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Journal articles on the topic 'Psychiatric care'
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Agyapong, Vincent I. O. "Continuing Care for Mentally Stable Psychiatric Patients in Primary Care: Patients' Preferences and Views." International Journal of Family Medicine 2012 (July 11, 2012): 1–5. http://dx.doi.org/10.1155/2012/575381.
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Objective. To investigate the preferences of psychiatric patients regarding attendance for their continuing mental health care once stable from a primary care setting as opposed to a specialized psychiatric service setting. Methods. 150 consecutive psychiatric patients attending outpatient review in a community mental health centre in Dublin were approached and asked to complete a semistructured questionnaire designed to assess the objectives of the study. Results. 145 patients completed the questionnaire giving a response rate of 97%. Ninety-eight patients (68%) preferred attending a specialized psychiatry service even when stabilised on their treatment. The common reason given by patients in this category was fear of substandard quality of psychiatric care from their general practitioners (GPs) (67 patients, 68.4%). Twenty-nine patients (20%) preferred to attend their GP for continuing mental health care. The reasons given by these patients included confidence in GPs, providing same level of care as psychiatrist for mental illness (18 patients or 62%), and the advantage of managing both mental and physical health by GPs (13 patients, 45%). Conclusion. Most patients who attend specialised psychiatric services preferred to continue attending specialized psychiatric services even if they become mentally stable than primary care, with most reasons revolving around fears of inadequate psychiatric care from GPs.
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Agyapong, V. I. O., T. B. Thekiso, and A. Guerandel. "The discharge of patients with enduring mental health problems into primary care: Patients’ preferences and views." European Psychiatry 26, S2 (March 2011): 1696. http://dx.doi.org/10.1016/s0924-9338(11)73400-9.
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ObjectivesTo investigate the preferences of psychiatric patients regarding attendance for their continued mental health care once stable from a primary care setting as opposed to a specialized psychiatric service setting.Methods150 consecutive psychiatric patients attending outpatient review in a community mental health centre in Dublin were approached and asked to complete a semi-structures questionnaire designed to assess the objectives of the study.Results145 patients completed the questionnaire giving a response rate of 97%. The majority of patients had a general practitioner (GP, 132, 94.3%) and most attended their GP every 3 months (68, 48.6%). Ninety-eight patients (70.0%) preferred attending a specialized psychiatry service even when stabilised on their treatment. The common reason was fear of substandard quality of psychiatric care from their GPs (68.4%), followed by inability to afford a GP appointment (23, 23.5%) and not having a GP (9, 9.2%). Thirty two patients (22.9%) preferred to attend their GP. Reasons for this included confidence in GPs providing same level of care as psychiatrist for mental illness (18, 56.3%), the advantage of managing both mental and physical health by GPs (13, 40.6%) and less stigma (28.1%).ConclusionAlthough most patients attended their GP more frequently than the psychiatry clinic, they preferred attending specialized psychiatric services once mentally stable than primary care with most reasons revolving around fears of inadequate psychiatric care from GPs.
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Bastiaens, Lucie. "alternatief voor het krankzinnigengesticht? Psychiatrische zorg in Maastricht en de lange aanloop naar een bureau voor psychiatrische voor- en nazorg (1937)." Studies over de sociaaleconomische geschiedenis van Limburg/Jaarboek van het Sociaal Historisch Centrum voor Limburg 65 (December 2, 2022): 76–107. http://dx.doi.org/10.58484/ssegl.v65i.12886.
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The care for psychiatric patients outside mental asylums developed in the Netherlands during the first decades of the twentieth century. In Maastricht, a psychiatric pre- and after care facility opened in 1937, but little is known about its history. This paper attempts to unravel this history and analyses to what extent causes which stimulated psychiatric care outside the mental asylum on a national level also played a role in Maastricht. It becomes clear that Maastricht had its own local dynamic; overcrowding of the mental asylum was never an issue here, growing costs of hospitalization in mental asylums did not encourage the local government in Maastricht to search for alternatives and due to the absence of a psychiatrist no new perspectives on hospitalization and psychiatric care in society came into being. Furthermore, it is likely that family members and philanthropic associations played an important role in taking care of and supporting psychiatric patients. It thus seems that in Maastricht there was no strong sense of urgency or need to develop new forms of psychiatric care outside the mental asylum. The provincial cross society initiated a psychiatric pre- and after care facility. This however could only be realized because of the presence of a psychiatrist in Maastricht since 1936, who supported this new facility. The Maastricht ‘case’ broadens our view and understanding of the development of psychiatric care in society in the Netherlands.
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Frey, R., D. Winkler, A. Naderi-Heiden, S. Strnad, E. Winkler-Pjrek, J. Scharfetter, and S. Kasper. "JS02-01 - Psychiatric intensive care." European Psychiatry 26, S2 (March 2011): 1999. http://dx.doi.org/10.1016/s0924-9338(11)73702-6.
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Psychiatric disorders per se or treatment resistance can cause life-threatening conditions. More than 25 years have passed since the term “psychiatric intensive care unit” (PICU) was introduced in the United Kingdom. This system is comprised of security units for psychiatric patients with suicidal or violent behaviour, providing a locked environment with more resources regarding personnel and care. The PICU concept at the Department of Psychiatry and Psychotherapy in Vienna, Austria, represents a progress towards optimal care of patients with serious psychiatric illnesses who also have critical somatic illnesses. One third of the patients are transferred from inpatient facilities of medical departments such as internal medicine, emergency medicine, trauma surgery or anesthesiology. Our PICU is dedicated to somatically, critically ill patients who have psychiatric symptoms (e.g., agition, aggression, impulsivity, delusions, catatonia, confusion, reduced consciousness, impaired self-reliance) complicating recovery from their critical, somatic condition. Generally, the dosages for antipsychotics are not higher than those at normal psychiatric wards. Benzodiazepine dosages of about 30mg diazepam equivalents per day are frequently used. In the years 2008 and 2009, 10% of all patients at the Viennese PICU were treated with electroconvulsive therapy. Delirium requires immediate therapy of underlying intracerebral pathologies, extracerebral illnesses or toxic features. Involuntary commitment, physical restraints and urinary catheterization were applied in approximately 50% of the patients, nasogastric tube or central venous catheter in 20%. In every case, intensive care nursing, monitoring of vital functions and specific experience at the interface between psychiatry and somatic medicine are required.
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Mitchell, A. R. K. "Participating in primary care." Psychiatric Bulletin 13, no. 3 (March 1989): 135–37. http://dx.doi.org/10.1192/pb.13.3.135.
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Traditionally, general practitioners and psychiatrists relate to one another through a system of cross referrals, from primary care to secondary care and back again, the referral being initiated by the GP through a request for a domiciliary visit or more usually for an out-patient assessment of the clinical problem. However, in the mid-1960s, individual psychiatrists began to report a new way of working, which consisted of the psychiatrist going by invitation into GPs' surgeries or health centres to work directly with the general practitioners and with other members of the primary health care team. A survey undertaken by Strathdee & Williams of the General Practice Research Unit of the Institute of Psychiatry, showed that by 1984 in England and Wales, one psychiatric consultant in five, sometimes with, sometimes without, junior staff, spent some time in a general practice setting. At the College meeting in Cambridge (April 1988), Pullen reported that in Scotland a similar survey showed that as many as 40 to 50% of psychiatric consultants spent some time in primary care settings.
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Beber, Elizabeth, Nicola M. Bailey, and Sally-Ann Cooper. "Health gain for epilepsy associated with learning disabilities psychiatric care." Irish Journal of Psychological Medicine 16, no. 2 (June 1999): 46–50. http://dx.doi.org/10.1017/s0790966700005140.
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AbstractObjectives: The establishment of a learning disabilities psychiatric service for people living in north Northamptonshire presented the opportunity to measure the clinical effectiveness of epilepsy care provided by learning disabilities psychiatrists.Method: Baseline and one year outcome health measurements were made on a group of adults with learning disabilities and epilepsy who received learning disabilities psychiatric care (n = 42), and also on a group of adults with learning disabilities and epilepsy who did not receive care from learning disabilities psychiatry -(n = 12). Comparisons were made between baseline and outcome measurements for those who did, compared to those who did not receive psychiatric care. The comparison group was included as conducting a baseline health assessment may itself improve the quality of healthcare by raising awareness of the issue (in a way that is unconnected to care provided by the psychiatrist).Results: Learning disabilities psychiatric care was found to effect reduced seizure frequency, with a reduced frequency of drug side-effects and reduced frequency of polypharmacy. The type of the person's seizures was more likely to be determined, medical reviews and appropriate blood test monitoring conducted and active interventions made to improve seizure control and to withdraw unnecessary drugs, if the person was receiving learning disabilities psychiatric care. Almost all of these results were highly statistically significant.Conclusion: It is important that learning disabilities psychiatric care is available to this group, as it has been demonstrated to effect health gain.
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Farhat, Nada M., Jolene R. Bostwick, and Stuart D. Rockafellow. "Improving Ambulatory Care Resident Training: Preparing for Opportunities to Treat Mental Illness in the Primary Care Setting." Journal of Pharmacy Practice 31, no. 5 (September 11, 2017): 497–502. http://dx.doi.org/10.1177/0897190017729598.
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Purpose: The development of an outpatient psychiatry clinical practice learning experience for PGY2 ambulatory care pharmacy residents in preparation for the treatment of psychiatric disorders in the primary care setting is described. Summary: With the increased prevalence of psychiatric disorders, significant mortality, and limited access to care, integration of mental health treatment into the primary care setting is necessary to improve patient outcomes. Given the majority of mental health treatment occurs in the primary care setting, pharmacists in patient-centered medical homes (PCMHs) are in a unique position with direct access to patients to effectively manage these illnesses. However, the increased need for pharmacist education and training in psychiatry has prompted a large, Midwestern academic health system to develop an outpatient psychiatry learning experience for PGY2 (Postgraduate Year 2) ambulatory care pharmacy residents in 2015. The goal of this learning experience is to introduce the PGY2 ambulatory care residents to the role and impact of psychiatric clinical pharmacists and to orient the residents to the basics of psychiatric pharmacotherapy to be applied to their future practice in the primary care setting. Conclusion: The development of an outpatient psychiatry learning experience for PGY2 ambulatory care pharmacy residents will allow for more integrated and comprehensive care for patients with psychiatric conditions, many of whom are treated and managed in the PCMH setting.
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Brittlebank, Andrew. "Strain and stress in palliative care." Psychiatric Bulletin 16, no. 5 (May 1992): 282–83. http://dx.doi.org/10.1192/pb.16.5.282.
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The Royal College of Psychiatrists' Guidelines for Training in Liaison Psychiatry (1988) recommend that trainee psychiatrists have the opportunity of working closely with an individual ward or department. Such an attachment may involve the trainee psychiatrist in staff support. This paper describes the involvement of a psychiatric trainee in the development of support structures in a hospice during a liaison attachment. The project not only shed light on the causes of staff strain in palliative care settings, but also provided an opportunity to participate in management.
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Butler, Dennis J., Dominique Fons, Travis Fisher, James Sanders, Sara Bodenhamer, Julie R. Owen, and Marc Gunderson. "A review of the benefits and limitations of a primary care-embedded psychiatric consultation service in a medically underserved setting." International Journal of Psychiatry in Medicine 53, no. 5-6 (August 22, 2018): 415–26. http://dx.doi.org/10.1177/0091217418791456.
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A significant percentage of patients with psychiatric disorders are exclusively seen for health-care services by primary care physicians. To address the mental health needs of such patients, collaborative models of care were developed including the embedded psychiatry consult model which places a consultant psychiatrist on-site to assist the primary care physician to recognize psychiatric disorders, prescribe psychiatric medication, and develop management strategies. Outcome studies have produced ambiguous and inconsistent findings regarding the impact of this model. This review examines a primary care-embedded psychiatric consultation service in place for nine years in a family medicine residency program. Psychiatric consultants, family physicians, and residents actively involved in the service participated in structured interviews designed to identify the clinical and educational value of the service. The benefits and limitations identified were then categorized into physician, consultant, patient, and systems factors. Among the challenges identified were inconsistent patient appointment-keeping, ambiguity about appropriate referrals, consultant scope-of-practice parameters, and delayed follow-up with consultation recommendations. Improved psychiatric education for primary care physicians also appeared to shift referrals toward more complex patients. The benefits identified included the availability of psychiatric services to underserved and disenfranchised patients, increased primary care physician comfort with medication management, and improved interprofessional communication and education. The integration of the service into the clinic fostered the development of a more psychologically minded practice. While highly valued by respondents, potential benefits of the service were limited by residency-specific factors including consultant availability and the high ratio of primary care physicians to consultants.
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Amin, Malik Awais, Muhammad Kamran, Shehzad Rauf, Sumaira Bukhsh, Isbah Gul, and Ahmed Shoaib Tabassum. "PSYCHIATRIC DISORDERS IN CHILDREN: PATTERN AND CORRELATES AMONG THOSE REPORTING TO A TERTIARY CARE HOSPITAL." PAFMJ 71, no. 3 (June 30, 2021): 924–28. http://dx.doi.org/10.51253/pafmj.v71i3.2527.
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Objective: To determine the pattern of psychiatric disorders among children reporting to the Psychiatry department Pakistan Naval Ship Shifa Hospital, Karachi.
Study Design: Comparative cross sectional study.
Place and Duration of Study: Psychiatry department Pakistan Naval Ship Shifa Hospital, Karachi, from Feb to Aug 2018.
Methodolgy: A total of 100 children, aged between 6-12 years of age, both male and female, meeting the selection criteria of the study, presenting to the Psychiatry department at Pakistan Naval Ship Shifa Hospital, were enrolled for this study. Informed consent was taken from the parents. The consultant psychiatrist interviewed the patients and diagnosed any psychiatric disorders based on international classification of diseases version 10. The data was recorded on the study proforma.
Results: Out of a total of 100 children, 66 (66%) were male, while 34 (34%) were female. The mean age of the participating children was 8.66 + 1.97 years. The most common psychiatric disorder was attention deficit hyperactivity disorder 44 (44%), followed by depression 30 (30%). Other diagnoses included oppositional defiant disorder 12 (12%), conduct disorder 9 (9%) and separation anxiety disorder 5 (5%).
Conclusion: Attention deficit hyperactivity disorder and depression are amongst the quite prevalent psychiatric disorders, than that was considered earlier.
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Kulkarni, Karishma, Alur Manjappa Adarsha, Rajini Parthasarathy, Mariamma Philip, Harihara Nagabhushana Shashidhara, Basavaraju Vinay, Narayana Manjunatha, Channaveerachari Naveen Kumar, Suresh Bada Math, and Jagadisha Thirthalli. "Concurrent Validity and Interrater Reliability of the “Clinical Schedules for Primary Care Psychiatry”." Journal of Neurosciences in Rural Practice 10, no. 03 (July 2019): 483–88. http://dx.doi.org/10.1055/s-0039-1697878.
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Abstract Background and Objectives There is limited access to specialized mental health care in countries such as India with a wide treatment gap for psychiatric illnesses. Integrating mental health delivery with primary health-care services is vital. The clinical schedules for primary care psychiatry (CSP) was designed for training primary care doctors (PCDs) to identify and diagnose psychiatric illness in patients presenting to primary care settings. This study aims to study the validity and reliability of the CSP and its hypothesis is that the CSP would help PCDs to identify psychiatric caseness. Methods The study was conducted at three primary health centers of Karnataka. Consented PCDs were briefly trained in the use of CSP and screened patients who were later interviewed by a psychiatrist using a semistructured interview and confirmed by International Statistical Classification of Diseases and Related Health Problems 10th edition (ICD-10) symptom checklist. The appropriate statistical analysis was performed. Results A total of 180 patients were included. Agreement was found between diagnoses made by PCDs and psychiatrist for 142 (78. 9%) patients with a Cohen's kappsychiatry pa (K) = 0. 57. The sensitivity was 91. 1% and specificity was 68. 3%. The interrater reliability showed K = 0. 7. Conclusion The CSP helps PCDs to make psychiatric diagnoses. It has a relatively high sensitivity with reasonably high specificity but mayneed clinical training.
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Veiga, I., P. Martinez, L. Vigo, J. Portillo, and A. Gago. "Alcohol dependence in a psychiatric interconsultation unit." European Psychiatry 26, S2 (March 2011): 119. http://dx.doi.org/10.1016/s0924-9338(11)71830-2.
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AimsTo determine the pattern of alcohol dependence among medical impatients who requires Psychiatric Interconsultation, with the purpose of achieve a better understanding of the problem and to suggest prevention strategies.MethodsSample studied was collected among all inpatients with diagnosis of alcohol dependence (DSM-IV-TR) admitted in our hospital during a study period of 3 years, from january 2007 to may 2010, who required psychiatric interconsultation.Results101 admissions with diagnosis of alcohol dependence were reviewed. There were 80 men (79,20%) and 21 women (20,8%). The mean of age was 53,13 years. The mean days of stay was 14,13. In this study, 60 subjects (59,40) there are medical history of alcohol dependence and 58 (57,42%) psychiatrc history.Aims of admissionAlcohol deprivation 13 cases (12,87%); convulsion 6 (5,94%); acute agitation 5 (4,95%); cranioencephalic trauma 5 (4,95%); alcohol intoxication 5 (4,95%); fracture 4 (3,96%); suicide attempt 6 (3,96%); psychiatric indication 10 (9,9%); primary care indication 3 (0,029%); organic problem secondary to alcohol 32 (31,68%); other 12 (6,11%). 42 patients were admitted in Unidade Medica de Alta precoz (41,58%); Medical 21 (20,79%); Traumatology department 4 (3,96%); Gastroenterology 12 (6,11%); Neurology 3 (0,029%); Other departments 19 (18,81%).ConclusionsThe main cause of medical admission are somatic complications of alcohol, finding that only 9.9% of the income was indicated by the psychiatrist and to 0.029% for the primary care physician. Primary, secondary and tertiary prevention 1, 2 and 3 of these complications should be a target of psychiatry.
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Gehri, Beatrice, Stefanie Bachnick, René Schwendimann, and Michael Simon. "Matching Registered Nurse Services With Changing Care Demands in Psychiatric Hospitals: Protocol for a Multicenter Observational Study (MatchRN Psychiatry Study)." JMIR Research Protocols 10, no. 8 (August 17, 2021): e26700. http://dx.doi.org/10.2196/26700.
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Background The quality of care is often poorly assessed in mental health settings, and accurate evaluation requires the monitoring and comparison of not only the outcomes but also the structures and processes. The resulting data allow hospital administrators to compare their patient outcome data against those reported nationally. As Swiss psychiatric hospitals are planned and coordinated at the cantonal level, they vary considerably. In addition, nursing care structures and processes, such as nurse staffing, are only reported and aggregated at the national level, whereas nurse outcomes, such as job satisfaction or intention to leave, have yet to be assessed in Swiss psychiatric hospitals. Because they lack these key figures, psychiatric hospitals’ quality of care cannot be reasonably described. Objective This study’s purpose is to describe health care quality by exploring hospital structures such as nurse staffing and the work environment; processes such as the rationing of care; nurse outcomes, including job satisfaction and work-life balance; and patients’ symptom burden. Methods MatchRN Psychiatry is a multicenter observational study of Swiss psychiatric hospitals. The sample for this study included approximately 1300 nurses from 113 units of 13 psychiatric hospitals in Switzerland’s German-speaking region. In addition, routine patient assessment data from each participating hospital were included. The nurse survey consisted of 164 items covering three dimensions—work environment, patient safety climate, and the rationing of care. The unit-level questionnaire included 57 items, including the number of beds, number of nurses, and nurses’ education levels. Routine patient data included items such as main diagnosis, the number and duration of freedom-restrictive measures, and symptom burden at admission and discharge. Data were collected between September 2019 and June 2021. The data will be analyzed descriptively by using multilevel regression linear mixed models and generalized linear mixed models to explore associations between variables of interest. Results The response rate from the nurse survey was 71.49% (1209/1691). All data are currently being checked for consistency and plausibility. The MatchRN Psychiatry study is funded by the participating psychiatric hospitals and the Swiss Psychiatric Nursing Leaders Association (Vereinigung Pflegekader Psychiatrie Schweiz). Conclusions For the first time, the MatchRN Psychiatry study will systematically evaluate the quality of care in psychiatric hospitals in Switzerland in terms of organizational structures, processes, and patient and nurse outcomes. The participating psychiatric hospitals will benefit from findings that are relevant to the future planning of nurse staffing. The findings of this study will contribute to improvement strategies for nurses’ work environments and patient experiences in Swiss psychiatric hospitals. International Registered Report Identifier (IRRID) DERR1-10.2196/26700
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Petersson, Lena, and Gudbjörg Erlingsdóttir. "Open Notes in Swedish Psychiatric Care (Part 1): Survey Among Psychiatric Care Professionals." JMIR Mental Health 5, no. 1 (February 2, 2018): e11. http://dx.doi.org/10.2196/mental.9140.
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Background When the Swedish version of Open Notes, an electronic health record (EHR) service that allows patients online access, was introduced in hospitals, primary care, and specialized care in 2012, psychiatric care was exempt. This was because psychiatric notes were considered too sensitive for patient access. However, as the first region in Sweden, Region Skåne added adult psychiatry to its Open Notes service in 2015. This made it possible to carry out a unique baseline study to investigate how different health care professionals (HCPs) in adult psychiatric care in the region expect Open Notes to impact their patients and their practice. This is the first of two papers about the implementation of Open Notes in adult psychiatric care in Region Skåne. Objective The objective of this study was to describe, compare, and discuss how different HCPs in adult psychiatric care in Region Skåne expect Open Notes to impact their patients and their own practice. Methods A full population Web-based questionnaire was distributed to psychiatric care professionals in Region Skåne in late 2015. The response rate was 28.86% (871/3017). Analyses show that the respondents were representative of the staff as a whole. A statistical analysis examined the relationships between different professionals and attitudes to the Open Notes service. Results The results show that the psychiatric HCPs are generally of the opinion that the service would affect their own practice and their patients negatively. The most striking result was that more than 60% of both doctors (80/132, 60.6%) and psychologists (55/90, 61%) were concerned that they would be less candid in their documentation in the future. Conclusions Open Notes can increase the transparency between patients and psychiatric HCPs because patients are able to access their EHRs online without delay and thus, can read notes that have not yet been approved by the responsible HCP. This may be one explanation as to why HCPs are concerned that the service will affect both their own work and their patients.
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Clark, Nicola, and Len Bowers. "Psychiatric nursing and compulsory psychiatric care." Journal of Advanced Nursing 31, no. 2 (February 2000): 389–94. http://dx.doi.org/10.1046/j.1365-2648.2000.01287.x.
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Serhal, Eva, Allison Crawford, Joyce Cheng, and Paul Kurdyak. "Implementation and Utilisation of Telepsychiatry in Ontario: A Population-Based Study." Canadian Journal of Psychiatry 62, no. 10 (May 25, 2017): 716–25. http://dx.doi.org/10.1177/0706743717711171.
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Objective: Rural areas in Ontario have fewer psychiatrists, making access to specialist mental health care challenging. Our objective was to characterise psychiatrists delivering and patients receiving telepsychiatry in Ontario and to determine the number of patients who accessed a psychiatrist via telepsychiatry following discharge from psychiatric hospitalisation. Method: We conducted a serial panel study to evaluate the characteristics of psychiatrists providing telepsychiatry from April 2007 to March 2013. In addition, we conducted a cross-sectional study for fiscal year 2012-2013 to examine telepsychiatry patient characteristics and create an in-need patient cohort of individuals with a recent psychiatric hospitalisation that assessed if they had follow-up with a psychiatrist in person or through telepsychiatry within 1 year of discharge. Results: In fiscal year 2012-2013, a total of 3801 people had 5635 telepsychiatry visits, and 7% ( n = 138) of Ontario psychiatrists provided telepsychiatry. Of the 48,381 people identified as in need of psychiatric care, 60% saw a local psychiatrist, 39% saw no psychiatrist, and less than 1% saw a psychiatrist through telepsychiatry only or telepsychiatry in addition to local psychiatry within a year. Three northern regions had more than 50% of in-need patients fail to access psychiatry within 1 year. Conclusions: Currently, relatively few patients and psychiatrists use telepsychiatry. In addition, patients scarcely access telepsychiatry for posthospitalisation follow-up. This study, which serves as a preliminary baseline for telepsychiatry in Ontario, demonstrates that telepsychiatry has not evolved systematically to address need and highlights the importance of system-level planning when implementing telepsychiatry to optimise access to care.
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Covington, Edward C., Paul Rodenhauser, Marvin E. Gottlieb, and Alma Houston. "Psychiatric Training for Primary Care Residents: Proposed Standards." International Journal of Psychiatry in Medicine 17, no. 4 (December 1988): 327–40. http://dx.doi.org/10.2190/n176-a1u7-08h5-eglv.
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Most of the nation's psychiatric care is provided by primary care physicians, and this trend is expected to continue. Primary care physicians see themselves as poorly trained in psychiatry, and evidence supports a high incidence of missed diagnosis and inadequate or inappropriate treatment. In addition, poor training may underlie the indifference to psychiatric problems often demonstrated by primary physicians. The Ohio Psychiatric Association Foundation has designated an annual award to be given to the primary care program which provides the best psychiatric training in the state, and the psychiatric training directors met to develop criteria for selecting the recipients. The resulting standards emphasize the importance of training which is relevant to a medical care setting, provided by psychiatrists, and supportive of the integration of psychiatric methods into-medical care.
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Agyapong, V. O. I., C. Conway, F. Jabber, A. Guerandel, and F. O’Connell. "Shared care between specialized psychiatric services and primary care - the experiences and expectation of primary care physicians in Ireland." European Psychiatry 26, S2 (March 2011): 1695. http://dx.doi.org/10.1016/s0924-9338(11)73399-5.
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ObjectiveThe study aims to explore the views of primary care physicians in Ireland on shared care of psychiatric patients between primary and secondary services.MethodsA self-administered questionnaire was posted to a random cross-section primary care physicians working in Ireland. Data were compiled and analyzed using descriptive statistics and analysis of variance.Results145 out of 300 questionnaires were returned giving a response rate of 48%. Overall, 77.9% of respondents reported that they completed a psychiatric rotation as part of their general practice training. Most General Practitioners expressed confidence in their ability to recognize and manage psychiatric disorders in primary care (on a confidence scale of 1 to 5, mean was 3.97, SD 0.699). There was a statistically, significant difference in confidence scores between those who had took a rotation in psychiatry as part of their GP training and those who did not, with the former reporting higher scores (4.04 vs. 3.72, F = 1.801, t = 2.363, p = 0.02)Regarding shared care, 95.8% of GPs were in favour of a formal shared care policy; however 42.8% expressed reservations regarding the implications of implementing such a policy. The most frequently expressed concerns related to the lack of resources in primary care for psychiatric patients (55.9%), financial implications for some patients (48.3%), and concern over communication with psychiatric services (42%).ConclusionThe majority of Primary Care physicians in Ireland would support a policy of shared care of psychiatric patients’; however they raise some concerns regarding practical implications of such a policy.
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Andrić-Petrović, Sanja, and Nađa Marić. "Improvement of the psychiatric care through outsourcing artificial intelligence technologies: Where are we now?" Medicinska istrazivanja 55, no. 2 (2022): 19–29. http://dx.doi.org/10.5937/medi55-37718.
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Currently, the world is entering the fourth industrial revolution - marked by artificial intelligence (AI) powered technologies. The growing ubiquity of AI technologies is already present in many sectors of modern society, but caution still prevails in medicine where their application is far from routine, although it is on the constant rise. Psychiatry has been recognized as one of the disciplines where significant contribution of AI technologies is expected for prediction, diagnosis, treatment and monitoring of persons with psychiatric disorders. Nearly half of the world's population live in countries that have fewer than one psychiatrist per 100 000 inhabitants, which is far below the health needs as the prevalence of psychiatric disorders is within the range of 10-20%. Thus, the question arises - whether AI technologies can help to fill the gap in unmet needs in psychiatry? The main types of autonomous technologies currently applied in psychiatry are machine learning and its subsets deep learning and computer vision, alongside natural language processing and chatbots. The present review will focus on the brief history of the concept, the utility of AI technologies in psychiatry, clinicians' attitudes, ethical dilemmas, clinical and scientific challenges. This review emphasizes that the psychiatric community should not be ignorant but could try to leave the comfort zone and do more to raise the awareness of AI technologies development achievements.
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Risal, Ajay, and Pushpa Prasad Sharma. "Psychiatric Morbidity Patterns in Referred Inpatients of Other Specialties." Journal of Nepal Medical Association 52, no. 189 (March 31, 2013): 238–44. http://dx.doi.org/10.31729/jnma.563.
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Introduction: Consultation-liaison psychiatry is an upcoming field dealing with interdepartmental collaboration heading into multidisciplinary and holistic care. In general hospital setting, psychiatrists need to be involved in evaluation of patients referred from other specialties. This study analyzed the psychiatric morbidity among the inpatients referred to Psychiatry Department from different wards in a Tertiary care University Teaching Hospital.
Methods: Total 385 subjects were referred to the Department of Psychiatry from different wards during a period of one year. Each of them underwent a detailed psychiatric evaluation by a consultant psychiatrist once they were medically stable. Psychiatric diagnosis was considered as per International Classification of Disease-10 criteria.
Results: The mean age of the subjects evaluated was 37.26 (±1.86); most of them were females 216 (56.4%), married 287 (74.5%), and homemaker 159 (41.3%). Maximum 271 (70.4%) referral was from Medical ward, and most of them 292 (75.8%) were admitted in general bed. The most common medical diagnosis was self-poisoning 115 (30.6%) followed by alcoholic liver disease 49 (12.7%); while the commonest 123 (31.9%) psychiatric diagnosis was depression (including Dysthymia and Adjustment disorder). Depression remained the commonest diagnosis among those referred from medical ward 131 (34.7%); while anxiety was mostly found in the emergency referral 94 (24.5%). Significant Correlation (P <0.05) was seen between the source of referral and Psychiatric diagnosis.
Conclusions: Psychiatric consultation was sought mostly by medical ward that had maximum number of patients presenting with self-poisoning. The commonest diagnosis seen in the referred in-patients was depression and anxiety disorder.
Keywords: consultation-liaison psychiatry; in-patient referral; psychiatric morbidity.
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Pelletier, Luc R. "Psychiatric Home Care." Journal of Psychosocial Nursing and Mental Health Services 26, no. 3 (March 1, 1988): 22–27. http://dx.doi.org/10.3928/0279-3695-19880301-08.
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Wallis, G. "Italian Psychiatric Care." Journal of the Royal Society of Medicine 82, no. 12 (December 1989): 776. http://dx.doi.org/10.1177/014107688908201238.
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Williams, Paul, and Michele Tansella. "Italian Psychiatric Care." Journal of the Royal Society of Medicine 83, no. 7 (July 1990): 476–77. http://dx.doi.org/10.1177/014107689008300726.
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Duffey, Janet, Marcia P. Miller, and Pamela Parlocha. "Psychiatric Home Care." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 11, no. 2 (March 1993): 22–28. http://dx.doi.org/10.1097/00004045-199303000-00004.
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Quinlan, Judith, and Gail Ohlund. "Psychiatric Home Care." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 13, no. 4 (July 1995): 20–25. http://dx.doi.org/10.1097/00004045-199507000-00004.
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Mayo, Terry L. "Psychiatric Home Care." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 16, no. 7 (July 1998): 486–87. http://dx.doi.org/10.1097/00004045-199807000-00019.
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CARSON, VERNA BENNER. "Psychiatric Home Care." Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 25, no. 10 (November 2007): 620–21. http://dx.doi.org/10.1097/01.nhh.0000298929.38093.da.
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Harrison, Anthony, and William Bruce-Jones. "Reforming psychiatric care." Psychiatric Bulletin 27, no. 07 (July 2003): 276. http://dx.doi.org/10.1017/s0955603600002609.
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Varma, Satish. "Holistic Psychiatric Care." Psychiatric News 38, no. 20 (October 17, 2003): 32. http://dx.doi.org/10.1176/pn.38.20.0032a.
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Harrison, Anthony, and William Bruce-Jones. "Reforming psychiatric care." Psychiatric Bulletin 27, no. 7 (June 2003): 276. http://dx.doi.org/10.1192/pb.27.7.276.
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Connolly, Joseph, and Isaac Marks. "Community-oriented psychiatric care." Psychiatric Bulletin 13, no. 1 (January 1989): 26–27. http://dx.doi.org/10.1192/pb.13.1.26.
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The College is debating how to train psychiatrists for community care (CC) that is spreading – ahead of hard evidence of its value for certain problems in the UK. Much future psychiatry will be practised in the community outside hospital within multidisciplinary teams not always led by a psychiatrist, and wherein the lead-rôle changes frequently within a single meeting depending on whose expertise and readiness to accept responsibility emerge.
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Moller, Mary D. "Leader Interview: A Vision for Mental Health Care." Creative Nursing 7, no. 1 (January 2001): 7–16. http://dx.doi.org/10.1891/1078-4535.7.1.7.
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This interview is with Jane A. Ryan, RN, MN, CNAA, immediate past president of the American Psychiatric Nurses Association. She began her nursing career in 1959 and spent 27 years in psychiatric nursing at the University of California at Los Angeles (UCLA) Medical Center Neuropsychiatric Institute, and eventually was responsible for nursing systems. Now she consults with the U.S. Justice Department on psychiatric nursing in state psychiatrist hospitals. Lisa Legge, managing editor of Creative Nursing Journal, interviewed Ms. Ryan.
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Meadows, Graham, Bruce Singh, Philip Burgess, and Irene Bobevski. "Psychiatry and the Need for Mental Health Care in Australia: Findings from the National Survey of Mental Health and Wellbeing." Australian & New Zealand Journal of Psychiatry 36, no. 2 (April 2002): 210–16. http://dx.doi.org/10.1046/j.1440-1614.2002.00990.x.
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Objective: This paper describes the pattern of consultations reported with psychiatrists and primary mental health care providers in the Australian adult population. It explores whether inequalities found in utilization of psychiatric services according to area are different in degree from inequalities in utilization of medical and surgical specialists, and describes the meeting of perceived needs for mental health care within those seen by psychiatrists. Method: The National Survey of Mental Health and Wellbeing (NSMHW) was a community survey employing clustered probability sampling, with a computerized field questionnaire which included sections of the composite international diagnostic interview (CIDI), as well as self-reported service utilization and perceived needs for care. Results: By survey estimates, 1.8% of the Australian population consulted a psychiatrist in the last year. Among people with an ICD 10-diagnosed mental disorder, 7.3% consulted a psychiatrist. Only about one in five people seen by a psychiatrist report the psychiatrist as the only mental health care provider. Disadvantaged areas of the cities and remote areas, when compared with the least deprived areas of the cities, showed lower rates of utilization. This effect is stronger in psychiatry than in other specialities. Patients seeing psychiatrists seem to be a more satisfied group than those seeing only other providers; nonetheless, some needs are not well met, and the role of the psychiatrist cannot be isolated as the cause of this satisfaction. Conclusions: Most care delivered by psychiatrists is de facto shared care. Psychiatrists as clinical professionals need to be continually mindful of the need to communicate with others providing care. Psychiatric services in Australia are not delivered in an equitable manner, and the inequalities are greater for psychiatric services than for other medical specialities.
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Petersson, Lena, and Gudbjörg Erlingsdóttir. "Open Notes in Swedish Psychiatric Care (Part 2): Survey Among Psychiatric Care Professionals." JMIR Mental Health 5, no. 2 (June 21, 2018): e10521. http://dx.doi.org/10.2196/10521.
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Background This is the second of two papers presenting the results from a study of the implementation of patient online access to their electronic health records (here referred to as Open Notes) in adult psychiatric care in Sweden. The study contributes an important understanding of both the expectations and concerns that existed among health care professionals before the introduction of the Open Notes Service in psychiatry and the perceived impact of the technology on their own work and patient behavior after the implementation. The results from the previously published baseline survey showed that psychiatric health care professionals generally thought that Open Notes would influence both the patients and their own practice negatively. Objective The objective of this study was to describe and discuss how health care professionals in adult psychiatric care in Region Skåne in southern Sweden experienced the influence of Open Notes on their patients and their own practice, and to compare the results with those of the baseline study. Methods We distributed a full population Web-based questionnaire to psychiatric care professionals in Region Skåne in the spring of 2017, which was one and a half years after the implementation of the service. The response rate was 27.73% (699/2521). Analyses showed that the respondents were representative of the staff as a whole. A statistical analysis examined the relationships between health professional groups and attitudes to the Open Notes Service. Results A total of 41.5% (285/687) of the health care professionals reported that none of their patients stated that they had read their Open Notes. Few health care professionals agreed with the statements about the potential benefits for patients from Open Notes. Slightly more of the health care professionals agreed with the statements about the potential risks. In addition, the results indicate that there was little impact on practice in terms of longer appointments or health care professionals having to address patients’ questions outside of appointments. However, the results also indicate that changes had taken place in clinical documentation. Psychologists (39/63, 62%) and doctors (36/94, 38%) in particular stated that they were less candid in their documentation after the implementation of Open Notes. Nearly 40% of the health care professionals (239/650, 36.8%) reported that the Open Notes Service in psychiatry was a good idea. Conclusions Most health care professionals who responded to the postimplementation survey did not experience that patients in adult psychiatric care had become more involved in their care after the implementation of Open Notes. The results also indicate that the clinical documentation had changed after the implementation of Open Notes. Finally, the results indicate that it is important to prepare health care professionals before an implementation of Open Notes, especially in medical areas where the service is considered sensitive.
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Shakya, Dhana Ratna. "Psychiatric Morbidity Profiles of Child and Adolescent Psychiatry Out-Patients in a Tertiary-Care Hospital." Journal of Nepal Paediatric Society 30, no. 2 (July 13, 2010): 79–84. http://dx.doi.org/10.3126/jnps.v30i2.2604.
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Background: Psychiatric morbidity is ubiquitous, affecting children, adolescents and adults. Age factorsplay a great role in pattern of morbidity profile. Psychiatric morbidity profile of children and adolescentsmay indicate different needs and priorities. Objective: This study aims to sort out referral pattern, attitudeabout psychiatric referral and morbidity profile among child and adolescent psychiatric out-patients in atertiary-care general hospital. Methodology: A total of 100 consecutive child and adolescent patientsin psychiatry OPD coming into contact with investigator psychiatrist were enrolled during the studyperiod. Diagnoses were made according to the ICD-10. Results: Fifty three of the subjects were female,majority of the cases (79) were of age between 13-18 years. Main ethnicity-caste groups seeking carewere Mongol, Brahmin, Chhetri and indigenous Terai tribes. People from semi-urban and urban settingspredominated in this study. Great majority (more than 80%) had reached this service in the 4th or in morethan the 4th step of their help seeking. Most of the subjects were comfortable and happy about psychiatricreferral. More than half had presented mainly with physical and somatic complaints. Major psychiatricdiagnoses encountered were mood (affective), anxiety, seizure, dissociative conversion disorders andmental retardation. Four percent of subjects had suicidal behaviours and 17% migraine headache.Conclusion: Common psychiatric diagnoses among these child and adolescent out-patients are mood,anxiety, seizure, dissociative conversion disorders and mental retardation.Key words: Attitude to psychiatric consultation; child and adolescent; out-patient; psychiatric morbidityDOI: 10.3126/jnps.v30i2.2604J. Nepal Paediatr. Soc. May-August, 2010 Vol 30(2) 79-84
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Collings, Sunny, and Sara Myers. "Psychiatric patients and their medical care." Psychiatric Bulletin 16, no. 2 (February 1992): 88–90. http://dx.doi.org/10.1192/pb.16.2.88.
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Informal discussions between psychiatric trainees reveal frequent difficulties and frustrations in providing adequate medical care to psychiatric patients. Our writing this article was prompted by the death of a patient who had been referred to casualty with behavioural and physical problems, and who, once labelled as a ‘psychiatric patient, did not receive the medical attention he required. Other trainees will have their own similar examples, at best resulting in only inconvenience to the junior doctor. This may seem surprising given the knowledge that people with psychiatric problems suffer increased physical morbidity. We were all taught as medical students that a physical presentation may mask a psychological problem and vice versa, and that both problems may co-exist. However, this knowledge does not always impinge on hospital clinical practice. From the viewpoint of junior psychiatrists, cross-specialty referral and consultation, and the provision of adequate medical care to our patients can be difficult. In this discussion, we will deal briefly with the contribution of ‘physical’ medicine to this state of affairs and then turn in more detail to the influence of psychiatry. Recommendations for improvement are made.
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Krupinski, Jerzy. "Social Psychiatry and Sociology of Mental Health: A View on Their Past and Future Relevance." Australian & New Zealand Journal of Psychiatry 26, no. 1 (March 1992): 91–97. http://dx.doi.org/10.3109/00048679209068313.
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The origins of social psychiatry can be traced to the age of enlightenment and to the effects of the industrial revolution. Social psychiatry deals with social factors associated with psychiatric morbidity, social effects of mental illness, psycho-social disorders and social approaches to psychiatric care. Since the end of World War II up to the early seventies it has been claimed that social psychiatry should concentrate on the fight against war, poverty, racial discrimination, urban decay and all other social ills affecting people's mental health, and that the psychiatrist should be responsible for the mental health of the society. In contrast, sociology of mental health questioned the expertise of the psychiatrist and the very existence of mental illness, claiming that it covers deviant behaviour rejected by the society. The paper refutes this approach indicating that not the existence but the perception and presentation of psychiatric illness are socially determined. Acknowledging the contribution of sociology and social sciences to psychiatry, it is suggested that the heroic period of social psychiatry and the iconoclastic approach of sociology of mental health are over. However, social psychiatry, enriched by the use of epidemiological methods, has still much to offer to the daily practice of psychiatry.
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Roness, Atle. "Psychiatric disorders in clergymen in psychiatric care." Nordic Journal of Psychiatry 48, no. 3 (January 1994): 209–13. http://dx.doi.org/10.3109/08039489409081361.
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Cankurtaran, Eylem Sahin, Ibrahim Kutluer, Murat Senturk, Gulten Bircan Erzin, Devrim Gursoy, and Eray Tombak. "Psychiatric consultations for nursing home residents: a perspective from Turkey and the implications for comparable countries." International Psychogeriatrics 20, no. 4 (August 2008): 752–63. http://dx.doi.org/10.1017/s1041610207006679.
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ABSTRACTBackground: No specialized geriatric psychiatry consultation services are available for elderly people in the institutional care system in Turkey. Our aim was to evaluate psychiatric consultations among the residents of three homes for the elderly in a country with a rapidly aging population, and to investigate possible problems regarding psychiatric consultations.Methods: The residents of three homes for the elderly, which served partially as “care and rehabilitation centers” (equivalent to nursing homes), were chosen for the study. Data on the use of psychiatric services (mainly patient consultations with a visiting psychiatrist) were collected and analyzed.Results: The percentage of patients in the three homes for the elderly who had psychiatric consultations between 2005 and 2007 was 31.8% (172/540). The main reasons for referral were forgetfulness (61%), depressive symptoms (37.7%), agitation and disruptive behavior (29.6%), and psychotic symptoms (27.9%). Of these patients, 46.5% were diagnosed with dementia, 20.9% with depression, 20.5% with behavioral and psychotic symptoms of dementia, and 18.6 % with primary psychotic disorders such as schizophrenia.Conclusion: Homes for the elderly in Turkey are not adequate in terms of consultations for psychiatric problems. Integration of these institutions with hospitals and organizing routine consultation visits from the psychiatry units would enhance the mental health of the elderly. Supporting the staff, maintaining good cooperation between them, and organizing educational programs in the field of mental health of the elderly are also required.
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Oosterhuis, Harry. "Between Institutional Psychiatry and Mental Health Care: Social Psychiatry in The Netherlands, 1916–2000." Medical History 48, no. 4 (October 1, 2004): 413–28. http://dx.doi.org/10.1017/s0025727300007948.
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The term “social psychiatry” became current in the Netherlands from the late 1920s. Its meaning was imprecise. In a general way, the term referred to psychiatric approaches of mental illness that focused on its social origins and backgrounds. In this broad interpretation social psychiatry was connected to the psycho-hygienic goal of preventing mental disorders, but also to epidemiological research on the distribution of mental illness among the population at large. The treatment called “active therapy”, introduced in Dutch mental asylums in the 1920s and geared towards the social rehabilitation of the mentally ill (especially through work), was also linked with social psychiatry. In a more narrow sense social psychiatry indicated what before the 1960s was usually called “after-care” and “pre-care”: forms of medical and social assistance for patients who had been discharged from the mental asylum or who had not yet been institutionalized. This article focuses on the twentieth-century development of Dutch social psychiatry in this more narrow sense, without, however, losing sight of its wider context: on the one hand institutional psychiatry for the insane and on the other the mental hygiene movement and several outpatient mental health facilities, which targeted a variety of groups with psychosocial and behavioural problems. In fact, the vacillating position of pre- and after-care services was again and again determined by developments in these adjacent psychiatric and mental health care domains. This overview is chronologically divided into three periods: the period between and during the two world wars, when psychiatric pre- and aftercare came into being; the post-Second World War era until 1982, when the Social-Psychiatric Services expanded and professionalized; and the 1980s and 1990s, when they became integrated in community mental health centres.
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Nechita, Petronela, Liliana Luca, Alina-Ioana Voinea, Codrina Moraru, and Mirona-Letiţia Dobri. "Coercive Measures and Stigmatization in the Psychiatric Medical Care." BRAIN. Broad Research in Artificial Intelligence and Neuroscience 11, no. 3sup1 (2020): 137–45. http://dx.doi.org/10.18662/brain/11.3sup1/129.
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The involuntary commitment of psychiatric patients has been done for almost a decade under the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Frequent involuntary psychiatric hospitalizations have led to stigma attitudes and discriminatory acts towards patients with mental disorders. The coercive medical measures are applied in the psychiatric institutions of the mental health protection agencies. Coercion gives rise to serious ethical debates in the psychiatric assistance. The individual who was hospitalized in a psychiatric hospital anticipates social rejection becoming defensive, withdraws socially, experiences a complex internal conflict. The goal for this study is to illustrate aspects linked to coercive measures, mechanical restraint at involuntary admission of patients with mental illnesses in the psychiatric medical assistance. Material and method: This study is a retrospective one, and the data was taken from the charts with involuntary admissions during the period of October 2002 to July 2012. The studied lot was comprised of 202 patients admitted involuntarily in a psychiatric hospital according to the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Results: Of the 25.7% patients admitted involuntarily, that required coercive measures during admission, 58% were contained for symptoms like self-harm. The mechanical contention measures were especially necessary in the acute cases with symptoms as self-harm and/or harm of others, but also in situations with hallucinatory-delirium symptoms. The ratio of male sex subjects was significantly higher in the subject lot that needed coercive measures during hospitalization, of those admitted involuntarily (86.5% vs. 72%) (p = 0.036). Conclusions: Involuntary admission and mandatory treatment remains in psychiatry a medical, legal and ethical problem. The required measures can lead mainly to clinical benefits, implying a paternal attitude from the psychiatry specialists by defying the patients’ autonomy. Treatment compliance is directly proportional to the overall level of functioning and inversely proportional to the level of self-stigmatization.
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Algin, Sultana, Sumaiya Nawsheen Ahmed, and Redwana Hossain. "Pattern of Psychiatric Referral in a Tertiary Care Hospital in Bangladesh." Bangladesh Journal of Medicine 31, no. 2 (August 8, 2020): 76–80. http://dx.doi.org/10.3329/bjm.v31i2.48536.
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Introduction: Consultation-liaison Psychiatry (CLP) is the study, practice and teaching of the relationbetween medical and psychiatric disorders.
Aim of the study: The aim of this study is to find out the referring department, reason for consultation,common psychiatric comorbidities and sociodemographic of the referred patients to psychiatrydepartment from the other departments of Bangabandhu Sheikh Mujib Medical University of Dhaka.
Methodology: This cross-sectional study was carried out from May 2018 to February 2020. Patientsreferred from different inpatient departments every Thursday were taken as study population.Psychiatric diagnoses of the patients were assigned by the consultant psychiatrist as per DSM-5criteria. Semi structured questionnaire was used to collect socio-demographic data.
Results: Among the referred patients (n= 89) 56% were female; 63% were aged between 19-59years; 65% were married; 58% were from urban background and 51% studied up to higher secondary.More than half of the patients were referred from different branches of Medicine (68%). Referral fromInternal Medicine was 14.6%, Rheumatology 13.5%, Neurology and Nephrology 10% respectively.The rest were from the branches of pediatrics, surgery and gynecology. Most common psychiatricdisorder was Major Depressive Disorder (37%) followed by Obsessive-Compulsive Disorder (17%)and Delirium (10.11%). 15% patient received no psychiatric diagnosis.
Conclusion: Psychiatric comorbidities in general medical illness are very common. CLP provides anopportunity to improve health outcomes for inpatients and reduce burden on the healthcare system.
Bangladesh J Medicine July 2020; 31(2) :76-80
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Albers, Janet R. "Psychiatric Care in Primary Care Practice." Primary Care: Clinics in Office Practice 43, no. 2 (June 2016): i. http://dx.doi.org/10.1016/s0095-4543(16)30011-2.
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Thapa, Arati, Mukesh Karki, and Aradhana Thapa. "Vitamin-D Deficiency among Psychiatric Outpatients Attending Tertiary Care Hospital." Journal of College of Medical Sciences-Nepal 16, no. 4 (December 31, 2020): 195–200. http://dx.doi.org/10.3126/jcmsn.v16i4.34460.
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Abstract
Background: Vitamin D deficiency is associated with various physical and mental illness. This study aimed to estimate the prevalence of vitamin D deficiency among patients with psychiatric illness who visited Psychiatry outpatient department of College of Medical Sciences and Teaching Hospital, Chitwan, Nepal and investigate association of vitamin D with clinical characteristics and psychiatric illness.
Methods: A total of 129 who attended Psychiatry OPD of College of Medical Sciences and Teaching Hospital were enrolled over a period of 4 months after taking informed written consent. Psychiatric diagnoses were established by attending psychiatrists as part of the routine assessment using ICD 10/DCR criteria. Serum vitamin D was assessed by standard method. Data was analyzed using SPSS.
Results: Among 129 participants, one hundred and seven patients (82.9%) showed vitamin D level below normal range. Thirty one (24%) had vitamin D deficiency, seventy six (58.9%) had vitamin D insufficiency and twenty two (17.1%) had normal vitamin D level. The mean level of vitamin D was 24.11± 10.19. However, there was no significant association noted between vitamin D state and socio demographic profile and psychiatric illness.
Conclusions: We have found a high percentage of vitamin D deficiency among psychiatric patients in our study. Thus, screening for vitamin D deficiency should be considered as an important part of assessment of patients with major psychiatric illnesses.
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Espada, N. M. Casado, A. Flores, M. T. Lozano López, B. Bote Bonaechea, A. B. Sánchez García, M. Rodríguez, and C. Roncero. "Psychiatric care in university population." European Psychiatry 64, S1 (April 2021): S729. http://dx.doi.org/10.1192/j.eurpsy.2021.1931.
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IntroductionIt is well-known that university students experience high levels of mental health problems (1). University life presents changes and challenges that can be stressful and may affect the mental health of its community (2,3). More than 20 years ago, the Social Affairs Service (SAS) of the University of Salamanca started a program that ensured the mental health care in their community. The Psychiatric Care Unit is part of this program and its objectives are: 1) to detect serious mental disorders; 2) treat mild mental disorders; 3) give information to prevent illness and promote mental health; 4) serve as support in patients with previous follow-up that has been discontinued due to the beginning of their studies; 5) liaise with referral psychiatrists.ObjectivesTo make known a Psychiatric Care Unit targeted in the university communityMethods18 people between 19 and 52 years old (22% male, 78% female) were evaluated between November and December of 2020 in the Psychiatric Care Unit of the Social Affairs Service (PCU-SAS, University of Salamanca). The assessment consisted in an interview carried out by a psychiatrist, in the presence of a medical graduate. Every patient belong to the university community (students/ staff).ResultsThe most frequent diagnosis in the sample is Adjustment Disorder (F43.2). Substance use, eating disorders, low-self-concept, perfectionism and emotional dysregulation are very prevalent symptoms along our sample.ConclusionsUniversities should invest in creating environments that promote student and staff mental wellbeing. However, the current body of evidence is scarce and more research is needed to recommend what are the best strategies(4).DisclosureNo significant relationships.
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Völlm, B. "Inpatient forensic psychiatric care: Legal provision in European countries." European Psychiatry 64, S1 (April 2021): S66. http://dx.doi.org/10.1192/j.eurpsy.2021.205.
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Abstract BodyForensic psychiatry is a specialty of psychiatry primarily concerned with individuals who have either offended or present a risk of doing so, and who also suffer from a psychiatric condition. These mentally disordered offenders(MDOs) are often cared for in secure psychiatric environments or prisons. However, the organisation of these services differs greatly between countries due to different traditions and legal frameworks. Some countries, e. g., require absent or reduced criminal responsibility (at the time of the index offence) in order to enter forensic services while others determine access on the basis of current need for treatment. Numbers detained in forensic services also vary significantly as does length of stay, raising significant economic and ethical challenges. This talk will present different legal concepts determining admission to forensic-psychiatric services, data on length of stay as well as approaches to risk assessment and treatment in Europe.DisclosureNo significant relationships.
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Oyebode, Femi, Elaine Gadd, David Berry, Mary Lynes, and Patricia Lashley. "Community psychiatric nurses in primary care: consumer survey." Psychiatric Bulletin 12, no. 11 (November 1988): 483–85. http://dx.doi.org/10.1192/pb.12.11.483.
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There has been a dramatic increase in the numbers of community psychiatic nurses (CPNs) in the last decade; in the period 1980–1985 the number grew from 1667 to 2758, an overall increase of 65%. Traditionally, CPNs were based within psychiatric institutions. However, in the period 1980–1985 there was growth from 8% to 16.2% in the population of CPNs based in health care centres or General Practitioner (GP) surgeries. Some of the functions of CPNs is also changing, developing away from involvement with chronic psychiatric patients towards patients with minor disorders. CPNs have also argued that work in the community and in GP surgeries is synonymous with primary prevention.
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Mutalik, Narayan R. "Pathways to Psychiatric Care: A Hospital Based Study." Journal of Medical Science And clinical Research 05, no. 04 (April 19, 2017): 20585–90. http://dx.doi.org/10.18535/jmscr/v5i4.138.
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Shakya, DR. "Psychiatric morbidities of elderly psychiatry out-patients in a tertiary-care hospital." Journal of College of Medical Sciences-Nepal 7, no. 4 (August 30, 2012): 1–8. http://dx.doi.org/10.3126/jcmsn.v7i4.6735.
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With the rise in life expectancy, the elder population is increasing. Morbidity profiles of elderly people may indicate different needs and priorities. This study aims to sort out referral pattern, attitude about psychiatric referral and morbidity profile among elderly psychiatric outpatients in a general hospital. A total of 100 consecutive elderly (>55 years) out-patients in psychiatry OPD coming into contact of the investigator and giving informed consent were enrolled. Diagnoses were made according the ICD-10. More (54%) were female, mainly of age, 55-70 years (79%). Main ethnicity groups seeking care were Mongol (32%), Brahmin (25%), indigenous Terai tribes (14%) and Newar (11%). People from cities and semi-urban settings predominated the study. Referrals made most commonly by the departments were medicine, family medicine, surgery and ENT. More than a fourth (28%) were dissatisfied and questioned about the referral to psychiatric service. Greater proportions (71%) were comfortable and happy about psychiatry referral. Mood related and physical complaints each were presenting complaints in about half of subjects. Major psychiatric diagnoses were mood affective, anxiety, substance use and organic psychiatric disorders. Great majority had physical co-morbidity. Common mental disorders among elderly psychiatry out-patients were mood affective, anxiety and substance use disorders. A significant number of elderly psychiatry out patients had physical comorbidity. Journal of College of Medical Sciences-Nepal,2011,Vol-7,No-4, 1-8 DOI: http://dx.doi.org/10.3126/jcmsn.v7i4.6735
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Westermeyer, Joseph. "Problems With Managed Psychiatric Care Without a Psychiatrist-Manager." Psychiatric Services 42, no. 12 (December 1991): 1221–24. http://dx.doi.org/10.1176/ps.42.12.1221.
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