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Journal articles on the topic 'Acute psychiatry'

Author: Grafiati

Published: 4 June 2021

Last updated: 7 February 2022

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1

Schweitzer, Jochen, Claudia Ginap, Joachim von Twardowski, Julika Zwack, Ulrike Borst, and Elisabeth Nicolai. "Training psychiatric teams to do family systems acute psychiatry." Journal of Family Therapy 29, no. 1 (February 2007): 3–20. http://dx.doi.org/10.1111/j.1467-6427.2007.00366.x.

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2

Radcliffe, Jonathan, and Roger Smith. "Acute in-patient psychiatry: how patients spend their time on acute psychiatric wards." Psychiatric Bulletin 31, no. 5 (May 2007): 167–70. http://dx.doi.org/10.1192/pb.bp.105.009290.

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Aims and MethodWe observed levels of social interaction and activity among in-patients on 16 acute psychiatric wards in 6 hospitals in a large mental health trust. Each ward was observed for 1 week and attendance at organised activities was audited over 3-week periods.ResultsAt any time during the day 84% of in-patients were socially disengaged and mainly inactive. On average only 4% of in-patients' time was spent in an organised group activity, with many in-patients opting out altogether. Provision and take-up of group activity programmes varied widely between wards.Clinical ImplicationsProvision of organised activity needs to be a higher priority in acute services, and there should be national and local standards for what should be provided. Concerted organisational strategies and assertive approaches by staff are needed to engage in-patients in group activity programmes.

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3

Choudry, Abid H. "Acute assessments in psychiatry." Psychiatrist 37, no. 7 (July 2013): 244. http://dx.doi.org/10.1192/pb.37.7.244.

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4

Middleton, Hugh. "A new specialty of acute in-patient psychiatry?" Psychiatric Bulletin 30, no. 11 (November 2006): 404–5. http://dx.doi.org/10.1192/pb.30.11.404.

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Luiz Dratcu makes a case for a new specialty of acute inpatient psychiatry; Frank Holloway argues otherwise. In neither instance are the arguments at all surprising, and in both they are eloquently expressed. The case for a new specialty is based upon recognition of a continuing need for acute psychiatric in-patient services, and recognition that these services require particular skills and facilities which are likely to be most efficiently and effectively provided when interests and activities are focused upon them. The case against does not deny the need for attention to widely acknowledged shortcomings of many acute psychiatric in-patient services, but it does ask the questions ‘what should constitute a specialty?’ and ‘what benefit would flow from having a specialty and for whom?’

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5

Andreoli, Antonio. "The role of psychotherapy in the treatment of acute mental disorders." Epidemiology and Psychiatric Sciences 13, no. 4 (December 2004): 227–36. http://dx.doi.org/10.1017/s1121189x00001743.

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SummaryThis work is directed to further investigate the significant relevance of psychotherapy to better management of acute psychiatric disorders. Over the last years, there was impressive increase of the amount of psychiatric patients referred to emergency and in-patient treatment and such increase allmost resulted from subjects with acute emotional discontrol associated with affective, personality and stress related disorders. According to such change of the clinical scene of contemporary psychiatry, more attention and funding are needed in the field of acute treatment services and combined treatment innovation and research is become a major challenge for community psychiatry. A real progress in the field is not, however a simple matter of psychoterapy technology transference. While several recent studies suggest that well designed combined treatment is cost-effective in these patients, new nosographic, management and dynamic models are required for succesful development of new crisis intervention programs within general psychiatry services.

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6

Flynn, Sarah. "Being positive about acute psychiatry." Mental Health Practice 7, no. 2 (October 2003): 8–10. http://dx.doi.org/10.7748/mhp.7.2.8.s15.

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7

Padma, Kumari, Sharol Fernandes, and Supriya Hegde. "A rare presentation of acute hyperglycemia with secondary mania: a case report." International Journal of Research in Medical Sciences 7, no. 12 (November 27, 2019): 4794. http://dx.doi.org/10.18203/2320-6012.ijrms20195557.

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This case report aims to highlight the diagnostic challenges in consultation-liaison psychiatry in case of Type 1 Diabetes Mellitus. Author report the case of a 60-year-old male who presented to the Psychiatry OPD with first episode of mania. Although hypoglycaemia is known to be associated with multiple psychiatric manifestations, the incidence of psychiatric symptoms and disorders in association with hyperglycaemia is not well reported. This case report highlights the rare presentation of secondary mania in a patient with Type 1 Diabetes Mellitus.

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8

Mattinson, Anna Rebecca, and Sarah Jane Cheeseman. "Development and implementation of a structured ward round in acute adult psychiatry." BMJ Open Quality 7, no. 3 (July 2018): e000035. http://dx.doi.org/10.1136/bmjoq-2017-000035.

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Delivering high quality care in acute psychiatry requires a coordinated approach from a multidisciplinary team (MDT). Weekly ward rounds are an important forum for reviewing a patient’s progress and developing a personalised care plan for the coming week. In general medicine, structured ward rounds and check lists have been shown to prevent omissions and improve patient safety; however, they are not widely used in psychiatry. At the Royal Edinburgh Hospital, the format of ward rounds differed between psychiatry wards and clinical teams, and care plans were not standardised. An audit in October 2015 found only 5% of acute psychiatric inpatients had a documented nursing care plan. It was agreed that a clear multidisciplinary care plan from the weekly ward round would be beneficial. A group of consultant psychiatrists identified seven key domains for ward round (Social needs, Community Mental Health Team liaison, Assessments required, Mental Health Act, Prescriptions: medication electroconvulsive therapy (ECT), T2/T3, Engagement with relatives and carers, Risk Assessment and Pass Plans). This was given the acronym SCAMPER. Following this, a clinical MDT on a paired male and female ward, developed and introduced a structured ward round sheet. Within 8 weeks this was being used for 100% of patients. It was subsequently introduced into three other acute adult psychiatry wards and the intensive psychiatric care unit. Staff feedback was sought verbally and via a questionnaire. This was positive. The form was widely accepted and staff felt it improved patient care and ward round quality.

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9

Cheng, Sammy Kin-Wing, Jenny Suk-Kwan Tsang, Kwok-Hung Ku, Chee-Wing Wong, and Yin-Kwok Ng. "Psychiatric complications in patients with severe acute respiratory syndrome (SARS) during the acute treatment phase: a series of 10 cases." British Journal of Psychiatry 184, no. 4 (April 2004): 359–60. http://dx.doi.org/10.1192/bjp.184.4.359.

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SummaryIn February 2003, Hong Kong was hit by a community-wide outbreak of severe acute respiratory syndrome (SARS). During the period of the outbreak, 10 patients with SARS with psychiatric complications were referred to our Consultation and Liaison Psychiatry Team for assessment and management. We found that both the direct and indirect effects of SARS such as symptom severity total isolation during treatment and administration of steroid were probable causes of psychiatric complications. In this paper, we report on the nature of their psychiatric problems, challenges to management and psychiatric treatment strategies used during the acute phase.

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10

Sharfstein, Steven S. "Letter from America: acute in-patient psychiatry bed shortages." Advances in Psychiatric Treatment 15, no. 6 (November 2009): 402–3. http://dx.doi.org/10.1192/apt.bp.109.006957.

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SummaryThe number of in-patient beds for psychiatric treatment in America has declined dramatically over the past 40 years. Public and private policies have encouraged an extremely short-term, crisis-stabilisation model of treatment. This is true on both general and subspecialty units. As a result, readmissions have increased, emergency rooms are crowded, and many patients end up homeless or incarcerated in the criminal justice system. These changes have created a public health crisis in America, and are the greatest challenges that American psychiatry faces today.

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11

Bennett, Jeffrey I., George Costin, Mehnaz Khan, Mir Nadeem Mazhar, Kristina Dzara, Mary Conklen, and Jo Ann Hannig. "Postgraduate Year-1 Residency Training in Emergency Psychiatry: An Acute Care Psychiatric Clinic at a Community Mental Health Center." Journal of Graduate Medical Education 2, no. 3 (September 1, 2010): 462–66. http://dx.doi.org/10.4300/jgme-d-10-00027.1.

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Abstract Objective The purpose of this study was to determine resident satisfaction with an acute care psychiatric clinic designed in collaboration with a nearby community mental health center. We also sought to demonstrate that this rotation helps meet program requirements for emergency psychiatry training, provides direct assessments of resident interviewing skills and clinical knowledge in the postgraduate year-1, and provides exposure to public sector systems of care. Methods We developed a resident satisfaction questionnaire and fielded it to each of the residents who participated in the clinic over the first 3 years. Data were collected, organized, and analyzed. Results Of the 15 residents in the acute care psychiatric clinic, 12 completed and returned the satisfaction questionnaires. Educational aspects of the clinic experience were rated favorably. Conclusions This postgraduate year-1 acute care psychiatric clinic provides a mechanism for the fulfillment of emergency psychiatry training as well as direct supervision of clinical encounters, which is a satisfactory and useful educational experience for trainees.

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12

Bennett, Benjamin, Ajay Mansingh, Cormac Fenton, and Jonathan Katz. "Graves’ disease presenting with hypomania and paranoia to the acute psychiatry service." BMJ Case Reports 14, no. 2 (February 2021): e236089. http://dx.doi.org/10.1136/bcr-2020-236089.

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This manuscript describes the case of a young woman, with no prior psychiatric history, who developed hypomania and paranoia as the principal presenting features of Graves’ disease. After starting treatment with carbimazole and propranolol, symptoms resolved without the use of antipsychotic drugs. Close liaison between psychiatry and endocrinology services was essential. This demonstrates that treating underlying thyrotoxicosis in patients presenting with psychiatric symptoms may lead to recovery without the use of antipsychotic medication. While agitation, irritability and mood lability are well-recognised thyrotoxic symptoms, psychosis is a rare presenting feature of Graves’ disease. All patients with agitation, delirium or psychiatric symptoms should have thyroid function checked as part of initial tests screening for organic disease. In new or relapsing psychiatric conditions, it is important to ask patients, their carers or relatives about symptoms of hypothyroidism or thyrotoxicosis.

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13

Hirsch, Steven R. "Planning for Bed Needs and Resource Requirements in Acute Psychiatry: Key points from the Report of the Royal College of Psychiatrists Working Party on Psychiatric Beds and Resources, 1986." Bulletin of the Royal College of Psychiatrists 11, no. 12 (December 1987): 398–407. http://dx.doi.org/10.1192/pb.11.12.398.

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In 1978 the Section for Social and Community Psychiatry of the Royal College of Psychiatrists set up a working party to reconsider the DHSS guideline of 0.5 beds per 1,000 population for acute psychiatric units and to develop a new approach which would enable planners to adopt an appropriate bed provision figure according to the needs of different district psychiatric services. This followed the realisation that Health Authorities were beginning to set arbitrarily their own norms for bed provision, often based on one or two examples within their region, despite the fact that there is a two to three fold variation between districts in the number of beds provided for acute psychiatry. For example, in 1981 Worcester used 0.19 acute beds per 1,000 population and Camberwell used 0.76.

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14

Moylan, Lois Biggin. "Physical Restraint in Acute Care Psychiatry." Journal of Psychosocial Nursing and Mental Health Services 47, no. 3 (March 1, 2009): 41–47. http://dx.doi.org/10.3928/02793695-20090301-10.

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15

Meades, Stephen. "Integrative care planning in acute psychiatry." Journal of Advanced Nursing 14, no. 8 (August 1989): 630–39. http://dx.doi.org/10.1111/j.1365-2648.1989.tb01605.x.

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16

Finlayson, Richard E. "Acute Care Psychiatry: Diagnosis & Treatment." Mayo Clinic Proceedings 73, no. 2 (February 1998): 196. http://dx.doi.org/10.1016/s0025-6196(11)63660-4.

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17

PASNAU, ROBERT O. "Acute Care Psychiatry: Diagnosis and Treatment." American Journal of Psychiatry 155, no. 10 (October 1998): 1455–56. http://dx.doi.org/10.1176/ajp.155.10.1455.

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18

Menninger, W. Walter. "Acute Care Psychiatry: Diagnosis and Treatment." Psychiatric Services 49, no. 4 (April 1998): 538. http://dx.doi.org/10.1176/ps.49.4.538.

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19

Richert, Gail Zehner. "Vocational Transition in Acute Care Psychiatry." Occupational Therapy in Mental Health 10, no. 4 (March 6, 1991): 43–61. http://dx.doi.org/10.1300/j004v10n04_04.

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20

Simpson, Neill. "Assessment in an acute psychiatry setting." Psychiatry 5, no. 10 (October 2006): 355–59. http://dx.doi.org/10.1053/j.mppsy.2006.07.008.

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21

Munoz, Jaime Phillip, and Patricia Schweikert. "A Program for Acute Inpatient Psychiatry." World Federation of Occupational Therapists Bulletin 21, no. 1 (January 1990): 42–46. http://dx.doi.org/10.1080/14473828.1990.11785210.

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22

Nelmes, Elizabeth, and Audrey Ng. "Psychiatric presentations in acute illness with COVID-19: a retrospective analysis." BJPsych Open 7, S1 (June 2021): S44. http://dx.doi.org/10.1192/bjo.2021.168.

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AimsTo assess the psychiatric presentations in patients with a diagnosis of COVID-19 referred to a liaison psychiatry department during a one month period in the peak of the global pandemic.MethodA retrospective analysis of the patients referred to liaison psychiatry during January 2021 who also had a diagnosis of COVID-19. Confirmed cases of COVID-19 were defined as those confirmed by COVID-19 PCR in respiratory samples or clinically suspected cases from chest radiograph or CT. Severe COVID-19 was defined as those requiring supplementary oxygen due to saturations of 93% or less.ResultDuring January 2021, a total of 24 patients were referred to liaison psychiatry with concurrent COVID-19 infection. Out of these patients, 63% had a previous mental health diagnosis. The most common reason for referral was low mood (37.5%), followed by agitation (25%) and psychosis (25%). When considering first psychiatric presentations with concurrent COVID-19 infection, the most common presentation was psychosis (44%). The time course of psychosis was most frequently seen in the seven days prior to a positive swab. In one case a patient was sectioned under the Mental Health Act for psychosis two days prior to developing symptoms. Two of these patients were worked up for possible encephalitis including radiological imaging and lumbar puncture. For patients defined as having severe COVID-19, the most common referral was low mood. In those referred for low mood, 66% had a history of an affective disorder. In two cases low mood was complicated by an acute stress reaction to recent bereavement. For one patient this included the bereavement of two relatives to COVID-19. For patients admitted to intensive care and intubated for respiratory support the most common referrals were low mood and agitation. These factors we found a barrier to successful rehabilitation following periods of significant illness.ConclusionThe impact of COVID-19 on psychiatric presentations extends beyond the socio-economic factors precipitating crises across the nation. Our findings of acute psychiatric illness in the prodromal phase of the viral illness suggest a neuropsychiatric pathogenesis to COVID-19.

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Barros, Régis Eric Maia, João Mazzoncini de Azevedo Marques, Isabela Panzeri Carlotti, Antonio Waldo Zuardi, and Cristina Marta Del-Ben. "Short admission in an emergency psychiatry unit can prevent prolonged lengths of stay in a psychiatric institution." Revista Brasileira de Psiquiatria 32, no. 2 (December 18, 2009): 145–51. http://dx.doi.org/10.1590/s1516-44462009005000014.

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OBJECTIVE: Characterize and compare acute psychiatric admissions to the psychiatric wards of a general hospital (22 beds), a psychiatric hospital (80) and of an emergency psychiatry unit (6). METHOD: Survey of the ratios and shares of the demographic, diagnostic and hospitalization variables involved in all acute admissions registered in a catchment area in Brazil between 1998 and 2004. RESULTS: From the 11,208 admissions, 47.8% of the patients were admitted to a psychiatric hospital and 14.1% to a general hospital. The emergency psychiatry unit accounted for 38.1% of all admissions during the period, with a higher variability in occupancy rate and bed turnover during the years. Around 80% of the hospital stays lasted less than 20 days and in almost half of these cases, patients were discharged in 2 days. Although the total number of admissions remained stable during the years, in 2004, a 30% increase was seen compared to 2003. In 2004, bed turnover and occupancy rate at the emergency psychiatry unit increased. CONCLUSION: The increase in the number of psychiatric admissions in 2004 could be attributed to a lack of new community-based services available in the area beginning in 1998. Changes in the health care network did affect the emergency psychiatric service and the limitations of the community-based network could influence the rate of psychiatric admissions.

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Parikh, Prakash, and Richard Stern. "Why do patients occupy acute psychiatry beds? A pilot study." Psychiatric Bulletin 14, no. 11 (November 1990): 657–60. http://dx.doi.org/10.1192/pb.14.11.657.

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The main aim of this pilot study was to identify factors influencing acute psychiatry bed use. The reasons for occupying a bed vary with time, so patients in the study were assessed on a weekly basis to monitor the changes in the factors thought to be responsible for continued stay. The reasons for bed occupancy also are often only known to those professionals directly involved in day to day care of patients, and it is suspected that the reasons often have little to do with manifest psychiatric illness. The reason for this study was to investigate this question.

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Rosenman, Stephen. "Acute Psychiatric Beds: Distribution and Staffing in NSW and ACT." Australian & New Zealand Journal of Psychiatry 29, no. 2 (June 1995): 238–47. http://dx.doi.org/10.1080/00048679509075916.

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This study examined the availability and staffing of acute psychiatry beds in NSW and ACT. “Gazetted” acute psychiatry hospitals (which take compulsory admissions under mental health law) were polled directly for bed numbers, occupancy and staffing for the year 1990–1991. The NSW Department of Health provided beds numbers for non-gazetted and private hospitals. Four analyses sequentially reallocated beds according to the origin of patients to estimate acute bed availability and use by regional populations. Socio-demographic determinants of acute admission rates were measured. Acute “gazetted” beds averaged 13.2 per 100,000 population but ranged from 6.9 to 49.1 per 100,000 when cross-regional flows were considered. “Non-gazetted” beds raised the provision to 15.5 per 100,000 and private beds raised provision further to 24.5 per 100,000. Inner metropolitan provision was higher than rural or provincial provision. The only determinant of the admission rate to gazetted beds was the number of available beds. Bed availability did not affect either bed occupancy or referral of patients to remote hospitals. Nursing staffing of gazetted units was reasonably uniform, although smaller units had significantly more nurses per bed. Medical staffing was highly variable and appears determined by staff availability. The average provision of acute psychiatric beds approximates lowest levels seen in international models for psychiatric services. Average occupancy rates suggest that there is not an overall shortfall of acute psychiatric beds, but uneven bed distribution creates barriers to access. Referral of patients to remote hospitals is not related to actual bed provision in the regions, but appears to reflect attitudes to ensuring local care. Recommendations about current de facto standards are made. Current average nursing and medical staffing standards are reported.

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Lelliott, Paul. "Acute psychiatric wards." Psychiatric Bulletin 23, no. 8 (August 1999): 505. http://dx.doi.org/10.1192/pb.23.8.505.

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Delle, Janelle Marie, and Joan E. King. "Capturing acute stress disorder in the trauma population." Journal of Nursing Education and Practice 8, no. 11 (June 20, 2018): 24. http://dx.doi.org/10.5430/jnep.v8n11p24.

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Acute Stress Disorder (ASD) is classified as a psychiatric diagnosis that was first introduced to the DSM-IV in 1994. It was introduced to describe acute stress reactions that precede Post-Traumatic Stress Disorder (PTSD). ASD usually occurs within the first month after the occurrence of a traumatic event. Early recognition of ASD is crucial from both an early treatment standpoint and avoidance of progressing to PTSD, especially in the trauma population, as late recognition can lead to long-term mental and physical suffering. At this time, there is no protocol for screening of ASD upon admission to a Level I trauma center in the Southeast in the Unites States. Hence, not all trauma patients are assessed for ASD. Often, acute stress is recognized several days after admission, with late referrals to the psychiatric team for psychological evaluation and treatment. This late psychiatric referral often leads to the patient’s inability to participate in physical rehabilitation due to stress and anxiety, thus increasing hospital stay and use of resources. Thus, collaborating between the primary medical team and psychiatry team is essential and facilitates the recovery process for potential acute or long-term psychiatric disorders. To determine if ASD was recognized in the trauma population at a large Level I Trauma Center in the Southeast, and if referrals to psychiatry were initiated in a timely manner, this quality improvement study was developed. The data from this study served to correlate the percentage of patients who screened positive for ASD on admission to a sub-acute trauma floor. A standardized tool called The Stanford Acute Stress Reaction Questionnaire (SASRQ) was used to determine the frequency of ASD in this trauma population. We also ascertained if the trauma nurse practitioners (NPs) had requested a psychiatric referral without the use of the SASRQ tool. Findings included 18 of the 50 trauma patients who had screened positive for ASD (36%). It was found that of those 18 patients who screened positive for ASD, 2 patients received a psychiatric consultation for evaluation and treatment. These findings suggest a needed focus of capturing ASD early in the admission process, using a validated screening tool, along with early psychological intervention to aid in prevention of PTSD post-discharge.

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van Harten, P. N., and H. W. Hoek. "Recognition of Movement Disorders in Psychiatry: Video Fragments." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70347-5.

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Movement disorders in psychiatry can be divided in those related to an underlying neurological or other somatic disease, related to a psychiatric syndrome, drug induced and psychogenic. In this workshop the typical clinical aspects of each of these movement disorders will be discussed and shown on video with the focus on drug induced. Drug induced can be divided in acute and tardive movement disorders. Acute movement disorders such as acute dystonia, akathisia, parkinsonism and mycoclonus, start short after taking dopamine receptor blocking agents, often an antipsychotic. Once recognized they are relatively easy to treat. Tardive movement disorders such as tardive dyskinesia and tardive dystonia start months or years after using dopamine receptor blocking agents. Treatment is often disappointing, therefore prevention is needed.

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Ballesteros, J., A. Uría, and P. Rico. "First psychiatric hospitalization in patients older than 65 years." European Psychiatry 33, S1 (March 2016): S184. http://dx.doi.org/10.1016/j.eurpsy.2016.01.404.

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IntroductionMedical assistance for elderly people with mental health problems increases at the same time that life expectancy does.ObjectivesThe aim of this work is to describe several demographic and clinical characteristics of elderly patients admitted for the first time to an acute inpatient psychiatry unit.MethodsObservational, descriptive, and retrospective study from June 2013 to May 2015, where it is analysed patients older than 65 years admitted to the acute psychiatric ward of Hospital de Getafe in that period without psychiatric hospitalization in their personal background.ResultsSeventeen patients were included of a total of 428 patients admitted in that period (3.97%). Mean age: 70.7 ± 4.7. A total of 10 male (58.9%). The average stay in the studied group was 18.5 days, slightly lower than general average stay in that period (19.2 days). No psychiatric background was found in 4 patients. The most common diagnoses was depressive episode (5 patients) followed by manic episode (4 patients) and delusional disorder. Every of them but one, were taking at least one antipsychotic drug at discharge.ConclusionsElderly patients represent a low percentage of the total of patients admitted to an acute inpatient psychiatry unit. Many of them, despite having long-term ambulatory psychiatric follow-up, require a first psychiatric hospitalization after 65 years, as well as other patients begin their treatment in the mental health services in that hospitalization. It is noteworthy that antipsychotic drugs are used very commonly in those patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Radhakrishnan, Vishwa. "Are specialist psychiatric services losing the PbR race?: commentary on… clustering in mental health payment by results." Advances in Psychiatric Treatment 20, no. 4 (July 2014): 235–36. http://dx.doi.org/10.1192/apt.bp.113.012443.

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SummaryPayment by results (PbR) is a payment platform for healthcare services. Introduced to acute physical healthcare services in England in 2003–2004, the system has continued to expand and is currently being implemented in acute mental health services. Owing to the variations and complexities of the patients who access specialist psychiatric services, existing clusters do not always accurately capture their needs. The development of PbR tools specific to psychiatric subspecialties is ongoing, but might not be available in the short term. The funding of acute mental health services through PbR might have funding implications for specialist services such as psychiatry of intellectual disability.

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Shoja shafti, Saeed. "Prevalence of Psychiatric Morbidities in Acute Coronary Heart Disease." Cardiovascular Psychiatry and Neurology 2014 (July 22, 2014): 1–5. http://dx.doi.org/10.1155/2014/407808.

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

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Syed, Z. "Occupational therapy: The process in acute psychiatry." African Journal of Health Professions Education 12, no. 1 (March 31, 2020): 9. http://dx.doi.org/10.7196/ajhpe.2020.v12i1.1185.

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Lim, Grace YX, and Michael TH Wong. "Migration and psychosis in acute inpatient psychiatry." Australasian Psychiatry 24, no. 6 (July 10, 2016): 548–52. http://dx.doi.org/10.1177/1039856216649772.

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Objective: We investigated the role of biological and psychosocial risk factors in the development of psychotic disorders with regards to immigrant status. Our hypothesis was that biological risk factors are more predictive of psychosis in non-immigrants, whereas psychosocial risk factors play a bigger role in immigrants. Method: A retrospective audit of admissions between December 2013 and June 2014 in an Australian adult inpatient unit was conducted, focussing on patients with psychotic disorders. We analysed the association between immigrant status, and biological and psychosocial variables. Results: For biological risk factors, non-immigrants had significantly more family history of psychotic disorders ( p = 0.021), illicit drug use ( p = < 0.001) and alcohol use ( p = < 0.001). For psychosocial risk factors, immigrants were more likely to have experienced a traumatic event ( p = 0.022). With regards to age of index presentation, age at onset of psychotic disorder, proportion of males and dysfunctional family background, there was no significant difference. Conclusion: Retrospective data in this report suggests that the development of psychotic disorders in immigrants and non-immigrants may be different.

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Perry, Benjamin I., Katie J. Goldring, and Sharmila J. Menon. "Prolactin monitoring in the acute psychiatry setting." Psychiatry Research 235 (January 2016): 104–9. http://dx.doi.org/10.1016/j.psychres.2015.11.041.

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35

Oyebode, Femi, Stuart Cumella, Gill Garden, and Judith Nicholls. "Development of outcome measures in acute psychiatry." Psychiatric Bulletin 16, no. 10 (October 1992): 618–19. http://dx.doi.org/10.1192/pb.16.10.618.

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This study is an evaluation of the use of two health status measures for monitoring the outcome of acute psychiatric treatment. The measures are the Sickness Impact Profile (SIP) and the Classification of Illness States (CIS). The SIP is a measure of the impact of sickness on patients' daily activities and behaviour. The CIS was initially developed to measure ‘morbidity states’ after hospital treatment and can be used to generate the ‘Rosser Index’, both of which have been shown to be valid and reliable measures (Rosser, 1988).

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Hustoft, Kjetil, Tor Ketil Larsen, Bjørn Auestad, Inge Joa, Jan Olav Johannessen, and Torleif Ruud. "Predictors of involuntary hospitalizations to acute psychiatry." International Journal of Law and Psychiatry 36, no. 2 (March 2013): 136–43. http://dx.doi.org/10.1016/j.ijlp.2013.01.006.

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Bowers, Len, Teresa Allan, Alan Simpson, Julia Jones, and Richard Whittington. "Morale is high in acute inpatient psychiatry." Social Psychiatry and Psychiatric Epidemiology 44, no. 1 (July 5, 2008): 39–46. http://dx.doi.org/10.1007/s00127-008-0396-z.

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Roaldset, J. O., P. Hartvig, and S. Bjørkly. "V-RISK-10: Validation of a Screen for Risk of Violence After Discharge from Acute Psychiatry." European Psychiatry 26, no. 2 (July 8, 2010): 85–91. http://dx.doi.org/10.1016/j.eurpsy.2010.04.002.

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AbstractBackgroundCurrent violence risk assessment instruments are time-consuming and mainly developed for forensic psychiatry. A paucity of violence screens for acute psychiatry instigated the development and validation of the V-RISK-10. The aim of this prospective naturalistic study was to test the predictive validity of the V-RISK-10 as a screen of violence risk after discharge from two acute psychiatric wards.MethodsPatients were screened with V-RISK-10 before discharge, and incidents of violence were recorded 3, 6, 9 and 12 months after discharge. A total of 381 of the 1017 patients that were screened completed the follow up.ResultsThe ROC-AUC values for any violent behaviour were 0.80 and 0.75 (p < 0.001) for the 3 and 12 months follow-up periods, respectively, and significant for both genders. The most accurate risk estimates were obtained for severe violence. For persons without a known history of violence prior to the screening, AUCs were 0.74 (p = 0.004) and 0.68 (p = 0.002).ConclusionsResults indicate that the V-RISK-10 is a valid and clinically useful screen for violence risk after discharge from acute psychiatry, and even significant for patients without a known previous history of violence.

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Fava, Giovanni A., Giancarlo Trombini, Silvana Grandi, Manuela Bernardi, and Renzo Canestrari. "A Psychosomatic Outpatient Clinic." International Journal of Psychiatry in Medicine 17, no. 3 (September 1988): 261–67. http://dx.doi.org/10.2190/0kya-qyv8-k16h-hwfd.

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Current emphasis in clinical psychosomatic medicine is on psychiatric interventions in acute medical and surgical situations (consultation-liaison psychiatry and medical-psychiatric units). Little interest has been taken in psychosomatic interventions in chronic situations and outpatient settings. The functioning of a psychosomatic outpatient clinic (POC) is described. One-hundred consecutive referrals were analyzed. The most frequent diagnostic finding—according to DSM III criteria-was subsumed under the rubric of “psychological factors affecting physical condition,” followed by affective illness, anxiety disturbances, and somatoform disorders. The results indicate that a POC may serve a specific and definable segment of patients, whose characteristics depart from the clinical populations in consultation-liaison psychiatry and medical-psychiatric units.

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Payne, Ann, and Julius Essem. "Management of patients' physical health in an acute psychiatric unit." Irish Journal of Psychological Medicine 25, no. 4 (December 2008): 127–30. http://dx.doi.org/10.1017/s079096670001123x.

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AbstractObjective: The aim of this study was to help clarify the range of acute medical problems experienced by patients on an acute psychiatric unit during a period of 28 days and nights, as encountered by psychiatric trainees, and to document any difficulties experienced by the trainee during these patient contacts.Method: This survey was carried out prospectively over 28 days and nights in an acute psychiatric ward attached to a teaching University Hospital. Following contact with an individual patient, the trainee recorded diagnosis, intervention and any difficulties encountered.Results: Thirty-three patient contacts were recorded (n = 33). Trainees faced a range of primary care problems 22/33 (67%), but moreover, three patients demonstrated more serious and potentially life threatening problems, leading to 11/33 (33%) patient contacts requiring urgent interventions.Conclusions: While the debate continues as to who is best placed to provide medical healthcare for psychiatric patients, this study provides evidence that psychiatry trainees are required to draw on their previous medical and surgical experience on an almost daily basis. As psychiatrists we should consider our options on how best to manage medical problems on the acute psychiatric unit and consequently ensure confident liaison with our medical and surgical colleagues.

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Freyne, Aideen, and Margo Wrigley. "Acute inpatient admissions in a community oriented old age psychiatry service." Irish Journal of Psychological Medicine 14, no. 1 (March 1997): 4–7. http://dx.doi.org/10.1017/s0790966700002810.

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AbstractObjective: This study reviewed all inpatient admissions in a community oriented old age psychiatry service with the aim of assessing the appropriateness of admission criteria, obtaining a profile of those admitted, and providing information about service utilisation.Method: A retrospective chart review of all first inpatient admissions from 1989-1993 was carried out. Information concerning sociodemographic and clinical variables, and outcome measures in terms of discharge destination, was obtained.Results: There were 205 first admissions in the study period. There were 37 patients (18%) admitted on an involuntary basis. One per cent of admissions were not assessed at home prior to admission. Six patients had no formal psychiatric disorder, of the remainder 53% had an organic, and 47% a functional psychiatric disorder. Of those admitted 68% were discharged to their original destination. Patients with dementia were more likely to be discharged to nursing homes. Other discharge destinations were also used.Conclusions: The policy of initial domiciliary assessment of all referrals prior to admission is feasible in the majority of cases. Defined admission criteria clarify reasons for admission, and ensures appropriate use of beds. The range of discharge destinations highlights the need for maintaining close ongoing links with other service providers.

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Szabo, Katalin A., Christopher L. White, Stephen E. Cummings, Raziya S. Wang, and Cameron D. Quanbeck. "Inpatient aggression in community hospitals." CNS Spectrums 20, no. 3 (February 26, 2015): 223–30. http://dx.doi.org/10.1017/s1092852914000820.

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Physical violence is a frequent occurrence in acute community psychiatry units worldwide. Violent acts by patients cause many direct injuries and significantly degrade quality of care. The most accurate tools for predicting near-term violence on acute units rely on current clinical features rather than demographic risk factors. The efficacy of risk assessment strategies to lower incidence of violence on acute units is unknown. A range of behavioral and psychopharmacologic treatments have been shown to reduce violence among psychiatric inpatients.

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Tarbuck, Andrew F. "Liaison psychiatry in Addenbrooke's Hospital: six months experience." Psychiatric Bulletin 14, no. 11 (November 1990): 668–70. http://dx.doi.org/10.1192/pb.14.11.668.

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Addenbrooke's Hospital is large (approximately 1,000 beds) and serves the functions of an academic and teaching centre, as well as providing acute care in medicine, surgery and the specialties for the inhabitants of Cambridge and the surrounding area. Before January 1989, all psychiatric beds were located at Fulbourn Hospital, three miles from the main Addenbrooke's site and all liaison psychiatric cover was provided by links between individual medical and psychiatric teams. However, since that date, a small in-patient psychiatric unit has been established on the Addenbrooke's site and at the same time, in order to gain closer compliance with the Royal College Guidelines (1988), arrangements were made for one of the registrar posts associated with this unit to form part of a liaison psychiatry team.

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Gardner, Katherine. "Evaluating virtual role play based learning to improve the confidence and competence of Junior Doctors undertaking on call shifts in inpatient Psychiatry." BJPsych Open 7, S1 (June 2021): S137. http://dx.doi.org/10.1192/bjo.2021.391.

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AimsTo enable junior doctors to practice their clinical skills in managing psychiatric emergencies via virtual role plays, and to gain confidence and competence in their skills in acute psychiatry. Lecture based learning about psychiatric emergencies is a part of the induction programme for all junior doctors starting their placements however practical learning and practice of skills in this area is not. The COVID-19 pandemic has further exacerbated this issue by providing an additional challenge to the delivery of face to face teaching for junior doctors both in clinical and educational settings.MethodThe author offered a virtual role play based teaching session to two cohorts of Junior Doctors (GP trainees and foundation trainees) who were starting their psychiatric hospital placements at Surrey and Borders Partnership. The virtual sessions were conducted over Microsoft teams. This session had been run once before as face to face teaching (F2F) in January 2019 (N = 9) prior to the COVID-19 pandemic. Data from this session were compared to data obtained from the virtual sessions in November 2020 and January 2021 (N = 16).Pre and post study questionnaires were administered via Microsoft Forms. Each session lasted 1 hour and consisted of 3 different role play scenarios based around acute psychiatric emergencies. One junior doctor volunteer acted as the ‘patient’ in each scenario and another volunteer as the ‘doctor’. The other participants all acted as observers. Each scenario lasted 10 minutes with ten minutes for feedback from the researcher afterwards using the ALOBA framework.Categorical, ordinal data were collected using a Likert scale and general qualitative feedback was also gathered.ResultThe questionnaire return rate was 100% for F2F teaching and 57% for virtual teaching. 100% of participants felt that F2F role play was an acceptable way to practice skills in acute psychiatry vs 75% of participants who felt this about virtual role play. 100% of participants found that F2F role play was ‘quite’ or ‘very’ effective in improving their confidence and perceived competence in acute psychiatry vs 88% of participants who felt this about virtual role play.ConclusionVirtual role play based learning is an acceptable and effective method in improving the confidence and perceived competence of junior doctors undertaking on call shifts in inpatient psychiatry but it appears to be less effective than face to face role play based learning. The researcher will act upon the qualitative feedback obtained which suggested ways in which the virtual session could be improved.

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Kelly, Ann, Diane Watson, Janet Raboud, and Dan Bilsker. "Factors in Delays in Discharge from Acute-Care Psychiatry." Canadian Journal of Psychiatry 43, no. 5 (June 1998): 496–501. http://dx.doi.org/10.1177/070674379804300508.

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Objective: To determine if there are any potential opportunities for patients to be discharged earlier and to determine what factors are responsible for delays in discharge. Method: A survey was completed by clinical staff of all patients on the wards of 12 adult psychiatry units in the Greater Vancouver Regional Hospital District (GVRD) for a 1-day period. The survey included a modified Brief Psychiatric Rating Scale (BPRS) and the Discharge Readiness Inventory (DRI). A 1-month follow-up measured discharge and nondischarge outcomes. Results: Of the 327 patients surveyed, 42% were ready for discharge at the time of the assessment, and 37% of those who were ready were not discharged within 2 weeks. Delayed patients had significantly higher scores for disorientation, hallucinations, conceptual disorganization, and manifest psychopathology and significantly lower scores for Community Adjustment Potential (CAP) (P < 0.05). The most frequent reasons given for delays were ongoing medication adjustment, behaviour stabilization, and discharge planning. Patients who were delayed were more likely to need services, to need or be waitlisted for a residential placement, to be a client of the community-based mental health team that provides ongoing support to clients living in the community, to have a diagnosis of schizophrenia, and to have had no previous psychiatric hospital admission. Conclusion: The removal of all barriers to delays would reduce lengths of stay by 11% for this sample of patients. This would require a shift of about 42 out of 327 beds to an alternate level of care. These “earlier discharge patients” will need ongoing medication and behaviour monitoring through a variety of community services.

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Solerdelcoll Arimany, M., P. Bruguera, P. Guzmán, and M. Balcells Oliveiró. "A case report of an acute confusional state related with perampanel." European Psychiatry 41, S1 (April 2017): S761. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1429.

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IntroductionPerampanel (PER) is a new selective, non-competitive AMPA glutamate receptor antagonist. PER is generally well tolerated, with dizziness, somnolence, headache, and fatigue as the most common treatment-emergent adverse events, however neuropsychiatric adverse reactions; particularly irritability and aggressiveness can be expected.ObjectiveWe describe a patient who developed and acute confusional state presumably related to treatment with PER.AimsAt the conclusion, the participants should be able to remember that PER is associated with psychiatric side effects.MethodsCollect the data of the clinical history of the patient, who was admitted in the acute psychiatry ward of our hospital.ResultsA 32-year-old woman diagnosed with pharmacoresistant juvenile myoclonic epilepsy, was referred to the emergency department because of severe behavioral disturbances, insomnia, irritability and aggressivity after increasing the dose of PER from 6 to 12 mg. Physical exploration, drug screen and blood tests were all normal. No abnormalities were found in CT, EEG and MRI, and then she was referred to psychiatric ward. At her admission, she presented fluctuations of her mental state and level of consciousness. She was diagnosed with acute confusional syndrome induced by PER, and consequently PER was stopped and risperidone was initiated. In the 4th week symptomatology remitted.ConclusionAnti-epileptic drug's (AEDs) are associated with psychiatric side effects. Patients with epilepsy have higher risk develop psychiatric symptoms and behavioral disturbances. There is evidence to suggest that AMPA receptors are involved in the pathogenesis of psychiatric conditions. Such mechanisms could be responsible of the psychiatric symptoms observed. Neuropsychological profiles of AEDs are important considerations for treatment selection, particularly in children and adolescents.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Torres, C., P. Nunes, S. Cunha, and M. Viana. "Bipolar Disorder Treatment in an Acute Inpatient Unit." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70832-6.

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Bipolar disorder is a chronic, debilitating psychiatric disease. The management of this disorder involves treating current episodes and preventing their long-term recurrence.Many patients with Bipolar Disorder are hospitalized at some point in the course of their illness. Although most bipolar patients do not require extended inpatient psychiatric hospitalizations, short-term hospitalizations may be necessary during acute or potential crises.Hospitalization is among the most expensive treatment options available, and it is therefore offered sparingly and generally only when no other treatment options will prove sufficient to ensure patient safety.A hospital setting should be considered when safety is in question due to suicidal, homicidal, or aggressive impulses or actions, as well as inability to care for self. Other clear indications for hospital admission are the need for diagnostic procedures, history of rapidly progressive symptoms (especially psychotic phenomena), the rupture of patient"s usual support systems and a patient"s grossly reduced ability to take care of themselves.The aim of this study is to characterize the inpatient treatment of bipolar patients admitted in the Hospital São João's Psychiatry Department. Data were collected from clinical files using an investigation protocol especially developed for this purpose. This protocol includes sociodemographic information, the referral source, the admission path, reason for hospitalization, current phase of disease, voluntary versus involuntary status, number of previous admissions, prescribed medications and length of stay.

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van der Post, Louk, Cornelis L. Mulder, Clemens M. L. Bernardt, Robert A. Schoevers, Aartjan T. F. Beekman, and J. Dekker. "Involuntary Admission of Emergency Psychiatric Patients: Report From the Amsterdam Study of Acute Psychiatry." Psychiatric Services 60, no. 11 (November 2009): 1543–46. http://dx.doi.org/10.1176/ps.2009.60.11.1543.

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Simpson, Steve, and Nick Middleton. "Fast stream psychiatric rehabilitation after recent hospital closure." Psychiatric Bulletin 18, no. 10 (October 1994): 613–14. http://dx.doi.org/10.1192/pb.18.10.613.

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A six year retrospective study was performed on the referrals to a fast stream rehabilitation unit in Plymouth (‘114’). In the wake of recent hospital closure, an historical perspective on the changes within the service and the model of our new rehabilitation service is presented. Clinical features, demographical details, outcomes and duration of stay were examined. New strains have been put on acute psychiatry resources and it was demonstrated that the rehabilitation process has had a beneficial effect on acute general psychiatric bed usage.

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Warneke, Lorne B. "Psychiatric Acute Observation Unit." Canadian Journal of Psychiatry 34, no. 3 (April 1989): 262. http://dx.doi.org/10.1177/070674378903400326.

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