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Emergency department psychiatry

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https://www.readbyqxmd.com/read/28726526/integrated-care-coordination-by-an-interprofessional-team-reduces-emergency-department-visits-and-hospitalisations-at-an-academic-health-centre
#1
Anne H Gaglioti, Patrick Barlow, Kate DuChene Thoma, George R Bergus
People with chronic behavioural and physical health conditions have higher healthcare costs and mortality rates than patients with chronic physical conditions alone. As a result, there has been promotion of integrated care for this group. It is important to train primary care residents to practice in integrated models of care with interprofessional teams and to evaluate the effectiveness of integrated care models to promote high-quality care for this at-risk group. We implemented an integrated, interprofessional care management programme for adults with chronic mental and physical health needs as part of a curriculum for family medicine and family medicine psychiatry residents...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28702268/distressing-visual-hallucinations-after-treatment-with-trazodone
#2
Gustavo Santos, Ana Maria Moreira
Trazodone, a second-generation atypical antidepressant, is increasingly being used off-label, in the treatment of insomnia. Although generally well tolerated, trazodone treatment can be associated with some complications. We describe a case of a 60-year-old man who received trazodone for primary insomnia. He returned, to the emergency department, two days later with distressing visual hallucinations, which prompted inpatient treatment. Trazodone was discontinued, leading to a complete resolution of his visual hallucinations, and he was treated with mirtazapine for 6 months...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28696434/when-should-governments-increase-the-supply-of-psychiatric-beds
#3
S Allison, T Bastiampillai, J Licinio, D A Fuller, N Bidargaddi, S S Sharfstein
Low numbers of hospital-based psychiatric beds create problems for people with severe mental illness (SMI), when they face extended emergency department (ED) waits, higher thresholds for admission to an acute bed, and short revolving-door stays with high rates of rehospitalisation. Limited access to inpatient treatment has been associated with higher suicide risk, premature mortality, homelessness, violent crime and incarceration. Ultimately, people with SMI can be transinstitutionalised to the criminal justice system...
July 11, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28653549/sociodemographic-and-clinical-profiles-of-homeless-mentally-ill-admitted-in-mental-health-institute-of-south-india-know-the-unknown-project
#4
Guru S Gowda, G Gopika, Narayana Manjunatha, Channaveerachari Naveen Kumar, Ravi Yadav, Dwarakanath Srinivas, Bharath Rose Dawn, Suresh Bada Math
OBJECTIVES: A significant number of homeless mentally ill (HMI) patients without any personal, family or other identification details represent a unique problem in the psychiatric services of developing countries like India in the context of legal, humanitarian and treatment issues. These patients pose challenge to the mental health professional in diagnosis and management. AIMS: To study the sociodemographic and clinical profiles of HMI patients admitted under psychiatry...
June 1, 2017: International Journal of Social Psychiatry
https://www.readbyqxmd.com/read/28637535/routine-hospital-management-of-self-harm-and-risk-of-further-self-harm-propensity-score-analysis-using-record-based-cohort-data
#5
S Steeg, R Emsley, M Carr, J Cooper, N Kapur
BACKGROUND: The care received by people presenting to hospital following self-harm varies and it is unclear how different types of treatment affect risk of further self-harm. METHOD: Observational cohort data from the Manchester Self-Harm Project, UK, included 16 456 individuals presenting to an Emergency Department with self-harm between 2003 and 2011. Individuals were followed up for 12 months. We also used data from a smaller cohort of individuals presenting to 31 hospitals in England during a 3-month period in 2010/2011, followed up for 6 months...
June 22, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28611885/american-association-for-emergency-psychiatry-task-force-on-medical-clearance-of-adult-psychiatric-patients-part-ii-controversies-over-medical-assessment-and-consensus-recommendations
#6
REVIEW
Michael P Wilson, Kimberly Nordstrom, Eric L Anderson, Anthony T Ng, Leslie S Zun, Jennifer M Peltzer-Jones, Michael H Allen
INTRODUCTION: The emergency medical evaluation of psychiatric patients presenting to United States emergency departments (ED), usually termed "medical clearance," often varies between EDs. A task force of the American Association for Emergency Psychiatry (AAEP), consisting of physicians from emergency medicine, physicians from psychiatry and a psychologist, was convened to form consensus recommendations for the medical evaluation of psychiatric patients presenting to U.S.EDs. METHODS: The task force reviewed existing literature on the topic of medical evaluation of psychiatric patients in the ED and then combined this with expert consensus...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28585587/depression-and-anxiety-in-patients-undergoing-elective-and-emergency-surgery-cross-sectional-study-from-allama-iqbal-memorial-teaching-hospital-sialkot
#7
Ansar Latif, Rana Mozammil Shamsher Khan, Kalsoom Nawaz
OBJECTIVE: To determine the frequency of depression and anxiety in post-operative patients undergoing elective and emergency surgery. METHODS: The cross-sectional analytical study was conducted at the Department of Surgery and Department of Psychiatry of the Allama Iqbal Memorial Teaching Hospital, Sialkot, Pakistan, from September 2013 to April 2016, and comprised patients due for elective or emergency surgery. Patients admitted to the surgical wards, including general surgical, neurosurgical, urological and orthopaedic wards, undergoing major surgical procedures were enrolled...
June 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28566025/management-of-mental-health-crises-among-youths-with-and-without-asd-a-national-survey-of-child-psychiatrists
#8
Luther G Kalb, Elizabeth A Stuart, David S Mandell, Mark Olfson, Roma A Vasa
OBJECTIVE: This study compared management by child psychiatrists of mental health crises among youths with and without autism spectrum disorder (ASD). METHODS: A custom online mental health crisis services survey was administered to members of the American Academy of Child and Adolescent Psychiatry. The survey probed three domains of crisis management: willingness to work with youths with a history of mental health crisis, comfort level in managing a mental health crisis, and availability of external resources during a crisis...
June 1, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28538605/the-heads-ed-evaluating-the-clinical-use-of-a-brief-action-oriented-pediatric-mental-health-screening-tool
#9
Mario Cappelli, Roger Zemek, Christine Polihronis, Nathalie R Thibedeau, Allison Kennedy, Clare Gray, Mona Jabbour, Sarah Reid, Paula Cloutier
OBJECTIVES: This effectiveness study aimed to evaluate the clinical use of the HEADS-ED tool for patients presenting to a pediatric emergency department (PED) for mental health (MH) care. METHODS: In this pragmatic trial, PED physicians used the HEADS-ED to guide their assessment and identify areas of MH need in 639 patients (mean [SD], 15.16 [1.40] years; female, 72.6%) who presented to the emergency department with MH concerns between May 2013 and March 2014. RESULTS: The HEADS-ED guided consultation to psychiatry/crisis, with 86% receiving a recommended consult...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28530334/-from-theory-to-practice-implementing-the-bio-psycho-social-model-in-clinical-and-research-activities-in-the-beer-sheva-mental-health-center
#10
Hagit Cohen, Doron Todder
The Beer Sheva Mental Health Center is the second largest mental health hospital in Israel and provides acute and chronic in-patient services for the entire population of the Southern District of Israel, from Ashdod to Eilat (about 1.2 million people) from adolescence to the elderly. The outpatient services include a variety of regional specialty services such as bipolar, eating disorders, anxiety, neuromodulation, gender-oriented, attention deficit hyperactivity disorder, sleep, dual diagnosis, geronto-psychiatry and post-traumatic stress disorder clinics and various rehabilitation day-care services...
December 2016: Harefuah
https://www.readbyqxmd.com/read/28474493/identifying-the-clinical-needs-and-patterns-of-health-service-use-of-adolescent-girls-and-women-with-autism-spectrum-disorder
#11
Ami Tint, Jonathan A Weiss, Yona Lunsky
Girls and women in the general population present with a distinct profile of clinical needs and use more associated health services compared to boys and men; however, research focused on health service use patterns among girls and women with Autism Spectrum Disorder (ASD) is limited. In the current study, caregivers of 61 adolescent girls and women with ASD and 223 boys and men with ASD completed an online survey. Descriptive analyses were conducted to better understand the clinical needs and associated service use patterns of girls and women with ASD...
May 5, 2017: Autism Research: Official Journal of the International Society for Autism Research
https://www.readbyqxmd.com/read/28471534/predicting-suicide-with-the-sad-persons-scale
#12
Cara Katz, Jason R Randall, Jitender Sareen, Dan Chateau, Randy Walld, William D Leslie, JianLi Wang, James M Bolton
BACKGROUND: Suicide is a major public health issue, and a priority requirement is accurately identifying high-risk individuals. The SAD PERSONS suicide risk assessment scale is widely implemented in clinical settings despite limited supporting evidence. This article aims to determine the ability of the SAD PERSONS scale (SPS) to predict future suicide in the emergency department. METHODS: Five thousand four hundred sixty-two consecutive adults were seen by psychiatry consultation teams in two tertiary emergency departments with linkage to population-based administrative data to determine suicide deaths within 6 months, 1, and 5 years...
May 4, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28456376/-consultation-liaison-during-the-peripartum-network-care-between-liaison-and-mobile-unit
#13
V Garez, E Devouche, A Bobin-Bègue, M Alecian, P Minjollet, A Vallerent, M Poget, H Oguibenine, C Héroux, F Medjkane, G Apter
OBJECTIVES: The pregnancy periods of peripartum and immediate postpartum represent moments of opportunity to access care. Both prevention and therapeutic management can be offered with a better chance of success during these periods. Our specific Consultation Liaison (CL) team PPUMMA was created in order to respond to the need for early detection of psychopathology and rapid implementation of therapeutic management and preventive measure for mother and child. The importance of urgently intervening "on site" seemed a necessity since duration of hospitalization in maternity wards is very short...
April 26, 2017: L'Encéphale
https://www.readbyqxmd.com/read/28348380/preventing-intrusive-memories-after-trauma-via-a-brief-intervention-involving-tetris-computer-game-play-in-the-emergency-department-a-proof-of-concept-randomized-controlled-trial
#14
L Iyadurai, S E Blackwell, R Meiser-Stedman, P C Watson, M B Bonsall, J R Geddes, A C Nobre, E A Holmes
After psychological trauma, recurrent intrusive visual memories may be distressing and disruptive. Preventive interventions post trauma are lacking. Here we test a behavioural intervention after real-life trauma derived from cognitive neuroscience. We hypothesized that intrusive memories would be significantly reduced in number by an intervention involving a computer game with high visuospatial demands (Tetris), via disrupting consolidation of sensory elements of trauma memory. The Tetris-based intervention (trauma memory reminder cue plus c...
March 28, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28320345/effect-of-telephone-follow-up-on-repeated-suicide-attempt-in-patients-discharged-from-an-emergency-psychiatry-department-a-controlled-study
#15
Sophie Exbrayat, Clotilde Coudrot, Xavier Gourdon, Aurélia Gay, Jessica Sevos, Jacques Pellet, Béatrice Trombert-Paviot, Catherine Massoubre
BACKGROUND: Attempted suicide is a major public health problem, and the efficacies of current postvention protocols vary. We evaluated the effectiveness of telephone follow-up of patients referred to an emergency psychiatric unit for attempted suicide on any further attempt/s over the following year. METHOD: In a single-center, controlled study with intent to treat, we evaluated the efficacy of a protocol of telephone follow-up of 436 patients at 8, 30, and 60 days after they were treated for attempted suicide...
March 20, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28248838/family-based-crisis-intervention-with-suicidal-adolescents-a-randomized-clinical-trial
#16
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
#17
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
#18
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
#19
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
#20
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
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