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Efficient psychiatrist

Matthew Buchbinder, Judith Regan, Mirela Aldea, Denise Makowski
A national effort to provide more expansive mental health care in the United States has been an increasing priority during the last decade. States have enacted laws that allow for the delegation of psychiatric services to physician assistants in an effort to address the shortage and geographic maldistribution of mental health services and to more efficiently use the skills of psychiatrists. This statutory scheme recognizing physician assistants has been effective in broadening access to mental health care in various southern states...
April 2017: Southern Medical Journal
Eric M Schmidt, Dean D Krahn, Marsden H McGuire, Sara Tavakoli, David M Wright, Hugo E Solares, Sonne Lemke, Jodie Trafton
U.S. health systems, policy makers, and patients increasingly demand high-value care that improves health outcomes at lower cost. This study describes the initial design and analysis of the Mental Health Management System (MHMS), a performance data and quality improvement tool used by the Veterans Health Administration (VHA) to increase the value of its mental health care. The MHMS evaluates access to and quality of mental health care, organizational structure and efficiency, implementation of innovative treatment options, and, in collaboration with management, resource needs for delivering care...
February 2017: Psychological Services
Charles R Jonassaint, Patrice Gibbs, Bea Herbeck Belnap, Jordan F Karp, Kaleab K Abebe, Bruce L Rollman
BACKGROUND: Computerised cognitive-behavioural therapy (CCBT) helps improve mental health outcomes in White populations. However, no studies have examined whether CCBT is acceptable and beneficial for African Americans. AIMS: We studied differences in CCBT use and self-reported change in depression and anxiety symptoms among 91 African Americans and 499 White primary care patients aged 18-75, enrolled in a randomised clinical trial of collaborative care embedded with an online treatment for depression and anxiety...
January 2017: BJPsych Open
Jaeyong Shin, Young Choi, Eun-Cheol Park, Kwang Hoon Lee, Seo Young Hwang, Sang Ho Oh, Sang Gyu Lee
The uncomfortable symptoms of atopic dermatitis (AD) often trigger psychological stress.We investigated the association between AD severity and outpatient visits to psychiatrists using Korean National Health Insurance claims data from 2004 to 2013.This was a retrospective cohort analysis; we estimated hazard ratios (HRs).Of the 266,182 subjects, 18,290 (6.9%) had a history of visiting a psychiatrist, and 25,419 (9.5%) were diagnosed with AD. Compared with the subjects without AD, subjects with AD had a higher HR for visiting a psychiatrist (3...
December 2016: Medicine (Baltimore)
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
Lynn E DeLisi
The genetic mechanism for schizophrenia still remains unknown despite decades of research. A tremendous amount of investigator time and effort has gone into ascertainment of clinical samples for genetic studies over the years. Most recently, a large international effort of unprecedented collaboration has occurred to combine data worldwide in pursuit of uncovering the relevant genetic risk factors. However, in the process, the use of multiplex families to understand the genetics has waned, and it has been presumed that large resources of unrelated patients and controls are more efficient to find risk alleles than families...
May 2016: Molecular Neuropsychiatry
Xia Hong, Jing Wei, Xiao-Hui Zhao, Ping Zeng, Li-Li Shi, Jin-Ya Cao, Xiao-Hong Liu
Objective To analyze liaison psychiatric service in a geriatric ward in a big general hospital and explore the way to improve accessibility of geriatric psychiatric service in general hospitals. Methods Elderly inpatients aged 65 years old or more admitted to a geriatrics ward in Peking Union Medical College Hospital in 7 years duration (January 2008 to December 2014) were enrolled in the study. Liaison psychiatrists attended ground round combined with psychiatric consultation from January 2008 to December 2009 (T1 period)...
August 2016: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
Paul Kurdyak, Lesley Wiesenfeld, Sanjeev Sockalingam
There is an increasing emphasis on quality and, relatedly, cost-effectiveness as it relates to the delivery of health care. Choosing Wisely is an initiative adopted by numerous specialties with the goal of starting a dialogue about efficient use of health care resources. People need to be able to access care to have an opportunity to choose wisely. There is a considerable amount of evidence that access to care is poor for specialty mental health care, particularly access to psychiatrists. Consequently, we suggest that psychiatrists and the broader mental health system need to consider working wisely, and in our paper outline key issues (for example, implementation of wait times and objective measures of need in a centralized referral management system; incorporation of performance indicators with longitudinal monitoring for continuous quality improvement) that need to be addressed to develop a mental health system that would allow people to access care to choose wisely...
January 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
J D Blom, F R E Smink, E V Kwidama, V M Vladár Rivero
BACKGROUND: A frequent complaint in psychiatry is that the psychiatrist-patient relationship and the quality of care are hampered by bureaucratic processes. AIM: To provide an analysis of various types of bureaucracy in psychiatry that can serve as a starting-point for the improvement of care and the performance of qualitative studies. METHOD: We conducted an exploratory study using PubMed, Google, and various Dutch medical journals. RESULTS: Contemporary psychiatry is characterised by a bureaucratic organization structure...
2016: Tijdschrift Voor Psychiatrie
M Villani, V Kovess-Masféty
INTRODUCTION: The progressive shifts in the legal and social contexts, along with major changes in information seeking habits with the development of the Internet, have placed patients' information at the core of medical practice. This has to be applied to the psychiatric fields as well, and to questions about how schizophrenic patients are being told their diagnosis nowadays in France. METHODS: This paper is a national and international literature review about schizophrenia diagnosis disclosure practices, from 1972 to 2014, using French and English languages and various psychology and medical databases...
June 29, 2016: L'Encéphale
Melanie P J Schellekens, Desiree G M van den Hurk, Judith B Prins, Johan Molema, Miep A van der Drift, Anne E M Speckens
BACKGROUND: Lung cancer patients and their partners report high rates of distress. Although distress is of importance, psychiatric disorders might be more important in terms of prognostic value and additional psychological treatment. This study examined the suitability of the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), Beck Depression Inventory (BDI-II) and State subscale of State Trait Anxiety Inventory (STAI-S) to screen for psychiatric disorders in lung cancer patients and partners...
October 2016: Journal of Affective Disorders
Gangqin Li, Thomas G Gutheil, Zeqing Hu
Laws and regulations about the forensic psychiatric systems in China and America were compared, and suggestions for improving the forensic psychiatric system of China were provided. There are many differences regarding the role of the forensic psychiatrist, the initiation of the assessment and the admission of expert opinion because of elements in the legal systems in China and America. The Chinese system has the advantages of objectivity, cost saving and high efficiency; but it has deficiencies in procedural justice and the admission of expert opinion...
July 2016: International Journal of Law and Psychiatry
Michael J Gitlin, David J Miklowitz
BACKGROUND: Split treatment refers to the involvement of 2 mental health professionals in the care of a psychiatric patient-one providing psychotherapy and the other psychopharmacologic management. Despite the widespread use of split treatment in outpatient psychiatric care, little data exist on its core features or cost-effectiveness compared with other models of treatment. METHODS: We reviewed published studies on split treatment, summarized the research data on split treatment, and created principles to guide its use in practice...
May 2016: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
Masaru Ohnishi, Shihomi Koyama, Akiko Senoo, Hiroko Kawahara, Yukito Shimizu
According to the nationwide survey of the National University students in Japan, the annual suicide rate in 2012 was 15.7 per 100,000 undergraduate students. In many universities, suicide prevention is an important issue regarding mental health measures, and each university is actively examining this. The current situation concerning measures for suicide prevention in the Japanese National Universities was investigated in 2009. In 2010, the "college student's suicide prevention measures guideline, 2010" was established based on the results of this investigation...
2016: Seishin Shinkeigaku Zasshi, Psychiatria et Neurologia Japonica
V Benard, G Vaiva, M Masson, P A Geoffroy
INTRODUCTION: Bipolar disorder (BD) is a severe and recurrent psychiatric disorder. The severity of prognosis in BD is mainly linked to the high rate of suicide in this population. Indeed, patients with BD commit suicide 20 to 30 times more frequently than the general population, and half of the BD population with an early age of onset have a history of suicide attempt. International therapeutic guidelines recommend lithium (Li) as the first-line treatment in BD for its prophylactic action on depressive or manic episodes...
June 2016: L'Encéphale
Alexandre St-Hilaire, Carol Hudon, Michel Préville, Olivier Potvin
OBJECTIVES: Little objective and nationally representative data are available concerning the influence of cognitive impairment no dementia (CIND) on utilization of healthcare services. The main objective was to compare the use of healthcare services over three years, between elders with current or incident CIND and those without CIND. A second objective was to evaluate the effect of depression and anxiety. METHODS: Cross-sectional and longitudinal data from a population-based survey of 2265 older adults living in Quebec (Canada) were used...
March 21, 2016: Aging & Mental Health
Sharon Stephan, Nancy Lever, Larraine Bernstein, Sarah Edwards, David Pruitt
OBJECTIVE: The purpose of this study was to describe the potential and limits of school telemental health (TMH) to support a full continuum from mental health promotion to intervention, particularly for students less likely to access community care. METHODS: A review of school TMH literature and model programs, and of data from focus groups with child psychiatry fellows, was undertaken to inform best practices and future directions for TMH in schools. RESULTS: Existing data suggest that TMH with children and adolescents is promising and well received...
April 2016: Journal of Child and Adolescent Psychopharmacology
A Cancel, F Naudet, P F Rousseau, B Millet, D Drapier
INTRODUCTION: Impulsivity is a transnosographical dimension with major consequences on medical care with which psychiatrists are frequently confronted. Furthermore, compliance is a major variable that can affect the efficiency of therapeutics and hospitalizations in psychiatry. A study was carried out in three drug and alcohol rehabilitation hospitalization units to find out if impulsivity can have consequences on compliance. METHOD: The studied population was composed of 85 patients aged from 18 to 70, hospitalized for one or more addiction disorders in a psychometric hospital in Vannes (France)...
August 2016: L'Encéphale
G Athanasiou, M-A Fengou, A Beis, D Lymberopoulos
Mental healthcare domain highlights the significance of trustworthiness between patient and psychiatrist for treatment process. In this paper, the issue of assessing psychiatrist trustworthiness from patient perspective, within a Ubiquitous Healthcare (UH) environment, is addressed. To meet that challenge, a Trust Assessment mechanism mimicking human cognitive judgment, is proposed. The exploitation of innovative fuzzy-probabilistic transformation model, denoted as cloud, for mechanism deployment enables fuzziness as well as adhered randomness of cognitive perception and assessment to be captured...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Maryann Waugh, Debbie Voyles, Marshall R Thomas
In the USA, the high cost and inefficiencies of the health care system have prompted widespread demand for a better value on investment. Reform efforts, focused on increasing effective, cost-efficient, and patient-centred practices, are inciting lasting changes to health care delivery. Integrated care, providing team-based care that addresses both physical and behavioural health needs is growing as an evidence-based way to provide improved care with lower overall costs. This in turn, is leading to an increasing demand for psychiatrists to work with primary care physicians in delivering integrated care...
2015: International Review of Psychiatry
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