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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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Khan, Khuram H., and Helen Walker. "TWINNING PROJECT: SIR COWASJEE JEHANGIR INSTITUTE OF PSYCHIATRY/BEHAVIOURAL SCIENCES PAKISTAN & THE STATE HOSPITAL CARSTAIRS SCOTLAND." Journal of Pakistan Psychiatric Society 20, no. 01 (March 3, 2023): 40–41. http://dx.doi.org/10.63050/jpps.20.01.234.
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Sir Cowasjee Jehangir Institute of Psychiatry Jehangir Institute of Psychiatry is a hospital located in Latifabad suburb of the city of Hyderabad, in Sindh, Pakistan. It was established in 1852 during the British Raj and was named after Jehangir Cowasji Jehangir Readymoney. It is the largest psychiatric hospital in Pakistan. It is locally known as Giddu Bandar Mental Hospital. The State Hospital Scotland is a psychiatric hospital near the village of Carstairs Junction, in South Lanarkshire, Scotland. It provides care and treatment in conditions of high security for around 140 patients from Scotland and Northern Ireland. The hospital is managed by the State Hospitals Board for Scotland which is a public body accountable to the First Minister of Scotland through the Scottish Government Health and Social Care Directorates. It is a Special Health Board, part of the NHS Scotland and the only hospital of its kind within Scotland.
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Wik, Amanda, Vera Hollen, and William H. Fisher. "Forensic patients in state psychiatric hospitals: 1999–2016." CNS Spectrums 25, no. 2 (June 21, 2019): 196–206. http://dx.doi.org/10.1017/s1092852919001044.
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Introduction.In recent years mental health officials have reported a rise in the number of forensic patients present within their state psychiatric hospitals and the adverse impacts that these trends had on their hospitals. To date there have been no large-scale national studies conducted to determine if these trends are specific only to a few states or representative of a more global trend. The purpose of this study was to investigate these reported trends and their national prevalence.Methods.The forensic directors of each state behavioral health agency (including the District of Columbia) were sent an Excel spreadsheet that had two components: a questionnaire and data tables with information collected between 1996 and 2014 from the State Profiling System maintained by the National Association of State Mental Health Program Directors Research Institute. They were asked to verify and update these data and respond to the questionnaire.Results.Responses showed a 76% increase nationally in the number of forensic patients in state psychiatric hospitals between 1999 and 2014. The largest increase was for individuals who were court-committed after being found incompetent to stand trial and in need of inpatient restoration services.Discussion.The data reviewed here indicate that increases in forensic referrals to state psychiatric hospitals, while not uniform across all states, are nonetheless substantial.Conclusion.More research is needed to determine whether this multi-state trend is merely a coincidence of differing local factors occurring in many states, or a product of larger systemic factors affecting mental health agencies and the courts.
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Sethi, Faisil, John Parkes, Eric Baskind, Brodie Paterson, and Aileen O'Brien. "Restraint in mental health settings: is it time to declare a position?" British Journal of Psychiatry 212, no. 3 (February 5, 2018): 137–41. http://dx.doi.org/10.1192/bjp.2017.31.
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SummaryThe emergence of a drive to reduce restrictive interventions has been accompanied particularly in the UK by a debate focussing on restraint positions. Any restraint intervention delivered poorly can potentially lead to serious negative outcomes. More research is required to reliably state the risk attached to a particular position in a particular clinical circumstance.Declaration of interestF.S. is a consultant psychiatrist in Psychiatric Intensive Care at the Maudsley Hospital, London. He is on the Executive Committee of the National Association of Psychiatric Intensive Care and Low Secure Units, and was a member of the National Institute for Health and Care Excellence Guideline Development Group for the Short-Term Management of Aggression and Violence (2015). J.P. is a senior lecturer at the Faculty of Health and Life Sciences, Coventry University. E.B. is a consultant and expert witness in violence reduction and the use of physical interventions, independent expert to the High Secure Hospitals Violence Reduction Manual Steering Group and a member of the College of Policing Guideline Committee Steering Group and Mental Health Restraint Expert Reference Group. B.P. is the clinical director for Crisis and Aggression Limitation and Management (CALM) Training and formerly a senior lecturer for the Faculty of Health, University of Stirling. He is a nurse and psychotherapist and presently chairs the European Network for Training in the Management of Aggression. A.O'B. is a consultant psychiatrist, the Director of Educational Programmes for the National Association of Psychiatric Intensive Care and Low Secure Units, and the Dean for Students at St George's University of London.
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Heuser, Isabella J., and Florian Holsboer. "Research Activity at the Max Planck Institute for Psychiatry (Munich): Depression in Later Life." International Psychogeriatrics 3, no. 1 (March 1991): 75–78. http://dx.doi.org/10.1017/s1041610291000546.
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The Max Planck Institute for Psychiatry (MPIP; Director: Florian Holsboer, M.D., Ph.D.) is a clinical research institute which serves psychiatric inpatients and several outpatient clinics (e.g., lithium clinic, memory clinic, anxiety disorder clinic, neuroleptic clinic). Affiliated with the Krankenhaus München-Schwabing, the largest general hospital in Bavaria (approximately 1,400 beds), the MPIP provides neurological and psychiatric consultation services for this center. According to the scientific concept envisioned by the first director of the MPIP, Emil Kraepelin, the Clinical Institute runs numerous on-site, state-of-the-art laboratories for basic research (molecular biology, neuroendocrinology, neuropharmacology, electrophysiology, neuropsychology, brain imaging) in order to bridge the gap between preclinical and clinical scientific activities.
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Bibyk, Inessa G., Liubov O. Lytvynova, Lyudmila I. Artemchuk, Оlena M. Donik, Natalia Y. Slutu, and Kateryna V. Orlychenko. "ANALYSIS OF THE STATE OF PSYCHIATRIC CARE IN UKRAINE." Клінічна та профілактична медицина, no. 3 (May 8, 2024): 100–106. http://dx.doi.org/10.31612/2616-4868.3.2024.12.
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The aim of the study. To analyze the current state of psychiatric care in Ukraine against the background of its reform; to investigate the dynamics of individual indicators of mental health and the activity of institutions providing psychiatric care for the period 2008-2021. Material and methods. The materials of the study were official statistical data from the reports of the State Statistics Service of Ukraine, the Center for Medical Statistics of the Central Health Service of the Ministry of Health of Ukraine for 2008–2021, and the Institute of Health Indicators and Evaluation (IHME, USA) on the global burden of diseases. Bibliographic, epidemiological, medical-statistical, analytical methods were used in the research. The results. The relevance of studying the current state of the organization of psychiatric care in Ukraine is primarily determined by the growing need of the population in connection with the negative impact of the consequences of the war on mental health. It was established that the prevalence of mental disorders in Ukraine in the period from 2008 to 2017 decreased by 17.8% and amounted to 3944.8; primary morbidity decreased by 38.7% and amounted to 300.9 cases per 100,000 population in 2017. Mortality from mental disorders in the period 2008-2017 decreased by 2.7 times to 2.3 cases per 100,000 population. However, in 2021 it was already 2.4. According to the second stage of the health care reform, there is a reduction in inpatient psychiatric facilities and their bed fund (by 40-50% on average). Medical facilities that provide psychiatric care lack qualified specialists (53-73% of positions are filled). Conclusions. Deinstitutionalization, which is carried out in Ukraine, is consistent with the Concept of the state target program of mental health care in Ukraine for the period until 2030. When reducing beds in psychoneurological hospitals, it is necessary to create conditions for alternative treatment of mentally ill patients in order to maintain the availability of care. The dynamics of changes in mental health indicators and the activity of healthcare institutions have regional features that must be taken into account when calculating the need for various types of psychiatric care. Optimizing psychiatric care is hindered by a lack of psychiatrists and psychologists, but the involvement of family doctors in the provision of psychological care and the introduction of mobile interdisciplinary teams will help.
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Andreeva, A. V., and M. G. Chirtsova. "Names of the Kazan scientists in the history of medicine of the Arkhangelsk oblast." Kazan medical journal 96, no. 2 (April 15, 2015): 264–67. http://dx.doi.org/10.17750/kmj2015-264.
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Article focuses on the role of Kazan scientists in the development and foundation of a number of departments of Arkhangelsk State Medical Institute, founded in 1932. The teaching staff for the most northern institution for higher medical education in the country was recruited from all over the Soviet Union. Founders and first heads of departments were the representatives of major scientific schools and leading universities, including the Kazan University/Kazan Medical Institute. Highly qualified specialists, scientists and healthcare managers with extensive experience played an important role in the development of healthcare in the European North of Russia. One of the first scientists of Kazan, who arrived at Arkhangelsk State Medical Institute, was psychiatrist I.N. Zhilin, whose activities are immortalized in the history of the department and the psychiatric hospital. Next Kazan representative, A.I. Labbok - anatomist, surgeon, doctor of sciences, professor, founder and first head of the department of operative surgery and topographic anatomy of the Institute. Surgeon A.A. Vechtomov became a professor and head of the Department of General Surgery, the head of the clinic, where during the Great Patriotic War the wounded from the Karelian Front and the Northern Fleet were treated. The founder of the Department of Pediatrics at Arkhangelsk State Medical Institute - Professor Yu.V. Makarov, came to Arkhangelsk from Kazan and his wife, G.A. Khayn-Makarova, who contributed much to military pediatrics. They were succeeded by associate professor A.G. Suvorov, who raised a galaxy of eminent pediatricians. Research of the data on many of Kazan scientists are still ongoing at the museum complex of the Northern State Medical University.
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Steger, Florian. "Neuropathological Research at the “Deutsche Forschungsanstalt fuer Psychiatrie” (German Institute for Psychiatric Research) in Munich (Kaiser-Wilhelm-Institute). Scientific Utilization of Children’s Organs from the “Kinderfachabteilungen” (Children’s Special Departments) at Bavarian State Hospitals." Journal of the History of the Neurosciences 15, no. 3 (September 2006): 173–85. http://dx.doi.org/10.1080/096470490523371.
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Shah, Sheena, Arshad Hussain, Sabreena Qadri, Fazle Roub, Insha Rauf, and Praveen Kumar. "COVID-19 antibody seroprevalence in residential psychiatric inpatients." BJPsych Open 7, S1 (June 2021): S102. http://dx.doi.org/10.1192/bjo.2021.305.
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AimsWhile other mental health care outpatient facilities were moved to COVID-centers in March 2020 during the COVID-19 pandemic, the Institute of Mental Health and Neurosciences in Kashmir remained the only functional outpatient facility in the region. It is the only mental health care hospital in the country with a residential facility for psychiatric inpatients catering to the whole population of Jammu and Kashmir, India. The Mental Health Care Act 2017 that neccesitated “halfway homes” is yet to be implemented in the state leaving it's inpatients entirely under the institution's care. This study is to investigate the seroprevalence of antibodies to SARS-COVID-19 virus in the 34 residential inpatients in separate male (23 patients) and female (11 patients) wards. This was done as an audit to strategies and measures taken by the institute in protecting it's inpatients.Method3 to 5 ml of peripheral venous blood samples were collected and plasma extracted and analysed using the CE-IVD Roche Cobas Elecsys AntiSARS-CoV-2, Electrochemiluminescence Immunoassay (ECLIA) for the qualitative detection of total Immunoglobulins (IgG, IgM and IgA; Pan Ig) generated against SARS-CoV-2 (Roche Diagnostics, Indianapolis, IN, USA). The test was performed according to the manufacturer's instructions.ResultOut of the 34 inpatients, 2 male inpatients tested positive for antibodies against SARS-CoV-2 (seroprevalence of 5.88%). In comparison, based on a report conducted by the government's Department of Community Medicine and Biochemistry on the 28th of October 2020, out of 2,361 participants in the community, 959 tested positive (seroprevalence of 40.6%).One of the inpatients that tested positive was re-admitted after testing negative via RT-PCR. The second patient was admitted after being found homeless. He was tested negative on day 1 via RAT and on day 5 via RT-PCR. We believe both of them aquired the infection in the community.ConclusionThis audit shows that the strategies implemented by the institute were effective in the prevention of the spread of COVID-19. Practical implementations of what works and improvisations are the proven methods of decreasing the mortality and morbidity in vulnerable populations while continuously providing vital mental health services.
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L., Versi, and Umashankar M. "Psychiatric profile of patients with alcoholism." International Journal of Research in Medical Sciences 5, no. 6 (May 27, 2017): 2305. http://dx.doi.org/10.18203/2320-6012.ijrms20172056.
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Background: The overall personality is related to the treatment outcome. Hence for successful treatment and management of alcohol dependent cases, it is essential to understand their personality. Objective was to study the psychiatric profile of patients with alcoholism.Methods: Present cross sectional hospital based study was conducted for six months in department of psychiatry, Institute of mental health, Hyderabad, a tertiary care psychiatric facility. This 600 bedded hospital has a daily outpatient clinic and provides inpatient care. Alcohol dependence syndrome and uncomplicated withdrawal state patients only were included in the present study. Age less than 18 and more than 60 years, patients with mental retardation, patients with personality disorders were excluded.Results: Majority of subjects belongs upper low socioeconomic status 57.50% (n=23), 36 (90%) were Hindus, two (5%) were Muslims and two (5%) were Christians. 42.5% (n=17) were illiterate, 22.5% (n=9) were having primary school education. 12.5% (n=5) were single, 87.5% (n=35) were married. 77.5% (n=31) were unskilled, 17.5% (n=7) were semiskilled, and 5% (n=2) were skilled. Maximum were from rural areas (67.5%) and 32.5% were from urban areas. self-injurious behavior is female and males are same 25% (n=5). Majority of males in the high-risk level of severity of alcoholism has banging head against something, to the extent that caused a bruise to appear type of behavior.Conclusions: Majority alcoholics were from low social classes, were illiterate, were married, unskilled workers. Hence these group people should be paid proper attention to prevent the occurrence of alcoholism among them.
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Shahwan, Shazana, Edimansyah Abdin, Yunjue Zhang, Rajeswari Sambasivam, Restria Fauziana, Mithila Mahesh, Say How Ong, Siow Ann Chong, and Mythily Subramaniam. "Deliberate Self-Harm in Psychiatric Outpatients Aged 14-35 Years in Singapore." Annals of the Academy of Medicine, Singapore 47, no. 9 (September 15, 2018): 360–72. http://dx.doi.org/10.47102/annals-acadmedsg.v47n9p360.
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Introduction: The main aim of the study was to identify the prevalence of deliberate self-harm (DSH) in a sample of youth outpatients attending the state psychiatric hospital in Singapore and to identify the sociodemographic and psychological/clinical risk factors associated with DSH. The secondary aim of the study was to examine if different forms of DSH had distinguishing risk factors. Materials and Methods: A total of 400 outpatients at the Institute of Mental Health completed a self-report survey comprising sociodemographic questions, the Functional Assessment of Self-Mutilation, Childhood Trauma Questionnaire, Parental Bonding Instrument and the Patient Health Questionnaire Depression Scale. Logistic regression models were used to test the associations. Results: The overall prevalence of DSH in our clinical population was 58.8%. Cutting/carving (25.4%) and hitting (20.4%) were the most common forms of DSH in the past 12 months. DSH acts were performed primarily for emotion regulation purposes. The risk factors for DSH in general were younger age group, female gender, abuse history and higher depression scores. Gender and age group were the factors that were differentially associated with cutting and hitting one’s self. Conclusion: There was a high prevalence of DSH in the psychiatric outpatient population. The risk factors identified in this study are consistent with those of international studies which point to their stability across cultures. Key words: Abuse, Asian, Cutting, Depression, Prevalence, Risk factors, Youth
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Ukrainets, Roman V., and Julia S. Korneva. "On the life of the defender of the fatherland and pathologist of professor Dmitry Pavlovich Svistelin." Bulletin of the Russian Military Medical Academy 23, no. 1 (May 12, 2021): 243–46. http://dx.doi.org/10.17816/brmma63660.
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Svistelin Dmitry Pavlovich was born on November 27, 1923 in the town Seredina-Buda in the Ukrainian Soviet Socialist Republic. During the Great Patriotic War, he served in the 164th Tank Brigade of the 16th Tank Corps, which took part in the Battle of Kursk. In one of the battles, Dmitry Pavlovich was severely wounded, but after the Victory of the Soviet Union he found the strength and entered the medical faculty of the Lviv State Medical Institute and graduated form it in 1951. Subsequently, Dmitry Pavlovich came to Smolensk, where he became a postgraduate at the Department of Pathological Anatomy of the Smolensk State Medical Institute. From that moment he paid his debt to the Motherland already as a doctor being the head of the pathological department of the Smolensk Regional Psychiatric Hospital. Subsequently, Dmitry Pavlovich began to teach at the Department of Pathological Anatomy and became interested in scientific activities under the guidance of Professor Vladimir Gerasimovich Molotkov, who later guided him for both his candidates and doctoral dissertations. Having achieved a great success in the pathological anatomy and becoming a professor, Dmitry Pavlovich decided to return to practice again. In 1996, he shifted to the post of pathologist in the expert-organizational-advisory department of the Smolensk Regional Institute of Pathology, which even today bears his name due to his outstanding work both for pathological anatomy in general and for Smolensk medicine. For services to the Motherland both as a defender of the Fatherland and as a doctor, Dmitry Pavlovich Svistelin has such awards as the Order of the Patriotic War, 2nd degree, as well as the badge Excellence in Public Health. On June 16, 2006, at the age of 82, Professor Dmitry Pavlovich Svistelin passed away and was buried at the New Cemetery in Smolensk.
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Bilici, Mustafa, Mehmet Bekaroğlu, Çiçek Hocaoğlu, Serhat Gürpınar, Cengiz Soylu, and Nafiz Uluutku. "Incidence of Completed and Attempted Suicide in Trabzon, Turkey." Crisis 23, no. 1 (January 2002): 3–10. http://dx.doi.org/10.1027//0227-5910.23.1.3.
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Summary: Objective: Studies of completed and attempted suicide in Turkey are based on data of State Institute of Statistics (SIS) and emergency clinics of the large hospitals. This study seeks (1) to find, independent of the SIS and hospital data, the annual incidences of completed and attempted suicide in Trabzon, Turkey; (2) to examine the associated factors between the incidence of completed and attempted suicide. Method: The data are derived by using a method specially designed for this study. Data sources include emergency clinics in all hospitals, village clinics, the Forensic Medical Center of Trabzon, the Governorship of Trabzon, “mukhtars” (local village representatives) of neighborhoods, the Office of the Public Prosecutor of Trabzon, the Police Headquarters and Gendarmerie, and the local press organs. Results: The incidences of completed and attempted suicide per 100,000 inhabitants turned out to be 2.60 and 31.5, respectively, whereas the SIS reported the incidence of completed suicide to be 1.11 per 100,000 inhabitants in Trabzon in 1995. Conclusion: Our results demonstrate that SIS data are inadequate for suicide research in Turkey. Our findings show that the risk of completed and attempted suicide is high in young, unmarried, and unemployed persons, and that these groups must be carefully evaluated for suicide risk. The study highlights the need for culture-specific research on suicidal behavior in Turkey.
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Corpuz, Marilou, Ruchika Jain, Gregory Weston, Priya Nori, Priya Nori, Carmel Boland-Reardon, Evan Bernard, Esther Graham, and Theresa Madaline. "494. COVID-19 Outbreak: A Tale of Two Psych Units." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S313—S314. http://dx.doi.org/10.1093/ofid/ofaa439.687.
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Abstract Background COVID infections in inpatient psychiatry units present unique challenges during the pandemic, including behavioral characteristics of the patients, structural aspect of the unit, type of therapy for the patients. We present COVID outbreaks in psychiatry units in two hospitals in our medical center in Bronx, NY, and describe our mitigation strategies. Methods Hosp A: In the early period of the pandemic in NY, 2 patients in the inpatient psychiatry unit tested positive for SARS-CoV-2 PCR. The unit was temporarily closed to new admissions. Hosp B: On 4/1, one of the patients in a 22 bed Psych unit, admitted since 3/10/20, developed fever, cough and tested positive for COVID-19 PCR. Two of her close contacts tested positive for SARS-COV-2 PCR. Results Hospital A: In total, 5 of the 29 patients (17.2%) in the unit were SARS-CoV-2 positive, all of whom were asymptomatic. Hospital B: Testing of the remaining patients showed positive PCR in 10/14. PCR tests of healthcare workers (HCW) were positive in 13/46. Except for the index patient, all the patients were asymptomatic but 32/46 HCW reported symptoms. One negative patient subsequently turned positive. Infection control and prevention strategies instituted in both hospitals were the same with subtle differences due to dissimilar burden of infection and structure of the units. Table 1 shows the timing of the outbreak and the rapid institution of preventive measures in each of the hospitals. There was still difficulty with patients regarding adherence. Some of the patients refused to stay in isolation and would roam. Compliance with masking and hand hygiene was problematic. Communication was of paramount importance. Multiple meetings were held between the Psychiatry staff, Infection Control and Prevention team, executive leadership of the hospital. Environmental Services and Engineering were also involved. Communications with the NY State Department of Health occurred frequently. Conclusion Strategies for management of COVID-19 patients in inpatient psychiatric units depends on the density of infected patients in the hospital and in the community. The implementation of practice change may need to be rapidly adjusted depending on the situation and available resources. Contingency plans should be formulated early on. Disclosures Gregory Weston, MD MSCR, Allergan (Grant/Research Support)
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T., Heera Shenoy, Remash K., and Sheela Shenoy T. "Prevalence and determinants of postnatal depression in a tertiary care teaching institute in Kerala, India." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 8, no. 9 (August 26, 2019): 3757. http://dx.doi.org/10.18203/2320-1770.ijrcog20193811.
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Background: Pregnancy and childbirth produce a variety of physiological, psychological and social consequences. Attitudes toward pregnancy and childbirth vary from culture to culture. Prevalence estimates range from 13 to 19% in resource-rich settings and 11 to 42% in resource- limited settings PND has a significant impact on the mother, the family, her partner and mother-infant interaction. This research aims to aid the early diagnosis of postnatal depression and the socio-demographic, obstetric, family dynamics, neonatal characteristics and psychiatric determinants of depression using EPDS among postnatal women in a tertiary hospital in Kerala state, India.Methods: 119 women between 2 to 6 weeks of postpartum period were subjected to a pre-tested pre-structured standard questionnaire. Diagnosis of depression was made using the Edinburgh postnatal depression scale. Possible depression is values >13 or more are invariably associated with depression.Results: Young age at marriage (p-value 0.022), love marriage (p-value 0.040) and low social support inadequate relationship with the in-laws was significantly associated with PND (p-0.003). Low birth weight was a significant determinant of PND (p-value-0.018). Gender of the new-born, fear and preference towards any particular gender and order of female child in multiparous woman had no association in determining postnatal depression. Childcare stress (p-value-0.011), psychiatry history in family and personal history of depression and mothers with low self-esteem (p-value-0.001) had odds of developing postnatal depression in the study.Conclusions: Early screening of the women and counselling of women and their family will reduce the maternal morbidity and adverse child outcomes.
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Liubov, P., and D. Egorova. "Transcranial magnetic stimulation in late-aged people with depressive disorders." European Psychiatry 66, S1 (March 2023): S234. http://dx.doi.org/10.1192/j.eurpsy.2023.539.
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IntroductionOne of the most common mental disorders in the elderly is depression.Because of the high frequency of side effects of pharmacotherapy and the comorbid medical illnesses, there are not many ways to treat it.Non-drug therapies, such as repetitive transcranial magnetic stimulation (rTMS), could help overcome the limitations of standard drug therapy for this type of mental disorders.ObjectivesDevelopment of approaches to improving improve the provision of psychiatric care to elderly patients using rTMS.Methods30 patients over the age of 60 with anxiety-depressive spectrum disorders meeting criteria F30-39, F06.3, F06.4 (ICD-10) and a control group with similar criteria that were not treated with rTMS, were recruited from the psychiatric department at a university hospital (Moscow Scientific Research Institute of Psychiatry). Clinical, psychopathological, anamnestic, psychometric (Montgomery-Asberg scale (MADRS), Hamilton scale (HARS), Mini-mental state examination scale (MMSE) instrumental (electroencephalography) research methods were used. Patients of the experimental group underwent 15 sessions of low-frequency rTMS on the right dorsolateral prefrontal cortex (RDLPC). Conditions for the application of 1200 pulses were as follows: frequency - 1 Hz; intensity - 120% of the threshold of motor response (RMT) of the subject; pulse number - 1200; pulse sequence - 300; sequence duration - 300 seconds; sequence interval - 60 seconds; and stimulation time - 23 minutes. Subsequently, the patients were re-examined using the above-mentioned scales to assess their mental state in dynamics.ResultsAnalysis of the collected data shows an increase in the number of respondents and the frequency of achieving remission in the experimental group compared to the control group. No severe side effects of rTMS were observed.ConclusionsrTMS may be a safe method of adjuvant therapy in groups of elderly patients with anxiety-depressive spectrum disorders. Further studies will be needed to clarify the results.Disclosure of InterestNone Declared
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Pisani, Anthony, Kenneth Connor, Kimberly Van Orden, Neil Jordan, Sara Landes, Geoffrey Curran, Michael McDermott, et al. "Effectiveness of a targeted brief intervention for recent suicide attempt survivors: a randomised controlled trial protocol." BMJ Open 13, no. 3 (March 2023): e070105. http://dx.doi.org/10.1136/bmjopen-2022-070105.
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IntroductionEffective, brief, low-cost interventions for suicide attempt survivors are essential to saving lives and achieving the goals of the National Strategy for Suicide Prevention and Zero Suicide. This study aims to examine the effectiveness of the Attempted Suicide Short Intervention Program (ASSIP) in averting suicide reattempts in the United States healthcare system, its psychological mechanisms as predicted by the Interpersonal Theory of Suicide, and the potential implementation costs, barriers and facilitators for delivering it.Methods and analysisThis study is a hybrid type 1 effectiveness–implementation randomised controlled trial (RCT). ASSIP is delivered at three outpatient mental healthcare clinics in New York State. Participant referral sites include three local hospitals with inpatient and comprehensive psychiatric emergency services, and outpatient mental health clinics. Participants include 400 adults who have had a recent suicide attempt. All are randomised to ‘Zero Suicide-Usual Care plus ASSIP’ or ‘Zero Suicide-Usual Care’. Randomisation is stratified by sex and whether the index attempt is a first suicide attempt or not. Participants complete assessments at baseline, 6 weeks, and 3, 6, 12 and, 18 months. The primary outcome is the time from randomisation to the first suicide reattempt. Prior to the RCT, a 23-person open trial took place, in which 13 participants received ‘Zero Suicide-Usual Care plus ASSIP’ and 14 completed the first follow-up time point.Ethics and disseminationThis study is overseen by the University of Rochester, with single Institutional Review Board (#3353) reliance agreements from Nathan Kline Institute (#1561697) and SUNY Upstate Medical University (#1647538). It has an established Data and Safety Monitoring Board. Results will be published in peer-reviewed academic journals, presented at scientific conferences, and communicated to referral organisations. Clinics considering ASSIP may use a stakeholder report generated by this study, including incremental cost-effectiveness data from the provider point of view.Trial registration numberNCT03894462.
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Carthy, Elliott, and David Murphy. "An audit into the use of psychotropic medications in patients with autism spectrum disorder in a high security psychiatric hospital." BJPsych Open 7, S1 (June 2021): S68. http://dx.doi.org/10.1192/bjo.2021.222.
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AimsAutism Spectrum Disorder (ASD) is a common neurodevelopmental disorder associated with difficulties in social communication and language development, preoccupations, a need for routine, sensory sensitivities and emotional dysregulation. People with autism who have violently offended may be prescribed psychotropic medications to treat comorbidities, or off-license to manage aggressive or challenging behaviours. However, the evidence base for their use remains scarce.MethodThis was a retrospective audit at Broadmoor Hospital, a high security psychiatric hospital in the United Kingdom, into the safe and appropriate prescribing of psychotropic medicines in those with an ASD compared to guidance from the National Institute for Health and Care Excellence (CG142): “Autism spectrum disorder in adults: diagnosis and management”. This first cycle was undertaken during May and June 2020 and included all patients with a confirmed or equivocal diagnosis of ASD in the preceding five years.ResultA total of 22 participants were included in this study. Of these, 17 participants had a confirmed diagnosis of ASD and five participants had a suspected diagnosis of ASD, but without formal confirmation with neurocognitive testing. A total of 13 (76.5%) participants with confirmed ASD were prescribed antipsychotic medication, nine of whom had an established comorbid mental disorder with psychotic symptoms. Of the remaining four, three had a diagnosis of a personality disorder. Three participants in this study had a confirmed diagnosis of ASD without any additional comorbid mental health diagnoses. No patients were prescribed psychotropic medicines for the core symptoms of ASD. The specific documentation of off-license use of antipsychotic medicines in those without a diagnosis of a psychotic disorder was poor. This was not recorded in any such participant in the preceding 12 months.ConclusionThis audit highlighted that dual diagnoses of ASD alongside non-affective psychosis and personality disorder are over-represented in this high security setting. The NICE clinical guidelines CG142 guidelines state that “antipsychotic medications should only be used for behaviour that challenges if …. the risk to the person or others is very severe”. By definition, all patients admitted to high security are deemed to be a grave and imminent risk to the public. Psychotropic medicines may therefore be clinically indicated at a much earlier stage than in community patients, instigated alongside appropriate psychosocial interventions and treatment of comorbid conditions. It may be that catered guidelines need to be formulated to support the safe and appropriate prescribing of psychotropic medicine in forensic settings.
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Wang, Feng. "Intervention Strategies for Psychological Disorders Combined with Vocal Fold Closure Disorders: The Effects of Respiratory Transformation and Self-Vocalization Techniques." International Journal of Biology and Life Sciences 3, no. 3 (September 25, 2023): 37–43. http://dx.doi.org/10.54097/ijbls.v3i3.06.
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The intervention effects of psychological disorders combined with vocal fold closure disorders can be achieved through the transformation of respiratory patterns and the establishment of self-vocalization techniques. However, current research lacks sufficient consideration in sample preprocessing and integrated learning, leading to classifier misguidance, poor classification accuracy, and instability. Through the use of psychiatric scales, assessments, and diagnoses by professional physicians in psychiatric hospitals, it is frequently observed that patients with vocal fold closure disorders also exhibit tendencies or diagnoses of depression, anxiety disorders, and other mental disorders. This issue is often overlooked by voice doctors, voice trainers, and speech trainers, neglecting the coexistence of psychological disorders in individuals with vocal production disorders. Over the past six years, based on the collection and analysis of American Journal of Speech® voice biomarkers, as well as practical experience in voice training and voice rehabilitation systems, it has been discovered that the adoption of correct and effective self- vocalization techniques can effectively intervene in the psychological disorders of patients with voice production disorders. This intervention helps patients recover their psychological state related to voice production in a relatively short period of time, promotes the rehabilitation of their own psychological disorders, and maximizes the restoration of appropriate vocal fold movements. By simultaneously intervening in respiratory techniques and vocal correction for patients with psychological disorders, a synergistic effect is achieved, resulting in dual benefits from a single effort. Currently, renowned teams such as Harvard University and the University of Oxford are conducting research focusing solely on the respiratory transformation of psychological disorders, which has been published in top academic journals. Practices such as meditation and breathing exercises are also widespread in Silicon Valley, USA. However, through nearly a century of scientific research and practical application, the AJS® system has found that the intervention effects achieved through respiratory transformation, the establishment of self-vocalization techniques, and individual-specific vowel sound training exceed the impact of any psychological counseling or meditation training. Furthermore, it significantly accelerates the voice rehabilitation of patients with vocal fold closure disorders, far surpassing the effects of training solely focused on vocal correction. This research path and achievement differ from the research conducted by the Institute of Architectural Acoustics at Tsinghua University and a tertiary hospital in China, which is based on the Jindrak hypothesis proposed by Jindrak K.F. and Jindrak H. in 1988, studying the intervention of human vocalization and cranial resonance on brain nerves: "The vibration caused by vocalization can massage the brain, promote the exchange of metabolic products between brain tissue and cerebrospinal fluid, and affect arachnoid granules, accelerating the flow of cerebrospinal fluid from the subarachnoid space into the superior sagittal sinus and lateral ventricle, and then returning to the bloodstream. This accelerates the renewal of cerebrospinal fluid and enhances brain cleansing. With the rapid development and continuous evolution of artificial intelligence and big data, our team has collaborated with experts in voice feature analysis from the Massachusetts Institute of Technology and the University of Pennsylvania, as well as psychology experts from Harvard University, and jointly established a software platform based on frequency- related sound (vocal) neural conduction mechanisms, developed through integrated algorithms. Currently, we use two software programs, Apotheose®, for the collection and analysis of voice biomarkers, to assist in the voice rehabilitation and vocal correction of patients with vocal production disorders. Additionally, through software and data, we assist rehabilitation patients in establishing their own voice feature files.
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Forlenza, Orestes Vicente, Alberto Stoppe Júnior, Edson Shiguemi Hirata, and Rita Cecília Reis Ferreira. "Antidepressant efficacy of sertraline and imipramine for the treatment of major depression in elderly outpatients." Sao Paulo Medical Journal 118, no. 4 (July 6, 2000): 99–104. http://dx.doi.org/10.1590/s1516-31802000000400005.
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CONTEXT: Most double-blind studies of efficacy and tolerability of sertraline as compared to tricyclics in the treatment of late-life major depression have used amitriptyline as a standard, leading to the inevitable conclusion that the former drug is better tolerated than the latter, with both being equally efficacious. OBJECTIVE: To compare the antidepressant efficacy and tolerability of sertraline (50 mg/day) and imipramine (150 mg/day) in the first 6 weeks of the treatment of major depression in the elderly. DESIGN: A randomized double-blind parallel study with 6 weeks of follow-up. SETTING: The psychogeriatric clinic at the Institute of Psychiatry, Hospital das Clínicas, Faculty of Medicine of the University of São Paulo. PARTICIPANTS: 55 severe and moderately depressed non-demented outpatients aged 60 years or more. INTERVENTION: Patients were assigned to sertraline 50 mg/day or imipramine 150 mg/day. MAIN MEASUREMENTS: CAMDEX interview. Psychiatric diagnosis followed the guidelines for "Major Depressive Episode" according to DSM-IV criteria. Severity of symptoms was evaluated using the "CGI" and "MADRS" scales. Cognitive state was assessed using the Mini-Mental State Examination. Side effects were assessed using the "Safetee-Up" schedule. RESULTS: Both groups had a significant decrease in depressive symptoms according to the MADRS scores after 6 weeks of treatment (P = 0.01). No significant differences between groups were detected regarding treatment outcome (t = 0.4; P = 0.7). Although the dropout rate was greater in the imipramine group, the overall tolerability among patients who completed the 6-week trial was similar in both test groups. CONCLUSIONS: Both sertraline and imipramine exhibited good efficacy and an acceptable side-effect profile for elderly depressed patients after 6 weeks of antidepressant treatment.
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Ahmadzadeh Asl, Massoud, Ahmad Shojaee, Behnam Shariati, Maryam Rasoolian, and Vahid Rashedi. "A Comparative Study on the Burden of Disease of Schizophrenia, Bipolar Disorder Type I, and Autism Spectrum Disorder on the Family Caregivers in Iran." Journal of Rehabilitation 22, no. 3 (October 1, 2021): 320–41. http://dx.doi.org/10.32598/rj.22.3.3143.1.
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Objective: Patients with severe psychiatric diseases, due to the debilitating and chronic nature of these diseases, requires prolonged care by family and other rated people. In addition to the patient, these diseases affect the caregiver and create high psychological, social, and individual pressure to take care of themselves. This study aims to compare the burden of schizophrenia, Bipolar Disorder (BD) type 1, and Autism Spectrum Disorder (ASD) on the family caregivers in Iran. Materials & Methods: In this descriptive-analytical study, using the non-probability sampling method, 450 family caregivers of patients with schizophrenia, BD type 1, and ASD were selected based on the inclusion criteria. Data collection tools comprised a demographic checklist, short-form Zarit Burden Interview (ZBI-12), and the Depression, Anxiety, and Stress Scale (DASS). The questionnaires were distributed to the patients selected from the Psychiatric Institute of Tehran, Iran Psychiatric Hospital, and Ali Asghar Hospital. The collected data were analyzed using descriptive statistics, ANOVA for evaluating the relationship of demographic factors with the amount and severity of disease burden, and interclass correlation coefficient in SPSS v. 22. Results: The disease burden was higher on caregivers of ASD patients, followed by that of BD type 1 and schizophrenia patients. The highest and lowest hours of care were related to the ASD and schizophrenia groups, respectively. Women made up the majority of family caregivers. The educational level of family caregivers was higher in the BD type 1 group and was lower in the schizophrenia group. Most caregivers in the BD type 1 group were employed, while most of them in the schizophrenia group were housewives. The lowest and highest income levels were related to the family caregivers of ASD and schizophrenia groups, respectively. The highest and lowest hospitalization frequencies were seen in the BD type 1 and ASD groups, respectively. Conclusion: The burden of three diseases on the family caregivers is high. It is recommended that state-run consulting and screening centers be more active in this field. Because of the low-income level of some family caregivers, it is better to plan for more employment of family caregivers with the assistance of governmental and non-governmental organizations. It is better to hold strategic classes for the family caregivers to reduce their disease burden. Different methods to reduce the burden of diseases in caregivers, such as lowering care hours and using respite care and respite recess and dividing tasks between caregivers, using social or daycare services, can reduce their symptoms of depression and anxiety. Their depression and anxiety should be monitored, and pharmacological and non-pharmacological measures should be used for their treatment.
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Sayil, Isik, and Halise Devrimci-Ozguven. "Suicide and Suicide Attempts in Ankara in 1998: Results of the WHO/EURO Multicentre Study of Suicidal Behaviour." Crisis 23, no. 1 (January 2002): 11–16. http://dx.doi.org/10.1027//0227-5910.23.1.11.
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Summary: Background: The rates and associated basic demographic features of attempted and completed suicides in a catchment area in Turkey were investigated as part of the WHO/Euro Multicentre Study of Suicidal Behaviour. Method: All hospitals in the catchment area were screened in order to identify attempted suicides. Statistics for completed suicides were obtained from the State Institute of Statistics (SIS). Results: The rates of attempted and completed suicides per 100,000 inhabitants over 15 years of age were 31.9 for males and 85.6 for females, and 9.9 for males and 5.6 for females, respectively. The majority of attempted suicides were in the 15-24-year-old age group, as is the case in all other European countries. The majority of completed suicides were also in the 15-24-year-old age group, although in other European centers most completed suicides occur in the 40+ age group. The most frequent methods were overdose for attempted suicide and hanging for completed suicide. The rates of both attempted and completed suicides were lower than those of other participating centers in Europe. Conclusion: Male sex is a risk factor for completed suicide and female sex is a risk factor for attempted suicide, while an age of 15-24 years may be a risk factor for both groups.
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Sharma, Shiv Shankar, Somen Bhattacharjee, Archana Kashyap, Ashok Thakur, and Sanjay Dubey. "Medical complications of puerperium: a single center observational study." International Journal of Advances in Medicine 5, no. 3 (May 22, 2018): 525. http://dx.doi.org/10.18203/2349-3933.ijam20181662.
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Background: Puerperium is of 6 weeks after delivery, when body reverts back to its original non pregnant state. This period holds its own set of medical issues with frequent occurrence of gynaecological complaints like hematoma, bleeding, painful discharge and many medical issues like pyrexia, mastalgia, coagulation disorders and depression. The management of all these problems is further complicated by consideration of lactation which prohibits use of many drugs. There are many studies available in international communities that analysed women in puerperium but the data from Indian subpopulation where most deliveries are conducted in government funded institutes is lacking. The current study was an observational single center study carried out at gynaecology department along with medicine and surgery department of a tertiary care hospital associated with a medical teaching institute for defining the epidemiological parameters of the puerperal maladies.Methods: 150 randomly selected pregnant subjects with otherwise uncomplicated pregnancies, both booked at our institute or referred at the time of delivery between January to July 2016 were included in the study. Both normal vaginal or assisted deliveries were considered irrespective of booking status. Patient not willing for consent, and patients reporting beyond 2 weeks of delivery were excluded. All patients were observed while in hospital and weekly thereafter till 6th week and detailed gynaecological, medical and psychiatric evaluation was carried out by a multidisciplinary team. Detailed evaluation of cause was carried out in all cases of pyrexia, pain or other objective symptoms and analysis of depression was done. All data were collected and analysed by spss 22.0 at the end of 6 weeks.Results: Of the 150 patients studied, 40% had caesarean delivery while 60% had normal vaginal delivery with or without episiotomy. The most common complications noted during puerperium were wound discharge (10.67%), perineal pain (10%), fever (15%) and Mastalgia & Mastitis (13%). Depression was diagnosed in 6% of the studied cases. Cause of fever was mastitis/breast abscess in 30%, Urinary tract infection in 24%, Malaria in 7% and puerperal sepsis in 12% cases, in rest of the cases the cause of fever could not be found. The puerperal complication rate was more in LSCS 22.95% as compared with vaginal deliveries 14.6%.Conclusions: Puerperium remains an important aspect of pregnancy where the nature of complications differs totally from those seen during antenatal period. Our study suggests that most important complications in puerperium are purulent discharge, perineal pain and pyrexia. Depression is a frequent occurrence in post-partum period and its early identification can benefit both maternal and child health. Fever in puerperium is fairly common Perineal infection, Breast infection, Urinary tract infection and Malaria being common causes. A vigilant multidisciplinary approach is required to optimally manage all these complications.
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Gulak, Morton B. "Architectural Guidelines for State Psychiatric Hospitals." Psychiatric Services 42, no. 7 (July 1991): 705–7. http://dx.doi.org/10.1176/ps.42.7.705.
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Linhorst, Donald M., and Lisa Parker Scott. "Assaultive Behavior in State Psychiatric Hospitals." Journal of Interpersonal Violence 19, no. 8 (August 2004): 857–74. http://dx.doi.org/10.1177/0886260504266883.
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Hunter, Richard H. "Public policy and state psychiatric hospitals." New Directions for Mental Health Services 1999, no. 84 (1999): 25–34. http://dx.doi.org/10.1002/yd.23319998404.
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Dunn, John. "Psychiatric training." Psychiatric Bulletin 18, no. 10 (October 1994): 643–44. http://dx.doi.org/10.1192/pb.18.10.643.
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The arrangement of medical services in Brazil is more akin to that of the USA than the UK. Private practice predominates but with a safety net of state funded hospitals. The majority of doctors working in state hospitals have contracts for 20 hours per week and are very poorly paid and they often have two or three jobs to compensate. These usually include working in a private clinic for part of the week and perhaps doing a period of on-call at another hospital. Some state hospitals are unable to fill vacant posts and there are frequent television reports of casualty departments having to close due to a lack of medical staff.
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Opalic, Petar, and Natasa Femic. "Research of the quality of life of schizophrenic patients in Belgrade." Medical review 61, no. 11-12 (2008): 625–31. http://dx.doi.org/10.2298/mpns0812625o.
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First of all, it was pointed to the specificity of the quality of life of psychiatric patients, primarily to the fact that the very poor mental state significantly reduces the life satisfaction. Then, an overview of results of general research of quality of life among schizophrenic patients was presented, in relation to their conditions of treatment, cultural setting, influence of socio-demographic and other factors. The very research was conducted on the sample of 80 subjects treated under the diagnosis of schizophrenia at the Institute of Mental Health in Belgrade - treated as out-patients in the day-hospital. The controls were 80 healthy subjects employed with a Health-care center in Belgrade. The statistical significance calculations of differences were related to replies to the instrument's questions - the instrument being a combination of Lancashire and Manchester Questionnaire. The questions referred to 15 features, classified according to five dimensions of quality of life (physical and medical; psychological and psychopathological; economic; relational and social; and axiological and transcendental dimension), and we arrived at the following: In terms of statistical significance, schizophrenic patients, in comparison to healthy controls confirmed taking medicaments significantly more often, that is, confirmed feeling as being chronic patients, suffering due to their bad disposition, fear and having hallucinations. The schizophrenic subjects, also confirmed something very interesting - that they were satisfied with their housing conditions and income. On the other hand, healthy controls, statistically speaking, replied significantly more often that they were satisfied with their sexual relations and relations with their friends, as well as that they were significantly more satisfied with their cultural and social activities. The results of our research were also commented on in relation to the social and other factors, and were compared to the results of similar researches.
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Saik, Susan, Brian B. Sheitman, Scott Mann, Walter W. Stelle, and James W. Osberg. "Providing Medical Care in State Psychiatric Hospitals." North Carolina Medical Journal 68, no. 2 (March 2007): 95–98. http://dx.doi.org/10.18043/ncm.68.2.95.
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Pawel, Michael A. "Closure of State Psychiatric Hospitals for Children." Psychiatric Services 53, no. 1 (January 2002): 101. http://dx.doi.org/10.1176/appi.ps.53.1.101.
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Nierman, Peter, and John Lyons. "Closure of State Psychiatric Hospitals for Children." Psychiatric Services 53, no. 1 (January 2002): 101—a—102. http://dx.doi.org/10.1176/appi.ps.53.1.101-a.
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Platman, Stanley R. "New problems in changing state psychiatric hospitals." Psychiatric Quarterly 59, no. 2 (1988): 103–12. http://dx.doi.org/10.1007/bf01065099.
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Nurenberg, Jeffry R., Steven J. Schleifer, Cheryl Kennedy, Mary O. Walker, and David Mayerhoff. "Medical Student Education in State Psychiatric Hospitals: A Survey of US State Hospitals." Academic Psychiatry 40, no. 2 (November 17, 2015): 304–8. http://dx.doi.org/10.1007/s40596-015-0449-z.
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Serra, Paolo. "Martyrs of the psychiatric hospitals." Temida 16, no. 2 (2013): 5–16. http://dx.doi.org/10.2298/tem1302005s.
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This article is based on the history of an Italian psychiatric hospital (Arezzo) that closed in 1989 and was turned into a university. The illegal and inhumane treatment in asylum-type institutions is condemned. In particular the treatment of those patients who, according to the analysis, hospital directors referred to as ?social cases.? These individuals did not stay in hospital because of health problems but only due to the lack of social care by the state. AS a consequence they are condemned to be ?prisoners? without committing any crimes.
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Bartholomew, Tom, and David Kensler. "Illness Management and Recovery in State Psychiatric Hospitals." American Journal of Psychiatric Rehabilitation 13, no. 2 (May 21, 2010): 105–25. http://dx.doi.org/10.1080/15487761003756977.
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Lewis, Allen N., N. A.
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Barnes, Arnold. "Race, Schizophrenia, and Admission to State Psychiatric Hospitals." Administration and Policy in Mental Health 31, no. 3 (January 2003): 241–52. http://dx.doi.org/10.1023/b:apih.0000018832.73673.54.
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Zakhmi, Tanya, Tejasvi Singh Randhawa, Manju Mohanty, Sunil Kumar Gupta, and Sushant Kumar Sahoo. "30 A Study to Assess Functional and Psychological Outcome After 6 Months of Moderate and Severe Traumatic Brain Injury (TBI)." Journal of the International Neuropsychological Society 29, s1 (November 2023): 138–39. http://dx.doi.org/10.1017/s1355617723002345.
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Objective:Assessment of clinical, functional and psychological outcome after 6 months of moderate and severe TBIParticipants and Methods:Sixty consecutive participants aged 18 and above with moderate to severe TBI (GCS score of 3-12 at admission) attending the Outpatient Department of Neurosurgery Specialty, Post Graduate Institute of Medical Education and Research, Chandigarh, India were recruited. The exclusion criteria were any pre-existing major psychiatric disorders, intellectual disability, current or past history of substance abuse, degenerative and/or progressive condition, terminal illness and past history of TBI. Ethical clearance was obtained from Institute Ethics Committee. Written informed consent was obtained from all participants prior to inclusion in the study. Socio-demographic details (age, sex, marital status, family type, place of residence, education and occupation) and clinical details (mode of injury, injury severity, treatment, status on discharge, any previous co morbidities) were obtained from participant and hospital records. Functional outcome was assessed by Glasgow Outcome Scale and Barthel’s Index of Activities of Daily Living. Mini Mental State Examination (MMSE) was used to assess cognitive status. Hospital Anxiety and Depression Scale was used to assess symptoms of anxiety and depression.Results:Out of 60 patients, 40 had moderate head injury and 20 patients had suffered from severe head injury. There were 53 male (88.3%) and 7 (11.7%) female and the mean age was 34 years (SD=14.5). The mean duration of TBI was 11 months (SD=6.5). Fifty percent participants were married and majority was living in joint/extended families. Majorities were residing in rural localities 36 (60%). With regard to education level 11.7% were illiterate, 33% were educated up to 10th standard and 21.7% up to 12th standard. With regard to occupation, 11.7% were unemployed, 6.7% were housewives, 11.7% were students, 8.3% were retired and rest (61.6%) was engaged in varied occupations.The most common mode of injury was road traffic accident (90%). Contusion was the most common CT abnormality noted (37 patients, 61.7%). Regarding treatment, 36 patients (60%) underwent surgical intervention and 24 (40%) were managed conservatively. With regard to surgical intervention, 28 (77.8 %) patients underwent decompressive hemicraniectomy and subsequent cranioplasty and rest 8 (22.2 %) underwent craniotomy and hematoma evacuation. As per Glasgow Outcome Scale, 50 (83%) had low disability and 10 (17%) had moderate to severe disability. The mean Barthel’s Index score was 19.6+1.07 (Range 15-20) which indicated that most of the patients had resumed independence in activities of daily living. Only 25% participants were observed to have cognitive impairment (MMSE). With regard to anxiety and depression 16.7% showed symptoms of anxiety whereas 30% showed symptoms of depression (HADS score >8).Conclusions:After 6 months of TBI, most participants had resumed independence in activities of daily living but cognitive impairment is persistent in 25% and symptoms of depression in 30% participants.
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Mohanty, Manju, Tejasvi Singh Randhawa, Sunil Kumar Gupta, Sushant Kumar Sahoo, and Tanya Zakhmi. "6 A Study to Assess the Impact of Injury Severity on Disease Specific Quality of Life After Traumatic Brain Injury (TBI)." Journal of the International Neuropsychological Society 29, s1 (November 2023): 118–19. http://dx.doi.org/10.1017/s1355617723002102.
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Objective:To assess the impact of injury severity on disease specific quality of life after Traumatic Brain InjuryParticipants and Methods:The study was carried out in Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India after obtaining ethical clearance from Institute Ethics Committee. Sixty consecutive patients aged 18 and above with moderate to severe TBI (GCS score of 3-12 at admission) attending the Outpatient Department of Neurosurgery Specialty were screened. Out of 60 participants, 40 had moderate TBI (GCS 9-12) and 20 patients had severe TBI (GCS 3-8). The participants having any pre-existing major psychiatric disorders, intellectual disability, current or past history of substance abuse, degenerative and/or progressive condition, terminal illness and past history of TBI were excluded. Written informed consent was obtained from each participant. Socio-demographic details and information about clinical status at the time of admission and discharge were obtained from participant and hospital records. Disease specific quality of life was measured by QOLIBRI (Quality of life after brain injury). It is a self-reported measure comprising of 37 items. The first part assesses the subjects’ satisfaction with his HRQL in 4 domains (cognition, self, daily life and autonomy, and social relationships). The second part measures how much the subject is bothered after TBI in 2 domains (emotions and physical problems). The other tools administered were Glasgow Outcome Scale and Barthel’s Index of Activities of Daily Living (functional status); Mini Mental State Examination (cognitive status): Hospital Anxiety and Depression Scale (anxiety and depression).Results:The data was analyzed using statistical package for social sciences software version 21 (SPSS). There were no significant differences between both groups with regard to age, gender, education status, marital status, family type and place of residence. Both groups were similar with regard to mode of injury and duration of injury. With regard to treatment during admission both group had significant differences. Among severe TBI group 90% underwent surgical intervention whereas among moderate TBI group only 45% underwent surgical intervention. Significant difference was present in GCS score at discharge between both the groups. After 6 months of injury both group had no significant difference with regard to functional status, global cognitive functioning, anxiety and depression. With regard to quality of life significant difference emerged between the groups on QOLIBRI total score. On various subscales of QOLIBRI - significant differences were noted only in the domains of social relationship and emotions. There were no differences between them on domains of cognition, self, daily life and physical problems.Conclusions:After 6 months of TBI, the participants in both groups (Moderate TBI and severe TBI) had similar functioning with regard to daily activities and psychological functioning. With regard to quality of life both groups emerged to be significantly different on overall quality of life and domains of social relationship and emotions.
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Looi, Jeffrey CL, Tarun Bastiampillai, William Pring, Stephen R. Kisely, and Stephen Allison. "Private psychiatric hospital care in Australia: a descriptive analysis of casemix and outcomes." Australasian Psychiatry 30, no. 2 (November 27, 2021): 174–78. http://dx.doi.org/10.1177/10398562211051252.
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Objective: To provide a rapid clinical update on casemix, average length of stay, and the effectiveness of Australian private psychiatric hospitals. Methods: We conducted a descriptive analysis of the publicly available patient data from the Australian Private Hospitals Association Private Psychiatric Hospitals Data Reporting and Analysis Service website, from 2015–2016 to 2019–2020. This was compared with corresponding reporting on public and private hospitals from the Australian Institute of Health and Welfare, and Australian Mental Health Outcomes and Classification Network. Results: In 2019–2020, there were 72 private psychiatric hospitals in Australia with 3582 acute beds. There were 42,942 inpatients with 1,286,470 days of care, and a mean length of stay 19.6 days (SD 13.9) for the financial year 2019–2020. The main diagnoses were major affective and other mood disorders (49%), and alcohol and other substance abuse disorders (21%). Clinician-rated outcome measures, that is, the HoNOS, showed an improvement effect size of 1.64, while the patient-rated MHQ-14 showed an improvement effect size of 1.18. Results are similar for previous years. Conclusions: Private psychiatric hospitals provide substantial, effective psychiatric care.
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Swarbrick, Margaret. "A Wellness and Recovery Model for State Psychiatric Hospitals." Occupational Therapy in Mental Health 25, no. 3-4 (August 31, 2009): 343–51. http://dx.doi.org/10.1080/01642120903084117.
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Cournos, Francine, Maureen Empfield, Ewald Horwath, and Martin Kramer. "The Management of HIV Infection in State Psychiatric Hospitals." Psychiatric Services 40, no. 2 (February 1989): 153–57. http://dx.doi.org/10.1176/ps.40.2.153.
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Jones, K., M. Robinson, and M. Goughtlev. "Long-term Psychiatric Patients in the Community." British Journal of Psychiatry 149, no. 5 (November 1986): 537–40. http://dx.doi.org/10.1192/bjp.149.5.537.
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The reduction of mental hospital populations in Britain and the United States has generated a considerable amount of literature on policy, but detailed studies of the effects on patients and the conditions under which they live after discharge are rare. In the United States, a National Institute of Mental Health review of the literature commented that “the question of what actually happens to patients who leave mental hospitals and re-enter the community is largely unanswered” (Bachrach, 1976).
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Poslavskaya, I. A. "The modern state of specialized psychiatric service for the population of the Moscow region." Kazan medical journal 100, no. 2 (December 15, 2019): 310–16. http://dx.doi.org/10.17816/kmj2019-310.
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Aim. To perform the analysis of psychiatric service of the Moscow region and to determine the basic targerts to improve the availability of psychiatric service for the population of the Moscow region. Methods. The study included the methods of retrospective statistical observation based on the data from the official statistical forms of annual reports (forms №14, №30, №36) of psychiatric institutions of the Moscow region in 2013-2017. Results. The Moscow region is a territory of sustainable social economic development. In terms of fertility it takes the 1st place among the subjects of the Central Federal district, and 27th place in the Russian Federation. Specialized psychiatric care for the population of the Moscow region is provided in neuropsychiatric dispensaries, hospitals, day hospitals of psychiatric clinics, based on three principles: a differentiated approach to assist different patient cohorts, stepwise and continuity of care at different stages. Despite the restructuring of the psychiatric service and the widespread reduction of the number of beds in the Russian Federation, bed capacity of psychiatric hospitals in the Moscow Region remains at the same level, although there has been a negative dynamics in the work of the hospital bed from 354.3 days in 2013 to 329 in 2017. At the same time, the efficiency of day hospitals has increased: the length of stay of patients in the day hospital has decreased from 51 in 2013 to 39 days in 2017, the day bed turnover rate has increased from 5.5 to 5.9. In five years, the number of patients discharged from day hospitals has increased: 2 200 in 2013 and 2 521 in 2017. In the outpatient service there is a steady decrease in the number of dispensary patients (decreased from 71 413 to 69 364 in 5 years), and vice versa, the number of patients provided with counseling and treatment increased from 79 023 to 93 697. The number of diseases-related visits to a psychiatrist is decreasing. In 2013, 781 243 disease-caused and home visits occured, in 2017 - 496 540. Conclusion. The results of the conducted study indicate both positive tendencies and negative sides of psychiatric service for the population of the Moscow region, which should be taken into account when planning reorganization and optimization of functioning of psychiatric service in the modern conditions: increased number of day beds, establishing medical rehabilitation departments, reduction of inefficient hospital beds.
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Smith, Angela Black, James T. Zoller, Glen T. Schumock, and Ann L. Richards. "Pharmacy staffing, workload, and productivity benchmarks in state psychiatric hospitals." American Journal of Health-System Pharmacy 75, no. 8 (April 15, 2018): 536–47. http://dx.doi.org/10.2146/ajhp170178.
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Holohean, Edward J., Blair A. Maddy, and Steven M. Banks. "Patient Subgroups in State Psychiatric Hospitals and Implications for Administration." Psychiatric Services 44, no. 10 (October 1993): 1002–4. http://dx.doi.org/10.1176/ps.44.10.1002.
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Snyder, Jennifer A., Laura M. Clark, and Nicole Tuomi Jones. "Provision and adaptation of group treatment in state psychiatric hospitals." Professional Psychology: Research and Practice 43, no. 4 (August 2012): 395–402. http://dx.doi.org/10.1037/a0029377.
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McGurrin, Martin C., and Trevor R. Hadley. "Quality of Care and Accreditation Status of State Psychiatric Hospitals." Psychiatric Services 42, no. 10 (October 1991): 1060–61. http://dx.doi.org/10.1176/ps.42.10.1060.
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Josiassen, Richard C., Dawn M. Filmyer, Alexander G. Geboy, Danielle Martin, Jessica L. Curtis, and Rita A. Shaughnessy. "Impact of Hyponatremia on Resource Utilization in State Psychiatric Hospitals." Journal of Clinical Psychopharmacology 32, no. 4 (August 2012): 580–82. http://dx.doi.org/10.1097/jcp.0b013e31825e002a.
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Nicolo, G. "Treating Schizophrenia in Mediterranean Region; do we need Reform? State of Art in Italy after 30 Years of Psychiatric Reform." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70496-1.
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In Italy 30 years ago a very radical psychiatric reform has been carried out. All psychiatric hospitals have been closed by law. This reform received very strong political support but was not scientific or evidence based. After 30 years it is necessary to evaluate the Italian reform scientifically.Basaglia's law was oriented, first to create a net of community care, and then to close Psychiatric Hospitals. The challenge was to improve the quality of life of patients that had spent their life in an Asylum. The patients admitted to psychiatric hospitals, normally had a diagnosis of Chronic Psychosis, Chronic bipolar disorder, mental retardation, but not other more prevalent psychiatric, sometimes more prevalent, diseases. The hypothesis was that psychiatric illness would improve further if the medical interventions were less specialised, thus the psychiatric intervention have to be very generic and supportive, specialization or pharmacologic treatment was perceived as bad practice. Many psychiatric illnesses did not receive specific treatment (panic attacks, personality disorders e.g)After 30 years this model shows some evidence of efficacy. We must consider weather we can really can apply this model in community treatment or whether we need a scientific based reform in which we can apply algorithms of treatment, early detection of disease and integrated and specialist treatment for severe psychopathology. Data from national health service will be presented and also some specific proposals in a European perspective.