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primary care psychiatry

Skye P Barbic, Stefan J Cano
This commentary argues the importance of robust, meaningful assessment of clinical and functional outcomes in psychiatry. Outcome assessments should be fit for the purpose of measuring relevant concepts of interest in specific clinical settings. As well, the measurement model selected to develop and test assessments can be critical for guiding care. Three types of measurement models are presented: classical test theory, item response theory, and Rasch measurement theory. To optimise current diagnostic and treatment practices in psychiatry, careful consideration of these models is warranted...
October 2016: BJPsych Bulletin
Soteri Polydorou, Stephen Ross, Peter Coleman, Laura Duncan, Nichole Roxas, Anil Thomas, Sonia Mendoza, Helena Hansen
OBJECTIVES: This report identifies the institutional barriers to, and benefits of, buprenorphine maintenance treatment (BMT) integration in an established hospital-based opioid treatment program (OTP). METHODS: This case study presents the authors' experiences at the clinic, hospital, and corporation levels during efforts to integrate BMT into a hospital-based OTP in New York City and a descriptive quantitative analysis of the characteristics of hospital outpatients treated with buprenorphine from 2006 to 2013 (N=735)...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Javier Bartolomei, Rachel Baeriswyl-Cottin, David Framorando, Filip Kasina, Natacha Premand, Ariel Eytan, Yasser Khazaal
BACKGROUND: We aimed to assess the opinion of primary care workers, social workers, translators and mental health caregivers who work with asylum seekers about the latter's unmet needs and barriers to access to mental healthcare. METHODS: We used a Likert scale to assess the opinion of 135 primary care workers (general practitioners, nurses, social workers and translators) and mental health caregivers about the proportion of asylum seekers with psychiatric disorders, their priority needs and their main barriers to mental health services...
September 29, 2016: BMC Psychiatry
Thomas Stompe, Kristina Ritter, David Holzer, Andrea Topitz, Thomas Wenzel
The refugee movements of the recent years are confronting the health care with new challenges. However, it has turned out that in Austria data on the mental health of migrants are nearly not available. Especially data on the frequency and patterns of comorbid substance abuse of migrants with mental disorders do not exist even from international studies. We analyzed data from 1819 patients (1726 first generation, 93 second generation) treated in the outpatient clinic for transcultural psychiatry and migration related disorders at the Vienna General Hospital: In first-generation migrants the cultural and religious background of the region of origin has the greatest impact on the frequency and the patterns of misused substances...
September 2016: Neuropsychiatrie: Klinik, Diagnostik, Therapie und Rehabilitation
David S Kroll, Annie Chakravartti, Kate Gasparrini, Carol Latham, Paul Davidson, Martha Byron-Burke, David F Gitlin
OBJECTIVE: Missed appointments decrease clinic capacity and negatively affect health outcomes. The objective of this study was to increase the proportion of filled initial psychiatry appointments in an urban, hospital-based primary care practice. METHODS: Patients were identified as having a high or low risk of missing their initial psychiatry appointments based on prior missed medical appointments. High-risk patients were referred to a walk-in clinic instead of a scheduled appointment...
October 2016: Journal of Psychosomatic Research
Eva Tedgård, Maria Råstam
OBJECTIVE: To investigate whether women raised in a family with substance abuse constitute a particularly vulnerable group of patients in an infant psychiatry setting and to identify the risk factors of suspected parental malfunctioning in women referred to treatment in an infant and toddler intervention program. BACKGROUND: A history of family substance abuse can severely disrupt the caretaking abilities of parents in ways that can have far-reaching consequences, and children growing up with insufficient parental care may incorporate this deficiency into their own parental behavior...
2016: SpringerPlus
Jeanne Eichler, Lydia Royeen
This article provides personal experiences of two clinicians on the topic of occupational therapy in the primary health care clinic. Lydia Royeen is a full time clinician in acute care and psychiatry and Jeanne Eichler is Assistant Professor and founder of the OTonCampus program at Saint Louis University. (PsycINFO Database Record
September 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Christopher N Kaufmann, Adam P Spira, Colin A Depp, Ramin Mojtabai
OBJECTIVES: To assess trends in continuing and new prescriptions for sedative-hypnotic medications, including benzodiazepines (BZDs) and non-BZD receptor agonists (nBZRAs). METHODS: Data came from the National Ambulatory Medical Care Survey and comprised 287 288 randomly sampled patient visits. Physicians reported medications prescribed and whether they were "continuing" or "new" prescriptions. We assessed trends in continuing BZD, new BZD, continuing nBZRA, and new nBZRA prescriptions from 2005 to 2012...
November 2016: American Journal of Public Health
Rachelle Ashcroft, Jose Silveira, Kwame Mckenzie
BACKGROUND: An opportunity to address the needs of patients with common mental disorders (CMDs) resides in primary care. Barriers are restricting availability of treatment for CMDs in primary care. By understanding the incentives that promote and the disincentives that deter treatment for CMDs in a collaborative primary care context, this study aims to help contribute to goals of greater access to mental healthcare. METHOD: A qualitative pilot study using semi-structured interviews with thematic analysis...
August 2016: Healthcare Policy, Politiques de Santé
Muhammad Ashar Malik, Murad Moosa Khan
BACKGROUND: The economic consequences of mental illnesses are much more than health consequences. In Low and Middle Income Countries (LMIC) the economic impact of mental illnesses is rarely analyzed. This paper attempts to fill the gap in research on economics of mental health in LMIC. We provide economic burden of mental illness in Pakistan that can serve as an argument for reorienting health policy, resource allocation and priority settings. AIM: To estimate economic burden of mental illnesses in Pakistan...
September 2016: Journal of Mental Health Policy and Economics
Karen J Coleman, Tani Hemmila, Mark D Valenti, Nasya Smith, Rachel Quarrell, Lynnice K Ruona, Emily Brandenfels, Barbara Hann, Todd Hinnenkamp, Margarita D Parra, Jeyn Monkman, Sue Vos, Rebecca C Rossom
OBJECTIVE: To understand how care managers implemented COMPASS and if this was related to patient health outcomes. METHODS: A total of 96 COMPASS care managers were approached to participate in the online survey and 93 (97%) provided responses. Correlations were generated between key survey responses and the average number of care management contacts, patient depression, blood pressure and glycosylated hemoglobin outcomes. RESULTS: Patients of care managers who reported spending more time on COMPASS-related tasks had higher rates of depression improvement (r=0...
August 18, 2016: General Hospital Psychiatry
Vincent Laprevote, Ulrike Heitz, Paolo Di Patrizio, Erich Studerus, Fabienne Ligier, Thomas Schwitzer, Raymund Schwan, Anita Riecher-Rössler
Chronic psychosis, as for instance schizophrenia, usually begins in young adulthood and may cause severe disability. It causes a mean loss of life expectancy of 22 years. Actual models of psychosis do not trace the beginning of psychosis to the first franc psychotic episode only, but to earlier symptoms. In a classical health system only considering the first psychotic episode, the mean duration of untreated illness (DUI) can last several years. Yet this DUI has a direct impact on the prognosis of the disease...
August 20, 2016: La Presse Médicale
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
Carianne M Hunt, Michael Spence, Anne McBride
BACKGROUND: On average, people with schizophrenia and psychosis die 13-30 years sooner than the general population (World Psychiatry 10 (1):52-77, 2011). Mental and physical health care is often provided by different organisations, different practitioners and in different settings which makes collaborative care difficult. Research is needed to understand and map the impact of new collaborative ways of working at the primary/secondary care interface (PloS One 7 (5); e36468). The evaluation presented in this paper was designed to explore the potential of a Community and Physical Health Co-ordinator role (CPHC) (CPHCs were previously Care Co-ordinators within the Community Mental Health Team, Community in the title CPHC refers to Community Mental Health) and Multi-Disciplinary Team (MDT) meetings across primary and community care, with the aim of improving collaboration of mental and physical health care for service users with Severe Mental Illness (SMI)...
2016: BMC Family Practice
Claudia L Reardon, Shane Creado
OBJECTIVES: When prescribing psychiatric medications to athletes, it is important to consider issues that are especially important for this population, including side effects, safety concerns, and anti-doping policies. Only one report, from 2000, describes the prescribing preferences of psychiatrists who work with athletes. This manuscript aims to update the findings from that report, so as to help inform prescribing practices of primary care physicians, psychiatrists, and other clinicians who work with athletes...
July 26, 2016: Physician and Sportsmedicine
Maria Muzik, Susan E Hamilton
Introduction Mood disorders impact many pregnant women, particularly those who have experienced symptoms prior to conception, and there are significant barriers, including stigma and access, to seeking and receiving appropriate treatments. Antidepressants are a helpful option in treating perinatal depression, but research on risks and benefits of antidepressant use in pregnancy is difficult given lack of "gold standard" comparative trials. Methods This paper summarizes current state of knowledge on the safety of antidepressants during pregnancy by providing a summary of the literature published in the past 3 years (January 2013-October 2015)...
July 26, 2016: Maternal and Child Health Journal
Ying-Xiu Dai, Mu-Hong Chen, Tzeng-Ji Chen
BACKGROUND: Relabeling has been proposed as a strategy to reduce the stigma associated with mental illnesses. Previous studies have shown that changing the names of psychiatry clinics has led to reduced feelings of being stigmatized among patients. In Taiwan, terms other than 'psychiatry' (in Chinese, jīng shén kē) are more commonly used in the names of psychiatry clinics. The term 'psychosomatic clinics' is widely used instead. AIMS: This study investigated the characteristics of psychiatry clinic names in order to better understand the role of clinic names in primary care settings...
July 20, 2016: International Journal of Social Psychiatry
Fabienne Ligier, Bernard Kabuth, Francis Guillemin
BACKGROUND: Suicide attempt among adolescents is a public health problem around the world. The risk of recurrence is high: about 30 % of adolescents. New ways to prevent suicide attempt recurrence being developed for adult suicide attempters include maintaining contact with them, and results are encouraging. METHODS/DESIGN: The MEDIACONNEX study will be a simple blinded, parallel-group, multicenter randomised controlled trial. It will compare usual care alone to a program based on usual care plus short message service (SMS) provided to adolescents who attempt suicide and who receive treatment in pediatric and adolescent psychiatry units at hospitals in eastern France...
2016: BMC Psychiatry
Deepa Pawar, Ramin Mojtabai, Aviva Goldman, Donna Batkis, Kathleen Malloy, Bernadette Cullen
The objective of this study was to assess the subjective responses of patient and staff to the provision of health-related information in an outpatient psychiatric clinic. Simple educational information on healthy eating, exercising, and smoking cessation was provided in the waiting area of a clinic over the course of a year. This information took the form of educational handouts, educational DVDs, and monthly "special events" such as a poster competition for smoking cessation. In addition, patients were given an opportunity to attend free nutritional counseling sessions...
July 2016: Journal of Psychiatric Practice
Sandor Kalmar
The author ascertains that healthy personality development faces increasingly serious obstacles and consequently the number of children in need of mental healthcare is on the rise. Child and adolescent psychiatry has drawn increasing appreciation, however, it is only formal and deficient in Hungary today and cannot assure optimal mental care according to the principles of evidence-based medicine. The author emphasizes that 75% of the first manifestation of the psychiatric disorders occurs during adolescence and young adulthood...
June 2016: Neuropsychopharmacologia Hungarica
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