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Involuntary hospitalization

Barry A Finegan, Daniel Roblin, Fadi Hammal
Quality problem: For smokers, hospital admission is accompanied by forced involuntary nicotine abstinence due to smoke-free site/grounds policies. An audit of patients admitted to our surgical wards revealed that identification of smoking status was inadequate and that nicotine addiction management (NAM) was infrequently offered. The project aimed to enhance both these metrics by initiating NAM in the post anesthesia care unit (PACU). Initial assessment: Out of 744 patients admitted to our PACU in August 2015, 54% had their smoking status documented...
March 14, 2018: International Journal for Quality in Health Care
R Mezzina
AIM: Italy pioneered deinstitutionalisation over the past 60 years and enforced a famous mental health (MH) reform law in 1978. Deinstitutionalisation has been completed with the very closure of all psychiatric hospitals over two decades. METHODS: After 40 years of implementation, this article presents the main achievements and challenges of the Italian MH reform law, including its long-term effect and impact in Italy and abroad. RESULTS: The Legislation of 1978 was based on the discovery of rights as a key tool in mental healthcare...
March 6, 2018: Epidemiology and Psychiatric Sciences
Tomasz Pawlowski, Piotr Baranowski
Background: Coercive measures are applied in psychiatry as a last resort to control self- and hetero-aggressive behaviors in situations where all other possible strategies have failed. For ethical and clinical reasons, the number of instances of coercion should be reduced as far as possible. Aim: The aim of the study was to identify sociodemographic and clinical characteristics of patients that were associated with coercion during hospital treatment. Materials and Methods: The study has a descriptive, longitudinal design, based on a 1 year prospective observation of patients admitted to a psychiatric hospital consisting of six inpatient psychiatric wards with a total of 236 beds...
October 2017: Indian Journal of Psychiatry
Daniel Schöttle, Benno G Schimmelmann, Friederike Ruppelt, Alexandra Bussopulos, Marietta Frieling, Evangelia Nika, Luise Antonia Nawara, Dietmar Golks, Andrea Kerstan, Matthias Lange, Michael Schödlbauer, Anne Daubmann, Karl Wegscheider, Anja Rohenkohl, Gizem Sarikaya, Mary Sengutta, Daniel Luedecke, Linus Wittmann, Gunda Ohm, Christina Meigel-Schleiff, Jürgen Gallinat, Klaus Wiedemann, Thomas Bock, Anne Karow, Martin Lambert
The ACCESS-model offers integrated care including assertive community treatment to patients with psychotic disorders. ACCESS proved more effective compared to standard care (ACCESS-I study) and was successfully implemented into clinical routine (ACCESS-II study). In this article, we report the 4-year outcomes of the ACCESS-II study. Between May 2007 and December 2013, 115 patients received continuous ACCESS-care. We hypothesized that the low 2-year disengagement and hospitalization rates and significant improvements in psychopathology, functioning, and quality of life could be sustained over 4 years...
2018: PloS One
Michael Lebenbaum, Maria Chiu, Simone Vigod, Paul Kurdyak
BACKGROUND: Involuntary admissions to psychiatric hospitals are common; however, research examining the trends in prevalence over time and predictors is limited. Aims To examine trends in prevalence and risk factors for involuntary admissions in Ontario, Canada. METHOD: We conducted an analysis of all mental health bed admissions from 2009 to 2013 and assessed the association between patient sociodemographics, service utilisation, pathway to care and severity characteristics for involuntary admissions using a modified Poisson regression...
March 2018: BJPsych Open
Josie Nott, Aspen Mcintosh, Clare Taube, Mark Taylor
OBJECTIVES: Shared decision-making (SDM) is promoted as beneficial in mental healthcare, despite a dearth of supportive evidence. We aimed to obtain patients' perspective on SDM in a 'real world' hospital sample. METHODS: Structured validated questionnaires were used to examine SDM with regard to treatment choices, and whether SDM influences attitudes towards treatment. The Mini-Mental State Examination was used to assess decision-making capacity. RESULTS: A total of 109 individuals participated, with 60% reporting experiencing SDM...
February 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
Liam Trevithick, Jane Carlile, Sunil Nodiyal, Patrick Keown
BACKGROUND: Community treatment orders (CTOs) were introduced in England in 2008. Aims To measure the rate of CTO use in England during the first 5 years following introduction. METHOD: The number of involuntary detentions and CTOs in National Health Service (NHS) hospital trusts was collected between 2009 and 2014. Rates of CTO use and the ratio of CTOs to detentions on admission were calculated, and how these varied between trusts. RESULTS: The number of new CTOs each year ranged between 3834 and 4647...
March 2018: British Journal of Psychiatry: the Journal of Mental Science
Ziyan Xu, Mario Müller, Barbara Lay, Nathalie Oexle, Thekla Drack, Marco Bleiker, Silke Lengler, Christina Blank, Stefan Vetter, Wulf Rössler, Nicolas Rüsch
People with severe mental illness and a history of involuntary hospitalization may experience stigma-related stress and suffer negative consequences as a result. However, the long-term impact of stigma stress on suicidality in this population remains unknown. This longitudinal study therefore examined stigma stress, self-stigma, self-esteem and suicidal ideation among 186 individuals with mental illness and recent involuntary hospitalization. After adjusting for age, gender, diagnoses and symptoms, more stigma stress at baseline predicted suicidal ideation after 2 years, mediated by increased self-stigma and decreased self-esteem after 1 year...
January 27, 2018: Social Psychiatry and Psychiatric Epidemiology
F Polistina, C Mazzucco, D Coco, M Frego
PURPOSES: To evaluate the impact of percutaneous cholecystostomy (PC) on severe acute cholecystitis (AC). METHODS: According to the ICD-9 classification, we retrospectively retrieved medical records of patients discharged with a diagnosis of AC from January 2007 to December 2016 at our hospital. Patients were then stratified according to the Tokyo 2013 (TG 13) AC severity criteria. Grade III AC was diagnosed according to the TG 13 criteria. Indications for PC were failure of optimal medical treatment within 48 h, worsening of clinical condition within early medical treatment, patients unfit for upfront surgery and patient's preference...
January 25, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
L Hochstrasser, D Fröhlich, A R Schneeberger, S Borgwardt, U E Lang, R-D Stieglitz, C G Huber
BACKGROUND: Psychiatric inpatient treatment is increasingly performed in settings with locked doors. However, locked wards have well-known disadvantages and are ethically problematic. In addition, recent data challenges the hypothesis that locked wards provide improved safety over open-door settings regarding suicide, absconding and aggression. Furthermore, there is evidence that the introduction of an open-door policy may lead to short-term reductions in involuntary measures. The aim of this study was to assess if the introduction of an open-door policy is associated with a long-term reduction of the frequency of seclusion and forced medication...
December 11, 2017: European Psychiatry: the Journal of the Association of European Psychiatrists
Chia-Hsiang Chan, Hung-Yu Chan, Yen-Ching Chen
Aripiprazole is a second-generation antipsychotics, acting as a partial dopamine D2 receptor agonist. Previous studies on aripiprazole for tardive dyskinesia (TD) treatment were limited and inconclusive. This study was aimed to examine the effectiveness of aripiprazole in psychotic patients with a pre-existing TD. This was an open-label 24-week prospective cohort study conducted in a public mental hospital in Northern Taiwan from January 2009 to February 2010.Psychotic patients were cross-titrated of prior antipsychotics with aripiprazole, and the severity of TD was assessed at baseline and at weeks 2, 4, 8, 12, 16, 20, and 24...
January 10, 2018: International Clinical Psychopharmacology
Abhishek Jain, Paul S Appelbaum
As in much of the world, mental health law in Israel has evolved over the past half-century toward greater protection of patients' liberty and an increased emphasis on due process. Part of that process in Israel involved taking decisions about prolonged involuntary hospitalization out of the hands of treating psychiatrists and turning them over to independent review panels. Argo and colleagues examined outcomes of discharge decisions made by these panels compared with treating psychiatrists. In this brief commentary, we describe related trends in mental health law in other countries, especially the U...
January 2, 2018: Israel Journal of Health Policy Research
Eva Krieger, Steffen Moritz, Ricarda Weil, Matthias Nagel
Coercive interventions for psychiatric patients are controversial. Research on different preventive measures has increased over the last years. The present study examined patients' attitudes towards and understanding of previously experienced coercive measures as well as their preferences related to coercive measures and possible alternatives. In total, 213 patients who had experienced coercion and 51 patient controls (patients staying voluntarily on a closed ward with no coercive treatment) from three acute wards were examined via expert interviews and questionnaires in the framework of a naturalistic trial...
December 13, 2017: Psychiatry Research
Patricia Westmoreland, Craig Johnson, Michael Stafford, Richard Martinez, Philip S Mehler
Anorexia nervosa has the highest mortality rate of any psychiatric illness. Predictors of mortality include chronicity of the illness, critically low body weight, and binging and purging behavior. Delusional beliefs body image, coupled with impaired judgment and cognition caused by starvation, often result in these patients adamantly resisting efforts to treat them. Guardianship, although useful in assisting with medical treatment decisions for patients with anorexia nervosa who are critically medically ill, is usually an inadequate intervention with respect to psychiatric treatment for these patients...
December 2017: Journal of the American Academy of Psychiatry and the Law
Benjamin Momo Kadia, Christian Morfaw, Armelle Corrine Gounoue Simo
BACKGROUND: Dihydroartemisinin-piperaquine is a combination of dihydroartemisinin and piperaquine which is highly effective in the treatment of uncomplicated falciparum malaria. Its adverse effects are generally tolerable and temporary. Choreoathetosis, an involuntary movement disorder characterized by continuous irregular twisting of the body, is not a documented adverse effect of this medication. CASE PRESENTATION: A 41-year-old Cameroonian man of black African ethnicity was brought to our primary care hospital because over the previous 6 hours he had been experiencing involuntary twisting movements of his body and he no longer had control of his limbs...
December 28, 2017: Journal of Medical Case Reports
Jacqueline R Ho, Jacquelyn R Hoffman, Lusine Aghajanova, James F Smith, Marisela Cardenas, Christopher N Herndon
Background: Infertility is a prevalent disease of reproductive health that exerts an impact on an estimated 80 million people worldwide. For many, involuntary childlessness becomes a central and preoccupying issue in their lives, the impact of which is exacerbated by lack of access to basic care and treatment. These effects maybe further magnified among immigrant communities, a growing but highly marginalized population that has been shown in other areas of reproductive health to experience worse health outcomes and delays in access to care...
2017: Contraception and Reproductive Medicine
Pierfrancesco Maria Balducci, Francesco Bernardini, Luca Pauselli, Alfonso Tortorella, Michael T Compton
BACKGROUND: Involuntary admission is challenging in terms of providing the most effective but least restrictive care in accordance with the country's regulations. A better understanding of correlates of voluntary versus involuntary admission legal status is crucial to improve clinical decision-making and effectiveness of the overall mental health care system. SUBJECTS AND METHODS: We collected chart-review data pertaining to 848 patients, discharged between June 2011 and June 2014, from an Italian inpatient psychiatric unit...
December 2017: Psychiatria Danubina
T Fovet, M Bertrand, M Horn, W Si Mohammed, D Dandelot, M-C Dalle, P Thomas, A Amad
The unités hospitalières spécialement aménagées (UHSA) are full-time inpatient psychiatric units for inmates in France. Their creation has been associated with several advances in access to psychiatric care for inmates in recent years. However, there is still only one means of involuntary hospitalization for prisoners in France: care by decision of a representative of the state (les soins sur décision d'un représentant de l'état [SDRE]). Interestingly, for SDRE to be recognized as legal by the French judge, the patient must be "a danger to himself or to the others"...
November 27, 2017: L'Encéphale
G T Duval, P-Y Paré, J Gautier, S Walrand, M Dinomais, C Annweiler
OBJECTIVES: To determine i) whether cases of elderly fallers had lower serum 25-hydroxyvitamin D (25OHD) concentration than controls without history of falls; and ii) whether serum 25OHD concentration was associated with specific mechanisms, circumstances and consequences of falls. DESIGN: Case-control study with a 1:2 ratio. SETTING: Geriatric ward of the University Hospital of Angers, France, between February 2012 and March 2014. PARTICIPANTS: 216 inpatients (72 cases and 144 age- and gender-matched controls)...
2017: Journal of Nutrition, Health & Aging
Michiaki Matsuda, Shinpei Takesako, Mitsuhiro Nakazaki, Toru Nandate, Fujio Umehara
We describe the case of a 90-year-old woman who was hospitalized in July 2016 and subsequently experienced a sudden decline in consciousness level resulting in a state of deep coma. Involuntary movements were not observed, and bilateral Babinski signs were inconclusive. Diffusion-weighted MRI (DWI) of the brain showed bilateral hyperintensity in the thalamus and internal capsule, laboratory testing detected high levels of plasma ammonia, and an electroencephalogram showed delta waves and triphasic waves predominantly in the frontal lobe...
December 27, 2017: Rinshō Shinkeigaku, Clinical Neurology
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