Journal articles on the topic 'Psychiatric hospital patients Victoria'
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MAQSOOD, NIAZ, JAMIL AHMED MALIK, BUSHRA AKRAM, Shoaib Luqman, and Naima Niaz. "PSYCHIATRIC INPATIENTS;." Professional Medical Journal 15, no. 01 (March 10, 2008): 104–13. http://dx.doi.org/10.29309/tpmj/2008.15.01.2706.
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To explore the pattern and prevalence of inpatient psychiatricmorbidity and to see how it differs from the pattern of psychiatric morbidity in community. Design: The details of all inpatients from the case register developed for a health information system was included in study Setting: In Departmentof Psychiatry and Behavioral Sciences, Bahawal Victoria Hospital, Bahawalpur. Period: From 1998-2003. Results: Atotal of 5426 patients were admitted in the six year. There was a slight difference of 0.8% in total number of males andfemales cases (i.e., 2764 males Vs 2662 females). Overall difference reported in the present study, in mean ages ofmales and females was 3.45 years (i.e., males = 31.85 Vs females = 28.40). Mean stay of patients in ward is 10-12days. Most patients were admitted with Conversion disorder 24% followed by Schizophrenia 23%, Depressive disorder20%, Drug Dependence 10%, Bipolar Disorder 7%. The patients with Neurotic Disorder and Organic Disorder werebelow 5%. Conclusion: The study showed that overall general pattern of inpatient psychiatric morbidity is in line withpattern of psychiatric morbidity in community and the partial variance can be explained in terms of social variables, asthis variance exist even across studies within community samples.
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Allison, Stephen, Tarun Bastiampillai, Jeffrey CL Looi, David Copolov, and Vinay Lakra. "Real-world performance of Victorian hospitals during the COVID-19 lockdowns." Australasian Psychiatry 30, no. 2 (April 2022): 239–42. http://dx.doi.org/10.1177/10398562221079281.
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Objective Victoria has low numbers of general adult psychiatric beds per capita by Australian and international standards. Hospital key performance indicators (KPIs) such as bed occupancy rates, emergency department waiting times and inpatient lengths of stay are proximal measures of the effects any shortfall in beds. We investigate the real-world performance of Victorian hospitals during the first year of the COVID-19 pandemic and the extended lockdowns in 2020. Conclusions The Victorian inpatient psychiatric system is characterised by high bed occupancies in many regions, extended stays in emergency departments awaiting a bed, and short inpatient lengths of stay, except for patients with excessively long stays on acute units (over 35 days) who are unable to be admitted to non-acute facilities. At the end of 2020, bed occupancies were high (above 90%) in 10 regions, with three regions having bed occupancies over 100%. However, state-wide average bed occupancy improved between 2019 (94%) and 2020 (88%). Other KPIs remained steady because acute hospitals did not experience the expected pandemic mental health demand-surge. For a more complete picture of the impact of the pandemic, Australia needs interconnected, centralised data systems.
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Turner, P. M., and T. J. Turner. "Validation of the Crisis Triage Rating Scale for Psychiatric Emergencies." Canadian Journal of Psychiatry 36, no. 9 (November 1991): 651–54. http://dx.doi.org/10.1177/070674379103600905.
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Using a sample of 500 emergency psychiatric patients at Victoria Hospital in London, Ontario, this study replicated part of the research on the Crisis Triage Rating Scale (CTRS) conducted by Bengelsdorf, Levy, Emerson and Barile in 1984. The relationship between the suggested CTRS cut-off score and the decision whether or not to hospitalize the patient was studied, independently of these scores. The relative contribution of each of the subscales (Dangerousness, Support System and Ability to Cooperate) to this decision was also determined. The results of this study suggest that using a cut-off score of 9, the easily administered Crisis Triage Rating Scale could be an additional assessment aid in determining whether patients require emergency hospital admission to a psychiatric unit.
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Draper, Brian M., and Annette Koschera. "Do Older People Receive Equitable Private Psychiatric Service Provision Under Medicare?" Australian & New Zealand Journal of Psychiatry 35, no. 5 (October 2001): 626–30. http://dx.doi.org/10.1080/0004867010060511.
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Objective: The objective of this study is to determine the 1998 rates, types, regional variation and Medicare expenditure of private psychiatry services for older people in Australia, as compared with younger adults and with 1985–1986 data. Method: Medicare Benefits Schedule Item Statistics for the psychiatric item numbers 300–352 and item 14224 were obtained from the Health Insurance Commission for each State and Territory. The items were examined in the age groups 15–64 years, 65 years and over and 75 years and over. Main outcome measures were per capita service provision by age group, State and Territory and Medicare expenditure by age group. Results: During 1998, 6.4% (5765.6 per 100 000) of private psychiatric services were to patients aged > 64 years. Patients aged 15–64 received 2.7 times the number of psychiatric services per capita than patients > 64 and 3.6 times that of patients aged > 74 years. Patients aged > 64 received more hospital and nursing home consultations, home visits and electroconvulsive therapy per capita, while younger adults used more office-based consultations, longer consultations, and group therapy. Victoria had the highest per capita rate (7659.2 per 100 000) and the Northern Territory the lowest (540.4 per 100 000), although the highest proportion of services to older patients was in Western Australia. Per capita the proportion of Medicare expenditure allocated to adults aged less than 65 years was 4.1 times that for adults over 64 years. Conclusions: Private psychiatric service provision to older people is inequitable when compared with younger adults. The proportion of Medicare private psychiatry expenditure on older adults has declined since 1985–1986.
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Cheung, P., I. Schweitzer, V. Tuckwell, and K. C. Crowley. "A Prospective Study of Aggression among Psychiatric Patients in Rehabilitation Wards." Australian & New Zealand Journal of Psychiatry 30, no. 2 (April 1996): 257–62. http://dx.doi.org/10.3109/00048679609076103.
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Objective: The aim of the study was to determine, among patients in rehabilitation wards, the prevalence and nature of aggressive behaviour and the relationship between aggressive behaviour and patient characteristics and ward factors. Method: The aggressive behaviour of all 220 inpatients within the rehabilitation program of a large psychiatric hospital in Victoria was assessed using the Staff Observation Aggression Scale. Results: Physical assaults occurred at a rate of 97.6 per 100 patients per year. About 40% of all incidents appeared to be unprovoked. Most physical incidents involved use of body parts and use of a weapon was uncommon. Aggression was most often directed at a staff member. Serious injury was rare. Aggressive behaviour was correlated with gender and duration of admission for the whole sample; however, there were different correlates of aggressive behaviour for different ward populations and different types of aggression. As for ward variables, time of day but not patient/staffing level was associated with aggressive behaviour. Conclusions: There was a high rate of aggressive behaviour among patients in rehabilitation wards; this should be taken into consideration in the planning of their community placement. The findings also caution against aggregating different ward populations and types of aggressive behaviour for research.
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Spence, S. A. "Presumed Curable: An Illustrated Casebook of Victorian Psychiatric Patients in Bethlem Hospital." BMJ 326, no. 7399 (May 22, 2003): 1150. http://dx.doi.org/10.1136/bmj.326.7399.1150.
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Turner, Trevor. "Presumed Curable: An Illustrated Casebook of Victorian Psychiatric Patients in Bethlem Hospital." International Journal of Psychiatry in Clinical Practice 8, no. 1 (January 2004): 66–67. http://dx.doi.org/10.1080/13651500310003831.
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Skinner, Adrian E. G., and Christine M. Williams. "A study of the measurement of changes occurring in long-term psychiatric patients discharged to residential care in the community." Psychiatric Bulletin 15, no. 6 (June 1991): 331–33. http://dx.doi.org/10.1192/pb.15.6.331.
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As more health authorities close large psychiatric hospitals the provision of small local facilities in which former residents of such hospitals are housed is increasing. Such houses tend to share many common characteristics dictated both by practical necessity and by deliberate policy – they tend to be large Victorian houses chosen because they have a larger number of bedrooms and they tend to be run in a much less formal manner than hospital wards (Goldberg, 1985).
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Langley, G. E. "Book Review: Presumed Curable: An Illustrated Casebook of Victorian Psychiatric Patients in Bethlem Hospital." Journal of Medical Biography 12, no. 1 (February 2004): 61–62. http://dx.doi.org/10.1177/096777200401200118.
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Ramsay, Rosalind. "150 years on: recycling the old asylums." Psychiatric Bulletin 15, no. 7 (July 1991): 434–35. http://dx.doi.org/10.1192/pb.15.7.434.
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The relocation of chronic psychiatric patients in the community may be of unexpected benefit to town planners. Many Victorian mental hospitals, largely redundant in terms of medical use, are high quality buildings – some are listed or otherwise of architectural merit – and they are often set in mature landscaped grounds. Architect John Burrell has developed the idea of using former psychiatric hospital sites on the edges of cities as a basis for establishing a new urban core to outer suburban areas. His plans for the Woodford Green site won him the top prize in a national competition ‘Tomorrow's New Communities’, which was organised earlier this year by the Town and Country Planning Association and the Joseph Rowntree Trust, with the backing of the Prince of Wales.
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Stuart, Geoffrey W., I. Harry Minas, Steven Klimidis, and Siobhan O'connell. "English Language Ability and Mental Health Service Utilisation: A Census." Australian & New Zealand Journal of Psychiatry 30, no. 2 (April 1996): 270–77. http://dx.doi.org/10.3109/00048679609076105.
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Objective: To explore the relationship between English language proficiency and mental health service utilisation. Methods: In September 1993, a sample census was conducted of all mental health services in the State of Victoria, including public and private hospital wards, outpatient consultations provided by psychiatrists and clinical psychologists, and primary mental health care provided by general practitioners. Response rates ranged from 37% for monolingual general practitioners (GPs) to 96% for inpatient units. Particular emphasis was placed on patients' English language proficiency and the role played by bilingual clinicians. Results: Over 80% of inpatients received a diagnosis of either dementia or psychosis. This proportion was even greater in the case of patients with English language difficulties. The latter group of patients underutilised specialist outpatient services, and those using these services were less likely to receive psychotherapy than fluent English speakers. They utilised GPs for mental disorder at at least the same rate as other patients. There was a marked preference for bilingual GPs, with 80% of patients with poor English language skills consulting GPs who spoke their native language. Conclusion: There appears to be considerable underutilisation of specialist mental health services by patients who are not fluent in English. The liaison-consultation model of psychiatric care may be an effective way of addressing this problem, given the important role already played by bilingual GPs in the psychiatric care of those whose native language is not English.
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Walmsley, Tom. "Undesirable reading: the real role of the clinical tutor." Psychiatric Bulletin 14, no. 3 (March 1990): 165–68. http://dx.doi.org/10.1192/pb.14.3.165.
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I was appointed clinical tutor at Knowle Hospital seven years ago with little idea of what my responsibilities would be. From the College literature (which I have not found very helpful) it seemed I was responsible in a more or less indirect way for the psychiatric education of most of those working in the hospital as well as of those local general practitioners who might refer patients here. In addition, all medical students in the place are my responsibility – a considerable number of young people. To complicate this task, our academic unit had moved out of Knowle two years before my arrival and new trainees were advised that Knowle Hospital (usually described as a ‘traditional Victorian mental hospital’) would be closing in the near future as modern community services were provided. Finally, the advent of proper management, welcomed by me, was spoiled by an indifference to psychiatric education which bordered on absurdity.
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AKHTAR, SAEED, ASIA MANZOOR,, and AZRA YASMEEN. "DEPRESSION IN DISSOCIATIVE (CONVERSION) DISORDER PATIENTS;." Professional Medical Journal 20, no. 02 (February 7, 2013): 272–78. http://dx.doi.org/10.29309/tpmj/2013.20.02.682.
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Objective: Prevalence of depression in Dissociative (Conversion) disorder Patients. Place and Duration of Study: Thestudy was conducted in the Department of Psychiatry & Behavioural Science / Bahawal Victoria Hospital & Quaid-e-Azam MedicalCollege, Bahawalpur, from February 2012 to May 2012. Subjects and Methods: The sample consisted of 100 consecutive in patients(Female 84, Male 16) of Dissociative (Conversion) disorder. They were interviewed and results were analyzed from the entries in aPerforma and Hamilton Rating Scale for Depression. Results: Majority of the patients were female (84%), uneducated (54%) andunmarried (60%). Mean age of our patients was 21.84±7.29 years. Depression was found in 76% of patients. Out of 76 depressedpatients had moderate depression, 24 had severe depression. Conclusions: Our study collaborates that depression was present in highproportion in patients with dissociative (conversion) disorder, which shows that co-morbid depression should not be over looked in thesepatients. It is recommended that every patient presenting with dissociative (Conversion) disorder should be assessed for co-morbiddepression and should be managed accordingly.
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Luqman, Naima, Niaz Maqsood, and Wajih-Ur Rehman. "DEPRESSION IN ACNE VULGARIS." Professional Medical Journal 25, no. 06 (June 10, 2018): 892–95. http://dx.doi.org/10.29309/tpmj/2018.25.06.277.
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INTRODUCTION: Acne vulgaris is a chronic inflammatory disorder of pilo-sebaceous glands,which most commonly affect face and trunk. It is most prevalent in adolescent age group. Ithas been seen that acne can have profound social and psychological effects which are notnecessarily related to its clinical severity. Objectives: To determine the frequency and severity ofdepression among acne patients attending the outpatient dermatology department, of a tertiarycare hospital. Study Design: Descriptive study. Place & Duration of Study: Department ofDermatology, Bahawal Victoria Hospital, Bahawalpur from September, 2013 to November, 2013.Subjects & Methods: Informed written consent was taken from patients for the study, seventypatients of acne, diagnosed by consultant dermatologist were inducted. The severity of acnewas determined by Global Acne Grading System. Both genders were included, the age rangewas from 16 to 40 years. Those patients with concomitant dermatological, psychiatric diseasesand those receiving systemic isotretinoin were excluded. The patients fulfilling inclusioncriteria were assessed for depressive symptoms and Hamilton Depression rating scale wasadministered for severity of depression. Results: 70 patients were included in the study, amongthem 14 (20%) were male and 56 (80%) were females. Most of the acne patients were of the age16-20 years [24 (34.3%)]. Mild depression was seen in 26% patients (18%-were females and8%-males). Severe depression was present in 14% of patients, among which 11% were females& 3% were males. Very severe depression was noted in 18% patients among which 16% werefemale and 2% were males. Conclusions: it can be concluded that Dermatologists should paydue attention to the psychological/ mental state of the patient while clinically evaluating andtreating patients suffering from acne vulgaris
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Dharwadkar, Nitin. "Effectiveness of an Assertive Outreach Community Treatment Program." Australian & New Zealand Journal of Psychiatry 28, no. 2 (June 1994): 244–49. http://dx.doi.org/10.1080/00048679409075635.
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The purpose of this paper is to describe an Adult Community Treatment (ACT) program in Dandenong, Victoria, and its effect upon admission rates and time in hospital for 50 of the serviceapos;s most disturbed patients. The implementation of the program was associated with a reduction in the annual re-admission rate from 38% (1989–90) to 21% (1990–91); the total length of hospital stay was also significantly reduced. The results support the value of community support programs in the management of the seriously mentally ill.
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MAQSOOD, NIAZ, BUSHRA AKRAM, and WAJID ALI. "PATIENTS WITH CONVERSION DISORDER." Professional Medical Journal 17, no. 04 (December 10, 2010): 715–20. http://dx.doi.org/10.29309/tpmj/2010.17.04.3031.
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Objectives: To assess the frequency of the various psychosocial stressors and stressful life events in patients presenting with conversion disorder. Study Design: Case series study. Place & Duration of Study: The study was conducted in the Department of Psychiatry & Behavioural Sciences, Bahawal Victoria Hospital & Quaid-e-Azam Medical College, Bahawalpur from January, 2009 to March, 2009. Subjects & Methods: The sample consisted of 100 in-patients (89 Female, 11 Male) with Conversion Disorder. They were interviewed andresults were analysed from the entries in a Performa. Results: Stressors were clearly identified in 100 patients. In all patients, we found more than one stressor. Among patients, there were (24%) In-laws problems, (23%) Love problems, (21%) Relationship problems with family, (20%) exam/study stress, (15%) marriage against will, (13%) demanding and pampered child, (11%) Issue less, (10%) sexual abuse, (8%) demand of marriage, (6%) overage in wait of marriage, (4%) death of partner, (3%) husband abroad and (3%) patient’s engagement break. Conclusions: We concluded that stressors and life events were present in all conversion disorder’s patients and these stressful life events are important causal factors for Conversion Disorder. Conversion Disorder has strong relationship with psychosocial stressors.
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Draper, Brian. "Melancholia in late life in New South Wales and Victoria, Australia, 1871–1905: symptoms, behaviours and outcomes." History of Psychiatry 33, no. 4 (November 19, 2022): 467–74. http://dx.doi.org/10.1177/0957154x221117000.
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In the late nineteenth century, the prognosis of late-life melancholia was believed to be poor. The medical casebooks of 40 patients aged 60+years, admitted to two Hospitals for the Insane in New South Wales with melancholia between 1871 and 1905, were examined. Psychosis (87.5%), depressed mood (80%), suicidal behaviour (55%), physical ill health (55%), restlessness (50%) and fears of harm to self (50%) were identified. Main outcomes were discharge (40%) and death (37.5%). Victoria’s Kew Hospital patient register for 1872–88 revealed 669 melancholia admissions with 30 aged 60+. Outcomes worsened significantly with age (chi square = 16.19, df = 4, p < 0.005), mainly due to higher mortality. Nineteenth-century late-life melancholia was a severe disorder despite many cases recovering.
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AKHTAR, SAEED, Bushra AKRAM, and AZRA YASMEEN. "DEPRESSION;." Professional Medical Journal 19, no. 03 (May 10, 2012): 319–23. http://dx.doi.org/10.29309/tpmj/2012.19.03.2124.
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Objective: Prevalence of Depression in patients presenting with Alcohol and Drug addiction. Place & duration of study: Thestudy was conducted in the Department of Psychiatry & Behavioural Sciences, Bahawal Victoria Hospital & Quaid-e-Azam Medical College,Bahawalpur from March, 2009 to May, 2009. Subjects & methods: The sample consisted of 50 in-patients (Male 46, Female 4) with Alcohol &Drug addiction. They were interviewed and results were analysed from the entries in a Performa and Hamilton Rating Scale for Depression.Results: Majority of the patients were male (92%), age group majority (74%) were between 21-40 years. Depression was found in 23(46%)patients, 14(28%) had severe depression and 9(18%) had mild to moderate depression. Conclusions: Significant numbers of patients ofalcohol and drug addiction have depression as co-morbidity, which can have important implications in the aetiology and prognosis. So everypatient seeking treatment for alcohol and drug addiction should be assessed for depression and we should develop a protocol to treatdepression in these patients.
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MAQSOOD, NIAZ, ISHTIAQ AHMAD, WAJID ALI, Wajeh ur Rehman, and Naima Niaz. "THE HYSTERIA." Professional Medical Journal 13, no. 02 (June 25, 2006): 303–9. http://dx.doi.org/10.29309/tpmj/2006.13.02.5033.
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Objectives: To find out the sociodemographic characteristics ofconversion disorders and to find if there is any difference between the presenting symptoms of rural and urbanpopulation. Design: A non-probability, purposive, hospital based sample. Place and Duration of Study: Psychiatrydepartment of Victoria Hospital Bahawalpur, from February 2004 to April 2005. Patients and Method: A sample of 100-patients was collected. Both sexes were included. DSM-IV criteria for conversion disorder were applied for diagnosisof all these patients. Informed consent was taken for inclusion in the study. Patients suffering from concurrent physicaldisorders were excluded. The first author (NM.) using a semi-structured pro-forma interviewed all these patients. Thesociodemographic characteristics and the clinical profile were collected. Statistical analysis was made with the statisticalpackage for windows, SPSS (version –10). The applied method for group comparison was chi square- test. Results:The mean age of patients from the urban area was 24.26±7.25 years, as compared to 22.15±7.49 years for thepatients from the rural area. Most of the patients were females and were married. Majority of the patients from the urbanas well as from the rural area were uneducated and from the lower socio-economic class. The onset of illness wastypically acute and sudden, with precipitating life event. Majority of the patients had family history of the illness and comorbidpsychiatric disorders. The presenting symptoms were either sensory, motor, mixed symptoms and psuedoseizures.The presenting symptoms of patient from both urban (p value of 0.008), and rural area (P value =0.013), werestatistically significant. There were no statistically significant association between the presenting symptoms and thearea of living. The p values of the entire chi square tests were greater than (0.05). Conclusion: Prompt elimination ofthe symptoms of conversion disorder is important to prevent secondary gains from reinforcing it and causing it to persistor reoccur. Psychiatric services need to be developed and updated for the provision of prompt and efficient treatment,for the patients with these chronic and sometimes disabling conversion disorders.
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Wong, Michael T. H., Michael T. H. Wong, and Christine Tye. "Low Hospital Inpatient Readmission Rate in Patients with Borderline Personality Disorder: A Naturalistic Study at Southern Health, Victoria, Australia." Australian & New Zealand Journal of Psychiatry 39, no. 7 (July 2005): 607–11. http://dx.doi.org/10.1080/j.1440-1614.2005.01633.x.
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Objective: To study how the standard management protocol and the special management contract relate to the clinical profile of patients with borderline personality disorder and their hospital admission pattern. Method: A retrospective review was undertaken using naturalistic data from the Client Management Interface over a 2-year period. The standard management protocol patient group and the special treatment contract patient group were compared with respect to variables which included basic demographic data, number of admissions, length of stay and comorbidity. Results: Eighty patients received a diagnosis of borderline personality disorder. The majority (81.2%) were managed with the standard management protocol and only 41.5% had more than one admission. For those who received a special treatment contract (18.8%), 93.3% of them had more than one admission. The special treatment contract group had a significantly higher total number of admissions (p<0.001), a higher number of admissions when they received (p<0.001) and did not receive (p=0.001) a diagnosis of borderline personality disorder, a higher number of comorbidities (p=0.004) but not more presentations to the emergency department. Conclusions: Most patients with borderline personality disorder treated with the standard management protocol had a low readmission rate. The small group of patients with comorbidities managed with a special treatment contract had multiple readmissions but not more crisis presentations to the emergency department. Further studies are required to elucidate the therapeutic mechanism of the standard management protocol and special treatment contract and how that impacts on presentations and admissions to a hospital.
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Zhao, Henry, Lauren Pesavento, Edrich Rodrigues, Patrick Salvaris, Karen Smith, Stephen Bernard, Michael Stephenson, et al. "009 The ambulance clinical triage-for acute stroke treatment (ACT-FAST) algorithmic pre-hospital triage tool for endovascular thrombectomy: ongoing paramedic validation." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 6 (May 24, 2018): A5.1—A5. http://dx.doi.org/10.1136/jnnp-2018-anzan.9.
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IntroductionThe ambulance clinical triage-for acute stroke treatment (ACT-FAST) algorithm is a severity based 3-step paramedic triage tool for pre-hospital recognition of large vessel occlusion (LVO), designed to improve specificity and paramedic assessment reliability compared to existing triage scales. ACT-FAST sequentially assesses 1. Unilateral arm fall to stretcher <10 s; 2a. Severe language disturbance (right arm weak), or 2b. Severe gaze deviation/hemi-neglect assessed by shoulder tap (left arm weak); 3. Clinical eligibility questions. We present the results of the ongoing Ambulance Victoria paramedic validation study.MethodsAmbulance Victoria paramedics assessed ACT-FAST in all suspected stroke patients pre-hospital in metropolitan Melbourne, Australia, and in the Royal Melbourne Hospital Emergency Department since July 2017. Algorithm results were validated against a comparator of ICA/M1 occlusion on CT-angiography with NIHSS ≥6 (Class 1 indications for endovascular thrombectomy).ResultsData were available from n=119 assessments (ED n=68, pre-hospital n=51). Patient diagnoses were LVO n=20 (15.6%), non-LVO infarcts n=45 (38.5%), ICH n=10 (8.3%) and no stroke on imaging n=44 (37.6%). ACT-FAST showed 85% sensitivity, 88.9% specificity, 60.7% (72% excluding ICH) positive predictive value and 96.7% negative predictive value for LVO. Of 10 false-positives, 4 received thrombectomy for non-Class 1 indications (basilar/M2 occlusions/cervical dissection), 3 were ICH, and 1 was tumour. Three false-negatives were LVO with milder syndromes.DiscussionThe ongoing ACT-FAST algorithm validation study shows high accuracy for clinical recognition of LVO. The streamlined algorithmic approach with just two examination items provides a more practical option for implementation in large emergency service networks. Accurate pre-hospital recognition of LVO will allow bypass to endovascular centres and early activation of neuro-intervention services to expedite endovascular thrombectomy.
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Gómez Sánchez-Lafuente, C., R. Reina Gonzalez, A. De Severac Cano, E. Mateos Carrasco, F. Moreno De Lara, and I. Tilves Santiago. "Prevalence of substance use disorder among bipolar affective disorder." European Psychiatry 33, S1 (March 2016): S299—S300. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1019.
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IntroductionHigh rates of substance abuse have been reported in the general population and users of mental health services. In our environment, relationship between substance abuse and manic phase has not been well characterized.AimsDetermining the prevalence of active substance abuse among patients admitted to acute mental health unit at Virgen de la Victoria Hospital at Malaga, diagnosed with mania or hipomanía.MethodsWe analysed urine and blood seeking for ethanol, cannabis and other 11 substances in 140 patients previously diagnosed with bipolar disorder prior to their admission at the Hospital for mania or hipomanía phase.ResultsThirty-seven percent of the patients were positive for drugs. Eighteen percent were positive for two or more drugs. Males had higher rates of abuse than females, except in MDMA and amphetamines. By subtypes, cannabis (37.2%) and ethanol (29.62%) were the most consumed drugs. In young age cohorts had higher rates of active substance abuse. Dual patients had longer average stays at hospital (2.6 days more) (Fig. 1).ConclusionsSubstance abuse is a major comorbidity in bipolar patients with manic phase. The active consumption of cannabis and ethanol especially emphasizes in men younger than 35 years.We believe priority should be given to recognition and multidisclipinary approach to substance use disorders in bipolar patients. Bipolar patients with comorbid substance abuse may have a more severe course, and may be a preventable factor of new relapses. This rate could increase healthcare costs and worse quality of life of these patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Peukert, Thomas. "285 Piloting and implementing an acute neurology service." Journal of Neurology, Neurosurgery & Psychiatry 89, no. 10 (September 13, 2018): A43.2—A43. http://dx.doi.org/10.1136/jnnp-2018-abn.149.
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Over the past decade, the number of patients attending the emergency department (ED) at the Royal Victoria Hospital Belfast, with neurological symptoms, has doubled. Typically, over 50% of these patients would subsequently be admitted to hospital. In 2013, a pilot project was conducted with the aim of evaluating the effectiveness of a rapid access neurology clinic on reducing such admissions.A dedicated neurology clinic was set up offering 12 slots per week. Patients were seen within 10 days of ED staff booking them into the clinics. Early results indicated that within the first month 28 admissions were avoided. As a result rapid access neurology clinics were rolled out. Two acute neurologists were appointed and since 2015, 3 rapid access clinics run per week (15 slots). In addition to the rapid access clinics, the acute neurology team also offer two additional services:Reviewing all patients who have been admitted under the medical take with neurological symptomsPatients who attend ED overnight but require urgent evaluation/tests can be sent home and will be seen the next morning by the acute neurology teamAnalysis indicates approximately 1250 admissions are avoided each year with an estimated cost saving of over £2 million.
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MAQSOOD, NIAZ, NAEEM-ULLAH LAGHARI, and BUSHRA AKRAM. "CONVERSION DISORDER;." Professional Medical Journal 20, no. 06 (December 15, 2013): 981–87. http://dx.doi.org/10.29309/tpmj/2013.20.06.1568.
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Objective: The objective of the study was to find out association and pattern of childhood sexual abuse in patientspresenting with conversion disorder. Study Design: A descriptive study. Place & duration of study: The study was conducted in theDepartment of Psychiatry & Behavioural Sciences, Bahawal Victoria Hospital & Quaid-e-Azam Medical College, Bahawalpur from June,2011 to December, 2011. Subjects & Methods: The sample consisted of 60 Female in-patients with Conversion Disorder by purposivesampling. They were interviewed and results were analysed from the entries in a semi structured Performa. Results: Out of 60 patients,34(57%) reported sexually abused in childhood and 26(43%) not abused. There were 19(32%) patients reported uncomfortable sexualtalk, sexual touching, 9(15%) reported attempted intercourse which was successful and 6(10%) reported attempted for intercourse butfailed in their aim. 14(23%) patients abused by their relatives, 5(8%) by Neighbours and strangers, 3(5%) by their health caregivers,boyfriends and class fellows and 1(2%) by teachers. Conclusions: This study shows a positive association between severe sexual abuse(Uncomfortable talk, sexual touching, penetration or attempted penetration) in childhood and Conversion Disorder in adult life.
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Scull, Andrew. "Presumed curable: An illustrated casebook of Victorian psychiatric patients in Bethlem hospital; Invention of hysteria: Charcot and the photographic iconography of the Salpêtrière." Journal of the History of the Behavioral Sciences 42, no. 3 (2006): 296–97. http://dx.doi.org/10.1002/jhbs.20183.
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Basu, Soumya, and Anton N. Isaacs. "Profile of transcultural patients in a regional Child and Adolescent Mental Health Service in Gippsland, Australia: The need for a multidimensional understanding of the complexities." International Journal of Social Psychiatry 65, no. 3 (March 18, 2019): 217–24. http://dx.doi.org/10.1177/0020764019835264.
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Background: Several childhood stressors related to immigration have been documented, and it is important for clinicians to understand and address the various factors that may lead to or act as maintaining factors of mental disorders in children and adolescents. Aims: To describe the cultural profile of transcultural patients presenting to a Child and Adolescent Mental Health Service (CAMHS) in regional Victoria and identify the most common disorders and psychosocial stressors they presented with. Method: Descriptive analysis was applied to 101 case records of patients with a transcultural background who attended the CAMHS of Latrobe Regional Hospital in Gippsland Victoria from 2013 to 2017. The Adverse Childhood Experience questionnaire was retrospectively applied to capture psychosocial stressors such as ‘bullying’, ‘racism’ and ‘family conflict’, sexual abuse, physical violence, parents with mental illness and parental substance use. Results: Almost 60% of patients were male and over 46% Aboriginal. Those from a non-Aboriginal background belonged to 19 different cultural entities, the most common of which was a mixed Asian and European heritage. The most common diagnoses were disruptive mood dysregulation disorder (38.6%), attention-deficit hyperactivity disorder (32.7%) and developmental trauma disorder (26.7%). The most common psychosocial stressors were conflict and death in the family (44.6%), domestic violence (41.6%) and emotional abuse (34.7%). ‘Parent in jail’ and ‘domestic violence’ were associated with having an Aboriginal background ( p < .005). ‘Cultural differences with parent’ was associated with a non-Aboriginal background ( p < .005). Conclusion: This study provides a snapshot of challenges faced by children from different cultural backgrounds while adjusting in a rural area in Australia. A broad-based formulation and cultural awareness by clinicians can enable a better understanding of the complexities, guide management plans and inform public health policies for primary prevention and early intervention.
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Maqsood, Niaz, Bushra Akram, Naima Luqman, and Rizwana Amin. "CONVERSION DISORDER;." Professional Medical Journal 21, no. 03 (June 10, 2014): 489–94. http://dx.doi.org/10.29309/tpmj/2014.21.03.2003.
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Objective: Frequency of the psychosocial stressors and stressful life events inchildren presenting with conversion disorder. Study design: A descriptive study. Place &duration of study: The study was conducted in the Department of Psychiatry & BehaviouralSciences, Bahawal Victoria Hospital & Quaid-e-Azam Medical College, Bahawalpur fromJanuary, 2010 to October, 2010. Subjects & methods: The sample consisted of 100 in-patients(62 Female, 38 Male) with Conversion Disorder. They were interviewed and results were analysedfrom the entries in a Performa. The Presumptive Stressful life Events Scale (PSLES) wasadministered by an open ended interview to elicit major life events in the past 10 months.Results: Stressors were clearly identified in 100 patients. In all patients, we found more than onestressor. Among patients, there were (29%) Educational and study stressors, (20%) Parent’sdeath / Separation, (20%) Sexual Abuse, (14%) Sibling Rivalry, (13%) Pampered / DemandingChild, (10%) Attention Seeking, (8%) Peer Group Problems, (8%) Improper Parenting, (8%)Learned behaviour, (7%) Emotional Involvement Issues, (5%) Habit of stealing and (4%) AdoptedChild. Conclusions: We concluded that stressors and life events were present in all conversiondisorder’s patients and these stressful life events are important causal factors for ConversionDisorder. Severe and sudden emotional stress serves to precipitate conversion reaction inpredisposed children. The symptom serves to solve the conflict and the gain obtained served toperpetuate the illness.
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Poss, C., C. Fernandes, M. Columbus, and K. Wood. "LO029: Undetected serious medical illness in mental health patients seen in an academic emergency department." CJEM 18, S1 (May 2016): S39—S40. http://dx.doi.org/10.1017/cem.2016.66.
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Introduction: Mental health concerns make up 5-10% of all adult presentations to Canadian emergency departments (ED). One challenge for the emergency physician (EP) is determining if a patient with a mental health concern has concomitant underlying medical illness. We defined “serious medical illness” (SMI) as a pathological condition that requires inpatient treatment on a medical or surgical ward. SMI undetected by emergency physicians in patients presenting with mental health concerns may result in adverse patient outcomes. The aim of this study was to determine the prevalence, timing, and etiology of undetected SMI in the ED among adult patients presenting with mental health concerns. Methods: A retrospective chart review was performed on all patients age 18 and older who presented to the ED at Victoria Hospital, London Health Sciences Centre between October 1, 2014 and April 30, 2015, who were subsequently referred to psychiatry by the EP. The primary outcome was the number of patients transferred to a medicine or surgery inpatient unit for treatment of their SMI within seven days of psychiatry admission from the ED. Results: 1,255 patients were referred to psychiatry during the study period. 803 patients were admitted and 452 were discharged. Of the admitted patients, 14/803 patients (1.7%) met our primary outcome. The mean age of patients in the SMI group (n=14) was 64 years. The mean age in the non-SMI group (n=1,241) was 38. In the SMI group, 3/14 patients died, 2/14 patients required an ICU admission, and 2/14 patients underwent a surgery for their missed SMI. The average length of psychiatry admission prior to transfer was 3.7 days. The average length of medical/surgical admission after transfer from psychiatry was 8.3 days. Undetected diagnoses included NSTEMI, serotonin syndrome, lithium toxicity, thoracic aortic aneurysm, gastrointestinal stromal tumour, forearm abscess, Parkinsonian crisis, and others. Conclusion: This chart review demonstrated a 1.7% rate of undetected serious medical illness in patients who presented to the ED with mental health concerns. Adverse outcomes included death, ICU admissions, and surgeries. This rate is similar to other studies on the topic. The SMI group tended to be older than the non-SMI group. This research may have implications on the appropriate workup and disposition of elderly patients presenting to the ED with mental health concerns.
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Segal, Steven P., Leena Badran, and Lachlan Rimes. "Accessing acute medical care to protect health: the utility of community treatment orders." General Psychiatry 35, no. 6 (December 2022): e100858. http://dx.doi.org/10.1136/gpsych-2022-100858.
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BackgroundThe conclusion that people with severe mental illness require involuntary care to protect their health (including threats due to physical—non-psychiatric—illness) is challenged by findings indicating that they often lack access to general healthcare and the assertion that they would access such care voluntarily if available and effective. Victoria, Australia’s single-payer healthcare system provides accessible medical treatment; therefore, it is an excellent context in which to test these challenges.AimsThis study replicates a previous investigation in considering whether, in Australia’s easy-access single-payer healthcare system, patients placed on community treatment orders, specifically involuntary community treatment, are more likely to access acute medical care addressing potentially life-threatening physical illnesses than voluntary patients with and without severe mental illness.MethodsReplicating methods used in 2000–2010, for the years 2010–2017, this study compared the acute medical care access of three new cohorts: 7826 hospitalised patients with severe mental illness who received a post-hospitalisation, community treatment order; 13 896 patients with severe mental illness released from the hospital without a community treatment order and 12 101 outpatients who were never psychiatrically hospitalised (individuals with less morbidity risk who were not considered to have severe mental illness) during periods when they were under versus outside community mental health supervision. Logistic regression was used to determine the influence of community-based community mental health supervision and the type of community mental health supervision (community treatment order vs non-community treatment order) on the likelihood of receiving an initial diagnosis of a life-threatening physical illness requiring acute care.ResultsValidating their shared elevated morbidity risk, 43.7% and 46.7%, respectively, of each hospitalised cohort (community treatment order and non-community treatment order patients) accessed an initial acute-care diagnosis for a life-threatening condition vs 26.3% of outpatients. Outside community mental health supervision, the likelihood that a community treatment order patient would receive a diagnosis of physical illness was 36% lower than non-community treatment order patients—1.30 times that of outpatients. Under community mental health supervision, their likelihood was two times greater than that of non-community treatment order patients and 6.6 times that of outpatients. Each community treatment order episode was associated with a 14.6% increase in the likelihood of a community treatment order patient receiving a diagnosis. The results replicate those found in an independent 2000–2010 cohort comparison.ConclusionsCommunity mental health supervision, notably community treatment order supervision, in two independent investigations over two decades appeared to facilitate access to physical healthcare in acute care settings for patients with severe mental illness who were refusing treatment—a group that has been subject to excess morbidity and mortality.
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Priest, R. G. "Hospital Beds for Psychiatric Patients." Psychiatric Bulletin 10, no. 11 (November 1, 1986): 322–23. http://dx.doi.org/10.1192/pb.10.11.322.
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McGovern, D. "Hospital beds for psychiatric patients." Bulletin of the Royal College of Psychiatrists 11, no. 4 (April 1987): 131. http://dx.doi.org/10.1192/pb.11.4.131-a.
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Priest, R. G. "Hospital beds for psychiatric patients." Bulletin of the Royal College of Psychiatrists 11, no. 4 (April 1987): 131–32. http://dx.doi.org/10.1192/pb.11.4.131-b.
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Priest, R. G. "Hospital Beds for Psychiatric Patients." Bulletin of the Royal College of Psychiatrists 10, no. 11 (November 1986): 322–23. http://dx.doi.org/10.1192/s0140078900023518.
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Members write to the College asking for guidance on planning services for psychiatric patients, and in particular on the desirable level of provision of hospital beds. At the request of the Executive and Finance Committee I am publishing the following information, based on a letter that I wrote to Regional Advisers.
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Sinclair, Julia, and David Baldwin. "Discharging psychiatric patients from hospital." Psychiatric Bulletin 26, no. 11 (November 2002): 436. http://dx.doi.org/10.1192/pb.26.11.436.
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Walker, Shona A., and John M. Eagles. "Discharging psychiatric patients from hospital." Psychiatric Bulletin 26, no. 7 (July 2002): 241–42. http://dx.doi.org/10.1192/pb.26.7.241.
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Gelber, Harry. "The experience of the Royal Children's Hospital mental health service videoconferencing project." Journal of Telemedicine and Telecare 4, no. 1_suppl (March 1998): 71–73. http://dx.doi.org/10.1258/1357633981931542.
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In April 1995 the Royal Children's Hospital Mental Health Service in Melbourne piloted the use of videoconferencing in providing access for rural service providers and their clients to specialist child and adolescent psychiatric input. What began as a pilot project has in two years become integrated into the service-delivery system for rural Victoria. The experience of the service in piloting and integrating the use of videoconferencing to rural Victoria has been an important development for child and adolescent mental health services in Australia.
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Sebastian, Linda. "Psychiatric Hospital Admissions: Assessing Patients' Perceptions." Journal of Psychosocial Nursing and Mental Health Services 25, no. 6 (June 1987): 25–28. http://dx.doi.org/10.3928/0279-3695-19870601-07.
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Colson, Donald B., Jon G. Allen, Lolafaye Coyne, David Deering, Nancy Jehl, William Kearns, and Herbert Spohn. "Profiles of Difficult Psychiatric Hospital Patients." Psychiatric Services 37, no. 7 (July 1986): 720–24. http://dx.doi.org/10.1176/ps.37.7.720.
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Roy, Alec, and Ronald Draper. "Suicide among psychiatric hospital in-patients." Psychological Medicine 25, no. 1 (January 1995): 199–202. http://dx.doi.org/10.1017/s0033291700028233.
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SynopsisWe examined for risk factors for suicide among psychiatric in-patients by comparing 37 in-patients from an Ontario Provincial Psychiatric Hospital who had committed suicide with 37 age and sex matched in-patient controls. Significantly more of the suicide victims had made a previous suicide attempt (62·2 v. 35·1%), suffered from schizophrenia (75·7 v. 35·1%), were involuntary at their last admission (70·3 v. 43·2%) and lived alone (70·3 v. 43·2%). Only six patients committed suicide on the ward. Almost a third of the patients, the majority schizophrenic, committed suicide after having been in the hospital for more than a year. These results suggest that in the psychiatric hospital setting the in-patient at risk for suicide has previously exhibited suicidal behaviour, suffers from schizophrenia, was admitted involuntarily, lives alone and that the risk of suicide may remain high among long-stay schizophrenics.
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Kigli, R., D. Amital, A. Barzilay, T. Katz, Z. Marzayev, and M. Kotler. "Absconding by patients from psychiatric hospital." European Psychiatry 23 (April 2008): S85. http://dx.doi.org/10.1016/j.eurpsy.2008.01.682.
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Farnham, Frank R., and David V. James. "Patients' attitudes to psychiatric hospital admission." Lancet 355, no. 9204 (February 2000): 594. http://dx.doi.org/10.1016/s0140-6736(00)00077-5.
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Powell, John, John Geddes, Jonathan Deeks, Michael Goldacre, and Keith Hawton. "Suicide in psychiatric hospital in-patients." British Journal of Psychiatry 176, no. 3 (March 2000): 266–72. http://dx.doi.org/10.1192/bjp.176.3.266.
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BackgroundPsychiatric hospital inpatients are known to be at high risk of suicide, yet there is little reliable knowledge of risk factors or their predictive power.AimsTo identify risk factors for suicide in psychiatric hospital in-patients and to evaluate their predictive power in detecting people at risk of suicide.MethodUsing a case–control design, 112 people who committed suicide while in-patients in psychiatric hospitals were compared with 112 randomly selected controls. Univariate analysis and multivariate analyses were used to estimate odds ratios and adjusted likelihood ratios.ResultsThe rate of suicide in psychiatric in-patients was 13.7 (95% CI 11.7–16.1) per 10 000 admissions. There were five predictive factors with likelihood ratios >2, following adjustment: planned suicide attempt, 4.1; actual suicide attempt, 4.9; recent bereavement, 4.0; presence of delusions, 2.3; chronic mental illness, 2.2; and family history of suicide, 4.6. On this basis, only two of the patients who committed suicide had a predicted risk of suicide above 5%.ConclusionsAlthough several factors were identified that were strongly associated with suicide, their clinical utility is limited by low sensitivity and specificity, combined with the rarity of suicide, even in this high-risk group.
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Allers, Eugene, U. A. Botha, O. A. Betancourt, B. Chiliza, Helen Clark, J. Dill, Robin Emsley, et al. "The 15th Biannual National Congress of the South African Society of Psychiatrists, 10-14 August 2008, Fancourt, George, W Cape." South African Journal of Psychiatry 14, no. 3 (August 1, 2008): 18. http://dx.doi.org/10.4102/sajpsychiatry.v14i3.165.
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<p><strong>1. How can we maintain a sustainable private practice in the current political and economic climate?</strong></p><p>Eugene Allers</p><p><strong>2. SASOP Clinical guidelines, protocols and algorithms: Development of treatment guidelines for bipolar mood disorder and major depression</strong></p><p> Eugene Allers, Margaret Nair, Gerhard Grobler</p><p><strong>3. The revolving door phenomenon in psychiatry: Comparing low-frequency and high-frequency users of psychiatric inpatient services in a developing country</strong></p><p>U A Botha, P Oosthuien, L Koen, J A Joska, J Parker, N Horn</p><p><strong>4. Neurophysiology of emotion and senses - The interface between psyche and soma</strong></p><p>Eugene Allers</p><p><strong>5. Suicide prevention: From and beyond the psychiatrist's hands</strong></p><p>O Alonso Betanourt, M Morales Herrera</p><p><strong>6. Treatment of first-episod psychosis: Efficacy and toleabilty of a long-acting typical antipsychotic </strong></p><p>B Chiliza, R Schoeman, R Emsey, P Oosthuizen, L KOen, D Niehaus, S Hawkridge</p><p><strong>7. Treatment of attention deficit hyperactivity disorder in the young child</strong></p><p>Helen Clark</p><p><strong>8. Holistic/ Alternative treatment in psychiatry: The value of indigenous knowledge systems in cllaboration with moral, ethical and religious approaches in the military services</strong></p><p>J Dill</p><p><strong>9. Treating Schizophrenia: Have we got it wrong?</strong></p><p>Robin Emsley</p><p><strong>10.Terminal questions in the elderly</strong></p><p>Mike Ewart Smith</p><p><strong>11. Mental Health Policy development and implementation in Ghana, South Africa, Uganda and Zambia</strong></p><p>Alan J Flisher, Crick Lund, Michelle Frank, Arvin Bhana, Victor Doku, Natalie Drew, Fred N Kigozi, Martin Knapp, Mayeh Omar, Inge Petersen, Andrew Green andthe MHaPP Research Programme Consortium</p><p><strong>12. What indicators should be used to monitor progress in scaling uo services for people with mental disorders?</strong></p><p>Lancet Global Mental Health Group (Alan J Flisher, Dan Chisholm, Crick Lund, Vikram Patel, Shokhar Saxena, Graham Thornicroft, Mark Tomlinson)</p><p><strong>13. Does unipolar mania merit research in South Africa? A look at the literature</strong></p><p>Christoffel Grobler</p><p><strong>14. Revisiting the Cartesian duality of mind and body</strong></p><p>Oye Gureje</p><p><strong>15. Child and adolescent psychopharmacology: Current trends and complexities</strong></p><p>S M Hawkridge</p><p><strong>16. Integrating mental illness, suicide and religion</strong></p><p>Volker Hitzeroth</p><p><strong>17. Cost of acute inpatient mental health care in a 72-hour assessment uniy</strong></p><p>A B R Janse van Rensburg, W Jassat</p><p><strong>18. Management of Schizophrenia according to South African standard treatment guidelines</strong></p><p>A B R Janse van Rensburg</p><p><strong>19. Structural brain imaging in the clinical management of psychiatric illness</strong></p><p>F Y Jeenah</p><p><strong>20. ADHD: Change in symptoms from child to adulthood</strong></p><p>S A Jeeva, A Turgay</p><p><strong>21. HIV-Positive psychiatric patients in antiretrovirals</strong></p><p>G Jonsson, F Y Jeenah, M Y H Moosa</p><p><strong>22. A one year review of patients admitted to tertiary HIV/Neuropsychiatry beds in the Western Cape</strong></p><p>John Joska, Paul Carey, Ian Lewis, Paul Magni, Don Wilson, Dan J Stein</p><p><strong>23. Star'd - Critical review and treatment implications</strong></p><p>Andre Joubert</p><p><strong>24. Options for treatment-resistent depression: Lessons from Star'd; an interactive session</strong></p><p>Andre Joubert</p><p><strong>25. My brain made me do it: How Neuroscience may change the insanity defence</strong></p><p>Sean Kaliski</p><p><strong>26. Child andadolescent mental health services in four African countries</strong></p><p>Sharon Kleintjies, Alan Flisher, Victoruia Campbell-Hall, Arvin Bhana, Phillippa Bird, Victor Doku, Natalie, Drew, Michelle Funk, Andrew Green, Fred Kigozi, Crick Lund, Angela Ofori-Atta, Mayeh Omar, Inge Petersen, Mental Health and Poverty Research Programme Consortium</p><p><strong>27. Individualistic theories of risk behaviour</strong></p><p>Liezl Kramer, Volker Hitzeroth</p><p><strong>28. Development and implementation of mental health poliy and law in South Africa: What is the impact of stigma?</strong></p><p>Ritsuko Kakuma, Sharon Kleintjes, Crick Lund, Alan J Flisher, Paula Goering, MHaPP Research Programme Consortium</p><p><strong>29. Factors contributing to community reintegration of long-term mental health crae users of Weskoppies Hospital</strong></p><p>Carri Lewis, Christa Kruger</p><p><strong>30. Mental health and poverty: A systematic review of the research in low- and middle-income countries</strong></p><p>Crick Lund, Allison Breen, Allan J Flisher, Ritsuko Kakuma, Leslie Swartz, John Joska, Joanne Corrigall, Vikram Patel, MHaPP Research Programe Consortium</p><p><strong>31. The cost of scaling up mental health care in low- and middle-income countries</strong></p><p>Crick Lund, Dan Chishlom, Shekhar Saxena</p><p><strong>32. 'Tikking'Clock: The impact of a methamphetamine epidemic at a psychiatric hospital in the Western Cape</strong></p><p>P Milligan, J S Parker</p><p><strong>33. Durban youth healh-sk behaviour: Prevalence f Violence-related behaviour</strong></p><p>D L Mkize</p><p><strong>34. Profile of morality of patients amitted Weskoppies Psychiatric Hospital in Sout frican over a 5-Year period (2001-2005)</strong></p><p>N M Moola, N Khamker, J L Roos, P Rheeder</p><p><strong>35. One flew over Psychiatry nest</strong></p><p>Leverne Mountany</p><p><strong>36. The ethical relationship betwe psychiatrists and the pharmaceutical indutry</strong></p><p>Margaret G Nair</p><p><strong>37. Developing the frameor of a postgraduate da programme in mental health</strong></p><p>R J Nichol, B de Klerk, M M Nel, G van Zyl, J Hay</p><p><strong>38. An unfolding story: The experience with HIV-ve patients at a Psychiatric Hospital</strong></p><p>J S Parker, P Milligan</p><p><strong>39. Task shifting: A practical strategy for scalingup mental health care in developing countries</strong></p><p>Vikram Patel</p><p><strong>40. Ethics: Informed consent and competency in the elderly</strong></p><p>Willie Pienaar</p><p><strong>41. Confronting ommonmoral dilemmas. Celebrating uncertainty, while in search patient good</strong></p><p>Willie Pienaar</p><p><strong>42. Moral dilemmas in the treatment and repatriation of patients with psychtorders while visiting our country</strong></p><p>Duncan Ian Rodseth</p><p><strong>43. Geriatrics workshop (Psegal symposium): Medico-legal issuess in geriatric psyhiatry</strong></p><p>Felix Potocnik</p><p><strong>44. Brain stimulation techniques - update on recent research</strong></p><p>P J Pretorius</p><p><strong>45. Holistic/Alternative treatments in psychiatry</strong></p><p>T Rangaka, J Dill</p><p><strong>46. Cognitive behaviour therapy and other brief interventions for management of substances</strong></p><p>Solomon Rataemane</p><p><strong>47. A Transtheoretical view of change</strong></p><p>Nathan P Rogerson</p><p><strong>48. Profile of security breaches in longerm mental health care users at Weskoppies Hospital over a 6-month period</strong></p><p>Deleyn Rema, Lindiwe Mthethwa, Christa Kruger</p><p><strong>49. Management of psychogenic and chronic pain - A novel approach</strong></p><p>M S Salduker</p><p><strong>50. Childhood ADHD and bipolar mood disorders: Differences and similarities</strong></p><p>L Scribante</p><p><strong>51. The choice of antipsychotic in HIV-infected patients and psychopharmacocal responses to antipsychotic medication</strong></p><p>Dinesh Singh, Karl Goodkin</p><p><strong>52. Pearls in clinical neuroscience: A teaching column in CNS Spectrums</strong></p><p><strong></strong>Dan J Stein</p><p><strong>53. Urinary Cortisol secretion and traumatics in a cohort of SA Metro policemen A longitudinal study</strong></p><p>Ugash Subramaney</p><p><strong>54. Canabis use in Psychiatric inpatients</strong></p><p><strong></strong>M Talatala, G M Nair, D L Mkize</p><p><strong>55. Pathways to care and treatmt in first and multi-episodepsychosis: Findings fm a developing country</strong></p><p>H S Teh, P P Oosthuizen</p><p><strong>56. Mental disorders in HIV-infected indivat various HIV Treatment sites in South Africa</strong></p><p>Rita Thom</p><p><strong>57. Attendanc ile of long-term mental health care users at ocupational therapy group sessions at Weskoppies Hospital</strong></p><p>Ronel van der Westhuizen, Christa Kruger</p><p><strong>58. Epidemiological patterns of extra-medical drug use in South Africa: Results from the South African stress and health study</strong></p><p>Margaretha S van Heerden, Anna Grimsrud, David Williams, Dan Stein</p><p><strong>59. Persocentred diagnosis: Where d ps and mental disorders fit in the International classificaton of diseases (ICD)?</strong></p><p>Werdie van Staden</p><p><strong>60. What every psychiatrist needs to know about scans</strong></p><p>Herman van Vuuren</p><p><strong>61. Psychiatric morbidity in health care workers withle drug-resistant erulosis (MDR-TB) A case series</strong></p><p>Urvashi Vasant, Dinesh Singh</p><p><strong>62. Association between uetrine artery pulsatility index and antenatal maternal psychological stress</strong></p><p>Bavanisha Vythilingum, Lut Geerts, Annerine Roos, Sheila Faure, Dan J Stein</p><p><strong>63. Approaching the dual diagnosis dilemma</strong></p><p>Lize Weich</p><p><strong>64. Women's mental health: Onset of mood disturbance in midlife - Fact or fiction</strong></p><p>Denise White</p><p><strong>65. Failing or faking: Isses in the fiagnosis and treatment of adult ADHD</strong></p><p>Dora Wynchank</p>
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Holmes, Jeremy. "Acute wards: problems and solutions." Psychiatric Bulletin 26, no. 10 (October 2002): 383–85. http://dx.doi.org/10.1192/pb.26.10.383.
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There has been a curious linguistic shift in the use of the word community in mental health (Holmes, 2001a). In the 1950s and early 1960s community psychiatry was synonymous with milieu therapy and the therapeutic community – that is, the attempt to create a vibrant community of patients and staff, in a shared space, working actively together to overcome disability, illness and stigma. The contrast was with insitutional psychiatry, caricatured as the silent, soulless and, at times, abusive wards of the Victorian mental hospital. The therapeutic community had two main psychotherapeutic tools: group therapy and creative therapies such as art therapy and psychodrama. These approaches were pioneered in specialist units such as the Henderson hospital (Norton & Haigh, 2002) but, more generally, progressive acute units emphasised the use of ward groups and the importance of patients playing an active part in decision-making.
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Upton, Mark W. M., G. Harm Boer, and Alastair J. Neale. "Patients or clients? – a hospital survey." Psychiatric Bulletin 18, no. 3 (March 1994): 142–43. http://dx.doi.org/10.1192/pb.18.3.142.
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The use of the term client, rather than patient, has become frequent in psychiatric hospitals. There is little evidence to justify this change, so this study surveyed the views of the in-patients in a community based psychiatric hospital to establish the term they prefer. It concludes that a dear majority of people admitted to a psychiatric hospital think of themselves as patients, not clients.
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Ong, Kevin, Andrew Carroll, Shannon Reid, and Adam Deacon. "Community Outcomes of Mentally Disordered Homicide Offenders in Victoria." Australian & New Zealand Journal of Psychiatry 43, no. 8 (January 1, 2009): 775–80. http://dx.doi.org/10.1080/00048670903001976.
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Objective: The aim of the present study was to describe characteristics and post-release outcomes of Victorian homicide offenders under the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 (and/or its forerunner legislation) released from forensic inpatient psychiatric care since the development of specialist forensic services. Method: A legal database identified subjects meeting inclusion criteria: hospitalized in forensic psychiatric care due to finding of mental impairment or unfitness to stand trial for homicide in Victoria; released into the community; and released between 1 January 1991 and 30 April 2002. Using clinical records, demographics, index offence, progress in hospital, diagnosis, psychosocial and criminological data were obtained. Outcomes (offending or readmission into secure care) were obtained from the clinical records. Results: Of the 25 subjects, 19 (76%) were male. Primary diagnoses on admission to forensic hospital care were schizophrenia, n = 16 (64%); other psychotic disorder, n = 5 (20%); depression, n = 3 (12%); and personality disorder, n = 1 (4%). Mean time in custodial supervision was 11 years and 2 months, less for those whose offence occurred after the development of forensic rehabilitation services. In the first 3 years after release, there was a single episode of criminal recidivism, representing a recidivism rate of 1 in 25 (4%) over 3 years. Twelve subjects (48%) were readmitted at some point in the 3 year follow up. Conclusion: There was a very low rate of recidivism after discharge, but readmissions to hospital were common. Lengths of custodial care were reduced after the introduction of forensic rehabilitation facilities. Recidivism is low when there are well-designed and implemented forensic community treatment programmes, consistent with other data suggesting a reciprocal relationship between safe community care and a low threshold for readmission to hospital, lessening re-offending at times of crisis. Further research should be directed at timing of release decisions, based on reducing identified risk factors to acceptable levels.
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Garrido-Cumbrera, M., H. Marzo-Ortega, J. Correa-Fernández, L. Christen, and V. Navarro-Compán. "AB1401 IMPACT OF THE COVID-19 PANDEMIC ON HEALTHCARE UTILIZATIONS OF RMD PATIENTS IN EUROPE. RESULTS FROM THE REUMAVID STUDY (PHASE 1 AND 2)." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1806. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2701.
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BackgroundThe beginning of the COVID-19 pandemic led to a collapse of healthcare systems that was difficult to manage.ObjectivesThe aim of this study was to assess the impact of the COVID-19 pandemic on RMD patients’ healthcare utilization.MethodsREUMAVID is an international cross-sectional study collecting data through an online survey on RMD in seven European countries led by the Health & Territory Research group of the University of Seville, together with a multidisciplinary team including patient representatives, rheumatologists, and health researchers. Data were collected in two phases, the first (P1) between April-July 2020 and the second (P2) between February-April 2021. Demographics, health behaviours, employment status, access to healthcare services, disease characteristics, WHO-5 Well-Being Index and Hospital Anxiety and Depression Scale (HADS) were collected in the survey. Healthcare utilization includes scheduled appointments and attendance at the rheumatologist, consultation of possible treatment effects if COVID-19 is contracted with the rheumatologist, primary health care and psychological care. Descriptive analysis and Mann-Whitney test was used to explore association with healthcare utilization in both phases of REUMAVID.ResultsThere were a total of 2,002 participants across both phases with comparable demographic characteristics [mean age 52.6 (P1) vs. 55.0 years (P2); 80.2% female (P1) vs 83.7% (P2); 69.6% married (P1) vs 68.3% (P2), 48.6% university educated (P1) vs 47.8% (P2)]. Most prevalent RMD was axial spondyloarthritis in P1 (37.2%), and rheumatoid arthritis in P2 (53.1%).Only 39.2% could have a scheduled appointment with their rheumatologist during P1, compared to 72.5% of patients in P2 (p<0.001). In this sense, only 41.6% of participants in the P1 attended such an appointment while in P2 this figure was 61.5% (p<0.001). The majority of patients (83%) had their scheduled face-to-face appointment changed to an online or telephone phone in the P2, although this proportion was lower in the P1 (54.4%). The most frequent reason for canceling the face-to-face appointment was the alternative of making it by phone or online (54.4% in P1 vs. 83.0% in P2, p<0.001).Although, in P1, 38.1% of participants could contact with their rheumatologist by phone or online, this proportion was 64.3% in P2 (p<0.001). In P1, 64.0% of patients were able to consult with their rheumatologist about the possible effects of treatment in case of contracting COVID-19 (vs. 41.2% in P2; p<0.001). With respect to general practitioners, 57.6% of patients in P1 declared to had accessed primary care or general practitioner (vs. 77.5% in P2; p<0.001). Furthermore, in P2, a higher proportion of participants (63.2%) were able to continue their psychological or psychiatric therapy either online or by phone (vs. 48.3% in P1; p<0.001; Figure 1)ConclusionDuring the first year of COVID-19 pandemic, RMD patients had easier access to the healthcare system, specifically to their rheumatologist. This access was improved through phone and online care. In addition, access to primary care as well as psychological care improved during the second year of pandemic.Figure 1.Bivariate analysis of healthcare utilization in P1 and P2 of REUMAVIDAcknowledgementsThis study was supported by Novartis Pharma AG. We would like to thank all patients that completed the survey as well as all of the patient organisations that participated in the REUMAVID study including: the Cyprus League for People with Rheumatism (CYLPER) from Cyprus, the Association Française de Lutte Anti-Rhumatismale (AFLAR) from France, the Hellenic League Against Rheumatism (ELEANA) from Greece, the Associazione Nazionale Persone con Malattie Reumatologiche e Rare (APMARR) from Italy, the Portuguese League Against Rheumatic Diseases (LPCDR), from Portugal, the Spanish Federation of Spondyloarthritis Associations (CEADE), the Spanish Patients’ Forum (FEP), UNiMiD, Spanish Rheumatology League (LIRE), Andalusian Rheumatology League (LIRA), Catalonia Rheumatology League and Galician Rheumatology League from Spain, and the National Axial Spondyloarthritis Society (NASS), National Rheumatoid Arthritis (NRAS) and Arthritis Action from the United Kingdom.Disclosure of InterestsMarco Garrido-Cumbrera Grant/research support from: has a research collaboration with and provides services to Novartis Pharma AG, Helena Marzo-Ortega Speakers bureau: AbbVie, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Takeda and UCB, Consultant of: AbbVie, Celgene, Janssen, Lilly, Novartis, Pfizer and UCB, Grant/research support from: Janssen and Novartis, José Correa-Fernández: None declared, Laura Christen Employee of: Novartis Pharma AG, Victoria Navarro-Compán Grant/research support from: AbbVie, BMS, Janssen, MSD, Novartis, Pfizer, Roche and UCB
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Waheed, Shafquat, Md Golam Rabbani, Abdullah Al Mamun, Jhunu Shamsun Nahar, Khaleda Begum, Mohammad Khairul Bashar, and Abul Fazal Mohammad Riaz Rony. "Psychiatric patients at general hospital emergency departments." Bangladesh Journal of Psychiatry 31, no. 1 (February 6, 2020): 7–14. http://dx.doi.org/10.3329/bjpsy.v31i1.45366.
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A cross-sectional descriptive type of study on 357 patients was carried out in the emergency departments of Dhaka Medical College Hospital (DMCH) and Shahid Sohrawardy Medical College (SSMCH), Dhaka in 2011 to find out the incidence and socio-demographic characteristics of psychiatric morbidities among the patients attended there. The patients were interviewed using GHQ-28 and SCID-I, All GHQ-28 screen positive and 25% of screen negative respondents (total 158) were assessed by SCID-I. Among them 42 (11.76% of all 357 cases) respondents were found with some form of psychiatric illness. Diagnosis of psychiatric illness was significantly higher in those scored 4 or more in GHQ-28. More psychiatric cases were found among 18-25 years age group (50%), male gender (54.76%), urban population (69.05%), Muslims (85.71%), being single (54.76%), patients with secondary level of education (45.24%), housewives (26.19%), members of nuclear families (78.57%), and members of lower-income group. Among these 42 psychiatric cases, 22 were assessed by a psychiatrist who was blind about GHQ-28 score and SCID-I diagnosis. Out of these psychiatrically ill 42 cases, Major Depressive Disorder was in 9 (2.52% of the total study population of 357), Conversion Disorder was in 8 (2.24%) and Anxiety Disorder was in 7 (1.96%) respondents. There were two cases of Bipolar I Disorder and a single case of extrapyramidal side effects (EPSEs) with schizophrenia. Psychiatric illnesses are important issues at the emergency departments which require special attention.
Bang J Psychiatry June 2017; 31(1): 7-14
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Sclafani, Michael J., Maryellen Phillips, and Barbara Caldwell. "Moving Psychiatric Patients to a New Hospital." Journal of Psychosocial Nursing and Mental Health Services 47, no. 2 (February 1, 2009): 26–31. http://dx.doi.org/10.3928/02793695-20090201-13.
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Birket-Smith, Morten, and Flemming J. Thusholt. "Suicides among patients in a psychiatric hospital." Nordic Journal of Psychiatry 47, no. 4 (January 1993): 299–304. http://dx.doi.org/10.3109/08039489309103341.
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