.5%), and ADHD (2.3%). The most commonly prescribed medications were antipsychotics(45.9%), followed by antidepressants (17.2%), mood stabilizers (16

  12. Information on antidepressants for psychiatric inpatients: the divide between patient needs and professional practice

    PubMed Central

    Desplenter, Franciska A.; Laekeman, Gert J.; De Coster, Sandra; Reyntens, Johan; De Baere, Sheila; De Boever, Willy; De Vos, Marc; Vrijders, Danny; De Fré, Claudine; De Keyster, Cécile; De Meulemeester, Katharina; Heremans, Marise; Rutgeerts, Cathérine; Simoens, Steven R.

    Background Medicine information is an integral part of patient care and a patient right. In particular, patients with a mental health diagnosis have a need for information on medicines. Objective This study aims to describe the current practice on information provision on antidepressants to inpatients in psychiatric hospitals. Methods A qualitative study was conducted consisting of semi-structured interviews with health care professionals (n=46) and patients (n=17) in 11 Flemish psychiatric hospitals. Two topic guides were designed for conducting the interviews with these respective stakeholders. The issues addressed in the topic guides related to: organization of information provision in the hospital, information on demand of the patient, information provision by health care professionals, information for relatives, evaluation of provided information, interdisciplinary contacts on information provision and satisfaction on current practice of information provision. The interviews were analysed according to the five stages of the framework analysis. Results Psychiatrists and nurses are the key players to provide information on antidepressants. Their approach depends on patient characteristics and mental state. Information is provided mainly orally. Health care professionals consider non-verbal cues of patients to verify if information has been understood. Health care professionals reported lack of time and lack of interdisciplinary contacts as negative aspects. Patients indicated that health care professionals take too little initiative to provide medicine information. Conclusions Patients are informed about their antidepressants through various pathways. Although the awareness is present of the importance of the individual approach and efforts are done to tailor information to the individual patient, improvement is still possible. Tailoring communication; assessing patient needs and preferences; matching of health care professional style and patient needs; and

  13. Evaluation of Trazodone and Quetiapine for Insomnia: An Observational Study in Psychiatric Inpatients

    PubMed Central

    Chou, Tony I-Fan; Yu, Junhua; Trinh, Karen; Pal, Jai; Perry, Paul J.

    2013-01-01

    Background: Insomnia is symptomatic of most psychiatric disorders. Non–habit-forming agents such as trazodone and quetiapine are commonly used off-label to treat patients with insomnia. The safety and efficacy of trazodone and quetiapine as medications for treatment of insomnia have never been directly contrasted. The objective of this study was to compare the effectiveness of trazodone to quetiapine among inpatient psychiatric patients by measuring the traditional sleep parameters of total sleep time, number of nighttime awakenings, sleep efficiency, sleep latency, length of hospitalization, and patient-reported side effects. Method: Participants were recruited from St Helena Hospital Center for Behavioral Health, Vallejo, California. Patient inclusion criteria were age 18 to 65 years, admitted between September 2011 and February 2012, and a physician order for trazodone or quetiapine for insomnia. Exclusion criteria included primary insomnia, pregnancy, concomitant order of trazodone and quetiapine, receiving trazodone or quetiapine up to 2 weeks prior to the study, and inability to coherently communicate. Subjective patient interviews and objective nursing sleep log reviews composed the data set. Results: On average, mean total sleep time hours were longer among patients receiving trazodone versus those receiving quetiapine according to patients’ subjective reports (7.80 vs 6.75, respectively, P < .01) and the nursing sleep logs (9.13 vs 8.68, respectively, P = .04). Patients receiving trazodone experienced fewer mean nighttime awakenings versus those receiving quetiapine (0.52 vs 0.75, respectively, P = .04) according to the nursing sleep log report. Patients receiving trazodone reported more side effects of constipation, nausea, and diarrhea than patients receiving quetiapine. Conclusions: With respect to total sleep time and nighttime awakenings, trazodone was a more effective alternative than quetiapine. However, patients receiving trazodone experienced

  14. How Patients and Nurses Experience an Open Versus an Enclosed Nursing Station on an Inpatient Psychiatric Unit.

    PubMed

    Shattell, Mona; Bartlett, Robin; Beres, Kyle; Southard, Kelly; Bell, Claire; Judge, Christine A; Duke, Patricia

    2015-01-01

    The inpatient environment is a critical space for nurses and patients in psychiatric settings. In this article, we describe nurses' and patients' perceptions of the inpatient environment both before the removal of a Plexiglas enclosure around a nurses' station and after its removal. Nurses had mixed feelings about the enclosure, reporting that it provided for confidentiality and a concentrated work space but also acknowledged the challenge of the barrier for communication with their patients. Patients unanimously preferred the nurses' station without the barrier, reporting increased feelings of freedom, safety, and connection with the nurses after its removal. It is important to consider the implications of environmental decisions in inpatient settings in order to promote a healthy workplace and healing environment for all community members.

  15. Feasibility Analysis of Adopting Medicare’s Mental Health Prospective Payment System for Tricare Beneficiaries Treated in Inpatient Psychiatric Facilities

    DTIC Science & Technology

    2005-12-01

    restricting the sample of this criterion is that the military inpatient psychiatric population tends to be concentrated in military catchment areas...determined by CMS using regression. For purposes of this analysis, the teaching adjustment was not 29 applied due to restrictions in the data, but is...584.5 (acute renal failure with lesion of tabular necrosis), 391.0 (acute rheumatic pericarditis ), and 041.1 (staphylococcus). The patient did not

  16. Predictors of aggression on the psychiatric inpatient service: self-esteem, narcissism, and theory of mind deficits.

    PubMed

    Goldberg, Brett R; Serper, Mark R; Sheets, Michelle; Beech, Danielle; Dill, Charles; Duffy, Kristine G

    2007-05-01

    Aggressive behavior committed by inpatients has significant negative effects on patients, clinical staff, the therapeutic milieu, and inpatient community as whole. Past research examining nonpsychiatric patient groups has suggested that elevated self-esteem and narcissism levels as well as self-serving theory of mind (ToM) biases may be robust predictors of aggressive behavior. In the present study, we examined whether these constructs were useful in predicting aggressive acts committed by psychiatric inpatients. Severity of psychiatric symptoms, demographic variables and patients' anger, and hostility severity were also examined. We found patients who committed acts of aggression were differentiated from their nonaggressive counterparts by exhibiting significantly higher levels of self-esteem and narcissistic superiority. In addition, aggressors demonstrated self-serving ToM biases, attributing more positive attributes to themselves, relative to their perceptions of how others viewed them. Aggressors also showed increased psychosis, fewer depressive symptoms, and had significantly fewer years of formal education than their nonaggressive peers. These results support and extend the view that in addition to clinical variables, specific personality traits and self-serving attributions are linked to aggressive behavior in acutely ill psychiatric patients.

  17. Interviews of psychiatric inpatients about their family situation and young children.

    PubMed

    Wang, A R; Goldschmidt, V V

    1994-12-01

    In this study, the perception by mentally ill parents of their family situation and young children was explored with the purpose of improving the basis for cooperation between families and professionals, when intervention is needed. Fifty consecutively admitted psychiatric inpatients with children 0-10 years old were interviewed by child psychiatrists, and their information constitutes the study material. It was generally easy to approach the patients as parents. Most of them were already preoccupied with their children's situation and seemed relieved to talk about it when guaranteed anonymity. Half of the patients experienced and described having emotional difficulties in relation to their children. Half of the 64 children were reported to suffer from physical or mental health problems, and an unexpected accumulation of children with serious and relatively rare medical conditions was registered. Most of the children had parents who had been mentally ill all their life, and many had 2 parents with mental disorders. Family discord was frequent. Many women related the debut of mental symptoms to childbirth. Attention is drawn to special patterns concerning suicidal and addicted patients.

  18. Catatonia in inpatients with psychiatric disorders: A comparison of schizophrenia and mood disorders.

    PubMed

    Grover, Sandeep; Chakrabarti, Subho; Ghormode, Deepak; Agarwal, Munish; Sharma, Akhilesh; Avasthi, Ajit

    2015-10-30

    This study aimed to evaluate the symptom threshold for making the diagnosis of catatonia. Further the objectives were to (1) to study the factor solution of Bush Francis Catatonia Rating Scale (BFCRS); (2) To compare the prevalence and symptom profile of catatonia in patients with psychotic and mood disorders among patients admitted to the psychiatry inpatient of a general hospital psychiatric unit. 201 patients were screened for presence of catatonia by using BFCRS. By using cluster analysis, discriminant analysis, ROC curve, sensitivity and specificity analysis, data suggested that a threshold of 3 symptoms was able to correctly categorize 89.4% of patients with catatonia and 100% of patients without catatonia. Prevalence of catatonia was 9.45%. There was no difference in the prevalence rate and symptom profile of catatonia between those with schizophrenia and mood disorders (i.e., unipolar depression and bipolar affective disorder). Factor analysis of the data yielded 2 factor solutions, i.e., retarded and excited catatonia. To conclude this study suggests that presence of 3 symptoms for making the diagnosis of catatonia can correctly distinguish patients with and without catatonia. This is compatible with the recommendations of DSM-5. Prevalence of catatonia is almost equal in patients with schizophrenia and mood disorders.

  19. Validation of the Psychopathic Personality Inventory among psychiatric inpatients: sociodemographic, cognitive and personality correlates.

    PubMed

    Claes, Laurence; Vertommen, Stefaan; Soenens, Bart; Eyskens, Ann; Rens, Els; Vertommen, Hans

    2009-10-01

    This study examined the internal structure and validity of the Psychopathic Personality Inventory (PPI) in a sample of 399 psychiatric inpatients. The construct validity of the PPI was examined by means of Confirmatory Factor Analysis (CFA). The divergent and convergent validity of the PPI were examined by correlating the PPI with demographic variables, intelligence, DSM-IV Axis I and Axis II disorders, and measures of impulsiveness, aggression, narcissism, and psychopathy. CFA supports the presumed 8-factor structure of the PPI and shows that the first-order PPI scales can be represented by two higher-order factors, that is, PPI-I (fearless dominance) and PPI-II (impulsive-aggressiveness). Males scored significantly higher on all PPI scales than females. PPI-I correlated positively with functional impulsiveness, amorality, social imperturbability, and self-centered narcissism. PPI-II was negatively related to age and educational level, and positively to physical and verbal aggression, dysfunctional impulsivity, and other-centered narcissism. Implications for clinical practice are outlined.

  20. Adolescent cocaine abuse. Addictive potential, behavioral and psychiatric effects.

    PubMed

    Estroff, T W; Schwartz, R H; Hoffmann, N G

    1989-12-01

    Four hundred seventy-nine drug abusing adolescent patients enrolled in seven Straight, Inc. Adolescent Drug-Abuse Treatment Programs in five geographic regions across the United States were studied to determine the severity and patterns of cocaine abuse. Of these, 341 admitted to cocaine use and became part of this survey. Cocaine use was categorized as heavy, intermediate, or light. Areas examined were the addictive spectrum, psychosocial dysfunction, and psychiatric symptoms. Intermediate and heavy users of cocaine abused significantly less marijuana and inhalants than light cocaine abusers. Heavy and intermediate users were more likely to use cocaine intravenously and to use crack. They developed tachyphylaxis more frequently, progressed to weekly use in less than 3 months more frequently, and became preoccupied with obtaining and using cocaine significantly more frequently. They used more sedative hypnotics to calm themselves and engaged in more criminal behavior, such as stealing from parents and stores and passing bad checks. They had more arrests for possession of drugs, stole more cars, sold more drugs, and were more likely to trade sexual favors to obtain the drug. Heavy and intermediate users were significantly more psychiatrically disturbed than light users, becoming more suspicious, nervous, aggressive, and demonstrating increased symptoms of fatigue, sleeplessness, decreased appetite, and increasing cocaine dysphoria. All of these symptoms could be mistaken for psychiatric disorders. This study suggests that cocaine is as addictive in adolescents as in adults; possibly more so. It also causes psychosocial dysfunction and psychiatric symptoms. Further research into cocaine addiction among adolescents is indicated.

  1. Internet Addiction and Psychiatric Symptoms among Korean Adolescents

    ERIC Educational Resources Information Center

    Jang, Keum Seong; Hwang, Seon Young; Choi, Ja Yun

    2008-01-01

    Background: The aims of this study were to identify the independent factors associated with intermittent addiction and addiction to the Internet and to examine the psychiatric symptoms in Korean adolescents when the demographic and Internet-related factors were controlled. Methods: Male and female students (N = 912) in the 7th-12th grades were…

  2. The Psychiatric Consequences of Child and Adolescent Sexual Abuse

    PubMed Central

    YÜCE, Murat; KARABEKİROĞLU, Koray; YILDIRIM, Zeynep; ŞAHİN, Serkan; SAPMAZ, Dicle; BABADAĞI, Zehra; TURLA, Ahmet; AYDIN, Berna

    2015-01-01

    Introduction The purpose of this study was to investigate the psychiatric consequences of sexual abuse and its associated factors in children and adolescents referred to our child and adolescent psychiatry clinic from official medico–legal units. Methods All victims of sexual abuse (n=590) aged 1–18 (mean: 13.56±3.38) referred from forensic units to Ondokuz Mayis University Child and Adolescent Psychiatry Clinic over a period of 2 years [boys: 83 (14.1%); girls: 507 (85.9%)] were included. Child and adolescent psychiatry and forensic medicine specialists evaluated all the cases. The Wechsler Intelligence Scale for Children-Revised Form (WISC-R) and the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T) were applied. Results Abuse-related psychiatric diagnoses (of which 45.9% were major depressive disorder and 31.7% were post-traumatic stress disorder cases) were made in 75.2% of the cases. In 80.3% of the cases, the perpetrators were known to their victims [incest, n=91 (15.1%)], and intercourse took place in 48.8%. Although gender and age were not significantly associated with the appearance of any psychiatric disorders, severity of abuse (e.g., intercourse; p=.006), additional physical assault (p<.001), and incest (p<.001) had a significant correlation with psychiatric disorders. To explore the predictive value of multiple factors in the appearance of any sexual assault-related psychiatric disorder, a logistic regression model was used to determine the best linear combination of age, gender, abuse severity, incest, involvement of any other victim, additional physical assault, and length of time from first abuse to first psychiatric evaluation. This combination of variables (occurrence of incest, additional physical assault, and a long duration from first abuse to first psychiatric evaluation) significantly predicted the appearance of a psychiatric disorder of any kind (χ2

  3. Psychiatric considerations in children and adolescents with HIV/AIDS.

    PubMed

    Benton, Tami D

    2011-08-01

    The psychosocial impact of human immunodeficiency virus (HIV) disease has been recognized since the beginning of the epidemic for affected adults, but there has been less focus on the impact of HIV on young people. Among HIV-positive (HIV+) adults, high levels of distress, psychiatric symptoms, and their associations with worse health outcomes were recognized early in the epidemic. Subsequently, many studies have focused on understanding the prevalence of psychiatric symptoms among HIV+ adults and on identifying effective treatments for these symptoms. Fewer studies have examined these symptoms and their treatments among HIV+ children and adolescents. This article reviews what is known about psychiatric syndromes among HIV+ youths, their treatments, and other psychosocial factors of concern to the psychiatrist when treating children and adolescents with HIV disease.

  4. Psychiatric considerations in children and adolescents with HIV/AIDS.

    PubMed

    Benton, Tami D

    2010-04-01

    The psychosocial impact of human immunodeficiency virus (HIV) disease has been recognized since the beginning of the epidemic for affected adults, but there has been less focus on the impact of HIV on young people. Among HIV-positive (HIV+) adults, high levels of distress, psychiatric symptoms, and their associations with worse health outcomes were recognized early in the epidemic. Subsequently, many studies have focused on understanding the prevalence of psychiatric symptoms among HIV+ adults and on identifying effective treatments for these symptoms. Fewer studies have examined these symptoms and their treatments among HIV+ children and adolescents. This article reviews what is known about psychiatric syndromes among HIV+ youths, their treatments, and other psychosocial factors of concern to the psychiatrist when treating children and adolescents with HIV disease.

  5. Non-suicidal self-injury (Nssi) in adolescent inpatients: assessing personality features and attitude toward death

    PubMed Central

    2012-01-01

    Background Non-suicidal self-injury (NSSI) is a common concern among hospitalized adolescents, and can have significant implications for short and long-term prognosis. Little research has been devoted on how personality features in severely ill adolescents interact with NSSI and "attitude toward life and death" as a dimension of suicidality. Developing more specific assessment methodologies for adolescents who engage in self-harm without suicidal intent is relevant given the recent proposal of a non-suicidal self-injury (NSSI) disorder and may be useful in predicting risk in psychiatrically impaired subjects. Methods Consecutively hospitalized adolescents in a psychiatric unit (N = 52; 71% females; age 12-19 years), reporting at least one recent episode of self-harm according to the Deliberate Self-harm Inventory, were administered the Structured Clinical Interview for DSM Mental Disorders and Personality Disorders (SCID I and II), the Children's Depression Inventory and the Multi-Attitude Suicide Tendency Scale (MAST). Results Mean age onset of NSSI in the sample was 12.3 years. All patients showed "repetitive" NSSI (high frequency of self-harm), covering different modalities. Results revealed that 63.5% of adolescents met criteria for Borderline Personality Disorder (BPD) and that the rest of the sample also met criteria for personality disorders with dysregulated traits. History of suicide attempts was present in 46.1% of cases. Elevated depressive traits were found in 53.8%. Results show a statistically significant negative correlation between the score on the "Attraction to Life" subscale of the MAST and the frequency and diversification of self-harming behaviors. Conclusions Most adolescent inpatients with NSSI met criteria for emotionally dysregulated personality disorders, and showed a reduced "attraction to life" disposition and significant depressive symptoms. This peculiar psychopathological configuration must be addressed in the treatment of adolescent

  6. Preliminary Findings on the Health of the Nation Outcome Scales for Children and Adolescents in an Inpatient Secure Adolescent Unit

    ERIC Educational Resources Information Center

    Hunt, Jenny; Wheatley, Malcolm

    2009-01-01

    To date there is limited research examining the use of the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) with adolescents in secure care. The aim of this article is to examine the inter-rater reliability, concurrent validity and clinical utility of HoNOSCA in an adolescent secure psychiatric unit. Twenty-four…

  7. Psychiatric comorbidity in adolescent electronic and conventional cigarette use.

    PubMed

    Leventhal, Adam M; Strong, David R; Sussman, Steve; Kirkpatrick, Matthew G; Unger, Jennifer B; Barrington-Trimis, Jessica L; Audrain-McGovern, Janet

    2016-02-01

    The popularity of electronic (e-) cigarettes has greatly increased recently, particularly in adolescents. However, the extent of psychiatric comorbidity with adolescent e-cigarette use and dual use of conventional (combustible) and e-cigarettes is unknown. This study characterized psychiatric comorbidity in adolescent conventional and e-cigarette use. Ninth grade students attending high schools in Los Angeles, CA (M age = 14) completed self-report measures of conventional/e-cigarette use, emotional disorders, substance use/problems, and transdiagnostic psychiatric phenotypes consistent with the NIMH-Research Domain Criteria Initiative. Outcomes were compared by lifetime use of: (1) neither conventional nor e-cigarettes (non-use; N = 2557, 77.3%); (2) e-cigarettes only (N = 412, 12.4%); (3) conventional cigarettes only (N = 152, 4.6%); and (4) conventional and e-cigarettes (dual use; N = 189, 5.6%). In comparison to adolescents who used conventional cigarettes only, e-cigarette only users reported lower levels of internalizing syndromes (depression, generalized anxiety, panic, social phobia, and obsessive-compulsive disorder) and transdiagnostic phenotypes (i.e., distress intolerance, anxiety sensitivity, rash action during negative affect). Depression, panic disorder, and anhedonia were higher in e-cigarette only vs. non-users. For several externalizing outcomes (mania, rash action during positive affect, alcohol drug use/abuse) and anhedonia, an ordered pattern was observed, whereby comorbidity was lowest in non-users, moderate in single product users (conventional or e-cigarette), and highest in dual users. These findings: (1) raise question of whether emotionally-healthier ('lower-risk') adolescents who are not interested in conventional cigarettes are being attracted to e-cigarettes; (2) indicate that research, intervention, and policy dedicated to adolescent tobacco-psychiatric comorbidity should distinguish conventional cigarette, e-cigarette, and dual use.

  8. Social Connectedness and One-Year Trajectories among Suicidal Adolescents Following Psychiatric Hospitalization

    ERIC Educational Resources Information Center

    Czyz, Ewa K.; Liu, Zhuqing; King, Cheryl A.

    2012-01-01

    This study examined the extent to which posthospitalization "change" in connectedness with family, peers, and nonfamily adults predicted suicide attempts, severity of suicidal ideation, and depressive symptoms across a 12-month follow-up period among inpatient suicidal adolescents. Participants were 338 inpatient suicidal adolescents, ages 13 to…

  9. Prevalence of Internet addiction in Latino adolescents with psychiatric diagnosis.

    PubMed

    Liberatore, Katia A; Rosario, Katyna; Colón-De Martí, Luz N; Martínez, Karen G

    2011-06-01

    Internet addiction (IA) is particularly relevant in the adolescent population. The aim of this study was to describe the prevalence of IA in a clinical sample of Latino adolescents receiving ambulatory psychiatric treatment. The correlation between their pattern of Internet use and their respective psychiatric diagnosis was also studied. Adolescent patients from the Psychiatric Ambulatory Clinic at the Pediatric University Hospital (N=71) completed the Internet Addiction Test (IAT) and a questionnaire about Internet use. Information regarding demographic and diagnostic data was retrieved from their clinical records. None of the subjects presented severe IA. A total of 71.8% (n=51) of the adolescents obtained scores reflecting no problem related to IA. Only 11.6% (n=5) of subjects have discussed Internet use with their therapist. Mood disorders showed a statistically significant (p=0.044) correlation with a higher score on the IAT. Mental health care practitioners must consider questions on Internet use as an essential part of the patients' evaluation given its significant correlation with diagnosis of a mood disorder.

  10. Course and predictors of physical aggressive behaviour after discharge from a psychiatric inpatient unit: 1 year follow-up.

    PubMed

    Amore, Mario; Tonti, Cristina; Esposito, William; Baratta, Stefano; Berardi, Domenico; Menchetti, Marco

    2013-08-01

    The present study analyzes course and predictors of physically aggressive behaviour over a 1-year follow up in a sample of patients discharged from a psychiatric inpatient unit. One hundred and eighty-six patients discharged from a locked short-term Psychiatric Inpatient Unit at the Bologna University Hospital. After discharge, two data collection contacts at 1 month and at 1 year were scheduled. In particular, psychiatrists, nurses, and other professionals were interviewed by the research staff using the Overt Aggression Scale. About 20 % of discharged patients showed physical aggressiveness in subsequent follow-up contacts. Risk factors for physical violence in the short-time period were social problems and a longer time from the first psychiatric contact. Living in residential facilities and physical aggressiveness during hospitalization were correlated to violence in the long-time period. Risk factors for physically violent behaviour differed in the short-term and long-term follow-ups; different causes of violent behaviour could be hypothesized.

  11. Inpatient Care or Outplacement: Which Is Better for the Psychiatric Medically Infirm Patient?

    ERIC Educational Resources Information Center

    Watson, Charles G.

    1976-01-01

    Geriatric ward patients (N=84) were randomly assigned to groups targeted for outplacement planning or inpatient care. During the following year, the mean Morale Inventory score of the outplacement sample improved while that of the inpatient group remained statis. Results argue for an increased emphasis on outplacement programs among geriatric…

  12. Post-Admission Cognitive Therapy: A Brief Intervention for Psychiatric Inpatients Admitted After a Suicide Attempt

    ERIC Educational Resources Information Center

    Ghahramanlou-Holloway, Marjan; Cox, Daniel W.; Greene, Farrah N.

    2012-01-01

    To date, no empirically based inpatient intervention for individuals who have attempted suicide exists. We present an overview of a novel psychotherapeutic approach, Post-Admission Cognitive Therapy (PACT), currently under development and empirical testing for inpatients who have been admitted for a recent suicide attempt. PACT is adapted from an…

  13. Practice Parameter for the Psychiatric Assessment and Management of Physically Ill Children and Adolescents

    ERIC Educational Resources Information Center

    Journal of the American Academy of Child & Adolescent Psychiatry, 2009

    2009-01-01

    An introduction for any medical health clinician on the knowledge and skills that are needed for the psychiatric assessment and management of physically ill children and adolescents is presented. These parameters are presented to assist clinicians in psychiatric decision making.

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

    PubMed

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

    2012-12-01

    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.

  15. Improving capacity and consent to treatment recording in psychiatric inpatient wards: A multi-centre quality improvement project

    PubMed Central

    Li, Ching; Stellman, Judith; Patel, Nitisha; Dalton, Florence

    2016-01-01

    Assessment of mental capacity provides an ethical and legal framework for care which values patients' autonomy whilst recognising the instances where it is appropriate to act in patients' best interests. Existing medical literature indicates that mental capacity is poorly documented in psychiatric inpatient settings. The aim of the project was to examine the frequency of capacity and consent to treatment documentation with a view to creating changes in practice by raising awareness about the importance of assessing and documenting mental capacity. A multi-centre quality improvement project was conducted in September 2014 across all general adult psychiatric inpatient wards in the North Central London Training Scheme. The frequency of documentation of capacity and consent to treatment for all adult psychiatric inpatient wards across North Central London was measured. Electronic patient notes were audited retrospectively to ascertain whether capacity and consent to treatment on admission, and within the preceding seven days of data collection, was recorded. Data was collected across three successive time points during a 12 month period following the implementation of changes. A total of 232 patients were included in the baseline measurements. The results highlighted a deficiency in the recording of capacity and consent to treatment for adult psychiatric inpatients. The results showed that, of the patients audited, 49.8% had their capacity and consent to treatment assessed on admission, 61.9% had a capacity assessment in the previous 7 days and 60.5% had consent recorded in the previous 7 days. These findings were presented at local hospital teaching sessions at each of the audited sites. These sessions also gave teaching on mental capacity. Audit cycle 1 was conducted 6 months later, this included 213 patients and showed a 30% improvement in the frequency of documentation across all measures. The results showed that 77% of patients audited had their capacity and

  16. Improving capacity and consent to treatment recording in psychiatric inpatient wards: A multi-centre quality improvement project.

    PubMed

    Li, Ching; Stellman, Judith; Patel, Nitisha; Dalton, Florence

    2016-01-01

    Assessment of mental capacity provides an ethical and legal framework for care which values patients' autonomy whilst recognising the instances where it is appropriate to act in patients' best interests. Existing medical literature indicates that mental capacity is poorly documented in psychiatric inpatient settings. The aim of the project was to examine the frequency of capacity and consent to treatment documentation with a view to creating changes in practice by raising awareness about the importance of assessing and documenting mental capacity. A multi-centre quality improvement project was conducted in September 2014 across all general adult psychiatric inpatient wards in the North Central London Training Scheme. The frequency of documentation of capacity and consent to treatment for all adult psychiatric inpatient wards across North Central London was measured. Electronic patient notes were audited retrospectively to ascertain whether capacity and consent to treatment on admission, and within the preceding seven days of data collection, was recorded. Data was collected across three successive time points during a 12 month period following the implementation of changes. A total of 232 patients were included in the baseline measurements. The results highlighted a deficiency in the recording of capacity and consent to treatment for adult psychiatric inpatients. The results showed that, of the patients audited, 49.8% had their capacity and consent to treatment assessed on admission, 61.9% had a capacity assessment in the previous 7 days and 60.5% had consent recorded in the previous 7 days. These findings were presented at local hospital teaching sessions at each of the audited sites. These sessions also gave teaching on mental capacity. Audit cycle 1 was conducted 6 months later, this included 213 patients and showed a 30% improvement in the frequency of documentation across all measures. The results showed that 77% of patients audited had their capacity and

  17. A guest in the house: nursing instructors' experiences of the moral distress felt by students during inpatient psychiatric clinical rotations.

    PubMed

    Wojtowicz, Bernadine; Hagen, Brad

    2014-07-23

    Significant research has been done on the impact of moral distress among nurses, particularly in acute and intensive care settings. However, little research to date has investigated the experiences that nursing students have with moral distress. Additionally, there is a dearth of research on the role of nursing instructors' perceptions of their responsibilities to their students when encountering morally distressing situations. This manuscript describes a qualitative study conducted with eight mental health nursing instructors who acknowledged a responsibility for helping students deal with moral distress and ethical issues, but who also struggled with ways to do so. Additionally, instructors expressed frustration with their "guest" status on inpatient psychiatric units and their powerlessness to effect moral change in a medical model of psychiatric care.

  18. Crisis intervention program: an alternative to inpatient psychiatric treatment for children.

    PubMed

    Blumberg, Samuel H

    2002-03-01

    This study evaluated the impact of a Crisis Intervention program as an alternative to use of psychiatric treatment beds for young children. A multidisciplinary community-based intervention was utilized, including family therapy, psychiatric intervention, and school consultations. The impact of the service was evaluated in relation to the use of psychiatric treatment beds by the population of children eligible for Medicaid or uninsured. In comparison to an historical control group, the program resulted in a 23% reduction in the use of psychiatric treatment beds. A cost-minimization analysis indicated that in addition to the program reducing the use of psychiatric treatment beds, the cost of treatment was also slightly reduced.

  19. The German system of medical in-patient rehabilitation in children and adolescents.

    PubMed

    Petersen, Corinna; Widera, Teresia; Kawski, Stephan; Kossow, Kai; Glattacker, Manuela; Koch, Uwe

    2007-03-01

    The prevalence of chronic health conditions in young people is constantly increasing. A very important question is in which setting (in-patient or out-patient) these patients should ideally be treated. In Germany, in-patient rehabilitation of children and adolescents with chronic health conditions has a long history. So far, however, no systematic data concerning structure, process or outcome quality have been assessed across facilities. Therefore, as a first step, a conjoint project of the statutory pension and health insurance institutes was initiated to assess and to describe the structure quality of in-patient medical rehabilitation clinics for children and adolescents in Germany. A questionnaire was filled out by the clinic directors which covered general information and the characteristics of structure quality, as well as structure-affiliated process characteristics of the clinics. The survey was planned as a cross-sectional study. A total of 177 clinic addresses were available. The return rate was 83.3%. Eventually, 79 clinics were included in the analysis. In sum, the results underline the heterogeneity of services in the field of child and adolescent rehabilitation. In conclusion, in-patient rehabilitation plays a major role for the treatment of children and adolescents with chronic health conditions in Germany. The results allow an analysis of the current clinic structures.

  20. The Relation between Anxiety Disorder and Experiential Avoidance in Inpatient Adolescents

    ERIC Educational Resources Information Center

    Venta, Amanda; Sharp, Carla; Hart, John

    2012-01-01

    The current study aimed to examine the relation between experiential avoidance and anxiety disorders, as well as the usefulness of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; Greco, Lambert, & Baer, 2008) in detecting anxiety disorder in a sample of adolescent inpatients. First, the relation between experiential avoidance and anxiety…

  1. Readiness to change smoking behavior in adolescents with psychiatric disorders.

    PubMed

    Apodaca, Timothy R; Abrantes, Ana M; Strong, David R; Ramsey, Susan E; Brown, Richard A

    2007-06-01

    There has been recent increased interest in utilizing motivational interviewing (MI) to increase adolescent readiness to quit smoking, but attempts to impact quit rates have thus far been discouraging. A better understanding of factors associated with adolescent readiness to quit smoking prior to receiving any intervention may provide guidance when tailoring future MI interventions in order to increase their effectiveness with this population. Adolescent smokers (N=191) who had been admitted to a psychiatric hospital and enrolled in a clinical trial evaluating MI completed questionnaires that assessed smoking behavior and variables thought to be related to smoking. Confidence to quit smoking and negative beliefs about smoking were significant predictors of adolescents' baseline readiness to quit smoking. The failure to demonstrate relationships between health consequences and readiness suggest that caution may be warranted in the use of feedback, a common component of MI-based interventions. Such feedback tends to focus on health consequences, which was unrelated to adolescent baseline readiness to change smoking behavior in the current study. Parallels between current results and the Theory of Planned Behavior are discussed in consideration of developing more effective MI-based interventions for adolescent smokers.

  2. Psychosocial work environment, stress factors and individual characteristics among nursing staff in psychiatric in-patient care.

    PubMed

    Hanna, Tuvesson; Mona, Eklund

    2014-01-20

    The psychosocial work environment is an important factor in psychiatric in-patient care, and knowing more of its correlates might open up new paths for future workplace interventions. Thus, the aims of the present study were to investigate perceptions of the psychosocial work environment among nursing staff in psychiatric in-patient care and how individual characteristics--Mastery, Moral Sensitivity, Perceived Stress, and Stress of Conscience--are related to different aspects of the psychosocial work environment. A total of 93 nursing staff members filled out five questionnaires: the QPSNordic 34+, Perceived Stress Scale, Stress of Conscience Questionnaire, Moral Sensitivity Questionnaire, and Mastery scale. Multivariate analysis showed that Perceived Stress was important for Organisational Climate perceptions. The Stress of Conscience subscale Internal Demands and Experience in current units were indicators of Role Clarity. The other Stress of Conscience subscale, External Demands and Restrictions, was related to Control at Work. Two types of stress, Perceived Stress and Stress of Conscience, were particularly important for the nursing staff's perception of the psychosocial work environment. Efforts to prevent stress may also contribute to improvements in the psychosocial work environment.

  3. 42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... psychiatric facility which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Council on Accreditation of Services for Families and Children, the Commission on Accreditation...

  4. 42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... psychiatric facility which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Council on Accreditation of Services for Families and Children, the Commission on Accreditation...

  5. 42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... psychiatric facility which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Council on Accreditation of Services for Families and Children, the Commission on Accreditation...

  6. 42 CFR 440.160 - Inpatient psychiatric services for individuals under age 21.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... psychiatric facility which is accredited by the Joint Commission on Accreditation of Healthcare Organizations, the Council on Accreditation of Services for Families and Children, the Commission on Accreditation...

  7. Domains of Chronic Stress and Suicidal Behaviors among Inpatient Adolescents

    ERIC Educational Resources Information Center

    Pettit, Jeremy W.; Green, Kelly L.; Grover, Kelly E.; Schatte, Dawnelle J.; Morgan, Sharon T.

    2011-01-01

    Little is known about the role of chronic stress in youth suicidal behaviors. This study examined the relations between specific domains of chronic stress and suicidal behaviors among 131 inpatient youth (M age = 15.02 years) who completed measures of stress, suicidal ideation, suicide attempt, and suicide intent. After controlling for…

  8. Cannabis Use during Adolescent Development: Susceptibility to Psychiatric Illness.

    PubMed

    Chadwick, Benjamin; Miller, Michael L; Hurd, Yasmin L

    2013-10-14

    Cannabis use is increasingly pervasive among adolescents today, even more common than cigarette smoking. The evolving policy surrounding the legalization of cannabis reaffirms the need to understand the relationship between cannabis exposure early in life and psychiatric illnesses. cannabis contains psychoactive components, notably Δ(9)-tetrahydrocannabinol (THC), that interfere with the brain's endogenous endocannabinoid system, which is critically involved in both pre- and post-natal neurodevelopment. Consequently, THC and related compounds could potentially usurp normal adolescent neurodevelopment, shifting the brain's developmental trajectory toward a disease-vulnerable state, predisposing early cannabis users to motivational, affective, and psychotic disorders. Numerous human studies, including prospective longitudinal studies, demonstrate that early cannabis use is associated with major depressive disorder and drug addiction. A strong association between schizophrenia and cannabis use is also apparent, especially when considering genetic factors that interact with this environmental exposure. These human studies set a foundation for carefully controlled animal studies which demonstrate similar patterns following early cannabinoid exposure. Given the vulnerable nature of adolescent neurodevelopment and the persistent changes that follow early cannabis exposure, the experimental findings outlined should be carefully considered by policymakers. In order to fully address the growing issues of psychiatric illnesses and to ensure a healthy future, measures should be taken to reduce cannabis use among teens.

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

    ERIC Educational Resources Information Center

    Rosenstein, Diana S.; Horowitz, Harvey A.

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

  10. Sleep and its importance in adolescence and in common adolescent somatic and psychiatric conditions

    PubMed Central

    Brand, Serge; Kirov, Roumen

    2011-01-01

    Restoring sleep is strongly associated with a better physical, cognitive, and psychological well-being. By contrast, poor or disordered sleep is related to impairment of cognitive and psychological functioning and worsened physical health. These associations are well documented not only in adults but also in children and adolescents. Importantly, adolescence is hallmarked by dramatic maturational changes in sleep and its neurobiological regulation, hormonal status, and many psychosocial and physical processes. Thus, the role of sleep in mental and physical health during adolescence and in adolescent patients is complex. However, it has so far received little attention. This review first presents contemporary views about the complex neurobiology of sleep and its functions with important implications for adolescence. Second, existing complex relationships between common adolescent somatic/organic, sleep-related, and psychiatric disorders and certain sleep alterations are discussed. It is concluded that poor or altered sleep in adolescent patients may trigger and maintain many psychiatric and physical disorders or combinations of these conditions, which presumably hinder recovery and may cross into later stages of life. Therefore, timely diagnosis and management of sleep problems appear critical for growth and development in adolescent patients. PMID:21731894

  11. Integrating real-time feedback of outcome assessment for individual patients in an inpatient psychiatric setting: a case study of personalized psychiatric medicine.

    PubMed

    Confer, Jacob R; White, Melissa; Groat, Michael M; Madan, Alok; Allen, Jon G; Fowler, J Christopher; Kahn, David A

    2015-01-01

    Routine assessment of psychiatric patient outcomes is rare, despite growing evidence that feedback to clinicians and patients concerning patient progress improves treatment outcomes. The authors present a case in which real-time feedback proved beneficial in the treatment of a woman with a personality disorder admitted for inpatient treatment due to worsening depression, anxiety, severe suicide risk, and decline in functioning. During the course of her 10-week hospitalization, she completed standardized assessments of symptoms/functioning at admission, at 2 week intervals, and at discharge. The distinctive feature of this case is the way in which real-time feedback to the treatment team, psychiatrist, and patient exposed hidden treatment barriers. In the midst of an improving profile with decreasing symptom severity, the patient experienced a spike in distress and symptoms, prompting her treatment team to examine the treatment plan and to engage the patient around understanding the decline in functioning. This intervention revealed a replay of a familiar pattern in the patient's life that led to the identification and repair of a rupture in the therapeutic alliance and to an improvement in the patient's functioning. This case expands on previous research concerning the integration of individualized assessments into outpatient treatment and it illustrates the need to extend outpatient research to inpatient settings.

  12. Dissociative and Sexual Behaviors in Children and Adolescents with Sexual Abuse and Psychiatric Histories.

    ERIC Educational Resources Information Center

    Friedrich, William N.; Jaworski, Theresa M.; Huxsahl, John E.; Bengtson, Brad S.

    1997-01-01

    Evaluated children (N=350) to assess the degree to which dissociation and sexual behavior discriminated sexually abused children and adolescents from nonpsychiatric and psychiatric comparison groups. Results show that psychiatric and nonpsychiatric samples differed in their reports of sexual concerns and dissociation, whereas psychiatric abused…

  13. Psychosocial and Psychiatric Factors Associated with Adolescent Suicide: A Case-Control Psychological Autopsy Study

    ERIC Educational Resources Information Center

    Portzky, Gwendolyn; Audenaert, Kurt; van Heeringen, Kees

    2009-01-01

    This study aimed at the investigation of psychosocial and psychiatric risk factors of adolescent suicide by means of a case-control psychological autopsy study. Relatives and other informants of 19 suicide victims and 19 matched psychiatric controls were interviewed by means of a semi-structured interview schedule. Psychiatric controls included…

  14. Comorbidity of Psychiatric Disorders and Nicotine Dependence among Adolescents: Findings from a Prospective, Longitudinal Study

    ERIC Educational Resources Information Center

    Griesler, Pamela C.; Hu, Mei-Chen; Schaffram, Christine; Kandel, Denise B.

    2008-01-01

    The relationship between nicotine dependence and DSM-IV psychiatric disorders in 1,039 adolescents is examined. Findings revealed that psychiatric disorders most usually predicted the onset of the first basis of nicotine dependence while nicotine dependence does not appear to have an influence on the onset of psychiatric disorders. Other…

  15. Crack and Cocaine Use among Adolescents in Psychiatric Treatment: Associations with HIV Risk

    ERIC Educational Resources Information Center

    Tolou-Shams, Marina; Feldstein Ewing, Sarah W. Tarantino, Nicholas; Brown, Larry K.

    2010-01-01

    Crack and cocaine use among adults has been associated with co-occurring psychiatric disorders as well as other drug use and unprotected sex. However, this issue is relatively unstudied in adolescents. This study collected data from 282 adolescents (mean age = 14.9 years) treated in intensive psychiatric treatment settings to understand the…

  16. The Prevalence and Characteristics of Psychiatric Disorders among Adolescent Bedouin with Mild to Moderate Intellectual Disability

    ERIC Educational Resources Information Center

    Manor-Binyamini, Iris

    2010-01-01

    The aim of this study was to examine the prevalence and types of psychiatric disorders among Bedouin adolescents with mild to moderate intellectual disability. This is the first study ever conducted on this topic within the Bedouin community in the Negev in Israel. The issue of psychiatric disorders among adolescents with intellectual disability…

  17. Self-Concept and Physical Self-Concept in Psychiatric Children and Adolescents

    ERIC Educational Resources Information Center

    Simons, J.; Capio, C. M.; Adriaenssens, P.; Delbroek, H.; Vandenbussche, I.

    2012-01-01

    Self-concept is a widely examined construct in the area of psychiatric disorders. This study compared the Physical Self-Description Questionnaire (PSDQ) scores of adolescents with psychiatric disorders (N=103) with the results of a matched group of non-clinical adolescents (N=103). Self-concept and Physical self-concept were lower in the clinical…

  18. Religion/Spirituality and adolescent psychiatric symptoms: a review.

    PubMed

    Dew, Rachel Elizabeth; Daniel, Stephanie S; Armstrong, Tonya D; Goldston, David B; Triplett, Mary Frances; Koenig, Harold G

    2008-12-01

    The aim of the current article is to review the literature on religion and spirituality as it pertains to adolescent psychiatric symptoms. One hundred and fifteen articles were reviewed that examined relationships between religion/spirituality and adolescent substance use, delinquency, depression, suicidality, and anxiety. Ninety-two percent of articles reviewed found at least one significant (p < .05) relationship between religiousness and better mental health. Evidence for relationships between greater religiousness and less psychopathology was strongest in the area of teenage substance use. Methods of measuring religion/spirituality were highly heterogeneous. Further research on the relationship of religion/spirituality to delinquency, depression, suicidality, and anxiety is warranted. Measurement recommendations, research priorities, and clinical implications are discussed.

  19. Religion, spirituality, and depression in adolescent psychiatric outpatients.

    PubMed

    Dew, Rachel E; Daniel, Stephanie S; Goldston, David B; Koenig, Harold G

    2008-03-01

    This study examines in a preliminary manner the relationship between multiple facets of religion/spirituality and depression in treatment-seeking adolescents. One hundred seventeen psychiatric outpatients aged 12 to 18 completed the brief multidimensional measure of religiousness/spirituality, the Beck Depression Inventory (BDI), a substance abuse inventory. Controlling for substance abuse and demographic variables, depression was related to feeling abandoned or punished by God (p < 0.0001), feeling unsupported by one's religious community (p = 0.0158), and lack of forgiveness (p < 0.001). These preliminary results suggest that clinicians should assess religious beliefs and perceptions of support from the religious community as factors intertwined with the experience of depression, and consider the most appropriate ways of addressing these factors that are sensitive to adolescents' and families' religious values and beliefs.

  20. A brief intervention is sufficient for many adolescents seeking help from low threshold adolescent psychiatric services

    PubMed Central

    2010-01-01

    Background There has been a considerable increase in the need for psychiatric services for adolescents. Primary health care practitioners have a major role in detecting, screening and helping these adolescents. An intervention entitled SCREEN is described in this article. The SCREEN intervention was developed to help practitioners to detect and screen adolescent needs, to care for adolescents at the primary health care level and to facilitate the referral of adolescents to secondary care services in collaboration between primary and secondary health care. Secondly, the article presents the background and clinical characteristics of youths seeking help from the SCREEN services, and compares the background factors and clinical characteristics of those patients referred and not referred to secondary care services. Methods The SCREEN intervention consisted of 1 to 5 sessions, including assessment by a semi-structured anamnesis interview, the structured Global Assessment Scale, and by a structured priority rating scale, as well as a brief intervention for each adolescent's chosen problem. Parents took part in the assessment in 39% of cases involving girls and 50% involving boys. During 34 months, 2071 adolescents (69% females) entered the intervention and 70% completed it. The mean age was 17.1 years for boys and 17.3 years for girls. Results For 69% of adolescents, this was the first contact with psychiatric services. The most common reasons for seeking services were depressive symptoms (31%). Self-harming behaviour had occurred in 25% of girls and 16% of boys. The intervention was sufficient for 37% of those who completed it. Psychosocial functioning improved during the intervention. Factors associated with referral for further treatment were female gender, anxiety as the main complaint, previous psychiatric treatment, self-harming behaviour, a previous need for child welfare services, poor psychosocial functioning and a high score in the priority rating scale

  1. "Helicobacter Pylori" Infection in Five Inpatient Units for People with Intellectual Disability and Psychiatric Disorder

    ERIC Educational Resources Information Center

    Clarke, David; Vemuri, Murali; Gunatilake, Deepthi; Tewari, Sidhartha

    2008-01-01

    Background: A high prevalence of "Helicobacter pylori" infection has been reported among people with intellectual disability, especially those residing in hospital and similar settings. Surveys of inpatients have found unusually high rates of gastrointestinal malignancy, to which "H. pylori" infection predisposes. Methods: "Helicobacter pylori"…

  2. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases (under the prospective payment system set forth in subpart F of part 412 of... physician finds that the patient could receive proper treatment in a SNF but no bed is available in...

  3. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... of the patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases (under the prospective payment system set forth in... hospitalization if the physician finds that the patient could receive proper treatment in a SNF but no bed...

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

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... patient for medical treatment or medically required inpatient diagnostic study; or (ii) Special or unusual services for cost outlier cases (under the prospective payment system set forth in subpart F of part 412 of... physician finds that the patient could receive proper treatment in a SNF but no bed is available in...

  5. Mood and Anxiety Symptoms in Psychiatric Inpatients with Autism Spectrum Disorder and Depression

    ERIC Educational Resources Information Center

    Charlot, Lauren; Deutsch, Curtis K.; Albert, Aranya; Hunt, Anne; Connor, Daniel F.; McIlvane, William J., Jr.

    2008-01-01

    Recent reports suggest that individuals with autism spectrum disorders (ASD) may experience depression at a high frequency, yet few published studies address this issue, especially among adults. In the current investigation, we reviewed features of depression and comorbid traits among depressed inpatients with intellectual disabilities (ID) as a…

  6. The criterion validity of the Borderline Personality Features Scale for Children in an adolescent inpatient setting.

    PubMed

    Chang, Bonny; Sharp, Carla; Ha, Carolyn

    2011-08-01

    The purpose of the current study was to examine the criterion validity of the Borderline Personality Features Scale for Children (BPFS-C) by assessing the performance of the self-report and a newly developed parent report version of the measure (BPFS-P) in detecting a borderline personality disorder (BPD) diagnosis in adolescent inpatients. This study also examined parent-child agreement and the internal consistency of the BPFS subscales. An inpatient sample of adolescents (n = 51) ranging from ages 12-18 completed the BPFS and were administered the Child Interview for DSM-IV Borderline Personality Disorder (CI-BPD) by trained clinical research staff. ROC analyses revealed that the BPFS-C has high accuracy (AUC = .931; Se = .856; Sp = .840) in discriminating adolescents with a diagnosis of BPD, as measured by the CI-BPD, while the BPFS-P has moderate accuracy (AUC = .795; Se = .733; Sp = .720). Parent-child agreement on total scores was significant (r = .687; p < .005). Cronbach's alphas suggested internal consistency for the four subscales of the BPFS. These findings support the criterion validity of this measure, particularly the self-report version, in adolescent inpatient settings.

  7. Domestic Violence in Methamphetamine Psychotic Users, Psychiatric Inpatients, and Healthy People: A Comparative Study

    PubMed Central

    Khalkhali, Seyed Mohammad Rasoul; Najafi, Kiomars; Ahmadi, Reza; Yousefnezhad, Azadeh; Hamidi, Azam; Ellahi, Masoumeh; Amiri, Ali; Montakhabi, Afsar; Zavarmousavi, Maryam

    2016-01-01

    Background: Domestic violence is a serious threat to the physical and mental health of women. The aim of the present study was to find and compare the frequency of domestic violence between methamphetamine users, patients with psychiatric disorders, and healthy people. Methods: In this analytical cross-sectional study, methamphetamine users (n=30) and patients with psychiatric disorders (n=30) were women whose husbands were hospitalized during 2014 in Shafa Psychiatric Hospital in Guilan. Diagnosis was done with DSMIV-TR. Healthy people (n=60) were women whose husbands had no primary or drug induced psychiatric disorder or addiction. CTS-2 test was used to evaluate violence. Results: The frequency of psychological, physical and sexual violence in the groups suffering from psychiatric disease and methamphetamine users was higher than the healthy group (P=0.001). We observed a direct correlation between the mean of psychological and physical violence in the three groups (r=0.9, P=0.001), (r=0.7, P=0.0001) and (r=0.53, P=0.005), respectively. Direct correlation between the psychological and physical violence was only observed in the healthy group (r=0.8, P=0.007). Conclusion: The results showed that methamphetamine users such as psychiatric patients are at increased risk of violence. Domestic violence screening of these patients is necessary. It seems that this substance is a new source of increasing domestic violence with more undesirable outcomes in Iran. PMID:27853328

  8. Coping Strategies Associated With Suicidal Behaviour in Adolescent Inpatients With Borderline Personality Disorder

    PubMed Central

    Knafo, Alexandra; Guilé, Jean-Marc; Breton, Jean-Jacques; Labelle, Réal; Belloncle, Vincent; Bodeau, Nicolas; Boudailliez, Bernard; de la Rivière, Sébastien Garny; Kharij, Brahim; Mille, Christian; Mirkovic, Bojan; Pripis, Cornelia; Renaud, Johanne; Vervel, Christine; Cohen, David; Gérardin, Priscille

    2015-01-01

    Objectives: To compare the coping strategies of adolescents with borderline personality disorder (BPD) to the coping strategies of adolescents without BPD, and to explore the association of coping with suicidal ideation and attempts among adolescents with BPD. Method: Adolescent inpatients (n = 167) aged 13 to 17 years were admitted after suicide attempts and evaluated within 10 days, using the abbreviated version of the Diagnostic Interview for Borderlines–Revised, the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version supported by a team consensus best estimate method for the primary diagnosis, the Adolescent Coping Scale, and the Columbia-Suicide Severity Rating Scale. Results: Firstly, compared with adolescents without BPD, adolescents with BPD relied more on nonproductive coping strategies, mostly avoidant strategies, and less on productive coping strategies. Secondly, coping appeared as a factor associated with suicidal ideation in adolescents with BPD. While while controlling for age, sex, and depression, multivariate analyses showed a significant positive association between the coping strategy to focusing on solving the problem and suicidal ideation. Conclusion: The use of avoidant strategies by adolescents with BPD could be viewed as attempts to increase emotional regulation. Problem-solving strategies in the immediate aftermath of a suicide attempt may prevent adolescents with BPD from overcoming a crisis and may increase suicidal ideation. PMID:25886671

  9. Stigma, Social Structure, and the Biomedical Framework: Exploring the Stigma Experiences of Inpatient Service Users in Two Belgian Psychiatric Hospitals.

    PubMed

    Sercu, Charlotte; Bracke, Piet

    2016-05-31

    The study discusses the stigma experiences of service users in mental health care, within the debate on the role of the biomedical framework for mental health care and power relations in society. Interview data of inpatient users (n = 42) and care providers (n = 43) from two Belgian psychiatric hospitals were analyzed using a constructivist grounded theory approach: Findings offer insight into how stigma experiences are affected by social structure. Stigma seemed to be related to the relation between care providers and service users their social position. The concept "mental health literacy" is used to frame this finding. In paying attention to the specific cultural and normative context, which influences the relationship between mental health literacy and stigma, it is further possible to cast some light on the meaning of the biomedical model for the construction and maintenance of power relations in mental health care and broader society.

  10. Development of the Observation Scale for Aggressive Behavior (OSAB) for Dutch forensic psychiatric inpatients with an antisocial personality disorder.

    PubMed

    Hornsveld, Ruud H J; Nijman, Henk L I; Hollin, Clive R; Kraaimaat, Floor W

    2007-01-01

    The Observation Scale for Aggressive Behavior (OSAB) has been developed to evaluate inpatient treatment programs designed to reduce aggressive behavior in Dutch forensic psychiatric patients with an antisocial personality disorder, who are "placed at the disposal of the government". The scale should have the sensitivity to measure changes in the possible determinants of aggressive behavior, such as limited control of displayed negative emotions (irritation, anger or rage) and a general deficiency of social skills. In developing the OSAB 40 items were selected from a pool of 82 and distributed among the following a priori scales: Irritation/anger, Anxiety/gloominess, Aggressive behavior, Antecedent (to aggressive behavior), Sanction (for aggressive behavior) and Social behavior. The internal consistency of these subscales was good, the inter-rater reliability was moderate to good, and the test-retest reliability over a two to three week period was moderate to good. The correlation between the subscales Irritation/anger, Anxiety/gloominess, Aggressive behavior, Antecedent, Sanction was substantial and significant, but the anticipated negative correlation between these subscales and the Social behavior subscale could not be shown. Relationships between the corresponding subscales of the OSAB and the FIOS, used to calculate concurrent validity, yielded relatively high correlations. The validity of the various OSAB subscales could be further supported by significant correlations with the PCL-R and by significant but weak correlations with corresponding subscales of the self-report questionnaires. The Observation Scale for Aggressive Behavior (OSAB) seems to measure aggressive behavior in Dutch forensic psychiatric inpatients with an antisocial personality disorder reliably and validly. Contrary to expectations, a negative relationship was not found between aggressive and social behavior in either the OSAB or FIOS, which were used for calculating concurrent validity.

  11. Curriculum development: Preparing trainees to care for children and adolescents with psychiatric disorders.

    PubMed

    Foley, Kimberly P; Haggerty, Treah S; Harrison, Natasha

    2015-01-01

    Family physicians provide care for about one-third of the children and adolescents in the United States, many of whom present with psychological concerns. Family physicians often do not recognize these psychological disorders and therefore do not diagnose or treat them. This report describes the implementation of a curriculum designed to increase family medicine trainees' level of awareness that children/adolescents experience psychiatric conditions. This goal is achieved through the addition of a clinical child/adolescent psychologist faculty member, resident self-assessment of training needs and subsequent development of didactic presentations to address these needs. The curriculum relies on the acquisition of child/adolescent psychiatric screeners, development of child/adolescent-focused bibliotherapy materials, and the development of a longitudinal behavioral sciences curriculum. To facilitate the screening of child/adolescent psychiatric disorders, a comprehensive collection of age-appropriate psychiatric screeners were compiled and made readily available in all precepting areas. To assist with the identification of specific child/adolescent psychiatric deficit areas, family medicine resident physicians were presented with an inventory of child/adolescent psychiatric, psychosocial, and behavioral topics, based upon American Academy of Family Practice guidelines and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition psychiatric disorders, and self-selected training deficiencies.

  12. Medicare program; inpatient rehabilitation facility prospective payment system for federal fiscal year 2012; changes in size and square footage of inpatient rehabilitation units and inpatient psychiatric units. Final rule.

    PubMed

    2011-08-05

    This final rule will implement section 3004 of the Affordable Care Act, which establishes a new quality reporting program that provides for a 2 percent reduction in the annual increase factor beginning in 2014 for failure to report quality data to the Secretary of Health and Human Services. This final rule will also update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for Federal fiscal year (FY) 2012 (for discharges occurring on or after October 1, 2011 and on or before September 30, 2012) as required under section 1886(j)(3)(C) of the Social Security Act (the Act). Section 1886(j)(5) of the Act requires the Secretary to publish in the Federal Register on or before the August 1 that precedes the start of each FY the classification and weighting factors for the IRF prospective payment system (PPS) case-mix groups and a description of the methodology and data used in computing the prospective payment rates for that fiscal year. We are also consolidating, clarifying, and revising existing policies regarding IRF hospitals and IRF units of hospitals to eliminate unnecessary confusion and enhance consistency. Furthermore, in accordance with the general principles of the President's January 18, 2011 Executive Order entitled "Improving Regulation and Regulatory Review," we are amending existing regulatory provisions regarding ''new'' facilities and changes in the bed size and square footage of IRFs and inpatient psychiatric facilities (IPFs) to improve clarity and remove obsolete material.

  13. Negative life events and non-suicidal self-injury in an adolescent inpatient sample.

    PubMed

    Liu, Richard T; Frazier, Elisabeth A; Cataldo, Andrea M; Simon, Valerie A; Spirito, Anthony; Prinstein, Mitchell J

    2014-01-01

    Although life stressors have been implicated in the aetiology of various forms of psychopathology related to non-suicidal self-injury (NSSI), particularly depression and suicidal behavior, they have rarely been examined in relation with NSSI. The objective of the current study was to assess the association between life stressors and NSSI in adolescent inpatients. Adolescent inpatients (n = 110) completed measures of life events, NSSI, and depressive symptoms at 3 time-points over a 9-month period. Higher rates of life stressors were significantly associated with greater NSSI. This finding held even after covarying concurrent depressive symptoms and gender. Life stressors may have a unique role in the pathogenesis of NSSI. Directions for future research and clinical implications are discussed.

  14. Negative Life Events and Non-Suicidal Self-Injury in an Adolescent Inpatient Sample

    PubMed Central

    Liu, Richard T.; Frazier, Elisabeth A.; Cataldo, Andrea M.; Simon, Valerie A.; Spirito, Anthony; Prinstein, Mitchell J.

    2014-01-01

    Objective Although life stressors have been implicated in the aetiology of various forms of psychopathology related to non-suicidal self-injury (NSSI), particularly depression and suicidal behavior, they have rarely been examined in relation with NSSI. The objective of the current study was to assess the association between life stressors and NSSI in adolescent inpatients. Methods Adolescent inpatients (n = 110) completed measures of life events, NSSI, and depressive symptoms at three time-points over a nine-month period. Results Higher rates of life stressors were significantly associated with greater NSSI. This finding held even after covarying concurrent depressive symptoms and gender. Conclusion Life stressors may have a unique role in the pathogenesis of NSSI. Directions for future research and clinical implications are discussed. PMID:24712970

  15. Use of movies for group therapy of psychiatric inpatients: theory and practice.

    PubMed

    Yazici, Esra; Ulus, Fuat; Selvitop, Rabia; Yazici, Ahmet Bülent; Aydin, Nazan

    2014-04-01

    This paper reports on the use of cinema therapy at a psychiatry clinic for inpatients. The program, "Watching Cinema Group Therapy," was used with over 500 inpatients over the course of one year. We found that using movies for group psychotherapy sessions encouraged the patients to talk about their beliefs, thoughts, and feelings while discussing the characters and stories. We also used the movies as a reward for patients who had developed a therapeutic alliance. It motivated the patients to be active instead of simply remaining in their rooms. As a follow-up to full-length films, it was more useful to show short scenes to patients who had been administered high doses of drugs. Movies can be an important, positive, and productive means of treatment and teaching.

  16. Predictors of non-drug psychiatric/psychotherapeutic treatment in children and adolescents with mental or behavioural disorders.

    PubMed

    Abbas, Sascha; Ihle, Peter; Adler, Jürgen-Bernhard; Engel, Susanne; Günster, Christian; Holtmann, Martin; Kortevoss, Axel; Linder, Roland; Maier, Werner; Lehmkuhl, Gerd; Schubert, Ingrid

    2017-04-01

    Children and adolescents with mental health problems need effective and safe therapies to support their emotional and social development and to avoid functional impairment and progress of social deficits. Though psychotropic drugs seem to be the preferential treatment, psychotherapy and psychosocial interventions are essential in mental health care. For Germany, current data on the utilization of psychotherapy and psychosocial interventions in children with mental health problems is lacking. To analyse why certain children and adolescents with mental or behavioural disorders do and others do not receive non-drug treatment, we assessed predictors associated with specific non-drug psychiatric/psychotherapeutic treatment including psychosocial interventions, psychotherapy and other non-drug treatments. The study is based on data of two large German health insurance funds, AOK and TK, comprising 30 % of the German child and adolescent population. Predictors of non-drug psychiatric/psychotherapeutic treatment were analysed for 23,795 cases and two controls for every case of the same age and sex in children aged 0-17 years following a new diagnosis of mental or behavioural disorder in 2010. Predictors were divided according to Andersen's behavioural model into predisposing, need and enabling factors. The most prominent and significant predictors positively associated with non-drug psychiatric/psychotherapeutic treatment were the residential region as predisposing factor; specific, both ex- and internalizing, mental and behavioural disorders, psychiatric co-morbidity and psychotropic drug use as need factors; and low area deprivation and high accessibility to outpatient physicians and inpatient institutions with non-drug psychiatric/psychotherapeutic department as enabling factors. In conclusion, the present study suggests that the residential region as proxy for supply of therapist and socioeconomic situation is an influencing factor for the use of psychotherapy. The

  17. Domains of chronic stress and suicidal behaviors among inpatient adolescents.

    PubMed

    Pettit, Jeremy W; Green, Kelly L; Grover, Kelly E; Schatte, Dawnelle J; Morgan, Sharon T

    2011-01-01

    Little is known about the role of chronic stress in youth suicidal behaviors. This study examined the relations between specific domains of chronic stress and suicidal behaviors among 131 inpatient youth (M age = 15.02 years) who completed measures of stress, suicidal ideation, suicide attempt, and suicide intent. After controlling for demographics, diagnostic status, past history of attempt, and life event stress, the predictors of suicidal ideation were chronic stress in family relationships, close friendship, and physical health. Chronic close friendship stress also predicted suicide intent among attempters after controlling for covariates. No domain robustly predicted the presence of an attempt or moderated the relation between life event stress and suicidal behaviors. These findings highlight the role of certain domains of chronic stress in suicidal ideation and suicide intent.

  18. ADHD and Aggression as Correlates of Suicidal Behavior in Assaultive Prepubertal Psychiatric Inpatients

    ERIC Educational Resources Information Center

    Goodman, Geoff; Gerstadt, Cherie; Pfeffer, Cynthia R.; Stroh, Martha; Valdez, Adina

    2008-01-01

    Forty-three psychiatrically hospitalized prepubertal children were assessed regarding their assaultive and suicidal behaviors. These children were subsequently classified into two groups, assaultive/suicidal (AS) and assaultive-only (AO). AS children had higher aggression and suicidal-scale scores, but not higher depression scores, and were more…

  19. Reading Problems, Psychiatric Disorders, and Functional Impairment from Mid- To Late Adolescence.

    ERIC Educational Resources Information Center

    Goldston, David B.; Walsh, Adam; Mayfield Arnold, Elizabeth; Reboussin, Beth; Sergent Daniel, Stephanie; Erkanli, Alaattin; Nutter, Dennis; Hickman, Enith; Palmes, Guy; Snider, Erica; Wood, Frank B.

    2007-01-01

    Objective: To examine psychiatric morbidity and functional impairment of adolescents with and without poor reading skills during mid- to late adolescence. Method: The sample consisted of 188 adolescents, 94 with poor reading skills and 94 with typical reading skills, screened from a larger sample in the public schools at age 15. To assess…

  20. Psychiatric Disorders in a Sample of Saudi Arabian Adolescents with Sickle Cell Disease

    ERIC Educational Resources Information Center

    Amr, Mostafa Abdel-Monhem; Amin, Tarek Tawfik; Hablas, Hatem Refaat

    2010-01-01

    The objectives of this study were to determine the magnitude of psychiatric disorders and to define socio-demographic and disease-related risk factors in a sample of adolescents with SCD in Al-Hassa, Saudi Arabia. The sample consisted of 110 adolescents with SCD and a convenient sample of 202 adolescents without SCD as controls. Psychiatric…

  1. Associations between problematic gaming and psychiatric symptoms among adolescents in two samples.

    PubMed

    Vadlin, Sofia; Åslund, Cecilia; Hellström, Charlotta; Nilsson, Kent W

    2016-10-01

    The aim of the present study was to investigate associations between problematic gaming and psychiatric symptoms among adolescents. Data from adolescents in the SALVe cohort, including adolescents in Västmanland who were born in 1997 and 1999 (N=1868; 1034 girls), and data from consecutive adolescent psychiatric outpatients in Västmanland (N=242; 169 girls) were analyzed. Adolescents self-rated on the Gaming Addiction Identification Test (GAIT), Adult ADHD Self-Report Scale Adolescent version (ASRS-A), Depression Self-Rating Scale Adolescent version (DSRS-A), Spence Children's Anxiety Scale (SCAS), and psychotic-like experiences (PLEs). Multivariable logistic regression analyses were performed, and adjusted for sex, age, study population, school bullying, family maltreatment, and interactions by sex, with two-way interactions between psychiatric measurements. Boys had higher self-rated problematic gaming in both samples, whereas girls self-rated higher in all psychiatric domains. Boys had more than eight times the probability, odds ratio (OR), of having problematic gaming. Symptoms of ADHD, depression and anxiety were associated with ORs of 2.43 (95% CI 1.44-4.11), 2.47 (95% CI 1.44-4.25), and 2.06 (95% CI 1.27-3.33), respectively, in relation to coexisting problematic gaming. Problematic gaming was associated with psychiatric symptoms in adolescents; when problematic gaming is considered, the probability of coexisting psychiatric symptoms should also be considered, and vice versa.

  2. Subgrouping with psychiatric inpatients in group psychotherapy: linking dependency and counterdependency.

    PubMed

    Spivack, Neal

    2008-04-01

    Abstract A model of inpatient group psychotherapy that focuses on two frequently observed patient subgroups reflecting contrasting attitudes toward authority is presented. The counterdependent subgroup overly values autonomy, opposes unit restrictions, and rejects treatment. The dependent subgroup tends to accept the unit's treatment and structure but is overly passive. In this model these attitudes are addressed in order to help patients adapt to the unit and to facilitate discharge. The author describes a three-stage group designed to help patients achieve these goals.

  3. Tics and psychiatric comorbidity in children and adolescents.

    PubMed

    Gadow, Kenneth D; Nolan, Edith E; Sprafkin, Joyce; Schwartz, Joseph

    2002-05-01

    This study examined comorbid psychiatric symptoms in a large, community-based sample of children and adolescents. The study sample comprised a total of 3006 school children: 413 preschool (3 to 5 years; 237 males, 176 females; mean age 4 years 2 months, SD 8 months), 1520 elementary school (5 to 12 years; 787 males, 733 females; mean age 8 years 2 months, SD 1 year 11 months), and 1073 secondary school children (12 to 18 years; 573 males, 500 females; mean age 14 years 4 months, SD 1 year 10 months), all of whom were attending regular education programs. Children were evaluated with a teacher-completed DSM-IV-referenced rating scale. The sample was divided into four groups: attention-deficit-hyperactivity disorder with tics (ADHD+tics), ADHD without tics (ADHD), tics without ADHD (T), and a comparison group i.e. neither ADHD nor tics (Non). The percentage of children with tic behaviors varied with age: preschool children (22.3%), elementary school children (7.8%), and adolescents (3.4%). Tic behaviors were more common in males than females, regardless of comorbid ADHD symptoms. For many psychiatric symptoms, screening prevalence rates were highest for the ADHD groups (ADHD+tics>ADHD>T>Non). However, obsessive-compulsive and simple and social phobia symptoms were more common in the groups with tic behavior. Findings for a community-based sample show many similarities with studies of clinically referred samples suggesting that teacher-completed ratings of DSM-IV symptoms may be a useful methodology for investigating the phenomenology of tic disorders.

  4. Medicare program; inpatient psychiatric facilities prospective payment system--update for fiscal year beginning October 1, 2014 (FY 2015). Final rule.

    PubMed

    2014-08-06

    This final rule will update the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs). These changes will be applicable to IPF discharges occurring during the fiscal year (FY) beginning October 1, 2014 through September 30, 2015. This final rule will also address implementation of ICD-10-CM and ICD-10-PCS codes; finalize a new methodology for updating the cost of living adjustment (COLA), and finalize new quality measures and reporting requirements under the IPF quality reporting program.

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

    PubMed Central

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

    2013-01-01

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

  6. Cognitive and social factors associated with NSSI and suicide attempts in psychiatrically hospitalized adolescents.

    PubMed

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

    2013-08-01

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

  7. Abuse, depressive symptoms, executive functioning, and overgeneral memory among a psychiatric sample of children and adolescents.

    PubMed

    Valentino, Kristin; Bridgett, David J; Hayden, Lisa C; Nuttall, Amy K

    2012-01-01

    Prior research has established the independent associations of depressive symptoms and childhood trauma to overgeneral memory (OGM); the present study addresses the potentially interactive effects between these two risk factors on OGM. In addition, the current study comprehensively evaluates whether executive functions (EF) mediate the relation between depressive symptoms and/or abuse to OGM in a child and adolescent sample. OGM was assessed among an inpatient-psychiatric sample of 49 youth (ages 7-17) with, and without, child abuse histories and depressive symptomatology. EF was assessed with standardized neuropsychological measures of verbal fluency, inhibition, and cognitive flexibility. There was a significant interaction of depressive symptoms and abuse in predicting OGM; the effect of depression on OGM was less pronounced among youth with abuse histories, who had elevated OGM at both low and high depressive symptoms relative to those with no abuse and low depressive symptoms. Among the EF measures, only category fluency was associated with OGM. An additive, rather than mediational, model was supported, whereby category fluency accounted for a significant proportion of variance in OGM above child abuse and depressive symptoms. The meaning of these findings for models of OGM and clinical practice are emphasized.

  8. Parent-youth agreement on symptoms and diagnosis: assessment with a diagnostic interview in an adolescent inpatient clinical population.

    PubMed

    Lauth, Bertrand; Arnkelsson, Guðmundur B; Magnússon, Páll; Skarphéðinsson, Guðmundur Á; Ferrari, Pierre; Pétursson, Hannes

    2010-12-01

    Diagnostic information on adolescents may be elicited from both youths and their parents, especially for depressive and suicidal symptomatology. The objective of this study was to examine the degree of agreement between parent and adolescent reports of major psychiatric disorders, at the diagnostic and at the symptom level, in a severely affected inpatient clinical population. 64 parent-adolescent pairs were interviewed separately with the semi-structured diagnostic interview Kiddie-SADS-PL. Symptomatology was also assessed with 11 self-report and parent-report scales, all translated, adapted and in most cases validated in Iceland. A total of 25 subscales were included to assess emotional dimensions such as depression or anxiety and cognitive dimensions such as attention deficit or self-concept. Good agreement was found for social phobia and fair agreement for generalized anxiety disorder. Although parent-youth agreement was poor in most cases at the symptoms level, significant correlations indicated consistency for most severity scores, except those related to depressive symptomatology, attention deficit, separation anxiety or conduct disorder. The low agreement between reports of suicidal ideation is in line with results from previous studies and suggests that parents might under- or over-estimate this symptomatology. The combination of data obtained with diagnostic interviews and rating-scales confirmed results from prior empirical work, giving greater weight to parents' reports of observable behavior and to adolescents' reports of subjective experiences, especially depressive symptomatology. Our findings suggest that both parent and child informants are necessary to obtain adequate assessments in adolescents. Further research should explore the correspondence between discrepant diagnoses and external criteria such as parental psychopathology or parent-child relationships and attachment. Psychoanalysis could benefit from cognitive neuroscience and use cognitive

  9. Placebo effect in child and adolescent psychiatric trials.

    PubMed

    Parellada, Mara; Moreno, Carmen; Moreno, Miguel; Espliego, Ana; de Portugal, Enrique; Arango, Celso

    2012-11-01

    Much literature has been written in the field of child psychiatry regarding the placebo as a tool to test drug efficacy in clinical trials, but quite little regarding the placebo effect itself or its clinical use in child psychiatry. In this article, we aim to critically review the literature regarding the placebo effect in children and adolescents with mental disorders, focusing especially on factors influencing the placebo effect and how they may influence the interpretation of clinical trials. The placebo effect seems to be more marked in children than adults, and particularly in children and adolescents with depression, although it is pervasive across ages and is present in non-psychiatric conditions as well. The use of a placebo in clinical trials as a comparator with drugs that have moderate efficacy at most makes it difficult to obtain positive results, and much effort is needed to design very high quality clinical trials that may overcome the limitations of using a placebo. In addition, the placebo effect across ages and clinical conditions must be tested directly (compared with no treatment whenever possible), in order to characterise which placebos work for what and to determine their use in clinical settings.

  10. Cost analysis of inpatient treatment of anorexia nervosa in adolescents: hospital and caregiver perspectives

    PubMed Central

    Wong, Matthew; Katzman, Debra K.; Akseer, Nadia; Steinegger, Cathleen; Hancock-Howard, Rebecca L.; Coyte, Peter C.

    2015-01-01

    Background Admission to hospital is the treatment of choice for anorexia nervosa in adolescent patients who are medically unstable; however, stays are often prolonged and frequently disrupt normal adolescent development, family functioning, school and work productivity. We sought to determine the costs of inpatient treatment in this population from a hospital and caregiver perspective, and to identify determinants of such costs. Methods We used micro-costing methods for this cohort study involving all adolescent patients (age 12–18 yr) admitted for treatment of anorexia nervosa at a tertiary care child and adolescent eating disorder program in Toronto, between Sept. 1, 2011, and Mar. 31, 2013. We used hospital administrative data and Canadian census data to calculate hospital and caregiver costs. Results We included 73 adolescents in our cohort for cost-analysis. We determined a mean total hospital cost in 2013 Canadian dollars of $51 349 (standard deviation [SD] $26 598) and a mean total societal cost of $54 932 (SD $27 864) per admission, based on a mean length of stay of 37.9 days (SD 19.7 d). We found patient body mass index (BMI) to be the only significant negative predictor of hospital cost (p < 0.001). For every unit increase in BMI, we saw a 15.7% decrease in hospital cost. In addition, we found higher BMI (p < 0.001) and younger age (p < 0.05) to be significant negative predictors of caregiver costs. Interpretation The economic burden of inpatient treatment for adolescents with anorexia nervosa on hospitals and caregivers is substantial, especially among younger patients and those with lower BMI. Recognizing the symptoms of eating disorders early may preclude the need for admission to hospital altogether or result in admissions at higher BMIs, thereby potentially reducing these costs. PMID:26389097

  11. Psychiatric Disorders and Sexual Risk among Adolescents in Mental Health Treatment

    PubMed Central

    Brown, Larry K.; Hadley, Wendy; Stewart, Angela; Lescano, Celia; Whiteley, Laura; Donenberg, Geri; DiClemente, Ralph

    2010-01-01

    Objective To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and limited. Method Eight hundred and forty adolescents (56% female, 58% African American, mean age 14.9 years) and their parents completed computerized assessments of psychiatric symptoms via the Computerized Diagnostic Interview Schedule for Children (C-DISC). Adolescents also reported on sexual risk behaviors (vaginal/anal sex, condom use at last sex) and completed urine screens for a sexually transmitted infection (STI). Results Adolescents meeting criteria for Mania, externalizing disorder (Oppositional Defiant, Conduct, and Attention Deficit Hyperactivity Disorders) or comorbid internalizing (Major Depressive, Generalized Anxiety, and Post-Traumatic Stress Disorders) and externalizing disorders were significantly more likely to report a lifetime history of vaginal or anal sex than those who did not meet criteria for any psychiatric disorder (OR = 2.0, 2.3 and 1.9, respectively). Adolescents meeting criteria for Mania were significantly more likely to have two or more partners in the past 90 days (OR= 3.2) and test positive for a STI (OR = 4.3) relative to adolescents who did not meet criteria for a psychiatric disorder. Conclusions The presence of internalizing and externalizing disorders, especially Mania, suggests the need for careful screening and targeting of adolescent sexual behavior during psychiatric treatment. PMID:20658815

  12. A Study of the Most Cost Effective Method of Providing Short Term Inpatient Psychiatric Care in the Washington, DC Catchment Area

    DTIC Science & Technology

    1984-06-01

    where care was provided to include the average length of stay for the short term psychiatric patient, total cost per hospital encounter as well as...for short term inpatient psychiatric care. This figure multiplied by the average length of stay and the projected number of CNA renders a range for...in FY 1983 estimates that the average length of stay (ALOS) in days is 54.2.15 This ALOS is elevated to 58 days when the Washington, D.C. catchment

  13. 'Shared-rhythm cooperation' in cooperative team meetings in acute psychiatric inpatient care.

    PubMed

    Vuokila-Oikkonen, P; Janhonen, S; Vaisanen, L

    2004-04-01

    The cooperative team meeting is one of the most important interventions in psychiatric care. The purpose of this study was to describe the participation of patients and significant others in cooperative team meetings in terms of unspoken stories. The narrative approach focused on storytelling. The data consisted of videotaped cooperative team meetings (n = 11) in two acute closed psychiatric wards. The QRS NVivo computer program and the Holistic Content Reading method were used. During the process of analysis, the spoken and unspoken stories were analysed at the same time. According to the results, while there was some evident shared-rhythm cooperation (the topics of discussion were shared and the participants had eye contact), there were many instances where the interaction was controlled and defined by health care professionals. This lack of shared rhythm in cooperation, as defined in terms of storytelling, was manifested as monologue and the following practices: the health care professionals controlled the storytelling by sticking to their opinions, by giving the floor or by pointing with a finger and visually scanning the participants, by interrupting the speaker or by allowing the other experts to sit passively. Implications for mental health nursing practice are discussed.

  14. The Role of Parenting Styles in the Relation Between Functions of Aggression and Internalizing Symptoms in a Child Psychiatric Inpatient Population.

    PubMed

    Pederson, Casey A; Rathert, Jamie L; Fite, Paula J; Stoppelbein, Laura; Greening, Leilani

    2016-10-01

    Psychiatric inpatient hospitalization is a costly intervention for youth. With rates of hospitalization rising, efforts to refine prevention and intervention are necessary. Aggression often precedes severe internalizing behaviors, and proactive and reactive functions of aggression are differentially associated with internalizing symptomatology. Thus, further understanding of the links between functions of aggression and internalizing symptomatology could aid in the improvement of interventions for hospitalized youth. The current study examined parenting styles, gender, and age as potential moderators of the relations between proactive and reactive aggression and internalizing symptoms. Participants included 392 children, 6-12 years of age admitted consecutively to a psychiatric inpatient unit. Reactive aggression was uniquely associated with anxiety symptoms. However, proactive aggression was associated with internalizing problems only when specific parenting styles and demographic factors were present. Although both proactive and reactive subtypes of aggression were associated with internalizing symptoms, differential associations were evident. Implications of findings are discussed.

  15. Emergency Presentations to an Inner-City Psychiatric Service for Children and Adolescents

    ERIC Educational Resources Information Center

    Dil, L. M.; Vuijk, P. J.

    2012-01-01

    Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of the function of mental health services in the…

  16. Inpatient forensic-psychiatric care: Legal frameworks and service provision in three European countries.

    PubMed

    Edworthy, Rachel; Sampson, Stephanie; Völlm, Birgit

    2016-01-01

    Laws governing the detention and treatment of mentally disordered offenders (MDOs) vary widely across Europe, yet little information is available about the features of these laws and their comparative advantages and disadvantages. The purpose of this article is to compare the legal framework governing detention in forensic psychiatric care in three European countries with long-established services for MDOs, England, Germany and the Netherlands. A literature review was conducted alongside consultation with experts from each country. We found that the three countries differ in several areas, including criteria for admission, review of detention, discharge process, the concept of criminal responsibility, service provision and treatment philosophy. Our findings suggest a profound difference in how each country relates to MDOs, with each approach contributing to different pathways and potentially different outcomes for the individual. Hopefully making these comparisons will stimulate debate and knowledge exchange on an international level to aid future research and the development of best practice in managing this population.

  17. An in-house prevocational training program for newly discharged psychiatric inpatients: exploring its employment outcomes and the predictive factors.

    PubMed

    Chuang, Wen-Fang; Hwang, Eric; Lee, Hui-Ling; Wu, Shang-Liang

    2015-06-01

    Individuals with severe mental disorders continue to experience low employment rates. Occupational therapists play an important role in helping these individuals develop the skills and obtain the supports necessary for productive living. This retrospective cohort study aimed to explore employment outcomes and identify factors predictive of the outcomes of an in-house prevocational training program designed for newly discharged psychiatric inpatients. Data retrieved from the files of 58 participants including demographics, diagnostic history, physical fitness, functional assessment results, the use of vocational counselling service and employment status were analyzed. The overall employment rates among the participants were high (67.2-79.3%) within the 6 months following the prevocational training program. No significant differences were found in the employment rates across the 1, 3 and 6-month time periods post-training. Vocational counselling service post-training and hand function were two factors predictive of participants' employment outcomes. Occupational therapists should attend to the clients' need for continuous vocational support and carefully identify the personal, functional and environmental factors contributing to successful employment. Caution in interpreting the results is warranted because of the lack of control and randomization in this retrospective study. Additional longitudinal cohort or experimental studies would add further certainty to the current findings.

  18. Length of psychiatric hospitalization is correlated with CYP2D6 functional status in inpatients with major depressive disorder

    PubMed Central

    Ruaño, Gualberto; Szarek, Bonnie L; Villagra, David; Gorowski, Krystyna; Kocherla, Mohan; Seip, Richard L; Goethe, John W; Schwartz, Harold I

    2016-01-01

    Aim This study aimed to determine the effect of the CYP2D6 genotype on the length of hospitalization stay for patients treated for major depressive disorder. Methods A total of 149 inpatients with a diagnosis of major depressive disorder at the Institute of Living, Hartford Hospital (CT, USA), were genotyped to detect altered alleles in the CYP2D6 gene. Prospectively defined drug metabolism indices (metabolic reserve, metabolic alteration and allele alteration) were determined quantitatively and assessed for their relationship to length of hospitalization stay. Results Hospital stay was significantly longer in deficient CYP2D6 metabolizers (metabolic reserve <2) compared with functional or suprafunctional metabolizers (metabolic reserve ≥2; 7.8 vs 5.7 days, respectively; p = 0.002). Conclusion CYP2D6 enzymatic functional status significantly affected length of hospital stay, perhaps due to reduced efficacy or increased side effects of the medications metabolized by the CYP2D6 isoenzyme. Functional scoring of CYP2D6 alleles may have a substantial impact on the quality of care, patient satisfaction and the economics of psychiatric treatment. PMID:23734807

  19. The Psychosocial Characteristics Associated with NSSI and Suicide Attempt of Youth Admitted to an In-patient Psychiatric Unit

    PubMed Central

    Preyde, Michèle; Vanderkooy, John; Chevalier, Pat; Heintzman, John; Warne, Amanda; Barrick, Kendra

    2014-01-01

    Introduction: The purpose of this study was to explore the prevalence of self-harm and the psychosocial factors associated with self-harming behaviours in youth admitted to an in-patient psychiatric unit. Methods: Cross-sectional surveys of standardized measures were administered to youth and a separate survey to their caregivers while the youth were in hospital. Results: The mean age of the 123 youth who participated was 15.74 (SD 1.51) years, and 90 of 121 (74.38%) reported being female. Of the 115 who completed this question, 101 (87.83%) indicated that they thought of injuring themselves and 89 (77.39%) did engage in NSSI within the past month, and 78 of 116 (67%) reported that they had made an attempt to take their life. Youth who reported that they had attempted suicide (lifetime) reported significantly less difficulty with emotion regulation than youth who engaged in NSSI only, or both NSSI and suicide attempts. Conclusions: These youth reported a very high prevalence of self-harm, and in general substantial difficulty with regulating their emotions, and difficulty with their interpersonal relationships. The psychosocial distinctions evident between groups may have practical utility. PMID:24872825

  20. Adverse Childhood Experiences Among Inpatient Youths with Severe and Early-Onset Psychiatric Disorders: Prevalence and Clinical Correlates.

    PubMed

    Benarous, Xavier; Raffin, Marie; Bodeau, Nicolas; Dhossche, Dirk; Cohen, David; Consoli, Angèle

    2017-04-01

    This study aimed to determine the prevalence and the clinical correlates of Adverse Childhood Experiences (ACEs) among 158 inpatient youths with two types of severe psychiatric disorders. ACEs were retrospectively collected with the ACEs scale and the List of Threatening Experiences Questionnaire in 77 patients hospitalized for a catatonic syndrome (average age 15.2 years) and 81 for a manic or mixed episode (average age 15.7 years). ACEs were frequent in youths suffering from bipolar disorder type I (BD-I) (58 %) and from catatonia (57 %), with around one quarter exposed to severe abuse (i.e., physical/sexual/emotional abuse or physical/emotional neglect). Youths with BD-I were more likely to be exposed to family violence compared to those with catatonia. Youths who had been exposed to ACEs did not exhibit a more severe presentation or a poorer response to treatment compared to others, either in the bipolar group or in the catatonic group.

  1. The impact of trauma on the onset of mental health symptoms, aggression, and criminal behavior in an inpatient psychiatric sample.

    PubMed

    Stinson, Jill D; Quinn, Megan A; Levenson, Jill S

    2016-11-01

    Experiences of trauma and maltreatment are frequent predictors of poor physical and mental health outcomes in adulthood. Existing literature also suggests an impact of developmental adversity on criminality and aggressive behavior, though little research exists describing the effects of cumulative adversity in forensic mental health samples. In the current study of 381 forensic mental health inpatients, rates of trauma, neglect, and parental substance abuse are reported in comparison with community norms. Cumulative adversity and the occurrence of foster care placement are examined via linear and logistic regression analyses in relation to age at first arrest, first psychiatric hospitalization, and onset of aggression, as well as history of suicide attempts and non-suicidal self-injury. Results revealed that experiences of developmental adversity were more common among participants than have been reported in community samples using the ACE survey, and that there were differential effects of gender on the prevalence of traumas experienced. Cumulative adversity scores were significantly associated with all outcomes, though the addition of foster care placement to the model significantly contributed to understanding outcomes, and in some cases, removed the effect of cumulative adversity. Implications and direction for future study are discussed.

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    Varied presentations of emotion dysregulation in autism complicate diagnostic decision making and may lead to inaccurate psychiatric diagnoses or delayed autism diagnosis for high-functioning children. This pilot study aimed to determine the concordance between prior psychiatric diagnoses and the results of an autism-specific psychiatric interview…

  3. Reduction of Seclusion and Restraint in an Inpatient Psychiatric Setting: A Pilot Study.

    PubMed

    Blair, Ellen W; Woolley, Stephen; Szarek, Bonnie L; Mucha, Theodore F; Dutka, Olga; Schwartz, Harold I; Wisniowski, Jeff; Goethe, John W

    2017-03-01

    The authors describe a quality and safety initiative designed to decrease seclusion/restraint (S/R) and present the results of a pilot study that evaluated the effectiveness of this program. The study sample consisted of consecutive admissions to a 120-bed psychiatric service after the intervention was implemented (October 2010-September 2012, n = 8029). Analyses compared S/R incidence and duration in the study sample to baseline (consecutive admissions during the year prior to introduction of the intervention, October 2008-September 2009, n = 3884). The study intervention, which used evidence-based therapeutic practices for reducing violence/aggression, included routine use of the Brøset Violence Checklist, mandated staff education in crisis intervention and trauma informed care, increased frequency of physician reassessment of need for S/R, formal administrative review of S/R events and environmental enhancements (e.g., comfort rooms to support sensory modulation). Statistically significant associations were found between the intervention and a decrease in both the number of seclusions (p < 0.01) and the duration of seclusion per admission (p < 0.001). These preliminary results support the conclusion that this intervention was effective in reducing use of seclusion. Further study is needed to determine if these prevention strategies are generalizable, the degree to which each component of the intervention contributes to improve outcome, and if continuation of the intervention will further reduce restraint use.

  4. Which values are important for patients during involuntary treatment? A qualitative study with psychiatric inpatients.

    PubMed

    Valenti, Emanuele; Giacco, Domenico; Katasakou, Christina; Priebe, Stefan

    2014-12-01

    Involuntary hospital treatment is practised throughout the world. Providing appropriate treatment in this context is particularly challenging for mental health professionals, who frequently face ethical issues as they have to administer treatments in the absence of patient consent. We have explored the views of 59 psychiatric patients who had been involuntarily admitted to hospital treatment across England. Moral deliberation theory, developed in the field of clinical bioethics, was used to assess ethical issues. Interviews were audio recorded and transcribed verbatim, and analysed through thematic content analysis. We have detected a number of circumstances in the hospital that were perceived as potentially conflictual by patients. We have established which patient values should be considered by staff when deliberating on ethically controversial issues in these circumstances. Patients regarded as important having freedom of choice and the feeling of being safe during their stay in the hospital. Patients also valued non-paternalistic and respectful behaviour from staff. Consideration of patient values in moral deliberation is important to manage ethical conflicts. Even in the ethically challenging context of involuntary treatment, there are possibilities to increase patient freedoms, enhance their sense of safety and convey respect.

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

    ERIC Educational Resources Information Center

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

    2009-01-01

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

  6. Characteristics of Patients Visiting the Child & Adolescent Psychiatric Clinic: A 26-Year Study from North India

    ERIC Educational Resources Information Center

    Malhotra, Savita; Biswas, Parthasarathy; Sharan, Pratap; Grover, Sandeep

    2007-01-01

    Aim: To study the sociodemographic and clinical profile of patients, who presented to the child and adolescent psychiatric services of a tertiary care centre over a 26-year period (1980-2005). Methodology: Data were abstracted retrospectively from detailed work up files of all subjects assessed in the Child and Adolescent Psychiatry (CAP) Clinic…

  7. Psychiatric Consequences for Israeli Adolescents of Protracted Political Violence: 1998-2004

    ERIC Educational Resources Information Center

    Slone, Michelle; Shechner, Tomer

    2009-01-01

    Background: This study examined relations between Israeli adolescents' political violence exposure and psychiatric consequences over seven years around the second Intifada and possible differential effects according to age and gender. Methods: Cross-sectional data was collected from 3667 adolescents aged 10-18, constituting two age groups of early…

  8. Children with a Prepubertal and Early Adolescent Bipolar Disorder Phenotype from Pediatric Versus Psychiatric Facilities

    ERIC Educational Resources Information Center

    Tillman, Rebecca; Geller, Barbara; Frazier, Jeanne; Beringer, Linda; Zimerman, Betsy; Klages, Tricia; Bolhofner, Kristine

    2005-01-01

    Objective: To examine characteristics between subjects with a prepubertal and early adolescent bipolar disorder phenotype from pediatric versus psychiatric venues. Method: Subjects (N = 93) with a prepubertal and early adolescent bipolar disorder phenotype were obtained through consecutive new case ascertainment from designated pediatric and…

  9. Psychiatric Syndromes in Adolescents with Marijuana Abuse and Dependency in Outpatient Treatment

    ERIC Educational Resources Information Center

    Diamond, Guy; Panichelli-Mindel, Susan M.; Shera, David; Dennis, Mike; Tims, Frank; Ungemack, Jane

    2006-01-01

    Objective: The purpose of the current study to assist in understanding the prevalence and clinical correlates of psychiatric distress in adolescents seeking outpatient services for marijuana abuse or dependency. Methods: In a multi-site randomized clinical trial, 600 adolescents and their parents were assessed at intake using the Global Appraisals…

  10. Psychiatric Problems and Trauma Exposure in Nondetained Delinquent and Nondelinquent Adolescents

    ERIC Educational Resources Information Center

    Adams, Zachary W.; McCart, Michael R.; Zajac, Kristyn; Danielson, Carla Kmett; Sawyer, Genelle K.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2013-01-01

    This study examined the prevalence of and associations between specific psychiatric disorders, substance use problems, and trauma exposure in a sample of delinquent and nondelinquent adolescents. A nationally representative sample of adolescents ("n" = 3,614; "M" age = 14.5 years, "SD" = 1.7; 51% male; 71% White,…

  11. Psychiatric Disorders and Sexual Risk among Adolescents in Mental Health Treatment

    ERIC Educational Resources Information Center

    Brown, Larry K.; Hadley, Wendy; Stewart, Angela; Lescano, Celia; Whiteley, Laura; Donenberg, Geri; DiClemente, Ralph

    2010-01-01

    Objective: To examine the relationship between psychiatric disorders and sexual behaviors among adolescents receiving mental health treatment. Adolescents in mental health treatment have been found to have higher rates of HIV risk behavior than their peers, but data concerning the relationship between psychopathology and risk are inconsistent and…

  12. Bidirectional Linkages between Psychological Symptoms and Sexual Activities among African American Adolescent Girls in Psychiatric Care

    ERIC Educational Resources Information Center

    Starr, Lisa R.; Donenberg, Geri R.; Emerson, Erin

    2012-01-01

    The current study examines longitudinal associations between light and heavy sexual experiences and psychiatric symptoms in African American adolescent girls receiving mental health care. Research supports bidirectional associations between adolescent romantic and sexual behaviors and depression and other mental health problems, but this finding…

  13. Frequency of Exposure to and Engagement in Nonsuicidal Self-Injury Among Inpatient Adolescents.

    PubMed

    Zhu, Lian; Westers, Nicholas J; Horton, Sarah E; King, Jessica D; Diederich, Andrew; Stewart, Sunita M; Kennard, Betsy D

    2016-01-01

    This study examined the relationship between frequency of exposure to non-suicidal self-injury (NSSI) and engagement in NSSI among adolescents. Ninety inpatient adolescents with a history of NSSI, ages 12 to 17, completed a structured interview. The majority of participants had learned about NSSI prior to initiating the behavior themselves. More frequent exposure to specific methods of NSSI was associated with greater frequency of using those same methods. Greater exposure to NSSI in the media and seeking out NSSI content were related to greater frequency of engagement in NSSI. Clinicians may help those who self-injure to become more knowledgeable and educated consumers of media to prevent NSSI behavior and contagion.

  14. Correlates of interpersonal dependency and detachment in an adolescent inpatient sample.

    PubMed

    Haggerty, Greg; Siefert, Caleb J; Bornstein, Robert F; Sinclair, Samuel Justin; Blais, Mark A; Zodan, Jennifer; Rao, Nyapati

    2015-01-01

    Interpersonal dependency has been linked to psychological distress, depression, help seeking, treatment compliance, and sensitivity to interpersonal cues in adult samples. However, there is a dearth of research focusing on dependency in child and adolescent samples. The current study examined the construct validity of a measure of interpersonal dependency. The authors investigated how interpersonal dependency and detachment relate to behavioral problems, subjective well-being, interpersonal problems, and global symptom severity in adolescent inpatients. Destructive overdependence (DO) and dysfunctional detachment (DD) were positively related to interpersonal distress, behavioral problems, and symptom severity and negatively related to psychological health and well-being. Healthy dependency (HD) was associated with fewer behavioral problems and less symptom severity and positively related to subjective well-being. The clinical implications of these findings are discussed.

  15. Gender differences in psychiatric disorders and clusters of self-esteem among detained adolescents.

    PubMed

    Van Damme, Lore; Colins, Olivier F; Vanderplasschen, Wouter

    2014-12-30

    Detained minors display substantial mental health needs. This study focused on two features (psychopathology and self-esteem) that have received considerable attention in the literature and clinical work, but have rarely been studied simultaneously in detained youths. The aims of this study were to examine gender differences in psychiatric disorders and clusters of self-esteem, and to test the hypothesis that the cluster of adolescents with lower (versus higher) levels of self-esteem have higher rates of psychiatric disorders. The prevalence of psychiatric disorders was assessed in 440 Belgian, detained adolescents using the Diagnostic Interview Schedule for Children-IV. Self-esteem was assessed using the Self-perception Profile for Adolescents. Model-based cluster analyses were performed to identify youths with lower and/or higher levels of self-esteem across several domains. Girls have higher rates for most psychiatric disorders and lower levels of self-esteem than boys. A higher number of clusters was identified in boys (four) than girls (three). Generally, the cluster of adolescents with lower (versus higher) levels of self-esteem had a higher prevalence of psychiatric disorders. These results suggest that the detection of low levels of self-esteem in adolescents, especially girls, might help clinicians to identify a subgroup of detained adolescents with the highest prevalence of psychopathology.

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

    PubMed

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

    2014-09-01

    Although aggression is part of daily life in psychiatric units for adolescents, empirical data on its prevalence are sparse. Only few studies have described prevalence of aggressive incidents in adolescent psychiatric wards, and data in forensic psychiatric care are even more limited. Available studies reported high prevalence rates of aggression, ranging from 0.4 to 2.4 incidents of aggression per day across (forensic) child and adolescent psychiatric units. Between 27 and 78 % of all admitted youth committed an aggressive act. In this study, we collected systematically registered data of all aggressive incidents from the first 2 years (2010-2012) on a newly established forensic adolescent psychiatric unit, which used a formal aggression management program embedded in the social competence model, which is based on early intervention in the 'chain of behavior' to prevent any further escalation. The inclusion of also minor aggressive incidents is unique in the literature and the clinical relevance is highlighted. A mean of one incident a day took place, with each adolescent involved in at least one incident. Notably, 1.7 aggressive incidents per month made seclusion of restraint use necessary. Based on the social competence theory, the aggression management model suggests intervening early in the cascade of aggression, in order to prevent further escalation and reduce the need for intrusive interventions. Evidence supported that aggression is a contextual event, as external factors clearly influence the incidence of aggression. Aggression management should be built on both relational and structural security.

  17. Intimate relationship involvement, intimate relationship quality, and psychiatric disorders in adolescents.

    PubMed

    Whisman, Mark A; Johnson, Daniel P; Li, Angela; Robustelli, Briana L

    2014-12-01

    Prior research has shown that poor relationship quality in marriage and other intimate relationships demonstrates cross-sectional and longitudinal associations with a variety of psychiatric disorders in adults. In comparison, there has been less research on the covariation between relationship quality and psychiatric disorders in adolescents, a developmental period that is associated with elevated risk of incidence of several disorders and that is important for the acquisition and maintenance of intimate relationships. The present study was conducted to examine the associations between intimate relationship involvement, intimate relationship quality, and psychiatric disorders in a population-based sample of adolescents. The associations between relationship involvement, positive and negative relationship quality, and 12-month prevalence of mood, anxiety, and substance use disorders were evaluated in adolescents from the National Comorbidity Survey-Adolescent Supplement. Participants completed an interview-based assessment of psychiatric disorders and a self-report measure of relationship quality. Results indicated that the prevalence of broad categories of mood, anxiety, and substance use disorders, and several specific disorders were significantly associated with (a) being married, cohabiting, or involved in a serious relationship; and (b) reporting more negative (but not less positive) relationship quality. For several disorders, the association between the disorder and relationship involvement was moderated by age, wherein the strength of the association decreased in magnitude with increasing age. Findings suggest that being in an intimate relationship and reporting higher levels of negative relationship quality are associated with the prevalence of several common psychiatric disorders in adolescents.

  18. Child and adolescent psychiatric patients and later criminality

    PubMed Central

    Engqvist, Ulf; Rydelius, Per-Anders

    2007-01-01

    Background Sweden has an extensive child and adolescent psychiatric (CAP) research tradition in which longitudinal methods are used to study juvenile delinquency. Up to the 1980s, results from descriptions and follow-ups of cohorts of CAP patients showed that children's behavioural disturbances or disorders and school problems, together with dysfunctional family situations, were the main reasons for families, children, and youth to seek help from CAP units. Such factors were also related to registered criminality and registered alcohol and drug abuse in former CAP patients as adults. This study investigated the risk for patients treated 1975–1990 to be registered as criminals until the end of 2003. Methods A regional sample of 1,400 former CAP patients, whose treatment occurred between 1975 and 1990, was followed to 2003, using database-record links to the Register of Persons Convicted of Offences at the National Council for Crime Prevention (NCCP). Results Every third CAP patient treated between 1975 and 1990 (every second man and every fifth woman) had entered the Register of Persons Convicted of Offences during the observation period, which is a significantly higher rate than the general population. Conclusion Results were compared to published results for CAP patients who were treated between 1953 and 1955 and followed over 20 years. Compared to the group of CAP patients from the 1950s, the results indicate that the risk for boys to enter the register for criminality has doubled and for girls, the risk seems to have increased sevenfold. The reasons for this change are discussed. Although hypothetical and perhaps speculative this higher risk of later criminality may be the result of lack of social control due to (1) rising consumption of alcohol, (2) changes in organisation of child social welfare work, (3) the school system, and (4) CAP methods that were implemented since 1970. PMID:17727714

  19. Adventure-Based Experiential Therapy with Inpatients in Child and Adolescent Psychiatry: An Approach to Practicability and Evaluation

    ERIC Educational Resources Information Center

    Eckstein, Florian; Rüth, Ulrich

    2015-01-01

    This article examines the use of adventure-based experiential therapy (AET) with child and adolescent psychiatry inpatients. AET environments, indications, practicality, therapeutic effects and research are outlined and clinical findings are reported. Activities such as rock-climbing, exploring a creek and caving are discussed and the limitations…

  20. Age Differences in Emergency Department Visits and Inpatient Hospitalizations in Preadolescent and Adolescent Youth with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Schlenz, Alyssa M.; Carpenter, Laura A.; Bradley, Catherine; Charles, Jane; Boan, Andrea

    2015-01-01

    This paper evaluated age differences in emergency department care and inpatient hospitalizations in 252 preadolescent and adolescent youth with autism spectrum disorders (ASDs; ages 9-18). Records from youth with ASDs were linked to acute care utilization records and were compared to a demographically similar comparison group of youth without ASDs…

  1. [Adolescents with diabetes type 1 in adolescent psychiatry and psychotherapy].

    PubMed

    Walter, Joachim

    2013-01-01

    Psychiatric comorbidity, family and biographical risk factors, and individual motivational aspects influence the therapeutic adherence and treatment motivation in Diabetes Type 1. The article provides basis diabetological knowledge for adolescent psychotherapists and describes practical out- and inpatient experiences and deliberations with especially problematic comorbid patients. In psychiatrically comorbid patients family conflicts and individual psychopathology is often reflected and manifested in selfharming diabetes management.

  2. Social connectedness and one-year trajectories among suicidal adolescents following psychiatric hospitalization.

    PubMed

    Czyz, Ewa K; Liu, Zhuqing; King, Cheryl A

    2012-01-01

    This study examined the extent to which posthospitalization change in connectedness with family, peers, and nonfamily adults predicted suicide attempts, severity of suicidal ideation, and depressive symptoms across a 12-month follow-up period among inpatient suicidal adolescents. Participants were 338 inpatient suicidal adolescents, ages 13 to 17, who were assessed at 3, 6, and 12 months posthospitalization. General liner models were fitted for depressive symptoms and suicidal ideation outcomes, and logistic regression was used for the dichotomous suicide attempt outcome. The moderating effects of gender and multiple attempt history were examined. Adolescents who reported greater improvements in peer connectedness were half as likely to attempt suicide during the 12-month period. Improved peer connectedness was also associated with less severe depressive symptoms for all adolescents and with less severe suicidal ideation for female individuals, but only at the 3-month assessment time point. Improved family connectedness was related to less severe depressive symptoms and suicidal ideation across the entire year; for suicidal ideation, this protective effect was limited to nonmultiple suicide attempters. Change in connectedness with nonfamily adults was not a significant predictor of any outcome when changes in family and peer connectedness were taken into account. These results pointing to improved posthospitalization connectedness being linked to improved outcomes following hospitalization have important treatment and prevention implications given inpatient suicidal adolescents' vulnerability to suicidal behavior.

  3. Predictors of self-esteem in adolescents with a psychiatric referral.

    PubMed

    Akdemir, Devrim; Çak, Tuna; Aslan, Cihan; Aydos, Büşra Sultan; Nalbant, Kevser; Çuhadaroğlu-Çetin, Füsun

    2016-01-01

    In the literature self-esteem is found to be lower in clinically referred adolescents compared to adolescents without any psychiatric disorder. The aim of this study is to examine self-esteem and associated socio-demographical and psychological factors in clinically referred adolescents in Turkey. Three hundred forty-nine adolescents aged between 12 and 18 years admitted to the Department of Child and Adolescent Psychiatry with a psychiatric complaint were enrolled. Rosenberg Self-Esteem Scale (RSES), Brief Symptom Inventory (BSI), Parenting Style Scale (PSS) and Sense of Identity Assessment Form (SIAF) were used for the evaluation. Self-esteem was lower in: girls, adolescents without siblings, living in non-nuclear families, with a past suicide attempt, and with history of a non-suicidal self-injurious behavior (NSSI). Self-esteem was negatively correlated with identity confusion on SIAF and positively correlated with acceptance/involvement on PSS. Significant predictors of self-esteem were gender, presence of a sibling, history of a NSSI and SIAF scores. Interactions between self-esteem and gender, psychiatric symptoms, parenting and identity development are complex in clinically referred adolescents. Further elucidation of the mechanisms through which these characteristics modify self-esteem will be necessary to guide families and clinicians to help adolescents to maintain high self-esteem levels.

  4. Motivational Interviewing to Reduce Substance Use in Adolescents with Psychiatric Comorbidity

    PubMed Central

    Brown, Richard A.; Abrantes, Ana M.; Minami, Haruka; Prince, Mark A.; Bloom, Erika Litvin; Apodaca, Timothy R.; Strong, David R.; Picotte, Dawn M.; Monti, Peter M.; MacPherson, Laura; Matsko, Stephen V.; Hunt, Jeffrey I.

    2016-01-01

    Substance use among adolescents with one or more psychiatric disorders is a significant public health concern. In this study, 151 psychiatrically hospitalized adolescents, ages 13-17 with comorbid psychiatric and substance use disorders, were randomized to a two-session Motivational Interviewing intervention to reduce substance use plus treatment as usual (MI) vs. treatment as usual only (TAU). Results indicated that the MI group had a longer latency to first use of any substance following hospital discharge relative to TAU (36 days versus 11 days). Adolescents who received MI also reported less total use of substances and less use of marijuana during the first 6 months post-discharge, although this effect was not significant across 12 months. Finally, MI was associated with a significant reduction in rule-breaking behaviors at 6-month follow-up. Future directions are discussed, including means of extending effects beyond 6 months and dissemination of the intervention to community-based settings. PMID:26362000

  5. Characteristics and staff resources of child and adolescent psychiatric hospital wards in Finland.

    PubMed

    Ellilä, H; Sourander, A; Välimäki, M; Piha, J

    2005-04-01

    The aim of this study is to describe structural characteristics and staff resources of child psychiatric and adolescent psychiatric hospital wards in Finland. The target group of the survey consisted of 69 child and adolescent psychiatric hospital units in Finland. Information was obtained from 64 units (93%). Most of the wards were based on 24-h-a-day provision. There were only 7-day-treatment programmes including two family wards. When compared internationally, the numbers of units, beds and staff levels were high in Finland, with all members of staff qualified. The nurse-patient ratio and psychiatrist resources were rather satisfactory. However, in many units there was a lack of psychologists, social workers and occupational therapists. General recommendations and guidelines for staff resources in child and adolescent hospital treatment wards are warranted.

  6. Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity.

    PubMed

    Hansen, Berit Hjelde; Alfstad, Kristin Å; van Roy, Betty; Henning, Oliver; Lossius, Morten I

    2016-09-01

    Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy.

  7. Personality Heterogeneity in Female Adolescent Inpatients with Features of Eating Disorders

    PubMed Central

    Hopwood, Christopher J.; Ansell, Emily B.; Fehon, Dwain C.; Grilo, Carlos M.

    2010-01-01

    Objective This study examined evidence for personality variability in adolescents with eating disorder features based in light of previous evidence that personality variability in adult women with eating pathology carries important clinical implications. Method Millon Adolescent Clinical Inventory personality data from adolescent girls with disturbed eating who were psychiatrically hospitalized were cluster analyzed and resulting groups were compared in terms of eating and comorbid pathology. Results Three sub-groups were identified among the 153 patients with eating disorder features: high-functioning, internalizing, and externalizing. The internalizing group was marked by eating-related and mood dysfunction, the externalizing group by elevated eating and mood pathology as well as impulsivity, aggression, and substance use, and the high-functioning group by lower levels of psychopathology and relatively high self-esteem. Conclusions These findings converge with previous research using different personality models in adult samples and highlight the clinical utility of considering personality heterogeneity among adolescent and adult women with disturbed eating. PMID:20965304

  8. Social Connectedness and One-Year Trajectories among Suicidal Adolescents Following Psychiatric Hospitalization

    PubMed Central

    Czyz, Ewa K.; Liu, Zhuqing; King, Cheryl A.

    2012-01-01

    Objective This study examined the extent to which post-hospitalization change in connectedness with family, peers, and non-family adults predicted suicide attempts, severity of suicidal ideation, and depressive symptoms across a 12-month follow-up period among inpatient suicidal adolescents. Method Participants were 338 inpatient suicidal adolescents, ages 13-17, who were assessed at three, six, and 12 months post hospitalization. General liner models were fitted for depressive symptoms and suicidal ideation outcomes, and logistic regression was used for the dichotomous suicide attempt outcome. The moderating effects of gender and multiple attempt history were examined. Results Adolescents who reported greater improvements in peer connectedness were half as likely to attempt suicide during the 12-month period. Improved peer connectedness was also associated with less severe depressive symptoms for all adolescents and with less severe suicidal ideation for females, but only at the three-month assessment time point. Improved family connectedness was related to less severe depressive symptoms and suicidal ideation across the entire year; for suicidal ideation, this protective effect was limited to non-multiple suicide attempters. Change in connectedness with non-family adults was not a significant predictor of any outcome when changes in family and peer connectedness were taken into account. Conclusions These results pointing to improved post-hospitalization connectedness being linked to improved outcomes following hospitalization have important treatment and prevention implications given inpatient suicidal adolescents’ vulnerability to suicidal behavior. PMID:22417194

  9. Medicare Program; Inpatient Psychiatric Facilities Prospective Payment System--Update for Fiscal Year Beginning October 1, 2015 (FY 2016). Final rule.

    PubMed

    2015-08-05

    This final rule updates the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) (which are freestanding IPFs and psychiatric units of an acute care hospital or critical access hospital). These changes are applicable to IPF discharges occurring during fiscal year (FY) 2016 (October 1, 2015 through September 30, 2016). This final rule also implements: a new 2012-based IPF market basket; an updated IPF labor-related share; a transition to new Core Based Statistical Area (CBSA) designations in the FY 2016 IPF Prospective Payment System (PPS) wage index; a phase-out of the rural adjustment for IPF providers whose status changes from rural to urban as a result of the wage index CBSA changes; and new quality measures and reporting requirements under the IPF quality reporting program. This final rule also reminds IPFs of the October 1, 2015 implementation of the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), and updates providers on the status of IPF PPS refinements.

  10. [A university department as a psychiatric service centre for children and adolescents].

    PubMed

    Remschmidt, Helmut; Walter, Reinhard; Theisen, Frank; Ulbrich, Rainer; Martin, Matthias

    2006-11-01

    The article reports on a system of care for psychiatrically ill children and adolescents that has been designed, established and expanded since 1980 by a university department in a rural region. The department is responsible for the mental health care of three counties with altogether 807 000 inhabitants. The development of this system of care was due in great part to the model program of the German Federal Government for the reform of mental health care that comprised 14 model regions, out of which the region of Marburg and its surrounding counties was the only one with a focus on the situation of psychiatrically ill children and adolescents. With the aid of this model program, a comprehensive evaluation of existing psychiatric services was carried out and at the same time, new services for this clientele were established such as a mobile child and adolescent psychiatric service and a day hospital. A particular focus was laid on the development of a complete network of psychiatric services with manifold, and over the years well proven, cooperation measures. Finally, the quality of mental health care was significantly increased by a continuous evaluation of services and the implementation of two institutes for psychotherapeutic training. Several research initiatives in the field of social psychiatry have contributed to this amelioration and at the same time, to a successful integration of mental health care and research.

  11. Why do many psychiatric disorders emerge during adolescence?

    PubMed Central

    Giedd, Jay N.; Keshavan, Matcheri; Paus, Tomáš

    2008-01-01

    What do we know about the maturation of the human brain during adolescence? Do structural changes in cerebral cortex reflect synaptic pruning? Are increases in white-matter volume driven by myelination? Is the adolescent brain more or less sensitive to reward? These are but a few questions we ask in this review while attempting to indicate how findings obtained in the healthy brain help in furthering our understanding of mental health during adolescence. PMID:19002191

  12. Psychiatric Aspects of Child and Adolescent Obesity: A Review of the Past 10 Years

    ERIC Educational Resources Information Center

    Zametkin, Alan J.; Zoon, Christine K.; Klein, Hannah W.; Munson, Suzanne

    2004-01-01

    Objective: To review the past 10 years of published research on psychiatric aspects of child and adolescent obesity and highlight information mental health professionals need for preventing obesity in youths and diagnosing and treating it. Method: Researchers performed computerized and manual searches of the literature and summarized the most…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  14. Adolescent Attitudes toward Psychiatric Medication: The Utility of the Drug Attitude Inventory

    ERIC Educational Resources Information Center

    Townsend, Lisa; Floersch, Jerry; Findling, Robert L.

    2009-01-01

    Background: Despite the effectiveness of psychotropic treatment for alleviating symptoms of psychiatric disorders, youth adherence to psychotropic medication regimens is low. Adolescent adherence rates range from 10-80% (Swanson, 2003; Cromer & Tarnowski, 1989; Lloyd et al., 1998; Brown, Borden, and Clingerman, 1985; Sleator, 1985) depending on…

  15. Psychiatric Impairment among Adolescents Engaging in Different Types of Deliberate Self-Harm

    ERIC Educational Resources Information Center

    Jacobson, Colleen M.; Muehlenkamp, Jennifer J.; Miller, Alec L.; Turner, J. Blake

    2008-01-01

    This retrospective chart review study of 227 participants examined the psychiatric profiles of outpatient adolescents ages 12 to 19 years (M = 15.08 years, SD = 1.72 years) engaging in different types of deliberate self-harm (DSH) behaviors. Participants were divided into four groups: no deliberate self-harm (NoDSH; n = 119), nonsuicidal…

  16. Psychiatric hospital treatment of children and adolescents in New South Wales, Australia: 12-year trends

    PubMed Central

    Sprague, Titia; Sharpe, Joanne

    2016-01-01

    Background It is preferable that children and adolescents requiring in-patient care for mental health problems are managed in age-appropriate facilities. To achieve this, nine specialist Child and Adolescent Mental Health Services (CAMHS) in-patient units have been commissioned in New South Wales (NSW) since 2002. Aims To examine trends in child and adolescent in-patient admissions since the opening of these CAMHS units. Method Analysis of separation data for under 18-year-olds to CAMHS, adult mental health and paediatric units for the period 2002 to 2013 in NSW, comparing districts with and without specialist CAMHS units. Results Separations from CAMHS, adult and paediatric units rose with time, but there was no interaction between time and health district type (with/without CAMHS unit). Five of eight health districts experienced increased separations of under 18-year-olds from adult units in the year of opening a CAMHS unit. Separations from related paediatric units increased in three of seven health districts. Conclusions Opening CAMHS units may be followed by a temporary increase in separations of young people from adult units, but it does not influence the flow of patients to non-CAMHS facilities in the longer term. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence. PMID:27703746

  17. Adolescent Sex Offenders' Rankings of Therapeutic Factors Using the Yalom Card Sort

    ERIC Educational Resources Information Center

    Sribney, Christine L.; Reddon, John R.

    2008-01-01

    Following 11-98 weeks of inpatient residential treatment, 69 male adolescent sex offenders completed the 60-item, 12-factor Yalom Card Sort. The rank orders were compared to adult sex offenders and a psychiatric adult outpatient group. Relative to adult psychiatric outpatients, the adolescent sex offenders had rated Instillation of Hope three…

  18. Multi-informant reports of psychiatric symptoms among high-functioning adolescents with Asperger syndrome or autism.

    PubMed

    Hurtig, Tuula; Kuusikko, Sanna; Mattila, Marja-Leena; Haapsamo, Helena; Ebeling, Hanna; Jussila, Katja; Joskitt, Leena; Pauls, David; Moilanen, Irma

    2009-11-01

    The aim of the study was to examine psychiatric symptoms in high-functioning adolescents with autism spectrum disorders reported by multiple informants. Forty-three 11- to 17-year-old adolescents with Asperger syndrome (AS) or high-functioning autism (HFA) and 217 typically developed adolescents completed the Youth Self-Report (YSR), while their parents completed the Child Behavior Checklist (CBCL). Teachers of adolescents with AS/HFA completed the Teacher Report Form (TRF). The informants reported significantly more psychiatric symptoms, especially withdrawn, anxious/depressed, social and attention problems, in adolescents with AS/HFA than in controls. In contrast to findings in the general population, the psychiatric problems of adolescents with AS/HFA are well acknowledged by multiple informants, including self-reports. However, anxiety and depressive symptoms were more commonly reported by adolescents with AS/HFA and their teachers than their parents, indicating that some emotional distress may be hidden from their parents.

  19. Substance Use in Adolescent Psychiatric Outpatients: Self-Report, Health Care Providers' Clinical Impressions, and Urine Screening

    ERIC Educational Resources Information Center

    Holzer, Laurent; Pihet, Sandrine; Passini, Christina Moses; Feijo, Isabelle; Camus, Didier; Eap, Chin

    2014-01-01

    Purpose: To determine the prevalence of substance use among adolescent psychiatric outpatients using a variety of data sources. Method: Using a questionnaire, 3-month prevalence of substance use data were obtained from 50 adolescents and their health care providers. Adolescents' self-reports and providers' clinical impressions were compared with…

  20. Childhood- versus Adolescent-Onset Antisocial Youth with Conduct Disorder: Psychiatric Illness, Neuropsychological and Psychosocial Function

    PubMed Central

    Johnson, Vicki A.; Kemp, Andrew H.; Heard, Robert; Lennings, Christopher J.; Hickie, Ian B.

    2015-01-01

    Objective The present study investigates whether youths with childhood-onset antisocial behavior have higher rates of psychiatric illness, neuropsychological and psychosocial dysfunction than youths who engage in antisocial behavior for the first time in adolescence. Prior studies have generally focused on single domains of function in heterogeneous samples. The present study also examined the extent to which adolescent-onset antisocial behavior can be considered normative, an assumption of Moffitt’s dual taxonomy model. Method Forty-three subjects (34 males, 9 females, mean age = 15.31, age range 12–21) with a diagnosis of conduct disorder (CD) were recruited through Headspace Services and the Juvenile Justice Community Centre. We compared childhood-onset antisocial youths (n = 23) with adolescent-onset antisocial youths (n = 20) with a conduct disorder, across a battery of psychiatric, neuropsychological and psychosocial measures. Neuropsychological function of both groups was also compared with normative scores from control samples. Results The childhood-onset group displayed deficits in verbal learning and memory, higher rates of psychosis, childhood maltreatment and more serious violent behavior, all effects associated with a large effect size. Both groups had impaired executive function, falling within the extremely low range (severely impaired). Conclusions Childhood-onset CD displayed greater cognitive impairment, more psychiatric symptoms and committed more serious violent offences. The finding of severe executive impairment in both childhood- and adolescent-onset groupings challenges the assumption that adolescent-onset antisocial behavior is a normative process. PMID:25835393

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

    PubMed Central

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

    2004-01-01

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

  2. Improving smoking cessation policy by assessing user demand for an inpatient smoking cessation service in adult psychiatric wards.

    PubMed

    Liu, Kathy; Creamer, Andrew

    2015-01-01

    Smoking rates are higher among people with mental health conditions compared to the general population. Smoking reduces physical, mental and financial well-being, and interacts with psychotropic drugs. An inpatient admission provides an opportunity to engage and support smokers in smoking cessation. Compliance with Trust/NICE smoking cessation guidelines was assessed in two inpatient wards, and a questionnaire evaluated user demand for an inpatient smoking cessation service. A need for improved documentation of smoking status to identify and treat smokers routinely was revealed. A new electronic health form was designed and introduced, and a clear pathway for onward referrals was developed. This intervention preceded the introduction of the Trust-wide smoke free policy from October 2014. The intervention doubled rates of documentation of smoking status, cessation advice and offer of NRT/referral. There were large differences between the two wards, highlighting the need for a tailored approach.

  3. 'She's manipulative and he's right off': a critical analysis of psychiatric nurses' oral and written language in the acute inpatient setting.

    PubMed

    Hamilton, Bridget; Manias, Elizabeth

    2006-06-01

    Remarks such as 'she's manipulative' and 'he's right off' are familiar to psychiatric nurses. This paper critiques the language nurses use in acute inpatient psychiatry services, highlighting the diverse discourses implicated in nurses' writing and speaking about patients. Based on a review of the literature, this paper examines ethnographic studies and discourse analyses of psychiatric nurses' oral and written language. A prominent debate in the literature surrounds nurses' use of standardized language, which is the use of set terms for symptoms and nursing activities. This review of spoken descriptions of patients highlights nurses' use of informal and local descriptions, incorporating elements of moral judgement, common sense language and empathy. Research into written accounts in patient files and records show nurses' use of objectifying language, the dominance of medicine and the emergence of the language of bureaucracy in health services. Challenges to the language of psychiatry and psychiatric nursing arise from fields as diverse as bioscience, humanism and social theory. Authors who focus on the relationship between language, power and the discipline of nursing disagree in regard to their analysis of particular language as a constructive exercise of power by nurses. Thus, particular language is in some instances endorsed and in other instances censured, by nurses in research and practice. In this paper, a Foucauldian analysis provides further critique of taken-for-granted practices of speech and writing. Rather than censoring language, we recommend that nurses, researchers and educators attend to nurses' everyday language and explore what it produces for nurses, patients and society.

  4. Bidirectional linkages between psychological symptoms and sexual activities among African American adolescent girls in psychiatric care.

    PubMed

    Starr, Lisa R; Donenberg, Geri R; Emerson, Erin

    2012-01-01

    The current study examines longitudinal associations between light and heavy sexual experiences and psychiatric symptoms in African American adolescent girls receiving mental health care. Research supports bidirectional associations between adolescent romantic and sexual behaviors and depression and other mental health problems, but this finding has not been examined among African American youth or in clinical samples. African American girls in psychiatric treatment suffer disparities in HIV/AIDS vulnerability, and understanding the context of girls' risk-taking (and how psychological symptoms contribute) may aid prevention efforts. Two-hundred-sixty-five African American girls seeking psychiatric care were assessed for mental health symptoms and light and heavy sexual behaviors. Participants completed a 6-month follow-up. Baseline light sexual activity predicted increased internalizing and externalizing symptoms and substance use at follow-up. Internalizing and externalizing symptoms predicted increased heavy sexual behaviors over time, including HIV-risk behaviors. Results support the association between romantic involvement and depression. Psychological symptoms may play a key role in the emergence of risky sexual behaviors among African American adolescent girls in psychiatric care and should be considered in prevention program development.

  5. Clinical validity of a dimensional assessment of self- and interpersonal functioning in adolescent inpatients

    PubMed Central

    Haggerty, Greg; Blanchard, Mark; Baity, Matthew R.; Defife, Jared A; Stein, Michelle B.; Siefert, Caleb J.; Sinclair, Samuel J.; Zodan, Jennifer

    2014-01-01

    The Social Cognition and Object Relations Scale-Global Rating Method (SCORS-G) is a clinical rating system assessing eight domains of self and interpersonal relational experience which can be applied to narrative response data (e.g., Thematic Apperception Test [TAT; Murray, 1943]; early memories narratives) or oral data (e.g., psychotherapy narratives, Relationship Anecdotal Paradigms). In the current study, seventy-two psychiatrically hospitalized adolescents consented and were rated by their individual and group therapist using the SCORS-G. Clinicians also rated therapy engagement, personality functioning, quality of peer relationships, school functioning, global assessment of functioning (GAF), history of eating disordered behavior and history of nonsuicidal self-injury. SCORS-G composite ratings achieved an acceptable level of inter-rater reliability and were associated with theoretically predicted variables (e.g., engagement in therapy; history of nonsuicidal self-injury). SCORS-G ratings also incrementally improved the prediction of therapy engagement and global functioning beyond what was accounted for by GAF scores. This study further demonstrates the clinical utility of the SCORS-G with adolescents. PMID:25010080

  6. [Issues in psychiatric evaluation of children and adolescents with visual impairment].

    PubMed

    Saisky, Yaniv; Hasid, Soli; Ebert, Tanya; Kosov, Irene

    2014-02-01

    Approximately 8% from those who are defined as blind in Israel are children and adolescents. Visual impairment is correlated with a high rate of psychopathology. However, some of these children and adolescents do not receive appropriate diagnosis and treatment. Often, the clinicians and those who treat the children/adolescents lack the proper professional knowledge related to the unique diagnosis and treatment of children/ adolescents who are visually impaired. Visual impairment might influence different aspects of the psychiatric diagnosis. These aspects include the influence of the impairment on different developmental axes; the reciprocal relationship between the child and his/her environment; the clinical presentation of different psychopathologies; and the different treatment modalities. In this review we discuss these issues. Moreover, we raise the question as to whether there is a need to adapt the psychiatric evaluation and the treatment specifically to the visually impaired child. The review is based on the existing literature in addition to our clinical experience, which stems from our work with children and adolescents who are at the "Jewish Institute for the Blind", an institute for children and adolescents with visual impairment in Israel.

  7. Psychiatric Disorders in Children and Adolescents Attending Pediatric Out Patient Departments of Tertiary Hospitals

    PubMed Central

    Jesmin, Akhter; Rahman, Khan Muhammad Zillur; Muntasir, Maruf Mohammad

    2016-01-01

    Objectives Psychiatric disorders are increasingly recognized among children and adolescents in Bangladesh. Psychiatric disorders are more common in children with chronic and acute pediatric disorders. Our study was designed to determine the psychiatric disorders among children and adolescents attending pediatric outpatient departments of tertiary care hospitals. Methods This cross-sectional study was carried out from July 2012 to February 2013 in pediatric outpatient departments of three prime tertiary level hospitals of Dhaka, Bangladesh. A purposive sampling technique was used. A total of 240 male and female children aged 5 to 16 years old were included in the study. We used a semi-structured questionnaire to obtain sociodemographic and other relevant clinical information about the children and their families from their parents or caregivers and a validated parent version of the Bangla Development and Well-Being Assessment (DAWBA) for measuring psychopathology. Results The mean age of the children was 9.0± 2.6 years. The majority (71%) of children were in the 5–10 year age group. The male/female ratio was 1.2:1. Among the respondents, 18% were found to have a psychiatric disorder. Behavioral disorders, emotional disorders, and developmental disorders were found in 9.0%, 15.0% and 0.4% respectively. Hyperkinetic disorder was the single most frequent (5.0%) psychiatric disorder. Conclusions A significant number of children were found to have psychiatric disorders. Our study indicates the importance of identification and subsequent management of psychiatric conditions among the pediatric population. PMID:27403237

  8. The association of chronic adversity with psychiatric disorder and disorder severity in adolescents.

    PubMed

    Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Fleiz, Clara; Medina-Mora, Maria Elena

    2011-09-01

    The purpose of this paper is to estimate the impact of chronic adversity on psychopathology in adolescents, taking into account the type of adversity, number of adversities experienced and type of psychiatric disorder, as well as to estimate the impact on severity of the disorder. A total of 3,005 male and female adolescents from the Mexican Adolescent Mental Health Survey aged 12-17 years were interviewed in a stratified multistage general population probability survey. Assessment of 20 DSM-IV disorders, disorder severity and 12 chronic childhood adversities were assessed with the adolescent version of the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A). Family dysfunction adversities including abuse presented the most consistent associations between chronic adversity and psychopathology and their impact was generally non-specific with regard to the type of disorder. Parental divorce, parental death and economic adversity were not individually associated with psychopathology. Among those with a psychiatric disorder, sexual abuse and family violence were associated with having a seriously impairing disorder. The odds of having a psychiatric disorder and a serious disorder increased with increasing numbers of adversities; however, each additional adversity increased the odds at a decreasing rate. While the study design does not allow for conclusions regarding causality, these findings suggest general pathways from family dysfunction to psychopathology rather than specific associations between particular adversities and particular disorders, and provide further evidence for the importance of family-focused intervention and prevention efforts.

  9. Crack and Cocaine Use among Adolescents in Psychiatric Treatment: Associations with HIV Risk

    PubMed Central

    Tolou-Shams, Marina; Ewing, Sarah W. Feldstein; Tarantino, Nicholas; Brown, Larry K.

    2011-01-01

    Crack and cocaine use among adults has been associated with co-occurring psychiatric disorders as well as other drug use and unprotected sex. However, this issue is relatively unstudied in adolescents. This study collected data from 282 adolescents (mean age=14.9 years) treated in intensive psychiatric treatment settings to understand the relationship between crack/cocaine use and HIV risk. Thirteen percent of youth reported ever using crack or cocaine. Use was not associated with age, gender, race/ethnicity or SES. After controlling for known factors that influence unprotected sex, the odds that those with a history of crack/cocaine use engaged in inconsistent condom use was six times greater than that for those youth who did not ever use. Thus, crack/cocaine use is prevalent even among younger adolescents with psychiatric disorders who are not in drug treatment. Its use is associated with high rates of sexual and other risk behaviors. A history of use should alert clinicians to a wide variety of possible behavioral risks. These results can also inform future adolescent HIV prevention intervention development. PMID:22224066

  10. Bullying Victimization (Being Bullied) Among Adolescents Referred for Urgent Psychiatric Consultation: Prevalence and Association With Suicidality

    PubMed Central

    Alavi, Nazanin; Roberts, Nasreen; Sutton, Chloe; Axas, Nicholas; Repetti, Leanne

    2015-01-01

    Objective: To examine the prevalence of bullying victimization among adolescents referred for urgent psychiatric consultation, to study the association between bullying victimization and suicidality, and to examine the relation between different types of bullying and suicidality. Method: A retrospective chart review was conducted for all adolescents referred to a hospital-based urgent consultation clinic. Our study sample consisted of adolescents with a history of bullying victimization. The Research Ethics Board of Queen’s University provided approval. Data analysis was conducted using SPSS (IBM SPSS Inc, Armonk, NY). Chi-square tests were used for sex, suicidal ideation, history of physical and sexual abuse, and time and type of bullying, and an independent sample t test was used for age. Results: The prevalence of bullying victimization was 48.5% (182 of 375). There was a significant association between being bullied and suicidal ideation (P = 0.01), and between sex and suicidal ideation (P ≤ 0.001). Victims of cyberbullying reported more suicidal ideation than those who experienced physical or verbal bullying (P = 0.04). Conclusions: Bullying victimization, especially cyberbullying, is associated with increased risk of suicidal ideation among adolescents referred for psychiatric risk assessment. The detailed history of the type and duration of bullying experienced by the victims should be considered when conducting a psychiatric risk assessment. PMID:26720189

  11. Neurological, Metabolic, and Psychiatric Adverse Events in Children and Adolescents Treated With Aripiprazole.

    PubMed

    Jakobsen, Klaus Damgaard; Bruhn, Christina Hedegaard; Pagsberg, Anne-Katrine; Fink-Jensen, Anders; Nielsen, Jimmi

    2016-10-01

    Aripiprazole is a partial dopamine agonist with only minor neurological and psychiatric adverse effects, making it a potential first-line drug for the treatment of psychiatric disorders. However, the evidence of its use in children and adolescents is rather sparse. The aim of this case study is to discuss adverse drug reaction (ADR) reports concerning aripiprazole-associated neurological and psychiatric events in children and adolescents. The ADR report database at Danish Medicines Agency was searched for all ADRs involving children and adolescents (<18 years) reported by the search term [aripiprazole] AND all spontaneous reports since the introduction of aripiprazole in 2003 until December 31, 2015. Nineteen case reports were included in the study and included both patients with psychotic disorders (PS group) and nonpsychotic disorders (non-PS group). The PS group consisted of 5 patients with schizophrenia and psychoses, not otherwise specified; and the non-PS group consisted of fourteen cases including autism spectrum disorders, attention deficit and hyperactivity disorder, obsessive-compulsive disorder, and Tourette syndrome. The main reported adverse effects in the non-PS group were chronic insomnia, Parkinsonism, behavioral changes psychoses, and weight gain, whereas the adverse effects in the PS group was predominantly anxiety, convulsions, and neuroleptic malignant syndrome. Although aripiprazole is considered safe and well tolerated in children and adolescents, severe adverse events as neuroleptic malignant syndrome, extreme insomnia, and suicidal behavior has been reported to health authorities. Clinicians should pay attention to these possible hazards when prescribing aripiprazole to this vulnerable group of patients.

  12. Cultural considerations in child and adolescent psychiatric emergencies and crises.

    PubMed

    Pumariega, Andres J; Rothe, Eugenio

    2003-10-01

    The United States is a country of immigrants. With the exception of Native Americans, every other American is, or descends from, an immigrant. First- and second-generation immigrant children are the most rapidly growing segment of the American population. The future of American society is ultimately related to the adaptation of these children. Addressing psychiatric emergencies in these populations requires attention to their cultural differences and needs.

  13. Group Qigong for Adolescent Inpatients with Anorexia Nervosa: Incentives and Barriers

    PubMed Central

    Gueguen, Juliette; Piot, Marie-Aude; Orri, Massimiliano; Gutierre, Andrea; Le Moan, Jocelyne; Berthoz, Sylvie; Falissard, Bruno; Godart, Nathalie

    2017-01-01

    Background Qigong is a mind-body intervention focusing on interoceptive awareness that appears to be a promising approach in anorexia nervosa (AN). In 2008, as part of our multidimensional treatment program for adolescent inpatients with AN, we began a weekly qigong workshop that turned out to be popular among our adolescent patients. Moreover psychiatrists perceived clinical benefits that deserved further exploration. Methods and findings A qualitative study therefore sought to obtain a deeper understanding of how young patients with severe AN experience qigong and to determine the incentives and barriers to adherence to qigong, to understanding its meaning, and to applying it in other contexts. Data were collected through 16 individual semi-structured face-to-face interviews and analyzed with the interpretative phenomenological analysis method. Eleven themes emerged from the analysis, categorized in 3 superordinate themes describing the incentives and barriers related to the patients themselves (individual dimension), to others (relational dimension), and to the setting (organizational dimension). Individual dimensions associated with AN (such as excessive exercise and mind-body cleavage) may curb adherence, whereas relational and organizational dimensions appear to provide incentives to join the activity in the first place but may also limit its post-discharge continuation. Once barriers are overcome, patients reported positive effects: satisfaction associated with relaxation and with the experience of mind-body integration. Conclusions Qigong appears to be an interesting therapeutic tool that may potentiate psychotherapy and contribute to the recovery process of patients with AN. Further analysis of the best time window for initiating qigong and of its place in overall management might help to overcome some of the barriers, limit the risks, and maximize its benefits. PMID:28152083

  14. Improving documentation of physical health investigations in an adolescent mental health inpatient unit

    PubMed Central

    Horton, David

    2015-01-01

    Physical health investigations, such as blood tests, ECGs, and appropriate radiological tests, are essential in the assessment and management of many patients in inpatient mental health settings. This project took place in a 12-bed adolescent mental health unit in Swindon, UK, where on average at least two-thirds of patients have a diagnosed eating disorder. Multidisciplinary ward rounds provide an appropriate setting for discussion and documentation of physical investigations. Over a two-week period, 22 electronic ward round entries were audited for any documentation of five common investigations - blood tests, ECG, MRI head, DEXA, and ovarian ultrasound. Blood tests were documented in 2/22 (9.1%), ECG, MRI head, DEXA, and ovarian ultrasound were documented in 0/22 (0%). Modifications were made to an electronic ward round template, to include headings for each of these investigations, with free-text boxes as well as drop-down boxes for the radiological tests. Following this, re-audit of 22 ward round entries over a two-week period showed documentation had hugely improved - blood tests were documented in 21/22 (95.5%), with ECG, MRI head, DEXA, and pelvis US all documented in 22/22 (100%). A further audit a month later showed these results were largely sustained. In conclusion, use of a simple, structured ward round template can hugely improve documentation of important physical investigations within mental health settings. PMID:26734411

  15. Psychiatric Disorders in Adolescence and Early Adulthood and Risk for Child-Rearing Difficulties during Middle Adulthood

    ERIC Educational Resources Information Center

    Johnson, Jeffrey G.; Cohen, Patricia; Kasen, Stephanie; Brook, Judith S.

    2008-01-01

    Data from a community-based longitudinal study were used to investigate the associations of parental psychiatric disorders evident by early adulthood with child-rearing behavior during middle adulthood. A series of psychiatric assessments was conducted during the adolescence (mean ages 14 and 16) and early adulthood (mean age 22) of 153 males and…

  16. The Influence of Sex on the Course and Psychiatric Correlates of ADHD from Childhood to Adolescence: A Longitudinal Study

    ERIC Educational Resources Information Center

    Monuteaux, Michael C.; Mick, Eric; Faraone, Stephen V.; Biederman, Joseph

    2010-01-01

    Background: Little is known about the influence of sex on the course of attention-deficit/hyperactivity disorder (ADHD) and its comorbid psychiatric conditions. The purpose of this study was to examine the effect of sex on the course and psychiatric correlates of ADHD from childhood into adolescence. Methods: Two identically designed,…

  17. Ecological Assessment of Clinicians’ Antipsychotic Prescription Habits in Psychiatric Inpatients: A Novel Web- and Mobile Phone–Based Prototype for a Dynamic Clinical Decision Support System

    PubMed Central

    Barrigón, Maria Luisa; Brandt, Sara A; Nitzburg, George C; Ovejero, Santiago; Alvarez-Garcia, Raquel; Carballo, Juan; Walter, Michel; Billot, Romain; Lenca, Philippe; Delgado-Gomez, David; Ropars, Juliette; de la Calle Gonzalez, Ivan; Courtet, Philippe; Baca-García, Enrique

    2017-01-01

    Background Electronic prescribing devices with clinical decision support systems (CDSSs) hold the potential to significantly improve pharmacological treatment management. Objective The aim of our study was to develop a novel Web- and mobile phone–based application to provide a dynamic CDSS by monitoring and analyzing practitioners’ antipsychotic prescription habits and simultaneously linking these data to inpatients’ symptom changes. Methods We recruited 353 psychiatric inpatients whose symptom levels and prescribed medications were inputted into the MEmind application. We standardized all medications in the MEmind database using the Anatomical Therapeutic Chemical (ATC) classification system and the defined daily dose (DDD). For each patient, MEmind calculated an average for the daily dose prescribed for antipsychotics (using the N05A ATC code), prescribed daily dose (PDD), and the PDD to DDD ratio. Results MEmind results found that antipsychotics were used by 61.5% (217/353) of inpatients, with the largest proportion being patients with schizophrenia spectrum disorders (33.4%, 118/353). Of the 217 patients, 137 (63.2%, 137/217) were administered pharmacological monotherapy and 80 (36.8%, 80/217) were administered polytherapy. Antipsychotics were used mostly in schizophrenia spectrum and related psychotic disorders, but they were also prescribed in other nonpsychotic diagnoses. Notably, we observed polypharmacy going against current antipsychotics guidelines. Conclusions MEmind data indicated that antipsychotic polypharmacy and off-label use in inpatient units is commonly practiced. MEmind holds the potential to create a dynamic CDSS that provides real-time tracking of prescription practices and symptom change. Such feedback can help practitioners determine a maximally therapeutic drug treatment while avoiding unproductive overprescription and off-label use. PMID:28126703

  18. Psychiatric Comorbidity in Adolescents and Young Adults with Autism

    ERIC Educational Resources Information Center

    Moseley, David S.; Tonge, Bruce J.; Brereton, Avril V.; Einfeld, Stewart L.

    2011-01-01

    This article reports the findings of a study investigating rates and types of comorbid mental disorder evident in adolescents and young adults with autism. A sample of 84 young people (M = 19.5 years, SD = 4.6) with "Diagnostic and Statistical Manual of Mental Disorders," 4th Edition, Text Revision (DSM-IV-TR; American Psychiatric…

  19. The Handbook of Psychiatric Drug Therapy for Children and Adolescents.

    ERIC Educational Resources Information Center

    Theesen, Karen A.

    A compilation of literature and clinical wisdom, this handbook provides the reader with current information on the safety and efficacy of the psychotropic agents in the pediatric population. It lists information on the pharmacokinetics, adverse effects, dosing, and suggested monitoring guidelines for children and adolescents. The guide may also be…

  20. [Psychometric properties of the Beck depression inventory-II (BDI-II) among adolescent psychiatric patients].

    PubMed

    Besier, Tanja; Goldbeck, Lutz; Keller, Ferdinand

    2008-02-01

    A revised version of the Beck depression inventory (BDI-II) has been translated into German. Until now the BDI-II has only been evaluated in several American studies with clinical and nonclinical samples of adolescents. 111 adolescent psychiatric patients (ages ranged from 15-18 years) participated in a study to evaluate reliability, construct and factorial validity, as well as the diagnostic discrimination of the BDI-II. Internal consistency was high (alpha=0.92), showing the homogeneity of the instrument. Associations with other clinical (parent and self report) instruments point in the expected direction and support the external validity of the BDI-II. A factor-analysis generated inconclusive results. The BDI-II differentiated very well between a subsample of depressed adolescents (n=46), a subsample of non-depressed adolescent patients (n=53) and a nonclinical sample (n=31). The results of this study support the use of the BDI-II as a severity measure of depressive symptoms among adolescent psychiatric patients.

  1. World wide use of psychotropic drugs in child and adolescent psychiatric disorders.

    PubMed

    Simeon, J G; Wiggins, D M; Williams, E

    1995-05-01

    1. Questionnaires were mailed to child psychiatrists world wide to obtain more precise information on views and approaches to the diagnosis and treatment of childhood psychiatric disorders. 2. Results indicated important problems related to the management of child psychiatry practice both overseas and in Canada. 3. The choice of medication was frequently restricted by lack of availability, and political or social attitudes. 4. A consensus on diagnosis and treatment guidelines in child and adolescent psychiatry remains an important issue.

  2. Psychiatric adjustment to leaving school in adolescents with intellectual disability: a pilot study.

    PubMed

    Hepper, F; Garralda, M E

    2001-12-01

    The negotiation of stressful life cycle transitions may contribute to the higher prevalence of psychiatric disorders amongst people with intellectual disability (ID). It is possible that leaving school at the age of 16 years might place particular psychological demands on adolescents, increasing the risk of psychiatric morbidity at a time when they are vulnerable as a result of losing the links with health services sustained through school attendance. The present pilot study was designed as a prospective cohort study to investigate whether there is an increase of psychiatric morbidity [rated with the Strengths and Difficulties Questionnaire (SDQ), and through semi-structured interviews with parents] in adolescents with ID at the time of their transition from school to adult education and services. Although there was a high frequency (eight out of 10 subjects) of reported emotional and behavioural problems prior to transition, there was no increase or decrease in psychiatric morbidity for the group as a whole during the 6 months after leaving school. However, there were marked individual differences in scores on the SDQ, which may be worth investigating in a larger study.

  3. Classifying child and adolescent psychiatric disorder by problem checklists and standardized interviews.

    PubMed

    Boyle, Michael H; Duncan, Laura; Georgiades, Kathy; Bennett, Kathryn; Gonzalez, Andrea; Van Lieshout, Ryan J; Szatmari, Peter; MacMillan, Harriet L; Kata, Anna; Ferro, Mark A; Lipman, Ellen L; Janus, Magdalena

    2016-11-14

    This paper discusses the need for research on the psychometric adequacy of self-completed problem checklists to classify child and adolescent psychiatric disorder based on proxy assessments by parents and self-assessments by adolescents. We put forward six theoretical arguments for expecting checklists to achieve comparable levels of reliability and validity with standardized diagnostic interviews for identifying child psychiatric disorder in epidemiological studies and clinical research. Empirically, the modest levels of test-retest reliability exhibited by standardized diagnostic interviews - 0.40 to 0.60 based on kappa - should be achievable by checklists when thresholds or cut-points are applied to scale scores to identify a child with disorder. The few studies to conduct head-to-head comparisons of checklists and interviews in the 1990s concurred that no construct validity differences existed between checklist and interview classifications of disorder, even though the classifications of youth with psychiatric disorder only partially overlapped across instruments. Demonstrating that self-completed problem checklists can classify disorder with similar reliability and validity as standardized diagnostic interviews would provide a simple, brief, flexible way to measuring psychiatric disorder as both a categorical or dimensional phenomenon as well as dramatically lowering the burden and cost of assessments in epidemiological studies and clinical research.

  4. Safety Planning for Military (SAFE MIL): rationale, design, and safety considerations of a randomized controlled trial to reduce suicide risk among psychiatric inpatients.

    PubMed

    Ghahramanlou-Holloway, Marjan; Brown, Gregory K; Currier, Glenn W; Brenner, Lisa; Knox, Kerry L; Grammer, Geoffrey; Carreno-Ponce, Jaime T; Stanley, Barbara

    2014-09-01

    Mental health related hospitalizations and suicide are both significant public health problems within the United States Department of Defense (DoD). To date, few evidence-based suicide prevention programs have been developed for delivery to military personnel and family members admitted for psychiatric inpatient care due to suicidal self-directed violence. This paper describes the rationale and detailed methodology for a study called Safety Planning for Military (SAFE MIL) which involves a randomized controlled trial (RCT) at the largest military treatment facility in the United States. The purpose of this study is to test the efficacy of a brief, readily accessible, and personalized treatment called the Safety Planning Intervention (Stanley and Brown, 2012). Primary outcomes, measured by blinded assessors at one and six months following psychiatric discharge, include suicide ideation, suicide-related coping, and attitudes toward help seeking. Additionally, given the study's focus on a highly vulnerable patient population, a description of safety considerations for human subjects' participation is provided. Based on this research team's experience, the implementation of an infrastructure in support of RCT research within DoD settings and the processing of regulatory approvals for a clinical trial with high risk suicidal patients are expected to take up to 18-24 months. Recommendations for expediting the advancement of clinical trials research within the DoD are provided in order to maximize cost efficacy and minimize the research to practice gap.

  5. Descriptive and Psychometric Properties of the Inventory of Motivations for Suicide Attempts (IMSA) in an Inpatient Adolescent Sample

    PubMed Central

    May, Alexis M.; O'Brien, Kimberly H. McManama; Liu, Richard T.; Klonsky, E. David

    2016-01-01

    Objectives Little is known about why adolescents attempt suicide. The current study examined the endorsement, structure, and clinical correlates of adolescents' suicide attempt motivations as measured by the Inventory of Motivations for Suicide Attempts (IMSA). Methods Suicidal adolescents (n = 52) in a psychiatric unit were administered the IMSA and interviewed about their suicide attempts. Results Psychache, Hopelessness, and Escape were the most strongly endorsed motivations, and Interpersonal Influence the least endorsed. IMSA scales exhibited a two-factor solution: 1) Internal and 2) Communication. Suicide intent was strongly correlated with Internal motivations and moderately inversely correlated with Communication motivations. Factor structure and mean endorsements were similar to adult samples. Conclusions The IMSA is a useful measure to assess attempt motivations in adolescents. PMID:27046630

  6. Evaluating the Appropriateness and Effectiveness of Long Term Inpatient Psychiatric Treatment for Adolescents.

    ERIC Educational Resources Information Center

    Dickert, Jeff; Sotinsky, Ted

    This paper describes the outcomes of a study that explored the significance of the Severity of Illness Rating Scale (SIRS) as a tool for utilization review and program evaluation. The SIRS was first introduced in March 1993 and soon became the centerpiece for the Arthur Brisbane Child Treatment Center's Utilization Review Plan. Since its…

  7. 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

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

    2012-01-01

    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…

  8. Dissociative identity disorder among adolescents: prevalence in a university psychiatric outpatient unit.

    PubMed

    Sar, Vedat; Onder, Canan; Kilincaslan, Ayse; Zoroglu, Süleyman S; Alyanak, Behiye

    2014-01-01

    The aim of this study was to determine the prevalence of dissociative identity disorder (DID) and other dissociative disorders among adolescent psychiatric outpatients. A total of 116 consecutive outpatients between 11 and 17 years of age who were admitted to the child and adolescent psychiatry clinic of a university hospital for the 1st time were evaluated using the Adolescent Dissociative Experiences Scale, adolescent version of the Child Symptom Inventory-4, Childhood Trauma Questionnaire, and McMaster Family Assessment Device. All patients were invited for an interview with the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) administered by 2 senior psychiatrists in a blind fashion. There was excellent interrater reliability between the 2 clinicians on SCID-D diagnoses and scores. Among 73 participants, 33 (45.2%) had a dissociative disorder: 12 (16.4%) had DID, and 21 (28.8%) had dissociative disorder not otherwise specified. There was no difference in gender distribution, childhood trauma, or family dysfunction scores between the dissociative and nondissociative groups. Childhood emotional abuse and family dysfunction correlated with self-reported dissociation. Of the dissociative adolescents, 93.9% had an additional psychiatric disorder. Among them, only separation anxiety disorder was significantly more prevalent than in controls. Although originally designed for adults, the SCID-D is promising for diagnosing dissociative disorders in adolescents, its modest congruence with self-rated dissociation and lack of relationship between diagnosis and childhood trauma and family dysfunction suggest that the prevalence rates obtained with this instrument originally designed for adults must be replicated. The introduction of diagnostic criteria for adolescent DID in revised versions of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, would refine the assessment of dissociative disorders in this age group.

  9. Association of child maltreatment and psychiatric diagnosis in Brazilian children and adolescents

    PubMed Central

    Scomparini, Luciana Burim; dos Santos, Bernardo; Rosenheck, Robert Alan; Scivoletto, Sandra

    2013-01-01

    OBJECTIVES: The objective of this study was to evaluate the association between different types of child maltreatment and the presence of psychiatric disorders in highly vulnerable children and adolescents served by a multidisciplinary program. METHODS: In total, 351 patients with a mean age of 12.47, of whom 68.7% were male and 82.1% lived in shelters, underwent psychiatric evaluations based on the Kiddie-Sads-Present and Lifetime Version. Two different methods were used to evaluate maltreatment: medical records were reviewed to identify previous diagnoses related to socioeconomic and psychosocial circumstances, and the Childhood Trauma Questionnaire was used to obtain a structured history of trauma. Bivariate associations were evaluated between psychiatric disorders and evidence of each type and the frequency of abuse. RESULTS: The most frequent psychiatric diagnoses were substance use disorders, affective disorders and specific disorders of early childhood, whereas 13.67% of the sample had no psychiatric diagnosis. All patients suffered neglect, and 58.4% experienced physical or sexual abuse. The presence of a history of multiple traumas was only associated with a diagnosis of substance use disorder. Mental retardation showed a strong positive association with reported physical abuse and emotional neglect. However, a negative correlation was found when we analyzed the presence of a history of multiple traumas and mental retardation. CONCLUSION: All children living in adverse conditions deserve careful assistance, but we found that physical abuse and emotional neglect were most strongly associated with mental retardation and multiple traumas with substance abuse. PMID:24037004

  10. The psychiatric treatment of 'behavioural problems' in adolescence: Between coercion and socialisation.

    PubMed

    Coutant, Isabelle

    2016-12-01

    A 2005 report from the French Institute for Medical Research highlighted factors likely to prompt 'behavioural problems' in children and adolescents, and recommended early identification of at-risk families. A number of mental health professionals rose up against such medicalisation of social issues. This ethnographic study was conducted in this climate, in a psychiatric unit, located in a disadvantaged area in the outskirts of Paris, that specialises in adolescents with such problems. The research emphasised how professionals resist being instrumentalised by juvenile counselling services and the justice system, the observed practices bearing traces of critiques of psychiatric institutions since the 1960s. Psychiatrists thus try to justify and legitimate their interventions, which are co-constructed by relevant counselling and mental health professionals and, as much as possible, adolescents and their parents. Consequently, full understanding of institutionalisation, beyond its aspects of constraint and subjection, also requires consideration of its potential as a step in the socialisation process, especially for adolescents from working class backgrounds bereft of social and cultural capital. Contact with professionals may confer a kind of power, 'the power to speak'. At least, that is what the professionals try to give them using the 'pedagogy of reflexivity'.

  11. Examining the impact of psychiatric diagnosis and comorbidity on the medical lethality of adolescent suicide attempts.

    PubMed

    McManama O'Brien, Kimberly H; Berzin, Stephanie C

    2012-08-01

    Specific psychiatric diagnoses and comorbidity patterns were examined to determine if they were related to the medical lethality of suicide attempts among adolescents presenting to an urban general hospital (N=375). Bivariate analysis showed that attempters with substance abuse disorders had higher levels of lethality than attempters without substance abuse. Regression results indicated having depression comorbid with any other diagnosis was not associated with medical lethality. However, having a substance abuse disorder was associated with higher suicide attempt lethality, highlighting the importance of substance abuse as a risk factor for lethal suicide attempts in adolescents. This finding stimulates critical thinking around the understanding of suicidal behavior in youth and the development and implementation of treatment strategies for suicidal adolescents with substance abuse disorders.

  12. The copycat phenomenon after two Finnish school shootings: an adolescent psychiatric perspective

    PubMed Central

    2012-01-01

    Background Two school shootings with altogether 18 victims took place in Finland in November 2007 and September 2008. Homicides and suicides are both associated with the copycat phenomenon. The aim of the present study was to characterize adolescent copycats who had threatened to carry out a school massacre. Methods The nation-wide study evaluated 77 13- to 18-year-old adolescents who were sent for adolescent psychiatric evaluations between 8.11.2007 and 30.6.2009, one of the reasons for evaluation being a threat of massacre at school. The medical files of the copycats were retrospectively analysed using a special data collection form. Data on demographics, family- and school-related issues, previous psychiatric treatment and previous delinquency, current symptoms, family adversities and psychiatric diagnoses were collected. The severity of the threat expressed and the risk posed by the adolescent in question were evaluated. The Psychopathy Checklist Youth Version was used to assess psychopathic traits. Results All of the copycats were native Finns with a mean age of 15.0 years. Almost two thirds of them had a history of previous mental health treatment before the index threat. Almost two thirds of the copycats suffered from anxiety and depressive symptoms, and almost half of the sample expressed either suicidal ideation or suicidal plans. Behavioural problems including impulse control problems, aggressive outbursts, the destruction of property as well as non-physical and physical violence against other persons were common. The diagnosis groups highlighted were behavioural and emotional disorders, mood disorders as well as schizophrenia-related disorders. The prevalence of pervasive developmental disorders was high. Only one of the copycats was assessed as expressing high traits of psychopathy. Conclusion The copycats with school massacre threats were characterized with a high prevalence of mental and behavioural disorders. Like actual school shooters, they

  13. Effects of motivational interviewing on smoking cessation in adolescents with psychiatric disorders

    PubMed Central

    Brown, R; Ramsey, S; Strong, D; Myers, M; Kahler, C; Lejuez, C; Niaura, R; Pallonen, U; Kazura, A; Goldstein, M; Abrams, D

    2003-01-01

    Objective:To test the hypothesis that among adolescent smokers hospitalised for psychiatric and substance use disorders, motivational interviewing (MI) would lead to more and longer quit attempts, reduced smoking, and more abstinence from smoking over a 12 month follow up. Design:Randomised control trial of MI versus brief advice (BA) for smoking cessation, with pre- and post-intervention assessment of self efficacy and intentions to change, and smoking outcome variables assessed at one, three, six, nine, and 12 month follow ups. Setting:A private, university affiliated psychiatric hospital in Providence, Rhode Island, USA. Patients or other participants:Consecutive sample (n = 191) of 13–17 year olds, admitted for psychiatric hospitalisation, who smoked at least one cigarette per week for the past four weeks, had access to a telephone, and did not meet DSM-IV criteria for current psychotic disorder. Interventions:MI versus BA. MI consisted of two, 45 minute individual sessions, while BA consisted of 5–10 minutes of advice and information on how to quit smoking. Eligible participants in both conditions were offered an eight week regimen of transdermal nicotine patch upon hospital discharge. Main outcome measures:Point prevalence abstinence, quit attempts, changes in smoking rate and longest quit attempt. Proximal outcomes included intent to change smoking behaviour (upon hospital discharge), and self efficacy for smoking cessation. Results:MI did not lead to better smoking outcomes compared to BA. MI was more effective than BA for increasing self efficacy regarding ability to quit smoking. A significant interaction of treatment with baseline intention to quit smoking was also found. MI was more effective than BA for adolescents with little or no intention to change their smoking, but was actually less effective for adolescents with pre-existing intention to cut down or quit smoking. However, the effects on these variables were relatively modest and only

  14. Health-related quality of life in adolescents with inflammatory bowel disease depends on disease activity and psychiatric comorbidity.

    PubMed

    Engelmann, G; Erhard, D; Petersen, M; Parzer, P; Schlarb, A A; Resch, F; Brunner, R; Hoffmann, G F; Lenhartz, H; Richterich, A

    2015-04-01

    Adolescent patients with inflammatory bowel disease (IBD) show an increased risk for behavioral and emotional dysfunction. Health-related quality of life (HRQoL) is influenced by medical illnesses, as well as by psychiatric disorders, but for adolescents with IBD, the extent to which HRQoL is influenced by these two factors is unclear. For 47 adolescent IBD patients, we analyzed disease activity, HRQoL and whether or not a psychiatric disorder was present. Disease activity was estimated using pediatric Ulcerative Colitis Activity Index and pediatric Crohn's Disease Activity Index. The IMPACT-III and the EQ-5D were used to measure HRQoL and QoL, respectively. In addition, patient and parent diagnostic interviews were performed. 55.3 % patients fulfilled DSM-IV criteria for one or more psychiatric disorders. In all patients, psychiatric comorbidity together with disease activity contributed to a reduction in quality of life. Adolescents with IBD are at a high risk for clinically relevant emotional or behavioral problems resulting in significantly lower HRQoL. We conclude that accessible, optimally structured psychotherapeutic and/or psychiatric help is needed in adolescent patients with IBD.

  15. Treatment of psychiatric disorders in children and adolescents with HIV/AIDS.

    PubMed

    Benton, Tami D

    2010-04-01

    We could not have predicted that HIV/AIDS would become one of our greatest public health challenges worldwide when the first cases were identified in the 1980s. More than 22 million people have died from the disease, and HIV is now the seventh-leading cause of death in the United States among 15- to 24-year-olds. At the beginning of this pandemic, most HIV infections of youth were acquired congenitally. Prenatal screening of pregnant women, early detection, and antiretroviral therapies have reduced mother-to-child transmission. Children born with HIV infections are now young adults living with HIV, while other adolescents are acquiring HIV primarily through high-risk behaviors. Associations between psychiatric symptoms and poor health outcomes have been recognized among adults. Few studies have examined these factors among youth. We review what is known about psychiatric syndromes among HIV-positive youth, and their treatments.

  16. The contribution of children's temperamental fear and effortful control to restraint and seclusion during inpatient treatment in a psychiatric hospital.

    PubMed

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

    2012-12-01

    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 children with poor effortful control (EC) and greater frustration would have more instances of R/S during psychiatric hospitalization. The contribution of children's fearfulness to R/S was also examined. A measure of temperament was completed by youths' clinicians and youths (n = 52) completed objective measures of EC. The frequency of R/S events for each participant was obtained from hospital records. After controlling for R/S risk factors, lower EC and higher fearfulness predicted increased R/S occurrences during the first 2 weeks of hospitalization and over the course of children's entire hospitalization. These findings indicate that temperament should potentially be considered in individualized treatment plans targeting the prevention and/or reduction of R/S. Additional implications of the findings are also discussed.

  17. Psychiatric Problems and Trauma Exposure in Non-detained Delinquent and Non-delinquent Adolescents

    PubMed Central

    Adams, Zachary W.; McCart, Michael R.; Zajac, Kristyn; Danielson, Carla Kmett; Sawyer, Genelle K.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2014-01-01

    Objective This study examined the prevalence of and associations between specific psychiatric disorders, substance use problems, and trauma exposure in a sample of delinquent and non-delinquent adolescents. Method A nationally representative sample of adolescents (n = 3,614; mean age = 14.5 years, SD = 1.7; 51% male; 71% White, non-Hispanic, 13.3% African American, non-Hispanic, 10.7% Hispanic) was interviewed via telephone about engagement in delinquent acts and their experience of posttraumatic stress disorder, major depressive episode, substance use, interpersonal violence, and other forms of trauma exposure. Results Delinquent adolescents were more likely than non-delinquent adolescents to experience trauma; they were also more likely to report past-year posttraumatic stress disorder, major depressive episode, alcohol abuse, and non-experimental drug use. After accounting for the effects of demographics and trauma exposure, delinquency was associated with increased likelihood of posttraumatic stress disorder and problematic substance use in both genders and increased likelihood of major depressive episode in girls. Conclusions Findings highlight substantial overlap among delinquency, trauma exposure, posttraumatic stress disorder, and major depressive episode in adolescents and the need for interventions that address these varied clinical problems. Future work should examine the factors underlying the development of these relations over time. PMID:23236966

  18. Likelihood of obtaining Structured Interview of Reported Symptoms (SIRS) and SIRS-2 elevations among forensic psychiatric inpatients with screening elevations on the Miller Forensic Assessment of Symptoms Test.

    PubMed

    Glassmire, David M; Tarescavage, Anthony M; Gottfried, Emily D

    2016-12-01

    The Miller Forensic Assessment of Symptoms Test (M-FAST) was designed as a screening measure for feigned psychiatric symptoms. When M-FAST Total Scores are elevated (raw score ≥6), the test manual recommends follow-up with a more comprehensive measure of feigning, such as the widely used and researched Structured Interview of Reported Symptoms (SIRS) or the revised version of the test (SIRS-2). The purpose of the current study was to evaluate how often M-FAST screening elevations are associated with subsequent elevations on the SIRS or SIRS-2. The sample included archival data from 100 forensic psychiatric inpatients who obtained M-FAST Total Score elevations ≥6 during screening and were subsequently administered the SIRS (that was also rescored using SIRS-2 criteria). Among examinees who elevated the M-FAST over the recommended cutoff, 66.0% met standard SIRS feigning criteria, 42% met SIRS-2 criteria for feigning, and 81.0% obtained at least 1 SIRS/SIRS-2 elevation in the Probable Feigning range or higher. These results are consistent with the M-FAST manual guidelines, which support the use of the ≥6 M-FAST cutoff score to screen for potential feigning (but not as an independent marker of feigning). A higher M-FAST cutoff score of ≥16 was associated with subsequently meeting full SIRS criteria for feigning in 100.0% of protocols. Because the SIRS criteria were designed to have very low false positive rates, these findings indicate that more confident assertions about feigning can be made when elevations reach this level on the MFAST. (PsycINFO Database Record

  19. Childhood and adolescent onset psychiatric disorders, substance use, and failure to graduate high school on time.

    PubMed

    Breslau, Joshua; Miller, Elizabeth; Joanie Chung, W-J; Schweitzer, Julie B

    2011-03-01

    We examined the joint predictive effects of childhood and adolescent onset psychiatric and substance use disorders on failure to graduate high school (HS) on time. Structured diagnostic interviews were conducted with a US national sample of adults (18 and over). The analysis sample included respondents with at least 8 years of education who were born in the US or arrived in the US prior to age 13 (N = 29,662). Psychiatric disorders, substance use and substance use disorders were examined as predictors of termination or interruption of educational progress prior to HS graduation, with statistical adjustment for demographic characteristics and childhood adversities. Failure to graduate HS on time was more common among respondents with any of the psychiatric and substance use disorders examined, ranging from 18.1% (specific phobia) to 33.2% (ADHD-combined type), compared with respondents with no disorder (15.2%). After adjustment for co-occurring disorders, significant associations with failure to graduate on time remained only for conduct disorder (OR = 1.89, 95% CI 1.57-2.26) and the three ADHD subtypes (Inattentive OR = 1.78, 95% CI 1.44-2.20, Hyperactive-Impulsive OR = 1.38, 95% CI 1.14-1.67, and Combined OR = 2.06, 95% CI 1.66-2.56). Adjusting for prior disorders, tobacco use was associated with failure to graduate on time (OR = 1.97, 95% CI 1.80-2.16). Among substance users, substance use disorders were not associated with on-time graduation. The findings suggest that the adverse impact of childhood and adolescent onset psychiatric disorders on HS graduation is largely accounted for by problems of conduct and inattention. Adjusting for these disorders, smoking remains strongly associated with failure to graduate HS on time.

  20. A Novel Screening and Diagnostic Tool for Child and Adolescent Psychiatric Disorders for Telepsychiatry

    PubMed Central

    Malhotra, Savita; Chakrabarti, Subho; Shah, Ruchita; Mehta, Anurati; Gupta, Aarzoo; Sharma, Minali

    2015-01-01

    Background: A diagnostic tool designed as part of a telepsychiatry application for diagnosis and management of child and adolescent psychiatric disorders in India was developed considering the paucity of trained child psychiatrists and mental health professionals in India. Materials and Methods: The diagnostic tool consisted of screening and 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) criteria-based diagnostic algorithms for 18 psychiatric disorders seen in childhood and adolescence. Accuracy of diagnoses and feasibility of use of the tool was examined by comparing it with detailed semi-structured clinical evaluations by a qualified psychiatrist with 50 psychiatric patients (children and adolescents). Statistical Analysis: Descriptive analyses and paired t-tests were conducted to compare the mean number of diagnosis generated by the two interviews. Sensitivity, specificity, positive and negative predictive values were computed for the screening and the diagnostic sub-modules of the tool, compared to the clinical diagnoses. Kappa coefficients were computed to assess agreement between the diagnoses generated by the diagnostic sub-module and the clinical diagnoses. Results: The screening sub-module had high sensitivity, high specificity and negative predictive values for all disorders. For the diagnostic sub-module, there was moderate (kappa-0.4–0.6) to substantial agreement (kappa > 0.6) for all the disorders, (except psychosis) and high sensitivity (barring a few disorders) and specificity for almost all the disorders. Positive predictive values were found to be acceptable to high for most disorders, with consistently high negative predictive values. Conclusion: The new tool was found to be comprehensive, reasonably short and feasible. Results showed acceptable level of accuracy in diagnosis generated by the tool. PMID:26424901

  1. A comparison of pattern of psychiatric symptoms in inpatients with bipolar disorder type one with & without methamphetamine use

    PubMed Central

    Gouran Ourimi, Elham; Shabani, Amir; Alavi, Kaveh; Najarzadegan, Mohammad Reza; Mirfazeli, Fatemehsadat

    2016-01-01

    Background: Iran is facing an outbreak of methamphetamine-induced disorders and frequent use of these substances in patients with bipolar disorder. Using or intoxication of methamphetamine in patients with bipolar I disorder may alter the patient's clinical profile; however there is limited studies about impact of methamphetamine on clinical manifestation of bipolar disorders. This study aimed to compare psychiatric symptoms in patients with bipolar I disorder with and without concomitant use of methamphetamine. Methods: In a cross-sectional study, psychiatric symptoms of bipolar I disorder in patients with (Meth+) and without (Meth-) methamphetamine use was evaluated. A number of 57 participants with Meth + and 50 subjects with Meth- were recruited. The clinical picture of bipolar disorder was investigated by Young Mania Rating Scale (YMRS), 17-item Hamilton Depressive Rating Scale (HDRS-17) and the Scale for Assessment of Positive Symptoms (SAPS). Statistical comparisons were performed using the T-test for independent samples and Mann- Whitney test. Results: There was no statistically significant difference between two groups regarding age, duration of illness and hospitalizations. However, male participants were significantly higher in Meth+ group than in Meth- one (p<0.001). The mean (± SD) scores in the two groups of Meth+ and Meth- for YMRS, HDRS, and SAPS were 31.3 (±1.3) and 34.0 (±1.2), 13.7 (±0.7) and 13.5±(0.5), and 50.0 (±1.9) and 48.0 (±2.1), respectively, which were not statistically significant (p<0.05). Conclusion: There was no significant difference in the overall clinical manifestation of bipolar I disorder in patients with and without methamphetamine use. However, in some symptomatology domains, there were some differences between the two groups. PMID:28210586

  2. A comparison of pattern of psychiatric symptoms in inpatients with bipolar disorder type one with & without methamphetamine use.

    PubMed

    Gouran Ourimi, Elham; Shabani, Amir; Alavi, Kaveh; Najarzadegan, Mohammad Reza; Mirfazeli, Fatemehsadat

    2016-01-01

    Background: Iran is facing an outbreak of methamphetamine-induced disorders and frequent use of these substances in patients with bipolar disorder. Using or intoxication of methamphetamine in patients with bipolar I disorder may alter the patient's clinical profile; however there is limited studies about impact of methamphetamine on clinical manifestation of bipolar disorders. This study aimed to compare psychiatric symptoms in patients with bipolar I disorder with and without concomitant use of methamphetamine. Methods: In a cross-sectional study, psychiatric symptoms of bipolar I disorder in patients with (Meth+) and without (Meth-) methamphetamine use was evaluated. A number of 57 participants with Meth + and 50 subjects with Meth- were recruited. The clinical picture of bipolar disorder was investigated by Young Mania Rating Scale (YMRS), 17-item Hamilton Depressive Rating Scale (HDRS-17) and the Scale for Assessment of Positive Symptoms (SAPS). Statistical comparisons were performed using the T-test for independent samples and Mann- Whitney test. Results: There was no statistically significant difference between two groups regarding age, duration of illness and hospitalizations. However, male participants were significantly higher in Meth+ group than in Meth- one (p<0.001). The mean (± SD) scores in the two groups of Meth+ and Meth- for YMRS, HDRS, and SAPS were 31.3 (±1.3) and 34.0 (±1.2), 13.7 (±0.7) and 13.5±(0.5), and 50.0 (±1.9) and 48.0 (±2.1), respectively, which were not statistically significant (p<0.05). Conclusion: There was no significant difference in the overall clinical manifestation of bipolar I disorder in patients with and without methamphetamine use. However, in some symptomatology domains, there were some differences between the two groups.

  3. Assessing the contribution of borderline personality disorder and features to suicide risk in psychiatric inpatients with bipolar disorder, major depression and schizoaffective disorder.

    PubMed

    Zeng, Ruifan; Cohen, Lisa J; Tanis, Thachell; Qizilbash, Azra; Lopatyuk, Yana; Yaseen, Zimri S; Galynker, Igor

    2015-03-30

    Suicidal behavior often accompanies both borderline personality disorder (BPD) and severe mood disorders, and comorbidity between the two appears to further increase suicide risk. The current study aims to quantify the risk of suicidality conferred by comorbid BPD diagnosis or features in three affective disorders: major depressive disorder (MDD), bipolar disorder (BP) and schizoaffective disorder. One hundred forty-nine (149) psychiatric inpatients were assessed by SCID I and II, and the Columbia Suicide Severity Rating Scale. Logistic regression analyses investigated the associations between previous suicide attempt and BPD diagnosis or features in patients with MDD, BP, and schizoaffective disorder, as well as a history of manic or major depressive episodes, and psychotic symptoms. Comorbid BPD diagnosis significantly increased suicide risk in the whole sample, and in those with MDD, BP, and history of depressive episode or psychotic symptoms. Each additional borderline feature also increased risk of past suicide attempt in these same groups (excepting BP) and in those with a previous manic episode. Of the BPD criteria, only unstable relationships and impulsivity independently predicted past suicide attempt. Overall, among patients with severe mood disorders, the presence of comorbid BPD features or disorder appears to substantially increase the risk of suicide attempts.

  4. Social and psychiatric functioning in adolescents with Asperger syndrome compared with conduct disorder.

    PubMed

    Green, J; Gilchrist, A; Burton, D; Cox, A

    2000-08-01

    Lack of standardized phenotypic definition has made outcome studies of Asperger syndrome (AS) difficult to interpret. This paper reports psychosocial functioning in 20 male adolescents with AS, defined according to current ICD-10 criteria, and a comparison group of 20 male adolescents with severe conduct disorder. Subjects were gathered from clinical referral. Evaluation used standardized interviewer rated assessments of social functioning and psychiatric morbidity. The AS group showed severe impairments in practical social functioning despite good cognitive ability and lack of significant early language delay. High levels of anxiety and obsessional disorders were found in AS; depression, suicidal ideation, tempers, and defiance in both groups. Results are compared with those from other studies. Relevance to clinical ascertainment and treatment is discussed.

  5. A 5-year retrospective study of demographic, anamnestic, and clinical factors related to psychiatric hospitalizations of adolescent patients

    PubMed Central

    Di Lorenzo, Rosaria; Cimino, Nina; Di Pietro, Elena; Pollutri, Gabriella; Neviani, Vittoria; Ferri, Paola

    2016-01-01

    Background Psychiatric emergencies of children and adolescents have greatly increased during the last years, but this phenomenon has not been studied in detail. The aim of this study was to analyze the correlation between acute psychiatric hospitalizations of adolescents and selected variables to highlight risk factors for psychiatric emergencies. Methods This retrospective research was conducted in the acute psychiatric public ward, Service of Psychiatric Diagnosis and Treatment (SPDT), and in the residential facility for adolescents, “The Medlar”, located in Modena. The sample was constituted by all adolescent patients (n=101, age range 14–18) who had acute hospitalizations (n=140) in SPDT and had been successively transferred to “The Medlar” (n=83), from February 2, 2010 to January 31, 2015. From clinical charts, we extracted demographic and anamnestic characteristics of patients and clinical variables related to hospitalizations. Data were statistically analyzed. Results Sixty-one percent of our patients lived with one divorced parent, with adoptive or immigrant family, or in institutions; 51% had experienced stressful events during childhood; 81% had a normal intellective level, but only 6% presented regular school performance. Parental psychiatric illness was negatively related, in a statistically significantly way, with onset age of adolescent mental disorders (coefficient −2.28, 95% confidence interval [CI]: −3.53 to 1.01, P<0.001, single linear regression; odds ratio: 4.39, 95% CI: 1.43–13.47, P<0.010, single logistic regression). The most frequent reasons for admission were aggressive behavior in males and suicide risk in females (P=0.002). The most frequent psychiatric diagnosis at SPDT discharge was “conduct disorder”, more frequent in males, followed by “adjustment disorder”, more frequent in females (P=0.001). In SPDT, the adolescent hospitalizations progressively increased fivefold at the end of the observation period

  6. Variations in Risk and Treatment Factors among Adolescents Engaging in Different Types of Deliberate Self-Harm in an Inpatient Sample

    ERIC Educational Resources Information Center

    Boxer, Paul

    2010-01-01

    This study employs a framework adopted in 2008 by Jacobson, Muehlenkamp, Miller, and Turner to explore differences in risk and treatment factors in a sample of 476 adolescent inpatients grouped with relation to their involvement in deliberately self-harmful (DSH) behavior. Participants were assigned to groups indicating no DSH, nonsuicidal…

  7. Psychiatric comorbidity distribution and diversities in children and adolescents with attention deficit/hyperactivity disorder: a study from Turkey

    PubMed Central

    Yüce, Murat; Zoroglu, Süleyman Salih; Ceylan, Mehmet Fatih; Kandemir, Hasan; Karabekiroglu, Koray

    2013-01-01

    Objective We aimed to determine distribution and diversities of psychiatric comorbidities in children and adolescents with attention deficit/hyperactivity disorder (ADHD) in terms of age groups, sex, and ADHD subtype. Materials and methods The sample included 6–18 year old children and adolescents from Turkey (N=108; 83 boys, 25 girls) diagnosed with ADHD. All comorbid diagnoses were determined based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version assessment. Results 96.3% of the cases were found to have at least one psychiatric comorbid diagnosis. The most frequent psychiatric comorbid disorder was oppositional defiant disorder (69.4%) followed by anxiety disorders (49%) and elimination disorders (27.8%). Disruptive behavior disorders were more common in ADHD-combined type. Depression and anxiety disorders were more common in girls. Separation anxiety disorder and elimination disorder were more common in children, whereas depression, bipolar disorder, obsessive–compulsive disorder, and social phobia were more common in the adolescents. Conclusion According to our results, when a diagnostic tool was used to assess the presence of comorbid psychiatric disorders in children and adolescents diagnosed with ADHD, almost all cases had at least one comorbid diagnosis. Therefore, especially in the clinical sample, ADHD cases should not be solely interpreted with ADHD symptom domains, instead they should be investigated properly in terms of accompanying psychiatric disorders. PMID:24265552

  8. Doing their best: strategies used by South African clinicians in working with psychiatric inpatients across a language barrier

    PubMed Central

    Kilian, Sanja; Swartz, Leslie; Chiliza, Bonginkosi

    2015-01-01

    Background and objectives South Africa has 11 official languages, but most psychiatrists can speak only English and Afrikaans and there are no formal interpreter posts in the mental healthcare system. As a result clinicians communicate with patients who have limited English language proficiency (LEP) without the use of interpreters. We present case material, constituting recordings of interactions between clinicians and LEP patients in a public psychiatric institution. The aim is to have a better understanding of how these clinical encounters operated and what communicative strategies clinicians used. Design We used the Roter interaction analysis system (RIAS) to evaluate clinicians’ conversational strategies and to analyze interactions between clinicians and patients. Results Clinicians showed a high degree of tenacity in trying to engage patients in the clinical conversation, build rapport, and gather crucial diagnostic information. However, patients often responded briefly and monosyllabically, or kept quiet. In psychiatry where commonality of language cannot be assumed, it is not possible to determine the clinical significance of these responses. Discussion Clinicians went to great lengths to understand LEP patients. It is also clear that patients were often not optimally understood. Clinicians would try to gain valid information in a polite manner, but would abandon these attempts repeatedly as it became clear that proper communication was not possible. Conclusions Our findings suggest that in the absence of interpreter services, the communication between clinicians and LEP patients is sparse and yields limited clinical information. The lack of proper language services stands in the way of optimal clinical care and requires urgent attention. PMID:26507606

  9. Non-Suicidal Self-Injury Disorder: An Empirical Investigation in Adolescent Psychiatric Patients

    PubMed Central

    Glenn, Catherine R.; Klonsky, E. David

    2013-01-01

    Objective Non-suicidal self-injury (NSSI) is a growing public health concern, especially among adolescents. In the current edition of the Diagnostic and Statistical Manual of Mental Disorders, NSSI is classified as a criterion of borderline personality disorder (BPD). However, a distinct NSSI disorder will now be included in DSM-5 as a “condition requiring further study.” Importantly, at this time, there is little direct evidence supporting the DSM-5 proposal over the DSM-IV classification. To address this need, the current study examined the extent to which NSSI occurs independently of BPD, and has clinical significance beyond a diagnosis of BPD in adolescent psychiatric patients. Method NSSI disorder was assessed based on the proposed DSM-5 criteria in 198 adolescents ages 12 to 18 (74% female; 64% Caucasian, 14% Hispanic, 10% African American, and 12% mixed/other ethnicity) from a psychiatric hospital. Major Axis I disorders, Axis II BPD, and suicide ideation and attempts were assessed with structured clinical interviews; emotion dysregulation and loneliness were measured with validated self-report questionnaires. Results First, results indicate that NSSI disorder occurs independently of BPD. Specifically, although there was overlap between the occurrence of BPD and NSSI disorder, this overlap was no greater than that between BPD and other Axis I disorders (e.g., anxiety and mood disorders). Second, NSSI disorder demonstrated unique associations with clinical impairment – indexed by suicide ideation and attempts, emotion dysregulation, and loneliness – over and above a BPD diagnosis. Conclusions Taken together, findings support the classification of NSSI as a distinct and clinically significant diagnostic entity. PMID:23682597

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

    PubMed

    2010-08-16

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

  11. Psychiatric and Substance Use Disorders as Risk Factors for Attempted Suicide among Adolescents: A Case Control Study.

    ERIC Educational Resources Information Center

    Kelly, Thomas M.; Cornelius, Jack R.; Lynch, Kevin G.

    2002-01-01

    Tests substance-related and non-substance-related psychiatric disorders as predictors of attempted suicide among adolescents. Bipolar disorder, cocaine use disorders, and conduct disorder were found to be predictive of attempted suicide in univariate testing. Higher rates of cocaine use disorder/conduct disorder, hallucinogen use disorder/conduct…

  12. Longitudinal Trajectories and Predictors of Adolescent Suicidal Ideation and Attempts Following Inpatient Hospitalization

    ERIC Educational Resources Information Center

    Prinstein, Mitchell J.; Nock, Matthew K.; Simon, Valerie; Aikins, Julie Wargo; Cheah, Charissa S. L.; Spirito, Anthony

    2008-01-01

    Remarkably little is known regarding the temporal course of adolescent suicidal ideation and behavior, the prediction of suicidal attempts from changes in suicidal ideation, or the prediction of suicidal attempts after accounting for suicidal ideation as a predictor. A sample of 143 adolescents 12-15 years old was assessed during psychiatric…

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

    ERIC Educational Resources Information Center

    Johnson, Daniel C.

    2010-01-01

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

  14. Bullying behaviour in schools, socioeconomic position and psychiatric morbidity: a cross-sectional study in late adolescents in Greece

    PubMed Central

    2012-01-01

    Background Bullying is quite prevalent in the school setting and has been associated with the socioeconomic position and psychiatric morbidity of the pupils. The aim of the study was to investigate the association between bullying and socioeconomic status in a sample of Greek adolescents and to examine whether this is confounded by the presence of psychiatric morbidity, including sub-threshold forms of illness. Methods 5,614 adolescents aged 16-18 years old and attending 25 senior high schools were screened and a stratified random sample of 2,427 were selected for a detailed interview. Psychiatric morbidity was assessed with a fully structured psychiatric interview, the revised Clinical Interview Schedule (CIS-R), while bullying was assessed with the revised Olweus bully/victim questionnaire. The following socio-economic variables were assessed: parental educational level and employment status, financial difficulties of the family and adolescents' school performance. The associations were investigated using multinomial logit models. Results 26.4% of the pupils were involved in bullying-related behaviours at least once monthly either as victims, perpetrators or both, while more frequent involvement (at least once weekly) was reported by 4.1%. Psychiatric morbidity was associated with all types of bullying-related behaviours. No socioeconomic associations were reported for victimization. A lower school performance and unemployment of the father were significantly more likely among perpetrators, while economic inactivity of the mother was more likely in pupils who were both victims and perpetrators. These results were largely confirmed when we focused on high frequency behaviours only. In addition, being overweight increased the risk of frequent victimization. Conclusions The prevalence of bullying among Greek pupils is substantial. Perpetration was associated with some dimensions of adolescents' socioeconomic status, while victimization showed no socioeconomic

  15. Treatment of Co-Occurring Substance Abuse and Suicidality among Adolescents: A Randomized Trial

    ERIC Educational Resources Information Center

    Esposito-Smythers, Christianne; Spirito, Anthony; Kahler, Christopher W.; Hunt, Jeffrey; Monti, Peter

    2011-01-01

    Objective: This study tested a cognitive-behavioral treatment protocol for adolescents with a co-occurring alcohol or other drug use disorder (AOD) and suicidality in a randomized clinical trial. Method: Forty adolescents (M[subscript age] = 15 years; 68% female, 89% White) and their families recruited from an inpatient psychiatric hospital were…

  16. Treatment for Adolescents Following a Suicide Attempt: Results of a Pilot Trial.

    ERIC Educational Resources Information Center

    Donaldson, Deidre; Spirito, Anthony; Esposito-Smythers, Christianne

    2005-01-01

    Objective: To compare the efficacy of a skills-based treatment protocol to a supportive relationship therapy for adolescents after a suicide attempt. Method: Thirty-nine adolescents (12-17 years old) and parents who presented to a general pediatric emergency department or inpatient unit of a child psychiatric hospital after a suicide attempt were…

  17. Assessment of PIC and MMPI Scales in Adolescent Psychosis: A Caution.

    ERIC Educational Resources Information Center

    Davies, Allison; And Others

    1987-01-01

    Investigated sensitivity of Personality Inventory for Children (PIC) and Minnesota Multiphasic Personality Inventory (MMPI) in assessing psychotic states in adolescents. Results from comparison of 29 psychotic and 58 nonpsychotic adolescent psychiatric inpatients suggest the need for a profile-analytic approach to PIC and MMPI interpretation in…

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

    PubMed Central

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

    2013-01-01

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

  19. Motor abilities of children and adolescents with a psychiatric condition: A systematic literature review

    PubMed Central

    Damme, Tine Van; Simons, Johan; Sabbe, Bernard; van West, Dirk

    2015-01-01

    AIM: To summarize research regarding the motor abilities of children and adolescents who suffer from a common psychiatric condition. METHODS: In order to outline the current knowledge regarding the motor abilities of children and adolescents with autism spectrum disorders (ASD), attention deficit hyperactivity disorder (ADHD), disruptive behavior disorders (DBD) and depression, a comprehensive systematic literature search was carried out using PubMed, Medline and ERIC databases. The databases were searched for relevant English language articles published between January 1990 and April 2014. Only studies that conducted a quantitative evaluation of motor ability and concerned individuals aged 0-18 years were included. A separate search was conducted for each disorder (ASD, ADHD, DBD, depression) in conjunction with each of the following keywords: (psycho/perceptuo) motor/movement skill(s), (psycho/perceptuo) motor/movement abilities, (psycho/perceptuo) motor/movement impairment, (psycho/perceptuo) motor/movement problem(s), motor function, motor coordination, motor performance, motor deficit(s). To detect supplementary relevant literature, the reference lists of the retrieved articles were examined. RESULTS: The search strategy yielded 51 studies meeting the inclusion criteria. In total, 28 studies were included that examined the motor abilities of children and adolescents with ASD. All studies indicated that they performed below average on various standardized motor assessment instruments. The overall prevalence rate for impairment in motor abilities ranged from 33% to 100%. Twenty-seven studies examined the motor abilities of children and adolescents with ADHD. Depending on the type of motor assessment tool and the cut-off points used by different researchers, prevalence rates of impairment in motor abilities are highly variable and ranged from 8% to 73%. Remarkably, there is a paucity of research addressing the motor abilities of individuals with DBD or depression

  20. Subregional Hippocampal Morphology and Psychiatric Outcome in Adolescents Who Were Born Very Preterm and at Term

    PubMed Central

    Cole, James H.; Filippetti, Maria Laura; Allin, Matthew P. G.; Walshe, Muriel; Nam, Kie Woo; Gutman, Boris A.; Murray, Robin M.; Rifkin, Larry; Thompson, Paul M.; Nosarti, Chiara

    2015-01-01

    Background The hippocampus has been reported to be structurally and functionally altered as a sequel of very preterm birth (<33 weeks gestation), possibly due its vulnerability to hypoxic–ischemic damage in the neonatal period. We examined hippocampal volumes and subregional morphology in very preterm born individuals in mid- and late adolescence and their association with psychiatric outcome. Methods Structural brain magnetic resonance images were acquired at two time points (baseline and follow-up) from 65 ex-preterm adolescents (mean age = 15.5 and 19.6 years) and 36 term-born controls (mean age=15.0 and 19.0 years). Hippocampal volumes and subregional morphometric differences were measured from manual tracings and with three-dimensional shape analysis. Psychiatric outcome was assessed with the Rutter Parents’ Scale at baseline, the General Health Questionnaire at follow-up and the Peters Delusional Inventory at both time points. Results In contrast to previous studies we did not find significant difference in the cross-sectional or longitudinal hippocampal volumes between individuals born preterm and controls, despite preterm individual having significantly smaller whole brain volumes. Shape analysis at baseline revealed subregional deformations in 28% of total bilateral hippocampal surface, reflecting atrophy, in ex-preterm individuals compared to controls, and in 22% at follow-up. In ex-preterm individuals, longitudinal changes in hippocampal shape accounted for 11% of the total surface, while in controls they reached 20%. In the whole sample (both groups) larger right hippocampal volume and bilateral anterior surface deformations at baseline were associated with delusional ideation scores at follow-up. Conclusions This study suggests a dynamic association between cross-sectional hippocampal volumes, longitudinal changes and surface deformations and psychosis proneness. PMID:26091104

  1. Chronic Stress and Adolescents' Mental Health: Modifying Effects of Basal Cortisol and Parental Psychiatric History. The TRAILS Study.

    PubMed

    Zandstra, Anna Roos E; Hartman, Catharina A; Nederhof, Esther; van den Heuvel, Edwin R; Dietrich, Andrea; Hoekstra, Pieter J; Ormel, Johan

    2015-08-01

    Large individual differences in adolescent mental health following chronic psychosocial stress suggest moderating factors. We examined two established moderators, basal cortisol and parental psychiatric history, simultaneously. We hypothesized that individuals with high basal cortisol, assumed to indicate high context sensitivity, would show relatively high problem levels following chronic stress, especially in the presence of parental psychiatric history. With Linear Mixed Models, we investigated the hypotheses in 1917 Dutch adolescents (53.2% boys), assessed at ages 11, 13.5, and 16. Low basal cortisol combined with the absence of a parental psychiatric history increased the risk of externalizing but not internalizing problems following chronic stress. Conversely, low basal cortisol combined with a substantial parental psychiatric history increased the risk of internalizing but not externalizing problems following chronic stress. Thus, parental psychiatric history moderated stress- cortisol interactions in predicting psychopathology, but in a different direction than hypothesized. We conclude that the premise that basal cortisol indicates context sensitivity may be too crude. Context sensitivity may not be a general trait but may depend on the nature of the context (e.g., type or duration of stress exposure) and on the outcome of interest (e.g., internalizing vs. externalizing problems). Although consistent across informants, our findings need replication.

  2. [Structural quality in inpatient and daycare child and adolescent psychiatry- indicators for planning future staff ratios for the era following the Psychiatry Personnel Act].

    PubMed

    Schepker, Renate; Fegert, Jörg M; Becker, Katja

    2015-11-01

    The German Psychiatry Personnel Act, which went into effect in 1990, has led to a decrease in the number of child and adolescent psychiatry inpatient beds, to a decrease in the length of stay, and to an increase in inpatient psychotherapy. Today, this act is outdated~ for a number of reasons, such as changes in the morbidity of the population, the rising number of emergencies, and new professional standards such as documentation. In addition, new legal provisions and conventions (like the UN Convention on the Rights of the Child) necessitate a complete reevaluation. Child and adolescent psychiatry needs a normative act to enable the necessary implementation. Many different rationales are available to support the debate.

  3. Treating Children and Adolescents in Residential and Inpatient Settings. Developmental Clinical Psychology and Psychiatry. Volume 36.

    ERIC Educational Resources Information Center

    Lyman, Robert D.; Campbell, Nancy R.

    This book examines the various components of hospital, residential, and outpatient treatments for children and adolescents with mental disorders. Options and settings for residential care are presented, including the principles and practical issues, such as providing continuing education, that underlie the decision making for placement of youth in…

  4. Examining Outcomes of Acute Psychiatric Hospitalization among Children

    PubMed Central

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

    2013-01-01

    Within the past two decades, few studies have examined outcomes of acute psychiatric hospitalization among children, demonstrating change in emotional and behavioral functioning. A secondary analysis of pre-test/post-test data collected on 36 children was conducted, using the Target Symptom Rating (TSR). The TSR is a 13-item measure with two subscales – Emotional Problems and Behavioral Problems and was designed for 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. PMID:23946699

  5. Inpatient and Emergency Room Visits for Adolescents and Young Adults With Spina Bifida Living in South Carolina

    PubMed Central

    Mann, Joshua R.; Royer, Julie A.; Turk, Margaret A.; McDermott, Suzanne; Holland, Margaret M.; Ozturk, Orgul D.; Hardin, James W.; Thibadeau, Judy K.

    2015-01-01

    Objective To compare emergency room (ER) and inpatient hospital (IP) use rates for persons with spina bifida (SB) to peers without SB, when transition from pediatric to adult health care is likely to occur; and to analyze those ER and IP rates by age, race, socioeconomic status, gender, and type of residential area. Design A retrospective cohort study. Setting Secondary data analysis in South Carolina. Participants We studied individuals who were between 15 and 24 years old and enrolled in the State Health Plan (SHP) or state Medicaid during the 2000–2010 study period. Methods Individuals with SB were identified using ICD-9 billing codes (741.0, 741.9) in SHP, Medicaid, and hospital uniform billing (UB) data. ER and IP encounters were identified using UB data. Multivariable Generalized Estimating Equation (GEE) Poisson models were estimated to compare rates of ER and IP use among the SB group to the comparison group. Main Outcome Measures Total ER rate and IP rate, in addition to cause-specific rates for ambulatory care sensitive conditions (ACSC) and other condition categories. Results We found higher rates of ER and IP use in persons with SB compared to the control group. Among individuals with SB, young adults (those 20–24 years old) had higher rates of ER use due to all ACSC (P = .023), other ACSC (P = .04), and urinary tract infections (UTI; P = .002) compared to adolescents (those 15–19 years old). Conclusions Young adulthood is associated with increased ER use overall, as well as in specific condition categories (most notably UTI) in individuals 15–24 years old with SB. This association may be indicative of changing healthcare access as people with SB move from adolescent to adult health care, and/or physiologic changes during the age range studied. PMID:25511690

  6. Three group psychotherapy settings with long-term adolescent inpatients: advantages and disadvantages.

    PubMed

    Ghuman, H S; Sarles, R M

    1988-01-01

    The authors describe three types of group psychotherapy settings on an adolescent service. The group setting which included all patients on the unit and employed multiple therapists and several nursing staff provided better communication, cohesiveness, and greater opportunity for staff training. Small groups provided comparatively more time for patient participation, less distraction, and better disclosure. Mixing patients from different units resulted in objective and keener observations by patients, but hall meetings became increasingly necessary to work out interpersonal issues among patients from the same unit. These observations by staff were confirmed by a patient questionnaire.

  7. Characteristics of aggression among psychiatric inpatients by ward type in Japan: Using the Staff Observation Aggression Scale - Revised (SOAS-R).

    PubMed

    Sato, Makiko; Noda, Toshie; Sugiyama, Naoya; Yoshihama, Fumihiro; Miyake, Michi; Ito, Hiroto

    2016-07-22

    Aggressive behaviour by psychiatric patients is a serious issue in clinical practice, and adequate management of such behaviour is required, with careful evaluation of the factors causing the aggression. To examine the characteristics of aggressive incidents by ward type, a cross-sectional descriptive study was conducted for 6 months between April 2012 and June 2013 using the Staff Observation Aggression Scale - Revised, Japanese version (SOAS-R) in 30 wards across 20 Japanese psychiatric hospitals. Participating wards were categorized into three types based on the Japanese medical reimbursement system: emergency psychiatric, acute psychiatric, and standard wards (common in Japan, mostly treating non-acute patients). On analyzing the 443 incidents reported, results showed significant differences in SOAS-R responses by ward type. In acute and emergency psychiatric wards, staff members were the most common target of aggression. In acute psychiatric wards, staff requiring patients to take medication was the most common provocation, and verbal aggression was the most commonly used means. In emergency psychiatric wards, victims felt threatened. In contrast, in standard wards, both the target and provocation of aggression were most commonly other patients, hands were used, victims reported experiencing physical pain, and seclusion was applied to stop their behaviour. These findings suggest that ward environment was an important factor influencing aggressive behaviour. Ensuring the quality and safety of psychiatric care requires understanding the characteristics of incidents that staff are likely to encounter in each ward type, as well as implementing efforts to deal with the incidents adequately and improve the treatment environment.

  8. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Medical, psychiatric, and social evaluations. 456... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inpatient Psychiatric..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a...

  9. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Medical, psychiatric, and social evaluations. 456... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inpatient Psychiatric..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a...

  10. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Medical, psychiatric, and social evaluations. 456... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inpatient Psychiatric..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a...

  11. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Medical, psychiatric, and social evaluations. 456... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inpatient Psychiatric..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a...

  12. 42 CFR 456.482 - Medical, psychiatric, and social evaluations.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Medical, psychiatric, and social evaluations. 456... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inpatient Psychiatric..., psychiatric, and social evaluations. If a facility provides inpatient psychiatric services to a...

  13. Socioeconomic Status and Intelligence Quotient as Predictors of Psychiatric Disorders in Children and Adolescents with High-Functioning Autism Spectrum Disorder and in Their Siblings

    ERIC Educational Resources Information Center

    Rosa, Mireia; Puig, Olga; Lázaro, Luisa; Calvo, Rosa

    2016-01-01

    Previous studies have shown high rates of comorbid disorders in children and adolescents with autism spectrum disorder, but failed to compare them with general population and few of them have identified predictors of comorbidity. This study compared the rates of psychiatric disorders in 50 children and adolescents with autism spectrum disorder, 24…

  14. Predicting Future Suicide Attempts Among Adolescent and Emerging Adult Psychiatric Emergency Patients.

    PubMed

    Horwitz, Adam G; Czyz, Ewa K; King, Cheryl A

    2015-01-01

    The purpose of this study was to longitudinally examine specific characteristics of suicidal ideation in combination with histories of suicide attempts and non-suicidal self-injury (NSSI) to best evaluate risk for a future attempt among high-risk adolescents and emerging adults. Participants in this retrospective medical record review study were 473 (53% female; 69% Caucasian) consecutive patients, ages 15 to 24 years (M=19.4 years) who presented for psychiatric emergency services during a 9-month period. These patients' medical records, including a clinician-administered Columbia-Suicide Severity Rating Scale, were coded at the index visit and at future visits occurring within the next 18 months. Logistic regression models were used to predict suicide attempts during this period. Socioeconomic status, suicidal ideation severity (i.e., intent, method), suicidal ideation intensity (i.e., frequency, controllability), a lifetime history of suicide attempt, and a lifetime history of NSSI were significant independent predictors of a future suicide attempt. Suicidal ideation added incremental validity to the prediction of future suicide attempts above and beyond the influence of a past suicide attempt, whereas a lifetime history of NSSI did not. Sex moderated the relationship between the duration of suicidal thoughts and future attempts (predictive for male patients but not female). Results suggest value in incorporating both past behaviors and current thoughts into suicide risk formulation. Furthermore, suicidal ideation duration warrants additional examination as a potential critical factor for screening assessments evaluating suicide risk among high-risk samples, particularly for male patients.

  15. Social cognition, psychopathological symptoms, and family functioning in a sample of inpatient adolescents using variable-centered and person-centered approaches.

    PubMed

    Gambin, Malgorzata; Gambin, Tomasz; Sharp, Carla

    2015-12-01

    The process of diagnosis and treatment planning for adolescents requires clinicians to integrate information about various domains of functioning especially: clinical signs and symptoms, social cognition and family functioning. In the current study we applied an integrative analytic approach to mirror case conceptualization by clinicians. Our analyses were performed on the data gathered from the 328 inpatient adolescents. We used a broad range of measures of social-cognitive constructs, family functioning and parent-and self-reported psychopathology. Using a combination of variable-based (PCA) and person-centered (LCA) analyses we determined class membership of adolescents based on variation in social cognition, psychopathology, and family functioning. We identified five latent classes: two internalizing groups, two externalizing groups and a severe psychopathology group. Patterns of general hyperfunctioning (characterized by hypermentalizing and hypervigilance to emotional stimuli) and hypofunctioning (manifested in undermentalizing and under-reactivity to emotional stimuli), can be observed in these groups.

  16. Depression, Meaninglessness, and Substance Abuse in "Normal" and Hospitalized Adolescents.

    ERIC Educational Resources Information Center

    Kinnier, Richard T.; And Others

    1994-01-01

    Examined relationships among depression, meaninglessness, suicide ideation, and substance abuse among 48 high school students and 113 adolescent psychiatric inpatients. Correlational analyses indicated that high school students who viewed themselves negatively, were depressed, or who had found little meaning in their lives were more likely to…

  17. Which factors may play a pivotal role on determining the type of psychiatric disorder in children and adolescents with epilepsy?

    PubMed

    Thome-Souza, Sigride; Kuczynski, Evelyn; Assumpção, Francisco; Rzezak, Patricia; Fuentes, Daniel; Fiore, Lia; Valente, Kette D

    2004-12-01

    Physicians have become aware of the high prevalence of psychiatric disorders (PDs) in children and adolescents with epilepsy; however, there are many controversies as to which factors may have an important role in the different types of PD. This study was designed to assess the main PD; verify the age of onset compared with the age of diagnosis of the PD; and determine which factors may be correlated with the type of PD described. For this purpose, a multidisciplinary team evaluated children and adolescents (4-18 years) with epilepsy and analyzed patient-related factors such as age (grouped according to Piaget's cognitive scale: <6 years, 7-13 years, >13 years), sex, family history of PDs, and cognitive status. With respect to epilepsy features, we considered age of onset, duration, seizure control at the time of psychiatric evaluation, refractoriness, antiepileptic drugs (mono- vs polytherapy), seizure type (generalized vs focal), and epilepsy type (idiopathic vs symptomatic/probably symptomatic). Depression occurred in 36.4% and attention-deficit hyperactivity disorder (ADHD) in 29.1%, these being the most frequent PDs in this series. Focal epilepsy was significantly more frequent in children and adolescents with PDs. As to the type of PD, age was an important factor, with a predominance of ADHD in children and depression in adolescents (P<0.0001). Family history was contributory for depression, but not for others PDs (P<0.0001). Depression remained underdiagnosed and untreated for a longer period. Impact of early diagnosis and treatment remains unknown.

  18. Norms, Reliability, and Item Analysis of the Hopelessness Scale in General Psychiatric, Forensic Psychiatric, and College Populations.

    ERIC Educational Resources Information Center

    Durham, Thomas W.

    1982-01-01

    Administered the Hopelessness Scale to criminal psychiatric inpatients, general psychiatric inpatients, and college students. Both psychiatric groups endorsed significantly more items in the hopeless direction. Found the scale more reliable with the psychiatric patients. Item analysis of the Hopelessness Scale suggests that three items were not…

  19. Psychiatric Emergencies

    PubMed Central

    Bayrakal, Sadi

    1972-01-01

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

  20. Monitoring of physical health parameters for inpatients on a child and adolescent mental health unit receiving regular antipsychotic therapy.

    PubMed

    Pasha, Nida; Saeed, Shoaib; Drewek, Katherine

    2015-01-01

    Physical health monitoring of patients receiving antipsychotics is vital. Overall it is estimated that individuals suffering with conditions like schizophrenia have a 20% shorter life expectancy than the average population, moreover antipsychotic use has been linked to a number of conditions including diabetes, obesity, and cardiovascular disease.[1-4] The severity of possible adverse effects to antipsychotics in adults has raised awareness of the importance of monitoring physical health in this population. However, there is little literature available as to the adverse effects of these medications in the child and adolescent community, which make physical health monitoring in this predominantly antipsychotic naïve population even more important. An expert group meeting in the UK has laid down recommendations in regards to screening and management of adult patients receiving antipsychotics, however no specific guidelines have been put in place for the child and adolescent age group.[5] The aim of this audit was to establish whether in-patients receiving antipsychotics had the following investigations pre-treatment and 12 weeks after treatment initiation: body mass index, hip-waist circumference, blood pressure, ECG, urea and electrolytes, full blood count, lipid profile, random glucose level, liver function test, and prolactin. This is in addition to a pre-treatment VTE risk assessment. These standards were derived from local trust guidelines, NICE guidelines on schizophrenia [6] and The Maudsley Prescribing Guidelines.[7] We retrospectively reviewed 39 electronic case notes in total, of which 24 cases were post intervention. Intervention included the use of a prompting tool. This tool was filed in the physical health files of all patients receiving antipsychotics which was intended as a reminder to doctors regarding their patient's need for physical health monitoring. Professionals involved in the monitoring of such parameters were educated in the importance and

  1. Crime and Psychiatric Disorders Among Youth in the US Population: An Analysis of National Comorbidity Survey-Adolescent Supplement

    PubMed Central

    Coker, Kendell L.; Smith, Philip H.; Westphal, Alexander; Zonana, Howard V.; McKee, Sherry A.

    2014-01-01

    Objective Current knowledge regarding psychiatric disorders and crime in youth is limited to juvenile justice and community samples. This study examined relationships between psychiatric disorders and self-reported crime involvement in a sample of youth representative of the US population. Method The National Comorbidity Survey-Adolescent Supplement (N=10,123; ages 13–17; 2001–2004) was used to examine the relationship between lifetime DSM-IV-based diagnoses, reported crime (property, violent, other), and arrest history. Logistic regression compared the odds of reported crime involvement with specific psychiatric disorders to those without any diagnoses, and examined the odds of crime by psychiatric comorbidity. Results Prevalence of crime was 18.4%. Youth with lifetime psychiatric disorders, compared to no disorders, had significantly greater odds of crime, including violent crime. For violent crime resulting in arrest, conduct disorder (CD; OR=57.5; 95% CI=30.4,108.8), alcohol use disorders (OR=19.5; 95% CI=8.8,43.2), and drug use disorders (OR=16.1; 95% CI=9.3,27.7) had the greatest odds with similar findings for violent crime with no arrest. Psychiatric comorbidity increased the odds of crime. Youth with 3 or more diagnoses (16.0% of population) accounted for 54.1% of those reporting arrest for violent crime. Youth with at least 1 diagnosis committed 85.8% of crime, which was reduced to 67.9% by removing those with CD. Importantly, 88.2% of youth with mental illness report never committing any crime. Conclusion Our findings highlight the importance of improving access to mental health services for youthful offenders in community settings given the substantial associations found between mental illness and crime in this nationally representative epidemiological sample. PMID:25062596

  2. Pathways to Psychiatric Care for Children and Adolescents at a Tertiary Facility in Northern Nigeria.

    PubMed

    Abdulmalik, Jibril O; Sale, Shehu

    2012-03-07

    There is limited availability of mental health services in Nigeria, and indeed most of Africa. Available services are also often under-utilized because of widespread ignorance and supernatural beliefs about the etiology of mental illnesses. The consequence, therefore, is a long and tedious pathway to care for the mentally ill, especially children and adolescents. This was a study of all new patients, aged 18 years and below, presenting over a 6 month period in 2009 (January - June) at the outpatient clinic of a tertiary psychiatric facility in northern Nigeria. A socio-demographic questionnaire was utilized, along with a record of the clinician's assessment of diagnosis for 242 patients. Subjects who had been withdrawn from school, or any previously engaged-in activity for longer than 4 weeks on account of the illness, were recorded as having disability from the illness. The children were aged 1-18 years (mean=12.3; SD=5.2) with males accounting for 51.7% (125) while 14.5% of the females (n=117) were married. Two thirds (64.5%) of the patients had been ill for longer than 6 months prior to presentation. One hundred and forty four subjects (59.5%) had received no care at all, while 36.4% had received treatment from traditional/religious healers prior to presentation. The most disabling conditions were ADHD (80%), mental retardation (77.8%), epilepsy (64.1%) and psychotic disorders (50%). There is urgent need for extending mental health services into the community in order to improve access to care and increase awareness about effective and affordable treatments.

  3. Pathways to Psychiatric Care for Children and Adolescents at a Tertiary Facility in Northern Nigeria

    PubMed Central

    Sale, Shehu

    2012-01-01

    There is limited availability of mental health services in Nigeria, and indeed most of Africa. Available services are also often under-utilized because of widespread ignorance and supernatural beliefs about the etiology of mental illnesses. The consequence, therefore, is a long and tedious pathway to care for the mentally ill, especially children and adolescents. This was a study of all new patients, aged 18 years and below, presenting over a 6 month period in 2009 (January – June) at the outpatient clinic of a tertiary psychiatric facility in northern Nigeria. A socio-demographic questionnaire was utilized, along with a record of the clinician’s assessment of diagnosis for 242 patients. Subjects who had been withdrawn from school, or any previously engaged-in activity for longer than 4 weeks on account of the illness, were recorded as having disability from the illness. The children were aged 1-18 years (mean=12.3; SD=5.2) with males accounting for 51.7% (125) while 14.5% of the females (n=117) were married. Two thirds (64.5%) of the patients had been ill for longer than 6 months prior to presentation. One hundred and forty four subjects (59.5%) had received no care at all, while 36.4% had received treatment from traditional/religious healers prior to presentation. The most disabling conditions were ADHD (80%), mental retardation (77.8%), epilepsy (64.1%) and psychotic disorders (50%). There is urgent need for extending mental health services into the community in order to improve access to care and increase awareness about effective and affordable treatments. PMID:28299078

  4. A Cost-Effectiveness Analysis of Proposed Inpatient Child and Adolescent Psychiatric Units at Eisenhower Army Medical Center

    DTIC Science & Technology

    1992-05-28

    average length of stay and average cost per stay, have to be defined to support the cost-effectiveness analysis. As...Hospital of Augusta. Average Length of Stay (in Days) 60 56 ..............--- .---------- .---- -- ------------. ----- 251 Fiscal Year(s) Cost...Effectiveness Analysis 27 As the average length of stay at Charter Hospital decreased, the total costs associated with each stay decreased. Figure 4

  5. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... Services of Inpatient Psychiatric Facilities § 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. (a) General requirements. (1)...

  6. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... Services of Inpatient Psychiatric Facilities § 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. (a) General requirements. (1)...

  7. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... Services of Inpatient Psychiatric Facilities § 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. (a) General requirements. (1)...

  8. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... Services of Inpatient Psychiatric Facilities § 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. (a) General requirements. (1)...

  9. 42 CFR 412.404 - Conditions for payment under the prospective payment system for inpatient hospital services of...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... payment system for inpatient hospital services of psychiatric facilities. 412.404 Section 412.404 Public... Services of Inpatient Psychiatric Facilities § 412.404 Conditions for payment under the prospective payment system for inpatient hospital services of psychiatric facilities. (a) General requirements. (1)...

  10. PreDictor Research in Obesity during Medical care - weight Loss in children and adolescents during an INpatient rehabilitation: rationale and design of the DROMLIN study

    PubMed Central

    2014-01-01

    Background Obesity in adults and children is increasing worldwide at alarming rates. Obese children and adolescents are likely to become obese adults with increased risk of a number of comorbidities. In addition to preventing the development of obesity at young age, it is necessary to individualize the therapy of already obese children and adolescents in order to increase the likelihood of weight loss and maintenance. Therefore, the aim of this study is to identify predictors which play a significant role in successful weight loss and weight loss maintenance in children and adolescents. Methods/Design Over a one year period, 60 obese children and adolescents between 9 to 17 years of age shall be recruited at an inpatient children rehabilitation facility in Germany. They will be investigated twice within a few days following admission and prior to discharge. The study will be an integrated component of an established inpatient weight-loss and in part psychosomatic therapy. The collected data can be grouped into four clusters: 1) demographic, sociometric and psychometric data, 2) objective and subjective parameters of body condition, 3) autonomic nervous system regulated functions and 4) objective and subjective parameters for eating behavior. Primary outcome is the change of the body mass index standard deviation score (BMI-SDS). In order to evaluate the data appropriately, all examinations will be also conducted in a normal-weight reference group, matched for age and gender. Discussion For some of the collected parameters the time span between measures may be too short. Therefore, a 6 months, 1 year and 2 year follow-up will be performed for evaluating the different predictors and their influence in regard to a successful intervention. Further middle- and long-term follow-up studies are planned. Trial Registration The study protocol was approved by the Ethics Committee of the University Hospital Tübingen, Germany. This study is registered at the German Clinical

  11. Risk and Protective Factors for Suicidality at 6-Month Follow-up in Adolescent Inpatients Who Attempted Suicide: An Exploratory Model

    PubMed Central

    Consoli, Angèle; Cohen, David; Bodeau, Nicolas; Guilé, Jean-Marc; Mirkovic, Bojan; Knafo, Alexandra; Mahé, Vincent; Laurent, Claudine; Renaud, Johanne; Labelle, Réal; Breton, Jean-Jacques; Gérardin, Priscille

    2015-01-01

    Objective: To assess risk and protective factors for suicidality at 6-month follow-up in adolescent inpatients after a suicide attempt. Methods: One hundred seven adolescents from 5 inpatient units who had a suicide attempt were seen at 6-month follow-up. Baseline measures included sociodemographics, mood and suicidality, dependence, borderline symptomatology, temperament and character inventory (TCI), reasons for living, spirituality, and coping scores. Results: At 6-month follow-up, 41 (38%) subjects relapsed from suicidal behaviours. Among them, 15 (14%) had repeated a suicide attempt. Higher depression and hopelessness scores, the occurrence of a new suicide attempt, or a new hospitalization belonged to the same factorial dimension (suicidality). Derived from the best-fit structural equation modelling for suicidality as an outcome measure at 6-month follow-up, risk factors among the baseline variables included: major depressive disorder, high depression scores, and high scores for TCI self-transcendence. Only one protective factor emerged: coping–hard work and achievement. Conclusion: In this very high-risk population, some established risk factors (for example, a history of suicide attempts) may not predict suicidality. Our results suggest that adolescents who retain high scores for depression or hopelessness, who remain depressed, or who express a low value for life or an abnormally high connection with the universe are at higher risk for suicidality and should be targeted for more intense intervention. Improving adolescent motivation in school and in work may be protective. Given the sample size, the model should be regarded as exploratory. PMID:25886668

  12. The Persistence and Stability of Psychiatric Problems in Adolescents with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Simonoff, Emily; Jones, Catherine R. G.; Baird, Gillian; Pickles, Andrew; Happe, Francesca; Charman, Tony

    2013-01-01

    Background: Psychiatric problems are common in autism spectrum disorders (ASDs), but the reasons are poorly understood. We use a longitudinal population-representative cohort to examine for the first time the persistence of psychiatric problems and to identify risk factors for their occurrence and stability. Methods: Eighty-one 16-year olds (75…

  13. Interactive Family Dynamics and Non-suicidal Self-Injury in Psychiatric Adolescent Patients: A Single Case Study

    PubMed Central

    Gatta, Michela; Miscioscia, Marina; Sisti, Marta; Comis, Ilaria; Battistella, Pier Antonio

    2017-01-01

    Non-Suicidal Self-Injury (NSSI) is a common, multifaceted phenomenon among adolescents. Recent researchers have shown that a number of psychological and psychiatric correlates are implicated in the onset/repetition of NSSI, but those previous studies did not directly observe the family interaction patterns of this clinical population. In this paper, the quality of family interactions was observed using the Lausanne Trilogue Play procedure to deepen the specific interactive dimensions associated with NSSI in adolescents. The results of a single case study showed a lack of positive emotional exchanges, a parenting style expressing hostility, a high level of control and difficulties in triangulation. Through this method, the authors show that a better understanding of the role of family interactions is crucial and could improve the assessment and treatment of Non-Suicidal Self-Injurious behaviors. Research and clinical implications are discussed. PMID:28220084

  14. Interactive Family Dynamics and Non-suicidal Self-Injury in Psychiatric Adolescent Patients: A Single Case Study.

    PubMed

    Gatta, Michela; Miscioscia, Marina; Sisti, Marta; Comis, Ilaria; Battistella, Pier Antonio

    2017-01-01

    Non-Suicidal Self-Injury (NSSI) is a common, multifaceted phenomenon among adolescents. Recent researchers have shown that a number of psychological and psychiatric correlates are implicated in the onset/repetition of NSSI, but those previous studies did not directly observe the family interaction patterns of this clinical population. In this paper, the quality of family interactions was observed using the Lausanne Trilogue Play procedure to deepen the specific interactive dimensions associated with NSSI in adolescents. The results of a single case study showed a lack of positive emotional exchanges, a parenting style expressing hostility, a high level of control and difficulties in triangulation. Through this method, the authors show that a better understanding of the role of family interactions is crucial and could improve the assessment and treatment of Non-Suicidal Self-Injurious behaviors. Research and clinical implications are discussed.

  15. "We Have to Be Satisfied with the Scraps": South African Nurses' Experiences of Care on Adult Psychiatric Intellectual Disability Inpatient Wards

    ERIC Educational Resources Information Center

    Capri, Charlotte; Buckle, Chanellé

    2015-01-01

    Background: Migrating nursing labour inadvertently reinforces South Africa's care drain, contributes to a global care crisis and forces us to reconsider migration motivation. This paper highlights issues that complicate psychiatric intellectual disability nursing care and identifies loci for change in an attempt to redress this care challenge.…

  16. Multifaceted Inpatient Psychiatry Approach to Reducing Readmissions: A Pilot Study

    ERIC Educational Resources Information Center

    Lang, Timothy P.; Rohrer, James E.; Rioux, Pierre A.

    2009-01-01

    Context: Access to psychiatric services, particularly inpatient psychiatric care, is limited and lacks comprehensiveness in rural areas. Purpose: The purpose of this study was to evaluate the impact on readmission rates of a multifaceted inpatient psychiatry approach (MIPA) offered in a rural hospital. Methods: Readmissions within 30 days of…

  17. Integration of computer and Internet-based programmes into psychiatric out-patient care of adolescents with depression.

    PubMed

    Kurki, Marjo; Hätönen, Heli; Koivunen, Marita; Anttila, Minna; Välimäki, Maritta

    2013-03-01

    The aim of this explorative study was to describe nurses' opportunities to integrate computer and Internet-based programmes in psychiatric out-patient care among adolescents with depression. Therefore, nurses' daily computer use and possible problems related to it were investigated. The data were collected by conducting focus group interviews with Finnish registered nurses (n =12) working at the out-patient clinics of two university central hospitals. The data were analysed using inductive content analysis. The analysis showed that nurses used the computer and Internet in their daily work for data transmission and informal interaction with adolescents. Findings revealed that nurses have good computer skills, a positive attitude towards using the computer and Internet and were motivated to make use of both on a daily basis. Problems faced in daily computer use were a lack of instructions and education, and lack of help and support. We can conclude that nurses have good opportunities to implement computer and Internet-based programmes in adolescent out-patient care. These results are encouraging keeping in mind that adolescents are the most active Internet users in society.

  18. Emotional and Behavioral Disturbances in Adolescents Involved in Witchcraft and Satanism.

    ERIC Educational Resources Information Center

    Burket, Roger C.; And Others

    1994-01-01

    Examined inpatient medical records of 157 consecutive adolescent admissions to private psychiatric hospital. Ten patients with interest in witchcraft and Satanism had significantly more diagnoses of identity disorder, alcohol abuse, and hallucinogen abuse. One-half reported history of self-mutilation. Found no significant difference in criminal…

  19. Suicidal Ideation of Psychiatrically Hospitalized Adolescents has One-Year Predictive Validity for Suicide Attempts in Girls Only

    PubMed Central

    Jiang, Qingmei; Czyz, Ewa K.; Kerr, David C. R.

    2016-01-01

    Clinicians commonly incorporate adolescents’ self-reported suicidal ideation into formulations regarding adolescents’ risk for suicide. Data are limited, however, regarding the extent to which adolescent boys’ and girls’ reports of suicidal ideation have clinically significant predictive validity in terms of subsequent suicidal behavior. This study examined psychiatrically hospitalized adolescent boys’ and girls’ self-reported suicidal ideation as a predictor of suicide attempts during the first year following hospitalization. A total of 354 adolescents (97 boys; 257 girls; ages 13–17 years) hospitalized for acute suicide risk were evaluated at the time of hospitalization as well as 3, 6, and 12 months later. Study measures included the Suicidal Ideation Questionnaire-Junior, Multidimensional Anxiety Scale for Children, Children’s Depression Rating Scale-Revised, Beck Hopelessness Scale, Youth Self-Report, and Personal Experiences Screen Questionnaire. The main study outcome was presence and number of suicide attempt(s) in the year after hospitalization, measured by the Diagnostic Interview Schedule for Children. Results indicated a significant interaction between suicidal ideation, assessed during first week of hospitalization, and gender for the prediction of subsequent suicide attempts. Suicidal ideation was a significant predictor of subsequent suicide attempts for girls, but not boys. Baseline history of multiple suicide attempts was a significant predictor of subsequent suicide attempts across genders. Results support the importance of empirically validating suicide risk assessment strategies separately for adolescent boys and girls. Among adolescent boys who have been hospitalized due to acute suicide risk, low levels of self-reported suicidal ideation may not be indicative of low risk for suicidal behavior following hospitalization. PMID:23996157

  20. ASD Symptom Severity in Adolescence of Individuals Diagnosed with PDD-NOS in Childhood: Stability and the Relation with Psychiatric Comorbidity and Societal Participation

    ERIC Educational Resources Information Center

    Louwerse, A.; Eussen, M. L. J. M.; Van der Ende, J.; de Nijs, P. F. A.; Van Gool, A. R.; Dekker, L. P.; Verheij, C.; Verheij, F.; Verhulst, F. C.; Greaves-Lord, K.

    2015-01-01

    The current 7-year follow-up study investigated: (1) the stability of ASD severity, and (2) associations of ASD severity in adolescence with (a) childhood and concurrent psychiatric comorbidity, and (b) concurrent societal functioning. The Autism Diagnostic Observation Schedule (ADOS) and the Diagnostic Interview Schedule for Children were…

  1. Intelligence and Birth Order among Children and Adolescents in Psychiatric Care

    ERIC Educational Resources Information Center

    Kirkcaldy, Bruce; Furnham, Adrian; Siefen, Georg

    2009-01-01

    A sample of around 2,500 adolescents in a child and adolescent psychiatry clinic in the region of Munster, Germany had their intelligence assessed. Family size (total number of siblings within a family) was significantly correlated with intelligence score categories (-0.08 and -0.19 for males and females). First borns and only children displayed…

  2. Personality traits as predictors of inpatient aggression in a high-security forensic psychiatric setting: prospective evaluation of the PCL-R and IPDE dimension ratings.

    PubMed

    Langton, Calvin M; Hogue, Todd E; Daffern, Michael; Mannion, Aisling; Howells, Kevin

    2011-05-01

    The Dangerous and Severe Personality Disorder (DSPD) initiative in England and Wales provides specialized care to high-risk offenders with mental disorders. This study investigated the predictive utility of personality traits, assessed using the Psychopathy Checklist-Revised (PCL-R) and the International Personality Disorder Examination, with 44 consecutive admissions to the DSPD unit at a high-security forensic psychiatric hospital. Incidents of interpersonal physical aggression (IPA) were observed for 39% of the sample over an average 1.5-year period following admission. Histrionic personality disorder (PD) predicted IPA, and Histrionic, Borderline, and Antisocial PDs all predicted repetitive (2+ incidents of) IPA. PCL-R Factor 1 and Facets 1 and 2 were also significant predictors of IPA. PCL-R Factor 1 and Histrionic PD scores were significantly associated with imminence of IPA. Results were discussed in terms of the utility of personality traits in risk assessment and treatment of specially selected high-risk forensic psychiatric patients in secure settings.

  3. [Inpatient psychotherapy].

    PubMed

    Spitzer, C; Rullkötter, N; Dally, A

    2016-01-01

    In German-speaking countries inpatient psychotherapy plays a major role in the mental healthcare system. Due to its characteristic features, i. e. multiprofessionalism, multimodality and method integration, the inpatient approach represents a unique and independent type of psychotherapy. In order to be helpful, the manifold verbal and non-verbal methods need to be embedded into an overall treatment plan. Additionally, the therapeutic milieu of the hospital represents an important effective factor and its organization requires a more active construction. The indications for inpatient psychotherapy are not only based on the mental disorder but also on illness, setting and healthcare system-related criteria. In integrative concepts, the multiprofessional team is a key component with many functions. The effectiveness of psychotherapeutic hospital treatment has been proven by meta-analysis studies; however, 20-30% of patients do not benefit from inpatient psychotherapy and almost 13% drop-out prematurely.

  4. Exposure to Violence, Posttraumatic Stress Symptoms, and Borderline Personality Pathology Among Adolescents in Residential Psychiatric Treatment: The Influence of Emotion Dysregulation.

    PubMed

    Buckholdt, Kelly E; Weiss, Nicole H; Young, John; Gratz, Kim L

    2015-12-01

    Exposure to violence during adolescence is a highly prevalent phenomenon associated with a range of deleterious outcomes. Theoretical literature suggests that emotion dysregulation is one consequence of exposure to violence associated with the manifestation of posttraumatic stress symptoms (PTSS) and borderline personality (BP) pathology. Thus, the goal of the present study was to examine the mediating role of emotion dysregulation in the relation between exposure to violence and both PTSS and BP pathology in a sample of 144 adolescents (age 10- to 17-years; 51% male; 55% African American) admitted to a psychiatric residential treatment center. Exposure to violence was associated with greater emotion dysregulation, which, in turn, was associated with greater PTSS and BP pathology. Furthermore, emotion dysregulation mediated the associations between exposure to violence and both PTSS and BP pathology. Findings suggest the importance of assessing and treating emotion dysregulation among violence-exposed adolescents in psychiatric residential treatment.

  5. Exposure to Violence, Posttraumatic Stress Symptoms, and Borderline Personality Pathology among Adolescents in Residential Psychiatric Treatment: The Influence of Emotion Dysregulation

    PubMed Central

    Buckholdt, Kelly E.; Weiss, Nicole H.; Young, John; Gratz, Kim L.

    2014-01-01

    Exposure to violence during adolescence is a highly prevalent phenomenon associated with a range of deleterious outcomes. Theoretical literature suggests that emotion dysregulation is one consequence of exposure to violence associated with the manifestation of posttraumatic stress symptoms (PTSS) and borderline personality (BP) pathology. Thus, the goal of the present study was to examine the mediating role of emotion dysregulation in the relation between exposure to violence and both PTSS and BP pathology in a sample of 144 adolescents (age 10- to 17-years; 51% male; 55% African American) admitted to a psychiatric residential treatment center. Exposure to violence was associated with greater emotion dysregulation, which, in turn, was associated with greater PTSS and BP pathology. Furthermore, emotion dysregulation mediated the associations between exposure to violence and both PTSS and BP pathology. Findings suggest the importance of assessing and treating emotion dysregulation among violence-exposed adolescents in psychiatric residential treatment. PMID:25500759

  6. Emotional face recognition in adolescent suicide attempters and adolescents engaging in non-suicidal self-injury.

    PubMed

    Seymour, Karen E; Jones, Richard N; Cushman, Grace K; Galvan, Thania; Puzia, Megan E; Kim, Kerri L; Spirito, Anthony; Dickstein, Daniel P

    2016-03-01

    Little is known about the bio-behavioral mechanisms underlying and differentiating suicide attempts from non-suicidal self-injury (NSSI) in adolescents. Adolescents who attempt suicide or engage in NSSI often report significant interpersonal and social difficulties. Emotional face recognition ability is a fundamental skill required for successful social interactions, and deficits in this ability may provide insight into the unique brain-behavior interactions underlying suicide attempts versus NSSI in adolescents. Therefore, we examined emotional face recognition ability among three mutually exclusive groups: (1) inpatient adolescents who attempted suicide (SA, n = 30); (2) inpatient adolescents engaged in NSSI (NSSI, n = 30); and (3) typically developing controls (TDC, n = 30) without psychiatric illness. Participants included adolescents aged 13-17 years, matched on age, gender and full-scale IQ. Emotional face recognition was evaluated using the diagnostic assessment of nonverbal accuracy (DANVA-2). Compared to TDC youth, adolescents with NSSI made more errors on child fearful and adult sad face recognition while controlling for psychopathology and medication status (ps < 0.05). No differences were found on emotional face recognition between NSSI and SA groups. Secondary analyses showed that compared to inpatients without major depression, those with major depression made fewer errors on adult sad face recognition even when controlling for group status (p < 0.05). Further, compared to inpatients without generalized anxiety, those with generalized anxiety made fewer recognition errors on adult happy faces even when controlling for group status (p < 0.05). Adolescent inpatients engaged in NSSI showed greater deficits in emotional face recognition than TDC, but not inpatient adolescents who attempted suicide. Further results suggest the importance of psychopathology in emotional face recognition. Replication of these preliminary results and examination of the role

  7. Screen Time on School Days and Risks for Psychiatric Symptoms and Self-Harm in Mainland Chinese Adolescents

    PubMed Central

    Liu, Mingli; Ming, Qingsen; Yi, Jinyao; Wang, Xiang; Yao, Shuqiao

    2016-01-01

    Objective: To investigate associations of television and of video game or non-educational computer use (VG/CU) exposure volumes in a typical school day with psychiatric symptoms and suicidal ideation/self-injurious behavior (self-harm), in mainland Chinese adolescents. Methods: Secondary school pupils (N = 13,659; mean age: 15.18 ± 1.89) from 10 urban areas sampled from different regions of mainland China were recruited. The subjects were divided into the following four screen exposure volume groups for television and VG/CU respectively based on a self-administered questionnaire: 0 h/day, >0 to ≤1 h/day, >1 to ≤2 h/day, and >2 h/day. Demographic and psychiatric symptoms were recorded for each respondent. Odds ratios (ORs) and 95% confidence intervals (CIs) for several types of psychological problems and self-harm were calculated. Results: More than 2 h per school day television watching was associated with higher risk of depression in both boys (OR = 1.33, 95%CI: 1.02–1.73) and girls (OR = 1.62, 95%CI: 1.19–2.21), of anxiety in boys (OR = 1.43, 95%CI: 1.05–1.95), of general emotional, behavioral, and social problems (GEBSPs; OR = 1.55, 95%CI: 1.01–2.39), and of oppositional defiant problems (OR = 1.65, 95% CI: 1.09–2.50) in girls, compared with no television exposure. Conversely, television exposure of no more than 1 h per school day was associated with lower self-harm risk in boys (OR = 0.81, 95%CI: 0.67–0.99) compared with no television exposure. High school day VG/CU time (>2 h) compared with no VG/CU were associated with higher risks of anxiety (OR = 1.40, 95%CI: 1.06–1.86) and of attention deficit/hyperactivity problems (ADHPs; OR = 1.56, 95%CI: 1.02–2.38) in boys. And any school day VG/CU exposure was associated with higher risks of self-harm and all other psychiatric problems in boys and all psychiatric problems (including anxiety and ADHPs) in girls (ORs, 1.44–3.69), compared to no VG/CU exposure. Conclusion: For secondary school

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

    ERIC Educational Resources Information Center

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

    2004-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  10. [About the heterogeneity in adolescents with gender identity disorder: differential importance of psychiatric comorbidity and considerations of individual psychodynamics].

    PubMed

    Korte, Alexander; Beier, Klaus M; Vukorepa, Julia; Mersmann, Maik; Albiez, Verena

    2014-01-01

    Gender identity disorder (GID), gender dysphoria (GD) respectively, is considered a multifactorial disease whose etiology is subject to complex bio-psycho-social conditions, each with different weighting. As a result, therapists, who treat children and adolescents with GID/GD, have to deal with a very heterogeneous group with individually varying causes, differing psychopathology and varying disease progression. In addition to general psychiatric aspects of development, particularly psychiatric comorbidity, but also the different individual psychodynamics--i. e. the specific constellation of conflicts and possible ego deficits and structural deficits in the learning history of the person are of differential importance. In regard to the indication for gender reassignment measures this sometimes is relevant for the decision. The difficulties arising for decision making and the usefulness of a systematic evaluation of case reports as a basis for further optimization of the treatment recommendations are illustrated by two case reports. In the course of this, also the disadvantages and potential dangers of too early diagnostic definition and introduction of gender somato-medical and legal measures are shown exemplarily.

  11. Detained Male Adolescent Offender's Emotional, Physical and Sexual Maltreatment Profiles and Their Associations to Psychiatric Disorders and Criminal Behaviors.

    PubMed

    Aebi, Marcel; Linhart, Susanne; Thun-Hohenstein, Leonhard; Bessler, Cornelia; Steinhausen, Hans-Christoph; Plattner, Belinda

    2015-07-01

    The objective of the present study was to analyse patterns of emotional, physical and sexual maltreatment in detained male juvenile offenders using latent class analysis (LCA). The association of maltreatment related LCA profiles with psychopathology and criminal behaviors was also studied. LCA based on the items of the Child Trauma Questionnaire (CTQ) assessing childhood emotional, physical, and sexual abuse was performed in a sample of 260 male adolescent offenders (mean age = 16.5 years, SD = 1.29 years). Chi square tests and general linear models were performed to assess the associations of CTQ profiles with categorical interview-based psychiatric disorders, dimensional Youth Self-Report problem scales, and officially registered offenses. LCA suggested a three class solution: (1) a no/mild trauma (NM; 76 %) (2) emotional and physical trauma (EP; 18 %) and (3) emotional, physical, and sexual trauma (EPS; 8 %). The classes EP and EPS were related to a variety of psychiatric disorders and self-reported mental health problems. Furthermore, EPS showed higher presence of a subsequent re-incarceration compared to NM. A majority of sexually abused juveniles also experienced emotional and physical abuse reflecting gravely disturbed family systems. Multiple abuse in childhood was associated with a broad variety of disorders including externalizing disorders and repeated criminal offending. Such findings indicate that trauma assessment is also relevant in externalizing youth. A comprehensive treatment approach for detained boys with multiple abuse experiences is required targeting both mental health needs and the reduction of criminal behaviors.

  12. Caffeine Use: Association with Nicotine Use, Aggression, and Other Psychopathology in Psychiatric and Pediatric Outpatient Adolescents

    PubMed Central

    Martin, Catherine A.; Cook, Circe; Woodring, John H.; Burkhardt, Gretchen; Guenthner, Greg; Omar, Hatim A.; Kelly, Thomas H.

    2009-01-01

    The objective of this study was to evaluate the relationship between caffeine use, other drug use, and psychopathology in adolescents, using self-report measures. The study group consisted of 132 adolescents (average age 14.01 ± 2.06 years, 52% female, 19% African American, 5% other categories, 76% Caucasian). Most (47%) were recruited from a child psychiatry clinic with emphasis on youth with disruptive disorders, with 35% from an adolescent pediatric clinic with emphasis on prevention of risk-taking behavior and 18% from a pediatric clinic for families with limited resources. Subjects were consecutively recruited before or after regular clinic visits. Consent was obtained from parents and assent from the youth. High caffeine consumption was associated with daily cigarette use; aggressive behavior; conduct, attention deficit/hyperactivity, and social problems; and increased somatic complaints in adolescents. PMID:18516472

  13. Caffeine use: association with nicotine use, aggression, and other psychopathology in psychiatric and pediatric outpatient adolescents.

    PubMed

    Martin, Catherine A; Cook, Circe; Woodring, John H; Burkhardt, Gretchen; Guenthner, Greg; Omar, Hatim A; Kelly, Thomas H

    2008-05-22

    The objective of this study was to evaluate the relationship between caffeine use, other drug use, and psychopathology in adolescents, using self-report measures. The study group consisted of 132 adolescents (average age 14.01 +/- 2.06 years, 52% female, 19% African American, 5% other categories, 76% Caucasian). Most (47%) were recruited from a child psychiatry clinic with emphasis on youth with disruptive disorders, with 35% from an adolescent pediatric clinic with emphasis on prevention of risk-taking behavior and 18% from a pediatric clinic for families with limited resources. Subjects were consecutively recruited before or after regular clinic visits. Consent was obtained from parents and assent from the youth. High caffeine consumption was associated with daily cigarette use; aggressive behavior; conduct, attention deficit/hyperactivity, and social problems; and increased somatic complaints in adolescents.

  14. Commentary on "Psychiatric Aspects of Child and Adolescent Obesity: A Review of the Past 10 Years"

    ERIC Educational Resources Information Center

    Fitzgibbon, Marian L.

    2004-01-01

    This article is a brief review of child and adolescent obesity over the past ten years. The starting point for the review is the well-known fact that there has been a dramatic rise in the prevalence of obesity among children, adolescents, and adults in the United Sates (Ogden et al., 2002). The rise has occurred across all age and ethnic groups,…

  15. Association between fetal DES-exposure and psychiatric disorders in adolescence/adulthood: evidence from a French cohort of 1002 prenatally exposed children.

    PubMed

    Soyer-Gobillard, Marie-Odile; Paris, Françoise; Gaspari, Laura; Courtet, Philippe; Sultan, Charles

    2016-01-01

    In utero diethylstilbestrol (DES) exposure has been demonstrated to be associated with somatic abnormalities in adult men and women. Conversely, the data are contradictory regarding the association with psychological or psychiatric disorders during adolescence and adulthood. This work was designed to determine whether prenatal exposure to DES affects brain development and whether it is associated with psychiatric disorders in male and female adolescents and young adults. HHORAGES Association, a national patient support group, has assembled a cohort of 1280 women who took DES during pregnancy. We obtained questionnaire responses from 529 families, corresponding to 1182 children divided into three groups: Group 1 (n = 180): firstborn children without DES treatment, Group 2 (n = 740): exposed children, and Group 3 (n = 262): children born after a previous pregnancy treated by DES. No psychiatric disorders were reported in Group 1. In Group 2, the incidence of disorders was drastically elevated (83.8%), and in Group 3, the incidence was still elevated (6.1%) compared with the general population. This work demonstrates that prenatal exposure to DES is associated with a high risk of psychiatric disorders in adolescence and adulthood.

  16. Eight-year incidence of psychiatric disorders and service use from adolescence to early adulthood: longitudinal follow-up of the Mexican Adolescent Mental Health Survey.

    PubMed

    Benjet, Corina; Borges, Guilherme; Méndez, Enrique; Albor, Yesica; Casanova, Leticia; Orozco, Ricardo; Curiel, Teresa; Fleiz, Clara; Medina-Mora, María Elena

    2016-02-01

    Half of mental disorders have their first onset before adulthood when the presence of a disorder may be particularly disruptive to developmental milestones. Retrospective prevalence estimates have been shown to underestimate the burden of mental illness and scarce data are available on the incidence of disorders throughout the adolescent period, especially in developing countries. Thus, the objective was to determine the incidence of mental disorders in an 8-year period from adolescence to young adulthood, onset of service use and their predictors in a Mexican cohort. 1071 respondents from a representative two-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. Disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. 37.9% experienced the onset of a psychiatric disorder and 28.4% sought services for the first time. Substance use disorders had the greatest incidence, followed by mood and behavior disorders, anxiety disorders and lastly eating disorders. Sex, age, school dropout, childhood adversities and prior mental disorders predicted the onset of new disorders. Being female, having more educated parents and most classes of disorder predicted first time service use. These findings contribute to a paradigm shift in conceptions of mental disorder similar to how we think of common physical afflictions as near universal experiences across the life course, but less frequent at any given moment. Adolescents are particularly vulnerable. Therefore, public health policy should focus on early universal promotion of positive mental health and structural determinants of mental health.

  17. Psychiatric diagnoses and psychosocial needs of outpatient deaf children and adolescents.

    PubMed

    Landsberger, Sarah A; Diaz, David R; Spring, Noah Z; Sheward, Jerry; Sculley, Charleen

    2014-02-01

    Deaf youth may be more vulnerable to psychiatric disorders but very little research data is available. The current study identified prevalence rates of psychiatric disorders and examined the psychosocial needs and strengths of deaf youth aged 4-17 receiving specialized outpatient mental health services for the deaf. Compared to hearing peers, deaf youth had greater rates of attention deficit hyperactivity disorder, conduct, autism-spectrum and bipolar disorders and spent three times longer in treatment than their hearing peers. In the deaf subsample, moderate-severe risk was found in social functioning (33.3 %) and suicidal behavior (14 %). Deaf youth had moderate to severe impairment in social relationships (54.8 %), school functioning (42.9 %). Over one-third of deaf youth had impaired family relationships, living situation, communication, judgment and physical health. Deaf youth present with higher rates of certain clinical disorders and have deficits in multiple life domains that may impact functioning and create a longer treatment course.

  18. The Longitudinal Association of Adolescent Dating Violence with Psychiatric Disorders and Functioning

    ERIC Educational Resources Information Center

    Brown, Adrienne; Cosgrave, Elizabeth; Killackey, Eoin; Purcell, Rosemary; Buckby, Joe; Yung, Alison R.

    2009-01-01

    While the prevalence, correlates and mental health impacts of intimate partner violence are well documented in adolescents and young adults, fewer studies have considered physical dating violence among clinical samples of help-seeking young people. In a sample of 98 young people aged 15-24 years (54% females) referred to a specialist public youth…

  19. Depressed Adolescents and Comorbid Psychiatric Disorders: Are There Differences in the Presentation of Depression?

    ERIC Educational Resources Information Center

    Small, David Marc; Simons, Anne D.; Yovanoff, Paul; Silva, Susan G.; Lewis, Cara C.; Murakami, Jessica L.; March, John

    2008-01-01

    Patterns and correlates of comorbidity, as well as differences in manifest depressive profiles were investigated in a sample of depressed adolescents. A sub-sample of the youth were characterized as belonging to either a "Pure" depression group, an "Internalizing" group (depression and co-occurring internalizing disorders), or an "Externalizing"…

  20. Specificity of Putative Psychosocial Risk Factors for Psychiatric Disorders in Children and Adolescents

    ERIC Educational Resources Information Center

    Shanahan, Lilly; Copeland, William; Costello, E. Jane; Angold, Adrian

    2008-01-01

    Background: Most psychosocial risk factors appear to have general rather than specific patterns of association with common childhood and adolescence disorders. However, previous research has typically failed to 1) control for comorbidity among disorders, 2) include a wide range of risk factors, and 3) examine sex by developmental stage effects on…

  1. Mindfulness-Based Stress Reduction for the Treatment of Adolescent Psychiatric Outpatients: A Randomized Clinical Trial

    ERIC Educational Resources Information Center

    Biegel, Gina M.; Brown, Kirk Warren; Shapiro, Shauna L.; Schubert, Christine M.

    2009-01-01

    Research has shown that mindfulness-based treatment interventions may be effective for a range of mental and physical health disorders in adult populations, but little is known about the effectiveness of such interventions for treating adolescent conditions. The present randomized clinical trial was designed to assess the effect of the…

  2. [Some impressions of child and adolescent psychiatric management in Berlin after the fall of the wall].

    PubMed

    Fegert, J M; Geiken, G; Lenz, K

    1992-12-01

    The fall of the Berlin wall caused a sudden increase in migration from East-Germany to West-Berlin. In our sample we compared 155 Berlin elementary school children to 17 children from East-Germany now living in Berlin and 25 immigrant children most oft them coming from Turkey and Poland. Although many authors expected short-term disorders of adaptation, we found a constancy of psychiatric diagnosis in the migration group. We noticed important differences particularly in the new psychosocial situation of the former East German mothers, with many single-mother-families, where the mothers now were often unemployed.

  3. Psychiatric emergencies.

    PubMed

    Cavanaugh, S V

    1986-09-01

    Psychiatric disorders are common in medical inpatient and outpatient populations. As a result, internists commonly are the first to see psychiatric emergencies. As with all medical problems, a good history, including a collateral history from relatives and friends, physical and mental status examination, and appropriate laboratory tests help establish a preliminary diagnosis and treatment plan. Patients with suicidal ideation usually have multiple stressors in the environment and/or a psychiatric disorder (i.e., a major affective disorder, dysthymic disorder, anxiety or panic disorder, psychotic disorder, alcohol or drug abuse, a personality disorder, and/or an adjustment disorder). Of all patients who commit suicide, 70% have a major depressive disorder, schizophrenia, psychotic organic mental disorder, alcoholism, drug abuse, and borderline personality disorder. Patients who are at great risk have minimal supports, a history of previous suicide attempts, a plan with high lethality, hopelessness, psychosis, paranoia, and/or command self-destructive hallucinations. Treatment is directed toward placing the patient in a protected environment and providing psychotropic medication and/or psychotherapy for the underlying psychiatric problem. Other psychiatric emergencies include psychotic and violent patients. Psychotic disorders fall into two categories etiologically: those that have an identifiable organic factor causing the psychosis and those that have an underlying psychiatric disorder. Initially, it is essential to rule out organic pathology that is life-threatening or could cause irreversible brain damage. After such organic causes are ruled out, neuroleptic medication is indicated. If the patient is not agitated or combative, he or she may be placed on oral divided doses of neuroleptics in the antipsychotic range. Patients who are agitated or psychotic need rapid tranquilization with an intramuscular neuroleptic every half hour to 1 hour until the agitation and

  4. Experiences of Domestic and School Violence Among Child and Adolescent Psychiatric Outpatients.

    PubMed

    Völkl-Kernstock, Sabine; Huemer, Julia; Jandl-Jager, Elisabeth; Abensberg-Traun, Marihan; Marecek, Sonja; Pellegrini, Elisabeth; Plattner, Belinda; Skala, Katrin

    2016-10-01

    The experience of cumulative childhood adversities, such as exposure to domestic violence or abuse by caregivers, has been described as risk factor for poor mental health outcomes in adolescence and adulthood. We performed an investigation of experience of violence in all patients aged 6 to 20 years who had consulted the Department of Child and Adolescent Psychiatry, Medical University of Vienna, as outpatients during the period of one year. We were using the Childhood Trauma Interview (CTI) in order to obtain information on the kind of violence. Seventy-five percent of all patients had reported experiences of violence. These youth were significantly more often involved in acts of school violence, thus a significant correlation between experience of domestic violence and violence at school could be revealed. The results of our study emphasize the need for interventions preventing violence both in domestic and in school environments.

  5. The effects of an 8-week multicomponent inpatient treatment program on body composition and anaerobic fitness in overweight and obese children and adolescents

    PubMed Central

    Karner-Rezek, Klaus; Knechtle, Beat; Fenzl, Matthias; Schlegel, Christian; Konrad, Manuela; Rosemann, Thomas

    2013-01-01

    Background High intensity exercise is considered as an effective means for reducing body fat. The aims of the present study were to investigate (1) whether body mass would be lost and body composition would change and (2) whether variables of anaerobic fitness prior to the intervention period would be related to loss of body mass and changes in body composition in overweight and obese children and adolescents. Methods A total of 28 children and adolescents (19 boys, 9 girls) attended an 8-week multicomponent inpatient program. Caloric intake was based on the subject’s weight and a daily energy deficit of ~500 kcal was targeted. At the beginning and at the end of the program, variables of anaerobic fitness were assessed using Wingate tests. Body composition was measured before and after the program using dual-energy X-ray absorptiometry. Results Body mass decreased by 11.4% ± 1.6% in boys and by 11.0% ± 2.8% in girls (P < 0.001). Fat mass decreased by 23.8% ± 6.1% in boys and by 21.5% ± 5.2% in girls (P < 0.001). The decrease in fat mass was associated with the decrease in body mass in boys (r = 0.54, P = 0.017) but not in girls (P > 0.05). The decrease in body mass and the decrease in fat mass were neither associated with overall energy expenditure nor with the energy deficit in both genders (P > 0.05). Mean power in W/kg increased in the Wingate tests by 95.4% ± 109.1% in boys and by 100.0% ± 119.9% in girls (P < 0.001). Conclusions Adjustments of the chronically positive imbalance of energy intake and energy expenditure of obese children and adolescents living in obesogenic environments should be addressed in a multisectoral approach. Future research in multicomponent childhood and adolescent weight loss programs should be directed towards a better understanding of the underlying complex dynamics in energy homeostasis which promote weight loss and changes in body composition due to high intensity exercise interventions. PMID:23525602

  6. "Coming ready or not" high fidelity human patient simulation in child and adolescent psychiatric nursing education: diffusion of Innovation.

    PubMed

    McGarry, Denise; Cashin, Andrew; Fowler, Cathrine

    2011-10-01

    This paper is the first to address high fidelity human patient simulation (HFHPS) as a technique to prepare pre-registration nursing students for practice in child and adolescent psychiatric nursing (CAPN). By examining the published literature in a systematic review, no evidence was located that discussed the application of this innovative mannequin-based educational technique for this population. Indeed, mental health nursing preparation generally had minimal literature addressing the adoption of HFHPS. Rogers' (2003) model of the "Diffusion of Innovation" was applied as a lens to explain this observation. His model fitted this observed pattern well and provided a range of explanatory paradigms. It was limited, however, in its predictive ability to suggest when and under what conditions HFHPS might be expected to be adopted by nursing preparation programmes for CAPN. At the conclusion to this examination, the absence of a conversation evident in the mental health or CAPN literature on the preparation of pre-registration nursing students using this educational technique is striking. The potential of this approach to be combined in new ways to better prepare nursing students for the challenges of practice in mental health or CAPN needs extensive examination.

  7. Psychiatric disorders and characteristics of abuse in sexually abused children and adolescents with and without intellectual disabilities.

    PubMed

    Soylu, Nusret; Alpaslan, Ahmet Hamdi; Ayaz, Muhammed; Esenyel, Selcen; Oruç, Mücahit

    2013-12-01

    The purpose of this study was to compare sexually abused children and adolescents, with and without intellectual disabilities (ID), in terms of post-abuse psychiatric disorders, features of the sexual abuse, and sociodemographic characteristics. The study included sexually abused children aged 6-16 years, who were sent to three different child mental health units for forensic evaluation; there were 102 cases (69 girls and 33 boys) with ID and 154 cases (126 girls and 28 boys) without ID. Researchers retrospectively examined the files, social examination reports, and the judicial reports of the cases. It was determined that in the group with ID, sexual abuse types including penetration and contact had higher rates, they were exposed to more frequent repeated abuses, the abuses were revealed with their own reports at a later period and lower rates, and post-abuse pregnancies were more frequent. It was also determined that the abuser was a familiar person and a family member at lower rates and more than one abuser was encountered more frequently, compared to the group without ID. While no difference was determined between the two groups in terms of the frequency of post-abuse post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), conduct disorder (CD) was observed more frequently in the group with ID. This study emphasizes that sexual abuse, which is an important problem in individuals with ID, has different features and effects.

  8. Nicotine dependence measures among adolescents with psychiatric disorders: evaluating symptom expression as a function of dependence severity.

    PubMed

    Strong, David R; Brown, Richard A; Ramsey, Susan E; Myers, Mark G

    2003-10-01

    Using methods based in item response theory, we examined a structured interview assessment of Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) nicotine dependence and the Modified Fagerström Tolerance Questionnaire (mFTQ) symptoms to explore the expression of particular symptoms as a function of level of nicotine involvement in a sample of 191 adolescents with psychiatric disorders. Despite our attempts to capture a broad range of smokers, 64% of teens were daily smokers and 68% met DSM-IV criteria for nicotine dependence. This paper describes the relative severity of DSM-IV and mFTQ items, as well as each item's ability to discriminate among individuals at various levels of nicotine involvement. Comparisons across measures revealed that the mFTQ was not particularly sensitive to individual variation in DSM-IV symptom counts, suggesting the physiological components were not strongly related to the predominantly cognitive and behavioral components of the DSM-IV nicotine dependence syndrome. However, the mFTQ relative to the DSM-IV consistently showed stronger relationships to the immediate consequences of nicotine deprivation (urge, craving), supporting the conceptualization of the mFTQ as measuring nicotine exposure. These analyses provide us with some preliminary understanding of the severity of particular symptoms and the order in which symptoms are likely to be expressed across levels of nicotine dependence.

  9. Psychiatric Disorders in Adolescents and Adults with Autism and Intellectual Disability: A Representative Study in One County in Norway

    ERIC Educational Resources Information Center

    Bakken, Trine L.; Helverschou, Sissel B; Eilertsen, Dag E.; Heggelund, Trond; Myrbakk, Even; Martinsen, Harald

    2010-01-01

    Few studies assess psychiatric disorders in representative samples of individuals with autism and ID. Symptoms of autism and psychiatric disorders have been confounded. PAC, a conceptually analysed and validated screening instrument, was used. Aims: Assess prevalence of psychiatric disorders in individuals with intellectual disability only…

  10. Combination pharmacotherapy for psychiatric disorders in children and adolescents: prevalence, efficacy, risks and research needs.

    PubMed

    Jureidini, Jon; Tonkin, Anne; Jureidini, Elsa

    2013-10-01

    Polypharmacy, defined as the concomitant use of two or more psychotropic drugs, has become increasingly common in the paediatric and adolescent population over the past two decades. Combining psychotropic drugs leads to possible increases in benefits, but also in risks, particularly given the potential for psychotropic drug interactions. Despite the increasing use of concomitant therapy in children and adolescents, there is very little evidence from controlled clinical trials to provide guidance for prescribers. Even while acknowledging the small evidence base, clinical practice guidelines from eminent medical organizations are either relatively silent on or tend to support the use of concomitant treatments more enthusiastically than the evidence would warrant, so that practice and guidance are running ahead of the science. Our narrative review shows that the published evidence for efficacy and safety of concomitant psychotropic drugs in children and adolescents is scanty. A comprehensive search located 37 studies published over the last decade, of which 18 were randomized controlled trials (RCTs). These focused mainly on stimulants, central sympatholytics (such as clonidine), antipsychotics and 'mood stabilizers'. While several small, often methodologically weak, RCTs demonstrated statistically significant advantages for dual pharmacotherapy over monotherapy, only adding central sympatholytics to stimulants for treating attention-deficit hyperactivity disorder (ADHD) symptoms was supported by substantial studies with an effect size large enough to suggest clinical importance. Non-randomized studies tended to have results that supported concomitant treatment, but all have design-related problems that decrease the reliability of the results. Two studies that specifically examined tolerability of combination pharmacotherapy compared with monotherapy showed significant increases in adverse effects, both subjective and objective, and other studies confirmed a

  11. Association of Parental Depression with Psychiatric Course from Adolescence to Young Adulthood among Formerly Depressed Individuals

    PubMed Central

    Rohde, Paul; Lewinsohn, Peter M.; Klein, Daniel N.; Seeley, John R.

    2005-01-01

    We examined whether parental major depressive disorder (MDD) is associated with course of depression and other psychopathology among formerly depressed adolescents as they enter adulthood. The sample consisted of 244 individuals (age 24) in a longitudinal study who had experienced MDD by 19. Maternal MDD was associated with MDD recurrence, chronicity, and severity, anxiety disorders, and (among sons only) lower psychosocial functioning in offspring between 19–24. Paternal MDD was associated with lower functioning. Sons of depressed fathers had elevated suicidal ideation and attempt rates in young adulthood. Recurrent paternal MDD was associated with depression recurrence in daughters but not sons. The impact of parental MDD on offspring could not be attributed to characteristics of the offspring’s depression prior to 19. PMID:16117578

  12. [Neuro-psychiatric comorbidity among children and adolescents who suffer from epilepsy].

    PubMed

    Doron, Yariv; Epstein, Orna; Heyman, Eli; Lahat, Eli

    2013-01-01

    Epilepsy is quite a common disorder in the child and adolescent population, and it has been studied for many years. Recently, a better understanding has been achieved regarding the comorbidities in epilepsy, including: major depression, anxiety, learning disabilities, etc.. The comorbidities are extensive and affect many aspects in the life of the patient, and his family members, including: psychological development, learning abilities, independence, etc.. Several mechanisms take part in these comorbidities, starting in the cell and ending with a broadened psychological effect. A better understanding of these mechanisms may assist the physicians in diagnosing their patients and tailoring a wide-approach treatment plan, thereby improving the patient's clinical status and his quality of life (and that of his family). The objective of this article is to describe some of the common comorbidities that are present in epilepsy, and outline the multi-disciplinary approach in treating the epileptic child and his/her family.

  13. Pharmacogenetics Informed Decision Making in Adolescent Psychiatric Treatment: A Clinical Case Report

    PubMed Central

    Smith, Teri; Sharp, Susan; Manzardo, Ann M.; Butler, Merlin G.

    2015-01-01

    Advances made in genetic testing and tools applied to pharmacogenetics are increasingly being used to inform clinicians in fields such as oncology, hematology, diabetes (endocrinology), cardiology and expanding into psychiatry by examining the influences of genetics on drug efficacy and metabolism. We present a clinical case example of an adolescent male with anxiety, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder who did not tolerate numerous medications and dosages over several years in attempts to manage his symptoms. Pharmacogenetics testing was performed and DNA results on this individual elucidated the potential pitfalls in medication use because of specific pharmacodynamic and pharmacokinetic differences specifically involving polymorphisms of genes in the cytochrome p450 enzyme system. Future studies and reports are needed to further illustrate and determine the type of individualized medicine approach required to treat individuals based on their specific gene patterns. Growing evidence supports this biological approach for standard of care in psychiatry. PMID:25710722

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  15. The impact of psychiatric diagnosis on treatment adherence and duration among victimized children and adolescents in São Paulo, Brazil

    PubMed Central

    Scivoletto, Sandra; Silva, Thiago F.; Cunha, Paulo Jannuzzi; Rosenheck, Robert A.

    2012-01-01

    OBJECTIVE: Despite the high prevalence of substance abuse and mood disorders among victimized children and adolescents, few studies have investigated the association of these disorders with treatment adherence, represented by numbers of visits per month and treatment duration. We aimed to investigate the effects of substance abuse and mood disorders on treatment adherence and duration in a special program for victimized children in São Paulo, Brazil. METHODS: A total of 351 participants were evaluated for psychiatric disorders and classified into one of five groups: mood disorders alone; substance abuse disorders alone; mood and substance abuse disorders; other psychiatric disorders; no psychiatric disorders. The associations between diagnostic classification and adherence to treatment and the duration of program participation were tested with logistic regression and survival analysis, respectively. RESULTS: Children with mood disorders alone had the highest rate of adherence (79.5%); those with substance abuse disorders alone had the lowest (40%); and those with both disorders had an intermediate rate of adherence (50%). Those with other psychiatric disorders and no psychiatric disorders also had high rates of adherence (75.6% and 72.9%, respectively). Living with family significantly increased adherence for children with substance abuse disorders but decreased adherence for those with no psychiatric disorders. The diagnostic correlates of duration of participation were similar to those for adherence. CONCLUSIONS: Mood and substance abuse disorders were strong predictive factors for treatment adherence and duration, albeit in opposite directions. Living with family seems to have a positive effect on treatment adherence for patients with substance abuse disorders. More effective treatment is needed for victimized substance-abusing youth. PMID:22249474

  16. Psychiatric Inpatient Rehabilitation: Is There a Future?

    ERIC Educational Resources Information Center

    Dick, Peter H.

    1990-01-01

    Review of 105 consecutive admissions of mentally ill patients to a British Hospital Rehabilitation Unit over 2 years showed relatively few were of the "long stay" variety and the overall number under age 65 had fallen. Most patients were admitted for sound clinical reasons after consideration of and sometimes trial of community…

  17. Effects of serotonin reuptake inhibitors on aggressive behavior in psychiatrically hospitalized adolescents: results of an open trial.

    PubMed

    Constantino, J N; Liberman, M; Kincaid, M

    1997-01-01

    Low concentrations of the neurotransmitter serotonin and its 5-hydroxyindoleacetic acid metabolite in the central nervous system have been associated with increased aggressive behavior in animals and humans. Controlled clinical trials of serotonin agonists in depressed adults have suggested that aggressive behavior is less likely during treatment with these medications than with placebo, but there have been no previous studies of selective serotonin reuptake inhibitors (SSRIs) and aggression in children. We prospectively followed the course of aggressive behavior in 19 psychiatrically hospitalized adolescents (not selected for aggressiveness) who received open clinical trials of fluoxetine, paroxetine, or sertraline. The patients received standard doses (equivalent to fluoxetine 10-40 mg daily) for a minimum of 5 weeks. The starting dose was 15 +/- 5 mg, and dosages were raised at a mean rate of 5 mg every 4 days up to a mean dose of 25 +/- 10 mg daily. Results from trials of the three SSRIs were clustered because the sample sizes were not sufficient for separate analyses. Overall, there were no statistically meaningful improvements in the level of aggressive behavior, as measured on a modified version of the Overt Aggression Scale, over the course of these patients' SSRI trials. Symptoms of physical aggression toward others or self were manifest in 12 of the 19 patients while on SSRIs. Of the 19 patients, 13 were assessed both on and off SSRIs: verbal aggression (p = 0.04), physical aggression toward objects (p = 0.05), and physical aggression toward self (p < 0.02) occurred significantly more frequently on SSRIs than off; no increase was observed in physical aggression toward others. Patients with the highest baseline aggressivity scores did not show greater improvement during SSRI treatment. Further research is warranted, particularly to explore whether SSRIs may have therapeutic effects on aggression at higher (or lower) doses than were administered in this

  18. Rates of DSM-IV Psychiatric Disorders Among Adolescents in a Large Metropolitan Area

    PubMed Central

    Roberts, Robert E.; Roberts, Catherine Ramsay; Xing, Yun

    2009-01-01

    We present prevalence data for adolescents in a large metropolitan area in the U.S. and the association of DSM-IV diagnoses to functional impairment and selected demographic correlates. We sampled 4,175 youths aged 11–17 years from households enrolled in large health maintenance organizations. Data were collected using questionnaires and the Diagnostic Interview Schedule for Children, Version IV (DISC-IV). Impairment was measured using the Child Global Assessment Scale and diagnostic specific impairment in the DISC-IV. 17.1% of the sample met DSM-IV criteria for one or more disorders in the past year; 11% when only DISC impairment was considered and 5.3% only using the CGAS. The most prevalent disorders were anxiety (6.9%), disruptive (6.5%), and substance use (5.3%) disorders. The most prevalent specific disorders were agoraphobia, conduct and marijuana abuse/dependence, then alcohol use and oppositional defiant disorder. Younger youths and females had lower odds for any disorder, as did youths from two parent homes. There was increased odds associated with lower family income. Females had greater odds of mood and anxiety disorders, males of disruptive and substance use disorders. There were greater odds of mood and disruptive disorders for older youths. Prevalences were highly comparable to recent studies using similar methods in diverse non-metropolitan populations. We found associations with age, gender, and to a lesser extent, socioeconomic status reported in previous studies. The inclusion of both diagnosis-specific impairment and global impairment reduced prevalence rates significantly. Our results suggest commonality of prevalences and associated factors in diverse study settings, including urban and rural areas. PMID:17107689

  19. Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area.

    PubMed

    Roberts, Robert E; Roberts, Catherine Ramsay; Xing, Yun

    2007-12-01

    We present prevalence data for adolescents in a large metropolitan area in the US and the association of DSM-IV diagnoses to functional impairment and selected demographic correlates. We sampled 4175 youths aged 11-17 years from households enrolled in large health maintenance organizations. Data were collected using questionnaires and the Diagnostic Interview Schedule for Children, Version IV (DISC-IV). Impairment was measured using the Child Global Assessment Scale and diagnostic specific impairment in the DISC-IV. 17.1% of the sample met DSM-IV criteria for one or more disorders in the past year; 11% when only DISC impairment was considered and 5.3% only using the CGAS. The most prevalent disorders were anxiety (6.9%), disruptive (6.5%), and substance use (5.3%) disorders. The most prevalent specific disorders were agoraphobia, conduct and marijuana abuse/dependence, then alcohol use and oppositional defiant disorder. Younger youths and females had lower odds for any disorder, as did youths from two parent homes. There was increased odds associated with lower family income. Females had greater odds of mood and anxiety disorders, males of disruptive and substance use disorders. There were greater odds of mood and disruptive disorders for older youths. Prevalences were highly comparable to recent studies using similar methods in diverse non-metropolitan populations. We found associations with age, gender, and to a lesser extent, socioeconomic status reported in previous studies. The inclusion of both diagnosis-specific impairment and global impairment reduced prevalence rates significantly. Our results suggest commonality of prevalences and associated factors in diverse study settings, including urban and rural areas.

  20. Predictors of Specialized Inpatient Admissions for Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Modi, Miti; McMorris, Carly; Palucka, Anna; Raina, Poonam; Lunsky, Yona

    2015-01-01

    Individuals with intellectual disability (ID) have complex mental health needs and may seek specialized ID psychiatric services. This study reports on predictors of specialized inpatient admissions for 234 individuals with ID who received outpatient services at a psychiatric hospital. Overall, from 2007-2012, 55 of the 234 outpatients were triaged…

  1. Association between neighbourhood air pollution concentrations and dispensed medication for psychiatric disorders in a large longitudinal cohort of Swedish children and adolescents

    PubMed Central

    Bråbäck, Lennart; Åström, Daniel Oudin; Strömgren, Magnus; Forsberg, Bertil

    2016-01-01

    Objective To investigate associations between exposure to air pollution and child and adolescent mental health. Design Observational study. Setting Swedish National Register data on dispensed medications for a broad range of psychiatric disorders, including sedative medications, sleeping pills and antipsychotic medications, together with socioeconomic and demographic data and a national land use regression model for air pollution concentrations for NO2, PM10 and PM2.5. Participants The entire population under 18 years of age in 4 major counties. We excluded cohort members whose parents had dispensed a medication in the same medication group since the start date of the register. The cohort size was 552 221. Main outcome measures Cox proportional hazards models to estimate HRs and their 95% CIs for the outcomes, adjusted for individual-level and group-level characteristics. Results The average length of follow-up was 3.5 years, with an average number of events per 1000 cohort members of ∼21. The mean annual level of NO2 was 9.8 µg/m3. Children and adolescents living in areas with higher air pollution concentrations were more likely to have a dispensed medication for a psychiatric disorder during follow-up (HR=1.09, 95% CI 1.06 to 1.12, associated with a 10 µg/m3 increase in NO2). The association with NO2 was clearly present in 3 out of 4 counties in the study area; however, no statistically significant heterogeneity was detected. Conclusion There may be a link between exposure to air pollution and dispensed medications for certain psychiatric disorders in children and adolescents even at the relatively low levels of air pollution in the study regions. The findings should be corroborated by others. PMID:27259522

  2. Psychiatric response to the Clapham rail crash.

    PubMed Central

    Burns, T P; Hollins, S C

    1991-01-01

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

  3. How Parental Reactions Change in Response to Adolescent Suicide Attempt.

    PubMed

    Greene-Palmer, Farrah N; Wagner, Barry M; Neely, Laura L; Cox, Daniel W; Kochanski, Kristen M; Perera, Kanchana U; Ghahramanlou-Holloway, Marjan

    2015-01-01

    This study examined parental reactions to adolescents' suicide attempts and the association of reactions with future suicidal self-directed violence. Participants were 81 mothers and 49 fathers of 85 psychiatric inpatient adolescents. Maternal hostility and paternal anger and arguing predicted future suicide attempts. From pre- to post-attempt, mothers reported feeling increased sadness, caring, anxiety, guilt, fear, and being overwhelmed; fathers reported increased sadness, anxiety, and fear. Findings have clinical implications; improving parent-child relationships post-suicide attempt may serve as a protective factor for suicide.

  4. Psychiatric Disorders Associated with the Onset and Persistence of Bulimia Nervosa and Binge Eating Disorder during Adolescence.

    ERIC Educational Resources Information Center

    Zaider, Talia I.; Johnson, Jeffrey G.; Cockell, Sarah J.

    2002-01-01

    Conducted a prospective longitudinal study to investigate whether anxiety, depressive, personality, or substance abuse disorders increase risk for onset of bulimia nervosa (BN) or binge eating disorder (BED) during adolescence. Findings for 201 adolescents suggest that adolescents with chronic depressive symptoms may be at elevated risk for the…

  5. Juvenile Mental Health Courts for Adjudicated Youth: Role Implications for Child and Adolescent Psychiatric Mental Health Nurses

    PubMed Central

    Burriss, F. Antoinette; Breland-Noble, Alfiee M.; Webster, Joe L.; Soto, Jose A.

    2013-01-01

    TOPIC Juvenile mental health courts for adjudicated youth. PURPOSE To describe the role of psychiatric nurses in reducing mental health disparities for adjudicated youth via juvenile mental health courts. SOURCES ISI Web of Knowledge; Sage Journals Online; HighWire; PubMed; Google Scholar and Wiley Online Library and websites for psychiatric nursing organizations. Years included: 2000–2010. CONCLUSIONS Juvenile mental health courts may provide a positive and effective alternative to incarceration for youth with mental health problems with psychiatric nurses playing a key role in program implementation. PMID:21501288

  6. Association of socioeconomic status with psychiatric problems and violent behaviours in a nationally representative sample of Iranian children and adolescents: the CASPIAN-IV study

    PubMed Central

    Heshmat, Ramin; Qorbani, Mostafa; Ghoreshi, Behnaz; Djalalinia, Shirin; Tabatabaie, Omid Reza; Safiri, Saeid; Noroozi, Mehdi; Motlagh, Mohammad-Esmaeil; Ahadi, Zeinab; Asayesh, Hamid; Kelishadi, Roya

    2016-01-01

    Objectives The aim of the present study was to evaluate the association between socioeconomic status (SES) and psychiatric problems and violent behaviours in a nationally representative sample of Iranian children and adolescents, based on nationwide surveillance programme data, 2011–2012. Methods Overall, 14 880 students, aged 6–18 years, were selected using a multistage cluster sampling method from rural and urban areas of 30 provinces in Iran. SES was estimated based on a main summarised component, extracted from principle component analysis of family assets and parents' jobs and education. For statistical analysis, SES was classified as ‘low’, ‘middle’ and ‘high’. The WHO-Global School Based Student Health Survey (WHO-GSHS) questionnaire was used to assess psychiatric problems and violent behaviours. Results In total, 13 486 students (participation rate 90.6%) completed the study: 50.8% were boys and 75.6% were urban residents, with a mean age of 12.47±3.36 years. In the multivariate model, the ORs of depression, anxiety, feeling worthless, anger, insomnia, confusion and physical fights were lower in students with high SES compared with those with low SES (p<0.05) but physical fights was lower in the high SES group than in the low SES group (p<0.05). No significant relationship was documented between SES and other variables, including getting worried, history of bullying and being victimised. Conclusions Children and adolescents with low SES were at higher risk for psychiatric problems and violent behaviours. Mental health policies and public interventional strategies should be considered at the public level, notably for low SES families. PMID:27531729

  7. Bibliometric assessment of publication output of child and adolescent psychiatric/psychological affiliations between 2005 and 2010 based on the databases PubMed and Scopus.

    PubMed

    Albayrak, Ozgür; Föcker, Manuel; Wibker, Katrin; Hebebrand, Johannes

    2012-06-01

    We aimed to determine the quantitative scientific publication output of child and adolescent psychiatric/psychological affiliations during 2005-2010 by country based on both, "PubMed" and "Scopus" and performed a bibliometric qualitative evaluation for 2009 using "PubMed". We performed our search by affiliation related to child and adolescent psychiatric/psychological institutions using "PubMed". For the quantitative analysis for 2005-2010, we counted the number of abstracts. For the qualitative analysis for 2009 we derived the impact factor of each abstract's journal from "Journal Citation Reports". We related total impact factor scores to the gross domestic product (GDP) and population size of each country. Additionally, we used "Scopus" to determine the number of abstracts for each country that was identified via "PubMed" for 2009 and compared the ranking of countries between the two databases. 61 % of the publications between 2005 and 2010 originated from European countries and 26 % from the USA. After adjustment for GDP and population size, the ranking positions changed in favor of smaller European countries with a population size of less than 20 million inhabitants. The ranking of countries for the count of articles in 2009 as derived from "Scopus" was similar to that identified via the "PubMed" search. The performed search revealed only minor differences between "Scopus" and "PubMed" related to the ranking of countries. Our data indicate a sharp difference between countries with a high versus low GDP with regard to scientific publication output in child and adolescent psychiatry/psychology.

  8. The Impact of Psychiatric Patient Boarding in Emergency Departments

    PubMed Central

    Nicks, B. A.; Manthey, D. M.

    2012-01-01

    Objectives. Studies have demonstrated the adverse effects of emergency department (ED) boarding. This study examines the impact of resource utilization, throughput, and financial impact for psychiatric patients awaiting inpatient placement. Methods. The authors retrospectively studied all psychiatric and non-psychiatric adult admissions in an Academic Medical Center ED (>68,000 adult visits) from January 2007-2008. The main outcomes were ED length of stay (LOS) and associated reimbursement. Results. 1,438 patients were consulted to psychiatry with 505 (35.1%) requiring inpatient psychiatric care management. The mean psychiatric patient age was 42.5 years (SD 13.1 years), with 2.7 times more women than men. ED LOS was significantly longer for psychiatric admissions (1089 min, CI (1039–1140) versus 340 min, CI (304–375); P < 0.001) when compared to non-psychiatric admissions. The financial impact of psychiatric boarding accounted for a direct loss of ($1,198) compared to non-psychiatric admissions. Factoring the loss of bed turnover for waiting patients and opportunity cost due to loss of those patients, psychiatric patient boarding cost the department $2,264 per patient. Conclusions. Psychiatric patients awaiting inpatient placement remain in the ED 3.2 times longer than non-psychiatric patients, preventing 2.2 bed turnovers (additional patients) per psychiatric patient, and decreasing financial revenue. PMID:22888437

  9. Cannabis and psychiatric disorders.

    PubMed

    Loga, Slobodan; Loga-Zec, Svjetlana; Spremo, Mira

    2010-06-01

    There are connection between use of cannabis and many psychiatric disturbances in adolescents, especially "cannabis psychosis", depression, panic attacks and suicide. Negative effects could occur either as a result of a specific pharmacological effect of cannabis, or as the result of stressful experiences during the intoxication of cannabis in young people. Potentially is very dangerous high frequency suicidal ideation among cannabis users.

  10. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false General requirements for psychiatric residential... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21 § 483.354 General requirements for psychiatric residential treatment facilities. A...

  11. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false General requirements for psychiatric residential... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21 § 483.354 General requirements for psychiatric residential treatment facilities. A...

  12. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false General requirements for psychiatric residential... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21 § 483.354 General requirements for psychiatric residential treatment facilities. A...

  13. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false General requirements for psychiatric residential... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21 § 483.354 General requirements for psychiatric residential treatment facilities. A...

  14. 42 CFR 483.354 - General requirements for psychiatric residential treatment facilities.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false General requirements for psychiatric residential... Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21 § 483.354 General requirements for psychiatric residential treatment facilities. A...

  15. Psychiatric home care: a new tool for crisis intervention.

    PubMed

    Spiro, A H

    1994-03-01

    The cost of psychiatric care has been rapidly increasing in recent years. Between 1984 and 1987, there was a 46 percent increase in psychiatric hospitals beds and a 60 percent increase in psychiatric units in general hospitals. This reflected a recognition by many health care systems that psychiatric patients were a good source of revenue. With this push toward more and more inpatient programs, crucial aspects of psychiatric care were left behind. Specifically, the limitations of inpatient therapy have not been recognized. Within the past five years, a new program has been developed and pioneered to use home care to prevent psychiatric hospitalizations and to also prevent the difficult transitions for psychiatric patients. Over a two-year period, this program was studied for its impact on the quality and cost of psychiatric care.

  16. The dynamics of psychiatric bed use in general hospitals

    PubMed Central

    Slade, Eric P; Goldman, Howard H

    2014-01-01

    This study examines general hospitals' adjustments in psychiatric bed utilization practices in response to increases in psychiatric inpatient admissions. Using panel data from 439 hospitals, monthly observations (N=7831) between 2007 and 2010 on psychiatric admissions, psychiatric bed occupancy rates, and average length-of-stay were created for psychiatric inpatients. In fixed-effects regressions, an increase in psychiatric admissions was associated with an increase in the probability of psychiatric bed use exceeding 100% occupancy and with a reduction of mean length-of-stay. These results were confirmed in instrumental variables models. General hospitals may dynamically adjust bed utilization practices in response to changing psychiatric bed needs. An implication of this dynamic adjustment model is that bed shortages are likely to be local, transitory events. PMID:24756929

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

    PubMed

    Slade, Eric P; Goldman, Howard H

    2015-03-01

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

  18. Treatment - mother-infant inpatient units.

    PubMed

    Glangeaud-Freudenthal, Nine M C; Howard, Louise M; Sutter-Dallay, Anne-Laure

    2014-01-01

    Infants of parents with psychiatric disorders may be particularly vulnerable and have a higher risk of developing psychiatric disorders in adulthood. Until the second half of the 20th century, women and infants were cared for separately. Today, hospitalisation of women with their babies in psychiatric mother-baby units enables psychiatric care of women and promotion of parent-infant interactions and child development. The distribution of psychiatric mother-baby units around the world, as well as within countries, varies strongly. Reasons for this may be related to the absence of national perinatal mental health policies related to psychiatric mother-baby unit location, differences in sources of referral for admission, and criteria for psychiatric mother-baby unit admission. Two principal national epidemiologic studies, in England and in France and Belgium, have described issues related to discharge from such care, as have smaller local studies, but no epidemiologic studies have yet demonstrated that joint inpatient psychiatric mother-baby unit care is cost-effective compared with separate care.

  19. HOLDING THE LINE WITH A WATCHFUL EYE: THE IMPACT OF PERCEIVED PARENTAL PERMISSIVENESS AND PARENTAL MONITORING ON RISKY SEXUAL BEHAVIOR AMONG ADOLESCENTS IN PSYCHIATRIC CARE

    PubMed Central

    Donenberg, Geri R.; Wilson, Helen W.; Emerson, Erin; Bryant, Fred B.

    2005-01-01

    Adolescents in psychiatric care are at increased risk of HIV, yet little is known about the family factors related to sexual risk taking among these youth. We explored whether perceived parental monitoring and perceived parental permissiveness were linked to high-risk sexual behavior in 169 ethnically diverse urban youth seeking mental health services in Chicago, and we tested whether adolescent gender moderated these associations. We evaluated sexual risk taking at a global level and for specific risk behaviors (e.g., sex without a condom, sex while using drugs and alcohol). Girls reported more risky sex overall than boys, and girls were more likely than boys to report having sex without a condom. At low levels of parental permissiveness, rates of risky sex among boys and girls’ did not differ, but at high levels of permissiveness girls reported more sexual risk taking than boys, and girls were more likely than boys to report having sex while using drugs and alcohol and having sex without a condom. Findings highlight the complexity of adolescent sexual behavior and the need for multilevel assessment of risk taking. Results suggest that parental monitoring and permissiveness are more strongly associated with sexual risk taking in troubled girls than troubled boys, and they underscore a need for gender-sensitive, family-focused HIV-prevention programs. PMID:12000232

  20. Psychometric Properties of the Resiliency Scales for Children and Adolescents and Use for Youth with Psychiatric Disorders

    ERIC Educational Resources Information Center

    Prince-Embury, Sandra

    2010-01-01

    This study examines psychometric properties of the Resiliency Scales for Children and Adolescents (RSCA) in two clinical samples: one child sample (n = 110) and one adolescent sample (n = 178). The purpose of the study was to examine the distribution characteristics and internal consistency of RSCA scale, subscale, and index scores for youth who…