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Psychiatric emergency services

Joyce Cheng, Paul Benassi, Claire De Oliveira, Juveria Zaheer, Michael Collins, Paul Kurdyak
OBJECTIVE: Despite the high prevalence of mental illnesses and addictions, treatment rates remain low. In April 2010, a regional mass media campaign was implemented to increase awareness of mental health services in central Toronto, Canada. We studied the impact of this campaign on rates of psychiatric emergency department (PED) visits among all hospital emergency departments (EDs) located in Toronto. DESIGN: Monthly PED visit totals were obtained for all Toronto EDs from April 1, 2007 to March 31, 2012 (n = 148,704)...
October 20, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Rohan Borschmann, Sian Oram, Stuart A Kinner, Rina Dutta, Cathy Zimmerman, Louise M Howard
OBJECTIVE: This study estimated the prevalence and correlates of self-harm among adult victims of human trafficking who accessed secondary mental health services, and it estimated the responses of mental health services to these individuals. METHODS: A clinical records database was searched for self-harm, sociodemographic, clinical, and service use characteristics among trafficked adults who accessed secondary mental health services in South London (2006-2012). Logistic regression models compared trafficked patients (N=84) and a matched cohort of nontrafficked patients (N=287)...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Thomas E Smith, Maria Abraham, Michael Bivona, Myles J Brakman, Isaac S Brown, Gita Enders, Sara Goodman, Liam McNabb, Joseph W Swinford
Objective: The study aimed to clarify the potential role and impact of behavioral health peer support providers on community hospital acute inpatient psychiatric units. Method: Qualitative interviews were conducted to examine perspectives of peer support providers (peers) and individuals who initially received peer services (recipients) during an inpatient stay on a community hospital psychiatric unit. Interviews elicited perspectives on interactions between peers and recipients, the role of peers vis-à-vis the clinical treatment team, and involvement of peers in discharge planning and transitions to community-based care...
October 13, 2016: Psychiatric Rehabilitation Journal
John Kasinathan, Gillian Sharp, Anthony Barker
OBJECTIVES: Olanzapine is a well established treatment for schizophrenia. The olanzapine pamoate depot (long-acting injectable) formulation improves compliance and clinical trials have shown it to be effective. However, there are no previously published reports evaluating olanzapine depot in violent patients with schizophrenia in the community. We evaluated the clinical efficacy of olanzapine depot, its effect on violence, hospitalization and incarceration in community patients with schizophrenia and prior history of serious violence...
October 2016: Therapeutic Advances in Psychopharmacology
Lisa Dolovich, Giulia Consiglio, Linda MacKeigan, Lusine Abrahamyan, Petros Pechlivanoglou, Valeria E Rac, Nedzad Pojskic, Elizabeth A Bojarski, Jiandong Su, Murray Krahn, Suzanne M Cadarette
BACKGROUND: MedsCheck Annual (MCA) is an Ontario government-funded medication review service for individuals taking 3 or more prescription medications for chronic conditions. METHODS: This cohort study analyzed linked administrative claims data from April 1, 2007, to March 31, 2013. Trends in MCA claims and recipient characteristics were examined. RESULTS: A total of 1,498,440 Ontarians (55% seniors, 55% female) received an MCA. One-third (36%) had 2 or more MCAs within 6 years...
September 2016: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
Shereen Katrak, Lawrence P Park, Christopher Woods, Andrew Muir, Charles Hicks, Susanna Naggie
Background.  Hepatitis C virus (HCV) infection is a leading cause of cirrhosis and the primary cause of liver transplantation in the United States, and coinfection with human immunodeficiency virus (HIV) increases the risk of comorbidities. However, healthcare utilization (HCU) patterns among HIV/HCV-coinfected patients are poorly understood. This study compared the rates of HCU and reasons for hospital admission among HCV-infected, HIV-infected, and HIV/HCV-coinfected veterans. Methods.  Hepatitis C virus- and HIV-infected and HIV/HCV-coinfected veterans in care with the Department of Veterans Affairs (VA) from 1998 to 2009 (n = 335 371, n = 28 179, n = 13 471, respectively) were identified by HIV- and HCV-associated International Classification of Diseases, Ninth Revision codes from the clinical case registry...
September 2016: Open Forum Infectious Diseases
Ryan M Silwanowicz, Donovan T Maust, Lisa S Seyfried, Claire Chiang, Claire Stano, Helen C Kales
OBJECTIVE: Our aim is to evaluate if and how neuropsychiatric symptoms (NPS) of dementia influence the management and disposition of older adults who present to emergency care settings. METHODS: This is a retrospective cohort study that involved the medical and psychiatric emergency departments of a tertiary academic medical center. Participants included patients ≥65 years of age with dementia who presented between 1 February 2012 and 16 July 2014 (n = 347)...
October 4, 2016: International Journal of Geriatric Psychiatry
Maya Sabatello, S Appelbaum
This paper considers the ethical, legal, and social issues raised by the prospect of increasing use of psychiatric genetic data in child custody litigation. Although genetic tests cannot currently confirm a parent or child's psychiatric diagnosis, it is likely that as relevant findings emerge, they will be introduced in family courts to challenge parental capacity. Here, we draw on three projected, but plausible, scenarios for obtaining psychiatric data about parents -- imposed genetic testing, access to medical records, and genetic theft -- then consider the use of psychiatric genetic data of children, to highlight the issues that judges, child custody evaluators, and clinicians who may provide treatment for parents or children with mental health issues will need to consider...
September 2016: Current Genetic Medicine Reports
Emily Liffick, Nicole F Mehdiyoun, Jenifer L Vohs, Michael M Francis, Alan Breier
OBJECTIVE: Because of the chronicity, severity, and marked psychosocial impairment that may characterize the illness, schizophrenia is an incredibly costly disease. Recent data indicate that intervention earlier in the course of schizophrenia produces cost savings. This study compared health service utilization and associated costs for patients receiving treatment for first-episode psychosis (FEP) delivered within the early-intervention (EI) model at the Prevention and Recovery Center for Early Psychosis (PARC) and for a matched sample of FEP patients receiving treatment as usual at a geographically similar mental health clinic...
October 3, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Susan I Woodruff, Cameron T McCabe, Melinda Hohman, John D Clapp, Audrey M Shillington, Kimberly Eisenberg, C Beth Sise, Edward M Castillo, Theodore C Chan, Michael J Sise
Emergency department (ED) settings have gained interest as venues for illegal drug misuse prevention and intervention, with researchers and practitioners attempting to capitalize on the intersection of need and opportunity within these settings. This study of 686 adult patients visiting two EDs for various reasons who admitted drug use compared daily cannabis-only users, nondaily cannabis-only users, and other drug users on sociodemographic and drug-related severity outcomes. The three drug use groups did not differ on most sociodemographic factors or medical problem severity scores...
2016: Cannabis Cannabinoid Res
Christoffer Torgaard Thomsen, Michael Eriksen Benros, Lene Halling Hastrup, Per Kragh Andersen, Domenico Giacco, Merete Nordentoft
INTRODUCTION: Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes...
2016: BMJ Open
Sharon M Holder, Kenneth Rogers, Eunice Peterson, Robbie Shoenleben, Dawn Blackhurst
OBJECTIVES: This study assessed improvement in the emergency department (ED) length of stay and costs after implementation of an ED program which added board-certified psychiatrists and trained psychiatric social workers to the pediatric ED. METHODS: A retrospective medical record and administrative data review were conducted for all pediatric psychiatric visits of children aged 5 to 18 years who were seen and discharged from the Greenville Memorial Hospital ED between January 1, 2007, and June 31, 2013...
September 23, 2016: Pediatric Emergency Care
Charlotte A Labys, Ezra Susser, Jonathan K Burns
BACKGROUND: Growing interest in strategies regarding early intervention for psychosis has led to a parallel interest in understanding help-seeking behavior, especially in low- and middle-income countries (LMICs). Nevertheless, few LMIC studies have examined individuals with psychosis in non-urban, non-hospital settings. Using the perspective of formal and informal community service providers, we aimed to uncover descriptions of people with psychosis in a rural South African community and illuminate the potential complexities of their help-seeking journeys...
2016: International Journal of Mental Health Systems
Nour Mekaoui, Lamiae Karboubi, Fatima Zahra Ouadghiri, Badr Sououd Benjelloun Dakhama
Suicidal behavior among children has significantly increased in Morocco. We conducted a study on the epidemiological aspect to propose a treatment strategy. Descriptive retrospective study over a period of 3 years (April 2012-April 2015) involving children who visited pediatric medical emergencies of the Children Hospital of Rabat after an autolysis attempt. We observed epidemiological parameters, history, social and family context, the means used, the presumed cause, clinical manifestation, and the management...
2016: Pan African Medical Journal
Niels Tangherlini, Julian Villar, John Brown, Robert M Rodriguez, Clement Yeh, Benjamin T Friedman, Paul Wada
OBJECTIVES: The San Francisco Fire Department's (SFFD; San Francisco, California USA) Homeless Outreach and Medical Emergency (HOME) Team is the United States' first Emergency Medical Services (EMS)-based outreach effort using a specially trained paramedic to redirect frequent users of EMS to other types of services. The effectiveness of this program at reducing repeat use of emergency services during the first seven months of the team's existence was examined. METHODS: A retrospective analysis of EMS use frequency and demographic characteristics of frequent users was conducted...
September 19, 2016: Prehospital and Disaster Medicine
J Stobbe, J R J de Leeuw, C L Mulder
BACKGROUND: No recent information is available concerning the working methods of the ambulatory psychiatric emergency services in The Netherlands.<br/> AIM: To obtain insight into the working methods of the ambulatory psychiatric emergency services.<br/> METHOD: We performed a descriptive research.<br/> RESULTS: Twenty of the 28 ambulatory psychiatric emergency services participated in our study (more than 71 %)...
2016: Tijdschrift Voor Psychiatrie
Kimberley Lee, Malcolm H Johnson, Julie Harris, Frederick Sundram
OBJECTIVES: As patients with medically unexplained physical symptoms may present frequently to hospital settings and receive potentially unnecessary investigations and treatments, we aimed to assess the frequency and type of medically unexplained physical symptoms presentations to clinical services and estimate the associated direct healthcare costs. METHODS: This study was undertaken at the largest district health board in New Zealand. All patients with a diagnosed presentation of medically unexplained physical symptoms in 2013 were identified using the district health board's clinical coding system...
2016: SAGE Open Medicine
Kevin D Shield, Paul Kurdyak, Paul A Shuper, Jürgen Rehm
OBJECTIVE: First, to compare the level of disability and functioning of patients who access psychiatric emergency services by diagnosis and service use frequency. Second, to compare patients who access psychiatric emergency services to the general population in terms of demographics and the level of disability and functioning. METHODS: Data from 420 patients were obtained by time-based sampling from August 2011 to February 2012 in the emergency department of a psychiatric hospital that provides services to adolescents and adults...
September 13, 2016: Journal of Clinical Psychiatry
Eugenia I Gorlin, Kristy Dalrymple, Iwona Chelminski, Mark Zimmerman
OBJECTIVE: Despite growing recognition that attention deficit/hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood, reports on the nature and extent of its psychiatric comorbidities have been mixed to date. This study compared the prevalence rates of all major Axis I disorders as well as borderline personality disorder in an unselected sample of adult psychiatric outpatients with and without ADHD. METHODS: As part of the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we administered a DSM-IV-based semi-structured diagnostic interview assessing ADHD and other psychiatric disorders to 1134 patients presenting for initial evaluation at an outpatient psychiatric practice...
October 2016: Comprehensive Psychiatry
Md Golam Rabiul Alam, Sarder Fakhrul Abedin, Moshaddique Al Ameen, Choong Seon Hong
Ambient assisted living can facilitate optimum health and wellness by aiding physical, mental and social well-being. In this paper, patients' psychiatric symptoms are collected through lightweight biosensors and web-based psychiatric screening scales in a smart home environment and then analyzed through machine learning algorithms to provide ambient intelligence in a psychiatric emergency. The psychiatric states are modeled through a Hidden Markov Model (HMM), and the model parameters are estimated using a Viterbi path counting and scalable Stochastic Variational Inference (SVI)-based training algorithm...
2016: Sensors
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