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Emergency department psychiatry

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https://www.readbyqxmd.com/read/29664808/trends-in-pharmacological-emergency-treatment-of-patients-suffering-from-schizophrenia-over-a-16-year-observation-period
#1
Monika Edlinger, Anna-Sophia Welte, Nursen Yalcin-Siedentopf, Georg Kemmler, Felix Neymeyer, W Wolfgang Fleischhacker, Alex Hofer
Patients suffering from schizophrenia are often treated in locked psychiatric units because of psychomotor agitation, hostility and aggressive behavior, or suicidality. Because of legal conditions, investigations on these acutely ill patients are difficult, and many studies do not represent 'real-life psychiatry'. This retrospective survey was conducted at the Department of Psychiatry, Psychotherapy and Psychosomatics of the Medical University, Innsbruck, Austria. Data were collected from the records of all adult inpatients suffering from a schizophrenia spectrum disorder according to the International Classification of Diseases, 10th ed...
April 16, 2018: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/29661003/outcomes-among-persons-with-hiv-following-a-mental-health-admission-a-population-based-study
#2
Cindy Lau, Claire E Kendall, Ann N Burchell, Ahmed M Bayoumi, Mona Loutfy, Sean Rourke, Tony Antoniou
Objective To compare outcomes following psychiatric hospitalization between people with and without HIV. Methods Population-based study of people with (n = 1,089) and without (n = 280,888) HIV who were hospitalized for psychiatric illness between January 1, 2006 and December 31, 2014. Results Overall, 9 (0.8%) people with HIV died within 30 days of discharge, compared with 3710 (1.3%) HIV-negative individuals. Following multivariable adjustment, there was no difference in the risk of readmission or emergency department (ED) visits for psychiatric illness in the 90 days following discharge...
April 17, 2018: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/29596725/antagonists-in-the-medical-management-of-opioid-use-disorders-historical-and-existing-treatment-strategies
#3
REVIEW
Adam Bisaga, Paolo Mannelli, Maria A Sullivan, Suzanne K Vosburg, Peggy Compton, George E Woody, Thomas R Kosten
BACKGROUND AND OBJECTIVES: Opioid use disorder (OUD) is a chronic condition with potentially severe health and social consequences. Many who develop moderate to severe OUD will repeatedly seek treatment or interact with medical care via emergency department visits or hospitalizations. Thus, there is an urgent need to develop feasible and effective approaches to help persons with OUD achieve and maintain abstinence from opioids. Treatment that includes one of the three FDA-approved medications is an evidence-based strategy to manage OUD...
April 2018: American Journal on Addictions
https://www.readbyqxmd.com/read/29593578/mental-disorder-the-need-for-an-accurate-definition
#4
Diogo Telles-Correia, Sérgio Saraiva, Jorge Gonçalves
There are several reasons why a definition for mental disorder is essential. Among these are not only reasons linked to psychiatry itself as a science (nosology, research) but also to ethical, legal, and financial issues. The first formal definition of mental disorder resulted from a deep conceptual analysis led by Robert Spitzer. It emerged to address several challenges that psychiatry faced at the time, namely to serve as the starting point for an atheoretical and evidence-based classification of mental disorders, to justify the removal of homosexuality from classifications, and to counter the arguments of antipsychiatry...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29580702/-methods-to-improve-suicidal-adolescents-compliance-to-care-after-emergency-discharge-a-literature-review
#5
J Lachal, S Grandclerc, M Spodenkiewicz, M R Moro
OBJECTIVES: Suicidal adolescents admitted in an Emergency Department (ED) present a high risk of suicidal reattempts. Poor observance of follow-up in this particular group imped the efficacity of the treatment. We propose to summarize the international literature on ED interventions promoting suicidal adolescents' adherence to care. METHOD: We carried out a comprehensive review of papers listed in PubMed, PsycInfo, and CINHAL databases using keywords about adolescence, suicide, and ED...
March 23, 2018: L'Encéphale
https://www.readbyqxmd.com/read/29549821/improving-suicide-risk-assessment-in-the-emergency-department-through-physician-education-and-a-suicide-risk-assessment-prompt
#6
Taras R Reshetukha, Nazanin Alavi, Eric Prost, Ryan H Kirkpatrick, Saad Sajid, Charmy Patel, Dianne L Groll
OBJECTIVE: To determine the efficacy of two interventions on suicide risk assessment within emergency departments (EDs) on improving the documentation of suicide risk factors by emergency medicine and psychiatric physicians during suicide risk assessment. METHOD: An educational intervention on suicide was provided to all emergency medicine and psychiatry physicians and was followed by the placement of a suicide risk assessment prompt within local EDs. The medical charts of all ED patients presenting with suicidal ideation or behaviours were reviewed immediately and six months after the interventions and compared to pre-intervention...
March 2, 2018: General Hospital Psychiatry
https://www.readbyqxmd.com/read/29527054/historical-aspects-of-the-institute-of-psychiatry-and-human-behavior-goa
#7
Ashish Srivastava, Bramhanand Cuncoliencar, Yvonne Da Silva Pereira
Organized delivery of mental health services in Goa had its origin during the Portuguese regime. From the inception of a mental asylum in the 1500s, mental health services have come a long way. In post liberation period, after 1961, under the guidance of a WHO Consultant, Dr. Govindaswamy, a new mental hospital was built at Panaji, Goa and it was named as the Abbe de Faria Institute. The Department of Psychiatry in Goa Medical College was established in 1968, and unlike in most parts of the country, where Psychiatry was a part of Medicine; here in Goa, it enjoyed an independent departmental status...
February 2018: Indian Journal of Psychiatry
https://www.readbyqxmd.com/read/29465842/paediatric-consultation-liaison-psychiatry-services-pclps-what-are-they-actually-doing
#8
F Lynch, C Kehoe, S MacMahon, E McCarra, R McKenna, A D'Alton, E Barrett, A Twohig, F McNicholas
Introduction Paediatric Consultation Liaison Psychiatry Services (PCLPS) are specialised services treating mental health difficulties co-morbid with medical problems. Methods Standardised clinical data was retrieved from all case notes (N=108) during the study timeframe (Jan-June 2016). Results The majority of children were female 59 (55%) with a mean age of 13. Presentation was typically via the Emergency Department (ED) (85, 79%), and of those, the majority (53, 62%) were 'out of hours' and for Deliberate Self-harm (44, 52%) Almost half of all cases seen (50, 46%) were previously known, and discharged back (84, 78%), to CAMHS...
December 18, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/29438853/gastric-ulceration-and-perforation-secondary-to-large-trichobezoar-a-case-report-describing-the-role-of-magnetic-resonance-imaging-in-diagnosis
#9
M M Hennessy, I Ivanovski, C B Ó Súilleabháin
INTRODUCTION: Trichotillomania and trichotillophagia can result in huge intraluminal coagulations of hair. Rarely, these can present with gastric perforation. This work has been reported in line with the SCARE criteria (Agha et al., 2016) [1]. PRESENTATION OF CASE: We report the case of a 15 year old girl who attended the emergency department with abdominal pain and vomiting. Ultrasound abdomen and pelvis identified free fluid within the pelvis concerning for inflammatory bowel disease...
February 10, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29385959/reducing-frequent-utilization-of-psychiatric-emergency-services-among-veterans-while-maintaining-quality-of-care
#10
Daniel M Blonigen, Luisa Manfredi, Adrienne Heinz, Xiaoyu Bi, Paola Suarez, Andrea L Nevedal, Anita A Vashi, Christine Timko, Todd Wagner
OBJECTIVE: Use of psychiatric emergency services in emergency departments (EDs) and inpatient psychiatry units contributes substantially to the cost of mental health care. Among patients who utilize psychiatric emergency services, a small percentage ("high utilizers") contributes a disproportionate share of the total cost, yet little is known about the context of care for these patients. This study employed qualitative methods to identify barriers to and facilitators of reducing use of psychiatric emergency services among high utilizers...
February 1, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29326819/association-between-bullying-and-pediatric-psychiatric-hospitalizations
#11
Hadassa Leader, Jasmine Singh, Ayesha Ghaffar, Cheryl de Silva
Objectives: Bullying is a serious public health issue. We sought to demonstrate an association between bullying victimization and hospital admissions for acute psychiatric problems. We described the demographics and types of bullying in a sample of hospitalized patients in Staten Island, NY, and compared bullying victimization scores with psychiatric versus medical admissions. Methods: Patients in grades 3-12 were recruited from the Staten Island University Hospital Inpatient Pediatrics unit and emergency department...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29157510/euthanasia-requests-in-a-canadian-psychiatric-emergency-room-a-case-series-part-1-of-the-mcgill-university-euthanasia-in-psychiatry-case-series
#12
David Benrimoh, Antoine Perreault, Frederique Van Den Eynde
Euthanasia was decriminalized in Quebec in December 2015, and Canada-wide in June 2016. Both the Provincial and Federal legislation have limited the right to medical assistance in dying (MAID) to end-of-life cases; which makes MAID inaccessible to most patients solely suffering from psychiatric illness. While some end-stage anorexia nervosa or elderly patients may meet the end-of-life criterion because of their medical comorbidities or their age (Kelly et al., 2003), repeated suicide attempts or psychotic disorganization would not qualify since they would not be seen as elements of an illness leading to a foreseeable "natural death" (Canada, 2016)...
November 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29153907/-violent-outburst-from-teenagers-in-the-pediatric-emergency-room-complex-cases
#13
L Cohen, C Gras-Le Guen, J Fleury, E Caldagues, L Dreno, G Picherot, N Vabres
INTRODUCTION: Teenagers admitted to the emergency room for a violent attacks episode are increasingly numerous. The source of agitation is multifactorial for these teenagers, often with a complex course. They jeopardize hospital wards, which are often ill-suited for and overwhelmed during these outbursts. This study aims to identify and describe all the teenagers admitted to the hospital over 1 year for a violent outburst and discuss their management. METHODS AND EQUIPMENT: Retrospective and descriptive study of teenagers admitted to the pediatric emergency department of the Nantes University Hospital for a violent outburst in 2015...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29096213/machine-based-classification-of-adhd-and-nonadhd-participants-using-time-frequency-features-of-event-related-neuroelectric-activity
#14
MULTICENTER STUDY
Hüseyin Öztoprak, Mehmet Toycan, Yaşar Kemal Alp, Orhan Arıkan, Elvin Doğutepe, Sirel Karakaş
OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) is the most frequent diagnosis among children who are referred to psychiatry departments. Although ADHD was discovered at the beginning of the 20th century, its diagnosis is still confronted with many problems. METHOD: A novel classification approach that discriminates ADHD and nonADHD groups over the time-frequency domain features of event-related potential (ERP) recordings that are taken during Stroop task is presented...
December 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29084129/analysis-of-incidents-of-violence-in-a-large-italian-hospital
#15
Dimitri Sossai, Francesco Stefano Molina, Mario Amore, Giovanna Ferrandes, Elena Sarcletti, Gabriella Biffa, Simone Accorsi, Martino Belvederi Murri, Marzia Jole Tomellini, Francesco Copello
INTRODUCTION: An increase in the rate of non-fatal violence events, from 20.65/10,000 in 2012 to 22.81/10,000 in 2014, was observed at the IRCCS Ospedale Policlinico San Martino in Genoa. OBJECTIVES: To analyze the incidence and outcome of the phenomenon of violence, by identifying the type of aggressive event and the ward in which it occurred, assuming that the occurrence is evenly distributed and not only limited to the psychiatric or to the emergency department...
October 27, 2017: La Medicina del Lavoro
https://www.readbyqxmd.com/read/28832806/a-psychotic-experience-during-adolescence-reasoning-about-differential-diagnosis-case-report
#16
Vítor Ferreira Leite, Carla Andrade Araújo
CONTEXT: The aim of the present clinical review was to illustrate the diagnostic difficulty associated with psychotic experiences during adolescence, in the light of the multiplicity of circumstances interplaying during this period. It was also intended to illustrate the observation that not all hallucinations occur in the context of a declared psychotic disorder. CASE REPORT: The patient was a 16-year-old adolescent girl who came to the Emergency Department of Coimbra Pediatric Hospital...
August 21, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28827260/extending-the-liaison-psychiatry-service-in-a-large-hospital-in-the-uk-a-before-and-after-evaluation-of-the-economic-impact-and-patient-care-following-ed-attendances-for-self-harm
#17
Brent C Opmeer, William Hollingworth, Elsa M R Marques, Ruta Margelyte, David Gunnell
OBJECTIVES: To evaluate the impact of an expansion of liaison psychiatry services (LPS) on patient management, outcomes and treatment costs for emergency department (ED) attendances for self-harm. DESIGN: Retrospective before and after cohort study using routinely collected Self-Harm Surveillance Register data. SETTING: A large hospital in South West England. SUBJECTS: Patients attending the ED for self-harm. INTERVENTIONS: Extension of the LPS' working hours from 9:00 to 17:00, Monday to Friday to 8:00 to 22:00, 7 days a week, following a £250 000 annual investment MAIN OUTCOME MEASURES: Number and characteristics of ED attendances for self-harm...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28805423/patterns-of-psychiatric-emergency-department-utilization-among-community-dwelling-medicare-beneficiaries-under-65
#18
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
#19
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
#20
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
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