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Emergency department psychiatry

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https://www.readbyqxmd.com/read/28248838/family-based-crisis-intervention-with-suicidal-adolescents-a-randomized-clinical-trial
#1
Elizabeth A Wharff, Katherine B Ginnis, Abigail M Ross, Erina M White, Matthew T White, Peter W Forbes
OBJECTIVE: In current practice, treatment as usual (TAU) for suicidal adolescents includes evaluation, with little or no intervention provided in the emergency department (ED), and disposition, usually to an inpatient psychiatry unit. The family-based crisis intervention (FBCI) is an emergency psychiatry intervention designed to sufficiently stabilize suicidal adolescents within a single ED visit so that they may return home safely with their families. The objective of this article is to report efficacy outcomes related to FBCI for suicidal adolescents and their families...
February 28, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28228063/psychiatric-consultation-and-referral-of-persons-who-have-attempted-suicide
#2
Marc Roelands, Reginald Deschepper, Johan Bilsen
BACKGROUND: Persons who have attempted suicide are often admitted to a hospital's emergency department (ED). The risk of them repeating their attempt is lower if they have had access to a psychiatrist in hospital and had been referred to mental health care services. However, the literature suggests this is often lacking. AIMS: To describe perceived barriers to and supportive factors for psychiatric consultation and appropriate referral of suicide attempters in the ED...
February 23, 2017: Crisis
https://www.readbyqxmd.com/read/28210358/american-association-for-emergency-psychiatry-task-force-on-medical-clearance-of-adults-part-i-introduction-review-and-evidence-based-guidelines
#3
REVIEW
Eric L Anderson, Kimberly Nordstrom, Michael P Wilson, Jennifer M Peltzer-Jones, Leslie Zun, Anthony Ng, Michael H Allen
INTRODUCTION: In the United States, the number of patients presenting to the emergency department (ED) for a mental health concern is significant and expected to grow. The breadth of the medical evaluation of these patients is controversial. Attempts have been made to establish a standard evaluation for these patients, but to date no nationally accepted standards exist. A task force of the American Association of Emergency Psychiatry, consisting of physicians from emergency medicine and psychiatry, and a psychologist was convened to form consensus recommendations on the medical evaluation of psychiatric patients presenting to EDs...
February 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28202296/psychosis-in-the-ed-a-case-of-nmda-receptor-antibody-encephalitis
#4
Joseph Fisher, Clifford Ellingson, Noah Tolby
Anti-N-methyl-d-aspartate antibody receptor (NMDAR) encephalitis is a newly recognized disease increasing in diagnostic frequency. A 27-year-old female presented with symptoms of oral dyskinesia, tachycardia, and altered mental status following a three-month history of depression, lethargy, catatonia, and auditory hallucinations. We utilized our facilities neurology and psychiatry consult services, performed a lumbar puncture (LP), and requested NMDAR antibody titers. Following admission the Anti-NMDAR antibody titer was elevated warranting treatment with intravenous immunoglobulin (IVIG), corticosteroids, and later rituximab...
February 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28196622/non-cardiac-chest-pain-a-review-for-the-consultation-liaison-psychiatrist
#5
Kirsti A Campbell, Elizabeth N Madva, Ana C Villegas, Eleanor E Beale, Scott R Beach, Jason H Wasfy, Ariana M Albanese, Jeff C Huffman
BACKGROUND: Patients presenting with chest pain to general practice or emergency providers represent a unique challenge, as the differential is broad and varies widely in acuity. Importantly, most cases of chest pain in both acute and general practice settings are ultimately found to be non-cardiac in origin, and a substantial proportion of patients experiencing non-cardiac chest pain (NCCP) suffer significant disability. In light of emerging evidence that mental health providers can serve a key role in the care of patients with NCCP, knowledge of the differential diagnosis, psychiatric co-morbidities, and therapeutic techniques for NCCP would be of great use to both consultation-liaison (C-L) psychiatrists and other mental health providers...
December 9, 2016: Psychosomatics
https://www.readbyqxmd.com/read/28152138/effect-of-reverse-triage-on-creation-of-surge-capacity-in-a-pediatric-hospital
#6
Gabor D Kelen, Ruben Troncoso, Joshua Trebach, Scott Levin, Gai Cole, Caitlin M Delaney, J Lee Jenkins, James Fackler, Lauren Sauer
Importance: The capacity of pediatric hospitals to provide treatment to large numbers of patients during a large-scale disaster remains a concern. Hospitals are expected to function independently for as long as 96 hours. Reverse triage (early discharge), a strategy that creates surge bed capacity while conserving resources, has been modeled for adults but not pediatric patients. Objective: To estimate the potential of reverse triage for surge capacity in an academic pediatric hospital...
February 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28119350/a-systematic-review-of-management-strategies-for-children-s-mental-health-care-in-the-emergency-department-update-on-evidence-and-recommendations-for-clinical-practice-and-research
#7
Amanda S Newton, Lisa Hartling, Amir Soleimani, Scott Kirkland, Michele P Dyson, Mario Cappelli
OBJECTIVE: Children with mental health crises require access to specialised resources and services which are not yet standard in general and paediatric EDs. In 2010, we published a systematic review that provided some evidence to support the use of specialised care models to reduce hospitalisation, return ED visits and length of ED stay. We perform a systematic review to update the evidence base and inform current policy statements. METHODS: Twelve databases and the grey literature were searched up to January 2015...
January 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28110990/quick-sofa-scores-predict-mortality-in-adult-emergency-department-patients-with-and-without-suspected-infection
#8
Adam J Singer, Jennifer Ng, Henry C Thode, Rory Spiegel, Scott Weingart
STUDY OBJECTIVE: The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identify patients with infection who are at risk of complications. We determined the association between qSOFA scores and outcomes in adult emergency department (ED) patients with and without suspected infection. METHODS: We performed a single-site, retrospective review of adult ED patients between January 2014 and March 2015...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28107153/human-trafficking-mental-illness-and-addiction-avoiding-diagnostic-overshadowing
#9
Hanni Stoklosa, Marti MacGibbon, Joseph Stoklosa
This article reviews an emergency department-based clinical vignette of a trafficked patient with co-occurring pregnancy-related, mental health, and substance use disorder issues. The authors, including a survivor of human trafficking, draw on their backgrounds in addiction care, human trafficking, emergency medicine, and psychiatry to review the literature on relevant general health and mental health consequences of trafficking and propose an approach to the clinical complexities this case presents. In their discussion, the authors explicate the deleterious role of implicit bias and diagnostic overshadowing in trafficked patients with co-occurring addiction and mental illness...
January 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28103871/a-descriptive-survey-study-of-violence-management-and-priorities-among-psychiatric-staff-in-mental-health-services-across-seventeen-european-countries
#10
Seamus Cowman, Anna Björkdahl, Eric Clarke, Georgina Gethin, Jim Maguire
BACKGROUND: In mental health services what is commonplace across international frontiers is that to prevent aggressive patients from harming themselves, other patients or staff, coercive measures and foremost, violence management strategies are required. There is no agreement, recommendations or direction from the EU on which measures of coercion should be practiced across EU countries, and there is no overall one best practice approach. METHODS: The project was conceived through an expert group, the European Violence in Psychiatry Research Group (EViPRG)...
January 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28006091/cardiometabolic-assessment-diagnosis-and-treatment-of-chronic-medical-illnesses-during-an-inpatient-psychiatric-hospitalization-colocated-medical-care-versus-treatment-as-usual
#11
COMPARATIVE STUDY
Jason R Tatreau, Suzanne Harris, Brian Sheitman, Beat D Steiner
Background: Reverse colocation care models reduce lifestyle risk factors, emergency department visits, and readmissions. Persons with serious mental illness have higher than average rates of cardiovascular disease-related morbidity and mortality, with second-generation antipsychotics (SGAs) conferring added related risks. Little is written about reverse colocated medical care (RCL) in inpatient psychiatric settings. The objective of this study was to identify associations between screening, diagnosis, and treatment of chronic medical comorbidities and mode of medical care for patients discharged from 2 inpatient psychiatric units on SGAs...
December 22, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27966096/psychiatric-emergencies-of-minors-with-and-without-migration-background
#12
Türkan Akkaya-Kalayci, Christian Popow, Thomas Waldhör, Dietmar Winkler, Zeliha Özlü-Erkilic
BACKGROUND: The conditions of children and adolescents with migration background receiving emergency psychiatric care in Europe are not well known. Migrants usually attend regular psychiatric care less frequently than the autochthonous population. We therefore speculated that, being undertreated, they would be overrepresented among psychiatric emergency care patients. METHODS: We retrospectively analyzed the records of 1093 minors aged 4‑18 years treated during a period of three years at the psychiatric emergency outpatient clinic of the Department of Child and Adolescent Psychiatry at the Medical University of Vienna...
March 2017: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
https://www.readbyqxmd.com/read/27918948/adult-autism-subthreshold-spectrum-adas-spectrum-validation-of-a-questionnaire-investigating-subthreshold-autism-spectrum
#13
L Dell'Osso, C Gesi, E Massimetti, I M Cremone, M Barbuti, G Maccariello, I Moroni, S Barlati, G Castellini, M Luciano, L Bossini, M Rocchetti, M Signorelli, E Aguglia, A Fagiolini, P Politi, V Ricca, A Vita, C Carmassi, M Maj
AIM: Increasing literature has shown the usefulness of a dimensional approach to autism. The present study aimed to determine the psychometric properties of the Adult Autism Subthreshold Spectrum (AdAS Spectrum), a new questionnaire specifically tailored to assess subthreshold forms of autism spectrum disorder (ASD) in adulthood. METHODS: 102 adults endorsing at least one DSM-5 symptom criterion for ASD (ASDc), 143 adults diagnosed with a feeding and eating disorder (FED), and 160 subjects with no mental disorders (CTL), were recruited from 7 Italian University Departments of Psychiatry and administered the following: SCID-5, Autism-Spectrum Quotient (AQ), Ritvo Autism and Asperger Diagnostic Scale 14-item version (RAADS-14), and AdAS Spectrum...
November 9, 2016: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/27917218/can-we-predict-agitation-in-patients-with-suicide-attempts-in-the-emergency-department
#14
Ayhan Akoz, Sultan Tuna Akgol Gur, Elif Oral, Ummu Zeynep Avsar, Mucahit Emet
BACKGROUND: The agitation in patients presenting to the emergency department (ED) after suicide attempts is common and an important problem. OBJECTIVE: To establish whether we can predict agitated patients among suicide attempt patients in ED. METHODS: This is a cross-sectional observational study of adult suicide attempt events in ED. Information was collected prospectively on a specially designed data-collection form. Patients aged 16 years old and above who presented to the ED for care due to suicide attempts were included in the study...
September 2016: African Health Sciences
https://www.readbyqxmd.com/read/27906411/mental-health-emergencies-in-paediatric-services-characteristics-diagnostic-stability-and-gender-differences
#15
Montserrat Porter, Rebeca Gracia, Joan-Carles Oliva, Montserrat Pàmias, Gemma Garcia-Parés, Jesús Cobo
INTRODUCTION: Child and adolescent psychiatric emergencies have increased in recent years. The main objective of our study is to analyze sociodemographic and clinical characteristics of psychiatric emergencies under 18 years old that came to our hospital. Secondary objectives were to study diagnostic stability made in the emergency department and undertake a gender analysis. METHODS: Descriptive cross-sectional study of patients attending the pediatric emergency department who required consultation to psychiatry service during 2010 and 2011, comparing data with two previous cross-sectional cuts (2002-2003 and 2006-2007)...
November 2016: Actas Españolas de Psiquiatría
https://www.readbyqxmd.com/read/27856605/medically-hospitalized-patients-with-eating-disorders-and-somatoform-disorders-in-pediatrics-what-are-their-similarities-and-differences-and-how-can-we-improve-their-care
#16
Patricia Ibeziako, Jennifer M Rohan, Simona Bujoreanu, Christine Choi, Meghan Hanrahan, Melissa Freizinger
OBJECTIVES: The purpose of the current study is to describe the demographic and clinical characteristics and health care use of medically hospitalized patients with eating disorders (ED) and somatoform disorders (SFD) in a pediatric setting and to use the findings to explore opportunities for improved care. METHODS: Retrospective chart reviews of 125 patients with SFD and 125 patients with ED (N = 250) seen at a tertiary pediatric facility over a 12- and 19-month period, respectively...
December 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27844247/a-profile-on-emergency-department-utilization-in-adolescents-and-young-adults-with-autism-spectrum-disorders
#17
Guodong Liu, Amanda M Pearl, Lan Kong, Douglas L Leslie, Michael J Murray
There has been an increase in utilization of the Emergency Department (ED) in individuals with autism spectrum disorder (ASD) which may reflect a deficit of services (Green et al., Journal of the American Academy of Child and Adolescent Psychiatry 40(3):325-332, 2001; Gurney et al., Archives of Pediatric and Adolescent Medicine 160:825-830, 2006; Leichtman et al., American Journal of Orthopsyhciatry 72(2):227-235, 2001). The current study examined the rates of ED utilization between 2005 and 2013 in ASD youth 12- to 21-years-old...
November 14, 2016: Journal of Autism and Developmental Disorders
https://www.readbyqxmd.com/read/27779291/-the-tasks-and-aims-of-hospital-psychiatry-today-and-in-the-future
#18
A Honig, D Sierink, B Verwey
Care provided by consultation-liaison (CL) psychiatry and general hospital (GH) psychiatry varies widely. This means that certain services are almost unrecognisable and therefore less readily available to patients. <br/> AIM: To describe the core tasks of current CL- and GH-psychiatry care and to suggest how these tasks can best be performed and developed in the future.<br/> METHOD: We conducted a selective review of relevant CL- and GH-related literature and combined the information we obtained with the results of a consultation with CL-psychiatrists about how CL- and GL psychiatry should function in the future...
2016: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/27777432/case-of-24-week-fetus-delivered-from-mother-on-life-support-with-brain-death-from-suicide-attempt-ethical-issues-associated-with-severe-complications
#19
Takeshi Nishimura, Keisuke Kohama, Takaaki Osako, Taihei Yamada, Hiroyuki Tanaka, Atsunori Nakao, Joji Kotani
Advances in critical care medicine have made it possible to sustain vital organ systems in brain-dead patients. One clinical scenario besides donor organ retrieval in which a benefit may be gained from continuing life support is pregnancy. A pregnant woman in her late 30's at 23 weeks gestation exhibiting worsening depression was referred to the Department of Psychiatry. One day after admission she attempted suicide by hanging and suffered a cardiopulmonary arrest. A fetal heart beat and fetal motion was confirmed immediately after resuscitation...
October 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/27766554/effective-research-mentorship-for-residents-meeting-the-needs-of-early-career-physicians
#20
Gerrit I van Schalkwyk, Rachel B Katz, Joseph Resignato, Susan C van Schalkwyk, Robert M Rohrbaugh
OBJECTIVE: Challenges in pursuing research during residency may contribute to the shortage of clinician-scientists. Although the importance of mentorship in facilitating academic research careers has been described, little is understood about early career research mentorship for residents. The aim of this study was to better understand the mentorship process in the context of psychiatry residency. METHOD: Semi-structured interviews were conducted with experienced faculty mentors in a psychiatry department at a large academic medical center...
October 20, 2016: Academic Psychiatry
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