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Psychiatric resources

David W Morris, Subroto Ghose, Ella Williams, Kevin Brown, Fuad Khan
Introduction: Hospital emergency departments (EDs) around the country are being challenged by an ever-increasing volume of patients seeking psychiatric services. This manuscript describes a study performed to identify internal and external factors contributing to repeated psychiatric patient admissions to the hospital main ED. Methods: Data from ED visits of patients who were admitted to the Parkland Memorial Hospital ED (the community hospital for Dallas County, TX, USA) with a psychiatric complaint more than once within a 30-day period were evaluated (n=202)...
2018: Neuropsychiatric Disease and Treatment
Mostafa Heydari, Saideh Masafi, Mehdi Jafari, Seyed Hassan Saadat, Shima Shahyad
AIM: Considering the key role of human resources as the main operator of organisations, the present research aimed to determine the effectiveness of acceptance and commitment therapy for anxiety and depression of Razi Psychiatric Center staff. MATERIALS AND METHODS: This research follows a quasi-experimental type with pre-test, post-test plans, and control group. Accordingly, 30 people were selected through volunteered sampling among Razi Psychiatric Center staff...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Samiullah Samiullah, Michael Malone, Abdul Waheed
Functional gastrointestinal disorders (FGIDs) are among the most challenging conditions to diagnose and manage. FGIDs are a heterogeneous group of conditions with varying and sometimes vague symptomatology. The Rome IV classification is the most comprehensive resource on FGIDs. FGIDs are common and are associated with significant social and economic burdens. The patient perspective includes anxiety, emotional distress, and mistrust of health care. Psychological stressors and concomitant psychiatric illness are common but not always present...
March 2018: FP Essentials
Muktesh Daund, Sushma Sonavane, Amresh Shrivastava, Avinash Desousa, Sanjay Kumawat
Mental hospitals are an integral part of mental health services in India. It is an interesting story how mental hospitals have responded to the challenges of contemporary period they were built in. It is beyond doubt that it is a progressive journey along with advances in mental health both in India and internationally. As in other countries, mental hospitals in India have responded to the social challenges, disparities, and poor resources of workforce and fiscal investment. Historically, there have been changes and three major reforms are needed, namely attempt to facilitate discharge and placing patients back into the family, introducing teaching and research in mental hospitals, and accountability to civil rights as per the requirements of the National Human Rights Commission...
February 2018: Indian Journal of Psychiatry
Anna McKinnon, Robert Keers, Jonathan R I Coleman, Kathryn J Lester, Susanna Roberts, Kristian Arendt, Susan M Bögels, Peter Cooper, Cathy Creswell, Catharina A Hartman, Krister W Fjermestad, Tina In-Albon, Kristen Lavallee, Heidi J Lyneham, Patrick Smith, Richard Meiser-Stedman, Maaike H Nauta, Ronald M Rapee, Yasmin Rey, Silvia Schneider, Wendy K Silverman, Mikael Thastum, Kerstin Thirlwall, Gro Janne Wergeland, Thalia C Eley, Jennifer L Hudson
BACKGROUND: Several delivery formats of cognitive behaviour therapy (CBT) for child anxiety have been proposed, however, there is little consensus on the optimal delivery format. The primary goal of this study was to investigate the impact of the child's primary anxiety diagnosis on changes in clinical severity (of the primary problem) during individual CBT, group CBT and guided parent-led CBT. The secondary goal was to investigate the impact of the child's primary anxiety diagnosis on rates of remission for the three treatment formats...
March 9, 2018: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Paul Charles Cheshire, Stephen Gibbons, Jemma Mouland
BACKGROUND: The National Health Service (NHS) scores well internationally on access to healthcare. But access has been measured on methods likely to undersample the more disadvantaged. Social landlords have access to more disadvantaged groups and may be able to improve health outcomes for their tenants and reduce their NHS usage by simple interventions. METHODS: This is a randomised controlled trial of 547 London social housing 'general needs' tenants over 50 years of age...
March 8, 2018: Journal of Epidemiology and Community Health
Karine Moschetti, Véra Zabrodina, Tenzin Wangmo, Alberto Holly, Jean-Blaise Wasserfallen, Bernice S Elger, Bruno Gravier
BACKGROUND: Prison health systems are subject to increasing pressures given the specific health needs of a growing and aging prison population. Identifying the drivers of medical spending among incarcerated individuals is therefore key for health care governance in prisons. This study assesses the determinants of individual health care expenditures within the prisons of the canton of Vaud, a large region of Switzerland. METHODS: We use a unique dataset linking demographic and prison stay characteristics as well as objective measures of morbidity to detailed medical invoice data...
March 7, 2018: BMC Health Services Research
Shiraz Ahmed, Kate Zara Peters, Nandini Chakraborty
AIM: The present study aimed to determine the influence of demographic and clinical features on the likelihood of patients being discharge to primary vs secondary care. The overarching aim of this service evaluation is to assess factors affecting discharge and determine important modulators of discharge destination to inform care planning in services. METHOD: Clinical and demographic data were extracted from patient notes of those discharged from the Psychosis Intervention and Early Recovery (PIER) service in Leicestershire between January 2005 and December 2013...
March 7, 2018: Early Intervention in Psychiatry
Cristiane S Paula, Jair J Mari, Isabel Altenfelder Santos Bordin, Euripedes C Miguel, Isabela Fortes, Natalia Barroso, Luis Augusto Rohde, Evandro Silva Freire Coutinho
PURPOSE: The purpose of the study is to identify early vulnerabilities for psychiatric disorders among Brazilian elementary school children, controlling for familial and community adversities. METHODS: This is a cross-sectional study examining the association between child psychiatric disorders and potential early vulnerabilities (disability, low intellectual quotient, and negative dimensions of the temperament trait self-directedness (low resourcefulness, low purposefulness, low enlightened second nature), controlling for the potential confounders: familial and community adversities...
March 6, 2018: Social Psychiatry and Psychiatric Epidemiology
Stephen C Gale, JoAnn Peters, Jason S Murry, Jessica S Crystal, Viktor Y Dombrovskiy
Background: Late middle age (LMA), is a watershed between youth and old age, with unique physical and social changes and declines in vitality, but a desire to remain active despite increasing comorbidity. While post-injury outcomes in the elderly are well studied, little is known regarding LMA patients. We analyzed the injured LMA population admitted to a rural, regional Level 1 Trauma Center relative to outcomes for both younger and older patients. Materials and methods: Our registry was queried retrospectively for patients admitted 7/2008- 12/2015; they were divided into three cohorts: 18-54, 55-65, and >65 years...
March 2018: Annals of Medicine and Surgery
R Mezzina
AIM: Italy pioneered deinstitutionalisation over the past 60 years and enforced a famous mental health (MH) reform law in 1978. Deinstitutionalisation has been completed with the very closure of all psychiatric hospitals over two decades. METHODS: After 40 years of implementation, this article presents the main achievements and challenges of the Italian MH reform law, including its long-term effect and impact in Italy and abroad. RESULTS: The Legislation of 1978 was based on the discovery of rights as a key tool in mental healthcare...
March 6, 2018: Epidemiology and Psychiatric Sciences
Nicholas J Carson, Meredith Gansner, Jeane Khang
Digital media (also called "new media") have become an important ecosystem in which adolescents develop biologically, psychologically, and socially. When assessing adolescents in the psychiatric interview, a nuanced understanding of digital media use can inform a more accurate formulation. However, there are few published resources to help the psychiatrist assess the impact of digital media during the initial adolescent interview. The authors propose an innovation on the traditional psychiatric assessment that addresses teen Internet use and digital media habits...
April 2018: Child and Adolescent Psychiatric Clinics of North America
Mamta Sood, Rakesh Kumar Chadda, Roy Abraham Kallivayalil
The focus of primary prevention is on reducing the disease incidence. Primary prevention in mental health has been given minimal priority in low-resource settings with no significant investments. General hospitals are one of the main providers of mental health services in South Asia. This paper focuses on primary prevention activities, which can be undertaken in a general hospital in South Asia with abysmally low-mental health resources. For implementing primary prevention in psychiatry, a general hospital may be conceptualized as a population unit, located in a well-populated area with easy accessibility where different kinds of communities, for example, students and resident doctors, consultants, patients and their caregivers, and paramedical, nursing, administrative and other supportive staff, coexist and have varied functions...
October 2017: Indian Journal of Psychiatry
Andrea Cipriani, Toshi A Furukawa, Georgia Salanti, Anna Chaimani, Lauren Z Atkinson, Yusuke Ogawa, Stefan Leucht, Henricus G Ruhe, Erick H Turner, Julian P T Higgins, Matthias Egger, Nozomi Takeshima, Yu Hayasaka, Hissei Imai, Kiyomi Shinohara, Aran Tajika, John P A Ioannidis, John R Geddes
BACKGROUND: Major depressive disorder is one of the most common, burdensome, and costly psychiatric disorders worldwide in adults. Pharmacological and non-pharmacological treatments are available; however, because of inadequate resources, antidepressants are used more frequently than psychological interventions. Prescription of these agents should be informed by the best available evidence. Therefore, we aimed to update and expand our previous work to compare and rank antidepressants for the acute treatment of adults with unipolar major depressive disorder...
February 20, 2018: Lancet
Christian Klode, Tilman Steinert, Andreas Blume, Peter Brückner-Bozetti, Aysin Senkal, Michael Lingenfelder
OBJECTIVE: To elucidate organizational and human resource management-related drivers of community mental health services and home treatment in Germany. METHODS: Systematic review of psychiatric and organizational science literature, additional manual search. RESULTS: Relevant driver variables in community mental health services and home treatment have mostly been addressed. However, only a few have been evaluated and complex cause-and-effect models are missing so far...
February 22, 2018: Psychiatrische Praxis
André Janse van Rensburg, Inge Petersen, Edwin Wouters, Michelle Engelbrecht, Gladys Kigozi, Pieter Fourie, Dingie van Rensburg, Piet Bracke
The Life Esidimeni tragedy in South Africa showed that, despite significant global gains in recognizing the salience of integrated public mental health care during the past decade, crucial gaps remain. State and non-state mental health service collaboration is a recognized strategy to increase access to care and optimal use of community resources, but little evidence exist about how it unfolds in low- to middle-income countries. South Africa's Mental Health Policy Framework and Strategic Plan 2013-20 (MHPF) underlines the importance of collaborative public mental health care, though it is unclear how and to what extent this happens...
February 15, 2018: Health Policy and Planning
Silvana Galderisi, Paola Rucci, Brian Kirkpatrick, Armida Mucci, Dino Gibertoni, Paola Rocca, Alessandro Rossi, Alessandro Bertolino, Gregory P Strauss, Eugenio Aguglia, Antonello Bellomo, Martino Belvederi Murri, Paola Bucci, Bernardo Carpiniello, Anna Comparelli, Alessandro Cuomo, Domenico De Berardis, Liliana Dell'Osso, Fabio Di Fabio, Barbara Gelao, Carlo Marchesi, Palmiero Monteleone, Cristiana Montemagni, Giulia Orsenigo, Francesca Pacitti, Rita Roncone, Paolo Santonastaso, Alberto Siracusano, Annarita Vignapiano, Antonio Vita, Patrizia Zeppegno, Mario Maj
Importance: Enhanced understanding of factors associated with symptomatic and functional recovery is instrumental to designing personalized treatment plans for people with schizophrenia. To date, this is the first study using network analysis to investigate the associations among cognitive, psychopathologic, and psychosocial variables in a large sample of community-dwelling individuals with schizophrenia. Objective: To assess the interplay among psychopathologic variables, cognitive dysfunctions, functional capacity, personal resources, perceived stigma, and real-life functioning in individuals with schizophrenia, using a data-driven approach...
February 14, 2018: JAMA Psychiatry
Julie Newman, Olimpia Paun, Louis Fogg
The current article presents the effects of a 90-minute staff training intervention aimed at reducing inpatient psychiatric seclusion rates through strengthened staff commitment to seclusion alternatives and improved de-escalation skills. The intervention occurred at an 18-bed adult inpatient psychiatric unit whose seclusion rates in 2015 were seven times the national average. Although the project's primary outcome compared patient seclusion rates before and after the intervention, anonymous staff surveys measured several secondary outcomes...
February 15, 2018: Journal of Psychosocial Nursing and Mental Health Services
Andrea Marcellusi, Gianluca Fabiano, Raffaella Viti, Pier Cesare Francesa Morel, Giuseppe Nicolò, Alberto Siracusano, Francesco Saverio Mennini
OBJECTIVES: Schizophrenia is a chronic, debilitating psychiatric disease with highly variable treatment pathways and consequent economic impacts on resource utilisation. The aim of the study was to estimate the economic burden of schizophrenia in Italy for both the societal and Italian National Healthcare perspective. METHODS: A probabilistic cost of illness model was applied. A systematic literature review was carried out to identify epidemiological and economic data...
February 8, 2018: BMJ Open
Suze G Berkhout
First-episode psychosis has garnered significant attention and resources within mental health services in North America, Europe and Australia/New Zealand since the 1990s. Despite this widespread embrace, little scholarship exists that examines underlying concepts, ideologies and imagery embedded within the early intervention paradigm. In this paper, I offer a sociohistorical analysis of the emergence of first-episode psychosis and early intervention as entities in psychiatry, drawing on contemporary philosophical thought to explore various concepts embedded in them...
February 3, 2018: Medical Humanities
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