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Emergency department psychiatry

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https://www.readbyqxmd.com/read/28805423/patterns-of-psychiatric-emergency-department-utilization-among-community-dwelling-medicare-beneficiaries-under-65
#1
Jingjing Qian, Saranrat Wittayanukorn, Richard A Hansen
This study estimated patterns and trends in all-cause (any reason, including psychiatry related) and psychiatric emergency department (ED) utilization among Medicare beneficiaries under 65 who were residing in community settings (i.e., noninstitutionalized or in their own homes). Medicare beneficiaries under the age of 65 enrolled in Medicare for Social Security Disability Insurance (SSDI) due to permanent physical or mental disabilities are a population with poor health conditions and high utilization of health services; however, this vulnerable population has received limited attention from researchers and policymakers compared to the Medicare beneficiaries 65 years and older...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28800810/international-emergency-psychiatry-challenges-disaster-medicine-war-human-trafficking-displaced-persons
#2
REVIEW
Michael Jaung, Suni Jani, Sophia Banu, Joy M Mackey
Mental health disorders are a major cause of morbidity and a growing burden in low-income and middle-income countries; but there is little existing literature on the detailed epidemiology, diagnosis, and treatment in low-resource settings. Special situations with vulnerable populations, such as those created by international humanitarian emergencies, refugees or internally displaced people, and victims of human trafficking, are increasing in prevalence. These victims are often resettled in developed countries and come to the emergency department seeking care...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800809/legal-and-ethical-challenges-in-emergency-psychiatry-part-2-management-of-inmates
#3
REVIEW
Andrew Foote, Britta Ostermeyer
Psychiatrists and clinicians encounter unique situations, challenges, and requirements in the treatment of jail and prison inmates in the emergency department. This article reviews the historical legal highlights pertaining to medical and psychiatric care of inpatients, as well as the professional, ethical, and legal aspects that allow clinicians to evaluate, treat, and properly disposition their inmate patients. In particular, this article discusses the specific suicide risk factors related to inmates and correctional facilities that should be ascertained and managed in a clinician's suicide risk assessment and intervention planning in this special high suicide risk patient population...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800799/emergency-department-medical-clearance-of-patients-with-psychiatric-or-behavioral-emergencies-part-2-special-psychiatric-populations-and-considerations
#4
REVIEW
Al Alam, James Rachal, Veronica Theresa Tucci, Nidal Moukaddam
Patients who present to the emergency department (ED) with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, there are wide variations in quality of care for these individuals. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach to patients. Our group has long advocated a dynamic comanagement approach for medical clearance in the ED, and this article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical/physical examination, and common pitfalls in the medical clearance process...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28800798/emergency-department-medical-clearance-of-patients-with-psychiatric-or-behavioral-emergencies-part-1
#5
REVIEW
Veronica Theresa Tucci, Nidal Moukaddam, Al Alam, James Rachal
Patients presenting to the emergency department with mental illness or behavioral complaints merit workup for underlying physical conditions that can trigger, mimic, or worsen psychiatric symptoms. However, interdisciplinary consensus on medical clearance is lacking, leading to wide variations in quality of care and, quite often, poor medical care. Psychiatry and emergency medicine specialty guidelines support a tailored, customized approach. This article summarizes best-practice approaches to the medical clearance of patients with psychiatric illness, tips on history taking, system reviews, clinical or physical examination, and common pitfalls in the medical clearance process...
September 2017: Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28796120/synthetic-cannabis-analogues-and-suicidal-behavior-case-report
#6
Pedro Miguel Dos Santos Oliveira, Ana Sofia Félix Morais, Nuno Gonçalo Gomes Fernandes Madeira
INTRODUCTION: Despite growing legal control, a wide range of synthetic cannabis analogues is currently used for recreational purposes, notwithstanding their well adverse outcomes, which appear to be more frequent and more serious than those associated with cannabis use. We present the case report of a patient with paranoid schizophrenia, who attempted suicide by serious bodily harm after a single use of "Shiva Ultra Strong," a compound of several synthetic cannabis analogues. CASE SUMMARY: A 32-year-old male patient with paranoid schizophrenia was brought to the emergency department presenting with a severe self-inflicted wound to the neck which lacerated the right jugular vein and ipsilateral airway, and narrowly missed the carotid bifurcation...
August 8, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28795915/where-teachers-are-few-documenting-available-faculty-in-five-tanzanian-medical-schools
#7
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...
December 2016: Global Health Action
https://www.readbyqxmd.com/read/28768699/use-of-a-23-hour-emergency-department-observation-unit-for-the-management-of-patients-with-toxic-exposures
#8
Rupeng Mong, Gabriel Joseph Arciaga, Hock Heng Tan
BACKGROUND: A significant proportion of patients with toxic exposures presenting to the ED require admission. However, most will improve within 24 hours, and so could potentially be managed in a short-stay observation unit. We describe the management and outcomes of these patients in a 23-hour ED observation unit (EDOU). METHODS: A retrospective chart review of all patients with toxic exposures admitted to the EDOU in Singapore between 1 April 2013 and 31 March 2015 was performed...
August 2, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28726526/integrated-care-coordination-by-an-interprofessional-team-reduces-emergency-department-visits-and-hospitalisations-at-an-academic-health-centre
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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