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Emergency department psychiatry

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https://www.readbyqxmd.com/read/28107153/human-trafficking-mental-illness-and-addiction-avoiding-diagnostic-overshadowing
#1
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
#2
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
#3
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
#4
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...
December 13, 2016: 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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27741957/where-teachers-are-few-documenting-available-faculty-in-five-tanzanian-medical-schools
#13
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
BACKGROUND: Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. OBJECTIVE: To describe the availability of faculty in medical schools in Tanzania. DESIGN: We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
2016: Global Health Action
https://www.readbyqxmd.com/read/27729818/workplace-violence-in-different-settings-and-among-various-health-professionals-in-an-italian-general-hospital-a-cross-sectional-study
#14
Paola Ferri, Monica Silvestri, Cecilia Artoni, Rosaria Di Lorenzo
BACKGROUND: Workplace violence (WPV) against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1) to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2) to identify the clinical and organizational factors related to this phenomenon. METHODS: The study was cross-sectional. In a 1-month period, we administered the "Violent Incident Form" to 745 professionals (physicians, head nurses, nurses, nursing assistants), who worked in 15 wards of a general hospital in northern Italy...
2016: Psychology Research and Behavior Management
https://www.readbyqxmd.com/read/27663833/ways-of-coping-and-multidimensional-health-locus-of-control-in-hospitalized-depressed-patients-admitted-through-the-emergency-department-or-consultations
#15
Catherine Gigot, Christine Reynaert, Nicolas Zdanowicz
BACKGROUND: In a previous study, we compared the family relationships of patients hospitalized in a psychiatry unit from either psychiatric consultations or after passing emergency room (E.R.). The intensity of depression was statistically comparable in both groups. What distinguishes patients transiting emergencies is that their families and couples are more cohesive and adaptable. In this study, we compare both groups in terms of coping mechanisms and multidimensional health locus of control (MHLC)...
September 2016: Psychiatria Danubina
https://www.readbyqxmd.com/read/27663829/comparison-of-components-of-the-depression-of-hospitalized-patients-admitted-through-the-emergency-department-or-consultations
#16
Nicolas Zdanowicz, Thomas Dubois, Christine Reynaert, Denis Jacques, Pauline Manceaux
BACKGROUND: In a previous study, we investigated the risk of admission to emergency (ER) of depressed patients prior to their hospitalization in psychiatry in comparison with hospitalized patients transferred from the consultations department (Cdpt). In the present study, we compare among the same patients variables affecting the intensity of depression in each group. METHOD: All patients with Major depressive disorder admitted in our department through emergencies (N=146) or consultations (N=2172) between January 1, 2010 and December 31, 2012 were included in an open study...
September 2016: Psychiatria Danubina
https://www.readbyqxmd.com/read/27605523/emergency-psychiatry-a-product-of-circumstance-or-a-growing-sub-speciality-field
#17
Paul Cammell
OBJECTIVES: This article reviews recent trends in the provision of psychiatric services to the emergency departments of tertiary hospitals in Australia, involving the establishment of specialised in-reach or liaison services as well as various forms of short stay unit attached to emergency departments. The Emergency Psychiatry Service at Flinders Medical Centre, South Australia, is described as a case example. Its specialised models of assessment and clinical care are described, highlighting how these are differentiated from more traditional models in inpatient, community and general hospital consultation-liaison psychiatry...
September 6, 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27569109/decline-in-consultant-availability-in-massachusetts-emergency-departments-2005-to-2014
#18
Jason L Sanders, Ali S Raja, Kohei Hasegawa, Jane Bittner, Janice A Espinola, Brianna Olamiju, Ashley F Sullivan, Carlos A Camargo
STUDY OBJECTIVE: Emergency department (ED) consultation is a common practice. There are few data on consultant availability or changes in availability over time, which may hinder resource planning and allocation. We conduct serial surveys of Massachusetts EDs to investigate these trends. METHODS: We surveyed ED directors in Massachusetts in 2006 (n=61 EDs), 2009 (n=63), and 2015 (n=63) about ED characteristics in the previous year, including specialty-specific consultant availability in person (yes/no) and continuous consultant availability (yes/no)...
October 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27481374/designing-services-for-frequent-attenders-to-the-emergency-department-a-characterisation-of-this-population-to-inform-service-design
#19
Rebecca Jacob, Mai Luen Wong, Catherine Hayhurst, Peter Watson, Cecily Morrison
Frequent attendance to the emergency department (ED) is a growing public health concern. Designing services for frequent attenders poses challenges, given the heterogeneous nature of this group. This was a two-part observational study identifying frequent attenders from ED records. The first stage studied trends and developed personas with emphasis on differentiating moderate frequent attenders (attending between 5 and 20 times per year) and extreme frequent attenders (attending more than 20 times). Stage 2 included a case note review of 100 consecutive frequent attenders...
August 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27473933/evaluation-of-voice-acoustics-as-predictors-of-clinical-depression-scores
#20
Nik Wahidah Hashim, Mitch Wilkes, Ronald Salomon, Jared Meggs, Daniel J France
OBJECTIVE: The aim of the present study was to determine if acoustic measures of voice, characterizing specific spectral and timing properties, predict clinical ratings of depression severity measured in a sample of patients using the Hamilton Depression Rating Scale (HAMD) and Beck Depression Inventory (BDI-II). STUDY DESIGN: This is a prospective study. METHODS: Voice samples and clinical depression scores were collected prospectively from consenting adult patients who were referred to psychiatry from the adult emergency department or primary care clinics...
July 26, 2016: Journal of Voice: Official Journal of the Voice Foundation
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