A Three-Month Follow-Up Study Evaluating Changes in Clinical Profile and Attitudes Towards Involuntary Admission

2016 ◽  
Vol 33 (S1) ◽  
pp. S477-S478 ◽  
Author(s):  
E. Bainbridge ◽  
B. Hallahan ◽  
D. McGuinness ◽  
A. Higgins ◽  
K. Murphy ◽  
...  

IntroductionInvoluntary admission and treatment is often a traumatic experience for patients and there is a wide variation in attitudes towards care even when patients are recovered.Objectives/aimsThe purpose of this large prospective study was to identify clinical predictors of attitudes towards care during involuntary admission.MethodsThree hundred and ninety-one consecutively admitted involuntarily patients to three psychiatric inpatient units over a 30-month period were invited to participate in the study. Comprehensive assessments at admission and 3 months after discharge were attained including measures of symptoms, insight, functioning, attitudes towards involuntary admission and coercive experiences. Multiple linear regression modelling was used to determine the optimal explanatory variables for attitudes towards care.ResultsTwo hundred and sixty-three individuals participated at baseline and 156 (59%) successfully completed follow-up assessments. Individuals improved significantly over time clinically and in their attitudes towards their care. At baseline greater insight (P < 0.001) and less symptoms (P = 0.02) were associated with more positive attitudes towards care as was older age (P = 0.001). At follow-up, greater insight (P < 0.001), less symptoms (P = 0.02) and being older (P = 0.04) were associated with more positive attitudes towards care. More positive attitudes towards care at follow-up were associated with greater improvements in insight over time (P < 0.001) and having a diagnosis of an affective psychosis (P = 0.0009).ConclusionsThe best predictors of positive attitudes towards care during and after involuntary admission are illness related factors, such as levels of insight and improvement in insight, rather than service or legislation related factors, such as the use of coercive measures, seclusion and restraint.Disclosure of interestThe authors have not supplied their declaration of competing interest.

2020 ◽  
pp. 1-11
Author(s):  
Thijs J. Burger ◽  
Frederike Schirmbeck ◽  
Jentien M. Vermeulen ◽  
Piotr J. Quee ◽  
Mariken B. de Koning ◽  
...  

Abstract Background Cognitive alterations are a central and heterogeneous trait in psychotic disorders, driven by environmental, familial and illness-related factors. In this study, we aimed to prospectively investigate the impact of high familial risk for cognitive alterations, unconfounded by illness-related factors, on symptomatic outcomes in patients. Methods In total, 629 probands with non-affective psychosis and their sibling not affected by psychosis were assessed at baseline, 3- and 6-year follow-up. Familial cognitive risk was modeled by three cognitive subtypes (‘normal’, ‘mixed’ and ‘impaired’) in the unaffected siblings. Generalized linear mixed models assessed multi-cross-sectional associations between the sibling cognitive subtype and repeated measures of proband symptoms across all assessments. Between-group differences over time were assessed by adding an interaction effect of time and sibling cognitive subtype. Results Probands affected by psychosis with a sibling of the impaired cognitive subtype were less likely to be in symptomatic remission and showed more disorganization across all time points. When assessing differences over time, probands of siblings with the impaired cognitive subtype showed less remission and less improvement of disorganization after 3 and 6 years relative to the other subtypes. They also showed less reduction of positive, negative and excitement symptoms at 6-year follow-up compared to probands with a sibling of the normal cognitive subtype. Conclusions Cross-sibling pathways from higher levels of familial cognitive vulnerability to worse long-term outcomes may be informative in identifying cognition-related environmental and genetic risks that impact psychotic illness heterogeneity over time.


2016 ◽  
Vol 33 (S1) ◽  
pp. S446-S447
Author(s):  
C.M. Carrillo de Albornoz Calahorro ◽  
M. Guerrero Jiménez ◽  
A. Porras Segovia ◽  
J. Cervilla Ballesteros

IntroductionDelusional disorder has reached an entity of growing interest with a prevalence in developed countries between 1 and 4% of the psychiatric consultations.ObjectiveTo describe various socio-demographic and clinical variables that characterize patients diagnosed with delusional disorder in Andalucía according to DSM-5 criteria.MethodsReviewing common medical history digital records. First, it has been proved whether it complies DSM-5 criteria for the diagnosis of delusional disorder. Then, there have been different epidemiological variables collected: age, sex, family psychiatric history, and marital status, and employment status, age of onset of illness, number of years of follow-up by specialized care, the number of visits to your computer, and number of hospitalizations in a psychiatric inpatient unit among others.of the 1927 patients studied, 1452 met the criteria for diagnosis of delusional disorder. These patients live in Andalusia and come to different mental health care units, with an average follow-up period of 9 years and 1 month.ResultsAbout half of the sample were women and half men (49% versus 51%).Forty-seven percent of the sample are married or have a couple, and 19% are in active employment.Thirty-two percent have a family history of psychiatric mental disorder written in his digital clinical record.Seventy-five percent of the sample meets criteria F22, while 25% are diagnosed as other psychoses.ConclusionThis is the largest record of cases registered with delusional disorder to date, in which we describe the biopsychosocial characteristics of this group of patients in the largest Spanish region.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2016 ◽  
Vol 33 (S1) ◽  
pp. s254-s255 ◽  
Author(s):  
N. Iriarte Yoller ◽  
J. Vicente García ◽  
F. Rico Villademoros

IntroductionNon-compliance is a significant problem in patients with first-episode psychosis (FEP), representing a challenge for mental health professionals due to the heterogeneous course and functional outcomes.ObjectivesThe aim was to describe the short-term compliance in FEP and analyze the demographics, clinical features, and management issues potentially associated with non-compliance.MethodsThis observational and retrospective study included all consecutive FEP admitted to our psychiatry unit from January to June 2015, belonging to our catchment area. To be categorized as compliant, patients had to attend month-1 and month-3 follow-up visits. Characteristics of compliant and non-compliant were compared using a bivariate analysis.ResultsWe included 18 patients whose characteristics are shown in the table. Overall, 8 (44.4%) were non-compliant. Patients who were non-compliant had a significantly shorter length of stay (10.3 [6.3] vs. 18.5 [8.9] days). Most patients (66.7%) had cannabis abuse, being slightly more frequent among non-compliant (75% vs. 60%, P = NS); in addition, the diagnosis of substance-induced psychotic disorder was also more common among non-compliant (50% vs 20%, P = NS). There were 2 patients who were readmitted, both in the non-compliant group (Table 1).ConclusionsShort-term non-compliance is high among patients with FEP. Despite the limitations of our study, our results suggest that, beside other factors (e.g. substance abuse), non-compliance could be associated with management-related factors.Disclosure of interestThe authors have not supplied their declaration of competing interest.


Author(s):  
Saad Samargandy ◽  
Karen A Matthews ◽  
Maria Mori Brooks ◽  
Emma JM Barinas-Mitchell ◽  
Jared W Magnani ◽  
...  

Background: Whether changes in blood pressure (BP) over women's midlife are more driven by chronological aging or the menopause transition (MT) has been debated. We sought to determine whether women can be classified into distinct trajectory groups based on pattern and level of systolic (SBP), diastolic blood pressure, pulse pressure (PP), and mean arterial pressure (MAP) over the MT, and to assess whether menopause-related factors predict the group and/or level of BP measures. Methods: Participants were from the Study of Women's Health Across the Nation (SWAN). Group-based trajectory modeling was used to identify women who shared distinct BP trajectories over time relative to menopause onset and to assess associations of menopause-related factors with trajectory group and/or level of BP measures. An accelerated rise relative to menopause onset suggests a menopause contribution. Results: The study included 3,302 multi-racial/ethnic women with BP measures over 17 follow-up visits (baseline age[SD]: 46.3[2.7]). Women were classified into either low, medium, or high trajectory group in each BP measure. The low SBP, PP, and MAP trajectories (in 35%, 53%, and 28% of the cohort, respectively) were rising slowly before menopause but showed a significant accelerated rise 1 year after menopause, indicating a menopause contribution. The remaining BP trajectories were rising up until menopause and either continued with the same rise or declined after menopause. A younger menopause age predicted the low SBP, PP, and MAP trajectories. A greater follicle-stimulating hormone level predicted lower SBP and PP levels, while vasomotor symptoms occurrence predicted higher SBP, PP, and MAP levels over time. Estradiol did not predict trajectory or level of any BP measure. Conclusions: Distinct BP trajectories over the MT exist that revealed a group of women whose SBP, PP, and MAP trajectories are consistent with a menopause contribution. Our findings support frequent monitoring of BP during the MT.


Author(s):  
Y Cui ◽  
M Russell ◽  
M Davern ◽  
H Christian

Abstract Background Emerging evidence supports the physical health and social benefits of dog ownership. This study examined the longitudinal effect of dog ownership and dog walking on mental health. Methods Data from a cohort of 1023 participants taking part in the RESIDential Environments project, in Perth, Western Australia were collected over a 2 year period (baseline and follow-up). Self-report survey items measured mental health (stress and depression), dog ownership status and weekly minutes of dog walking. Logistic regression models accounted for potential confounding factors including socio–demographic, self-rated health and baseline mental health. Results Overall, no statistically significant effects were observed over time between dog ownership and stress (adjusted OR: 1.20; 95% CI: 0.79, 1.81) or depression (adjusted OR: 1.51; 95% CI: 0.72, 3.16). There was a small inverse but non-significant association between weekly minutes of dog walking and stress over time (adjusted OR: 0.85; 95% CI: 0.60, 1.22). Conclusion There was little evidence of prospective associations between dog ownership or dog walking and mental health. Further research is required to confirm longitudinal relationships between dog ownership and dog walking and mental health and investigate dog-related factors, such as a person’s attachment to their dog.


2004 ◽  
Vol 19 (2) ◽  
pp. 67-71 ◽  
Author(s):  
B.D. Kelly ◽  
M. Clarke ◽  
S. Browne ◽  
O. McTigue ◽  
M. Kamali ◽  
...  

AbstractHaving a diagnosis of schizophrenia is a risk factor for involuntary admission to psychiatric inpatient care, but we have a limited understanding of why some patients and not others require involuntary admission. We aimed to identify the predictors of involuntary admission in first episode schizophrenia. We used validated instruments to assess clinical and socio-demographic variables in all patients (n = 78) with first episode schizophrenia from a defined geographical area admitted to a Dublin psychiatric hospital over a 4-year period. Involuntary patients (n = 17) could not be distinguished from voluntary patients (n = 61) on the basis of age, gender, living status, marital status, drug abuse or duration of untreated psychosis. Neither positive nor negative symptoms were useful predictors of admission status. Lack of insight was a strong predictor of involuntary status.


2020 ◽  
Vol 129 (10) ◽  
pp. 977-982
Author(s):  
Takao Ogawa ◽  
Keigo Nakamura ◽  
Sayuri Yamamoto ◽  
Ichiro Tojima ◽  
Takeshi Shimizu

Objectives: The aims of the present study were to clarify the time-course of olfactory recovery and the prognostic factors in PIOD patients treated with Toki-shakuyaku-san (TSS). Methods: A retrospective cohort study of patients with PIOD was conducted by reviewing patients’ medical records. This study included patients who received TSS or a combination of TSS and zinc sulfate. Olfactory function was examined by T&T olfactometer at each 3-monthly follow-up visit. Patients with normal and mild olfactory dysfunction were excluded. Gender, age, treatment, duration of disease until the first visit and olfactory function scores of the T&T olfactometer at the first visit were analyzed as candidate clinical predictors of recovery. Results: A total of 82 PIOD patients with ages ranging from 16 to 79 years were included. The mean duration of follow-up was 14.5 months (range 3-45 months). The number of patients with olfactory recovery increased for 24 months and the cumulative recovery rate was 77.3%. In about 60% of patients, olfactory recovery occurred within 6 months. Multivariate analysis showed that younger age (<65 years) and residual olfactory function were significantly associated with good olfactory recovery. Conclusions: We revealed recovery rates over time in patients with PIOD. The recovery of olfactory function often occurred during the early period (≤6 months). However, the number of patients with olfactory recovery increased for a long-term of 24 months after the first visit. Residual olfactory function and younger age were prognostic factors exactly. TSS may be a useful therapeutic agent for patients with PIOD. We believe that these results provide important information that is useful for counseling patients with PIOD.


2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Marzieh . Shamkhani ◽  
Ali . Khalafi

The purpose of this study was to determine the effectiveness of positive learning on happiness, Aggression and hope for adolescents with leukemia in Ahvaz. The sample consisted of 30 people who were selected by available sampling method. 15 subjects in the experimental group and 15 in the control group were randomly assigned. The experimental design was a pre-test-post-test type with control group and follow-up period. Measurement tools included Oxford Happiness Inventory (Argyle, 1989); Ahwaz's Aggression Questionnaire (Zahedifar, Najarian, and Shokrkon, 2000); Hope Scale (Schneider, 1991). To run, at first, the pre-test was taken from both groups. Then, the experimental group was trained in 14 sessions of 90 minutes, and after each group, they were subjected to post-test. And one month later, the follow-up process was completed. Data analysis was performed using multivariate covariance analysis (MANCOVA) and one-way analysis of covariance (ANCOVA). The results showed that positive attitudes toward happiness, aggressiveness and hopefulness of adolescents with leukemia in Ahvaz were effective.


2017 ◽  
Author(s):  
Matteo Vergani ◽  
Ana-Maria Bliuc

We investigate differences in the psychological aspects underpinning Western mobilisation of two terrorist groups by analysing their English-language propaganda. Based on a computerized analysis of the language used in two English-language online magazines circulated by ISIS and al-Qaeda (i.e., Dabiq and Inspire), we found significant differences in their language - the ISIS’ language being higher in authoritarianism and its level of religiousness. In a follow-up experimental study, we found that being high in religiousness and authoritarianism predicts more positive attitudes towards the language used by ISIS, but not towards the language used by al-Qaeda. The results suggest that ISIS’ propaganda may be more effective in mobilising individuals who are more authoritarian and more focused on religion than that of al-Qaeda. These findings are consistent with the behaviour observed in recent homegrown terrorist attacks in the USA and Europe.


Author(s):  
Georgina E. Sellyn ◽  
Alan R. Tang ◽  
Shilin Zhao ◽  
Madeleine Sherburn ◽  
Rachel Pellegrino ◽  
...  

OBJECTIVEThe authors’ previously published work validated the Chiari Health Index for Pediatrics (CHIP), a new instrument for measuring health-related quality of life (HRQOL) for pediatric Chiari malformation type I (CM-I) patients. In this study, the authors further evaluated the CHIP to assess HRQOL changes over time and correlate changes in HRQOL to changes in symptomatology and radiological factors in CM-I patients who undergo surgical intervention. Strong HRQOL evaluation instruments are currently lacking for pediatric CM-I patients, creating the need for a standardized HRQOL instrument for this patient population. This study serves as the first analysis of the CHIP instrument’s effectiveness in measuring short-term HRQOL changes in pediatric CM-I patients and can be a useful tool in future CM-I HRQOL studies.METHODSThe authors evaluated prospectively collected CHIP scores and clinical factors of surgical intervention in patients younger than 18 years. To be included, patients completed a baseline CHIP captured during the preoperative visit, and at least 1 follow-up CHIP administered postoperatively. CHIP has 2 domains (physical and psychosocial) comprising 4 components, the 3 physical components of pain frequency, pain severity, and nonpain symptoms, and a single psychosocial component. Each CHIP category is scored on a scale, with 0 indicating absent and 1 indicating present, with higher scores indicating better HRQOL. Wilcoxon paired tests, Spearman correlations, and linear regression models were used to evaluate and correlate HRQOL, symptomatology, and radiographic factors.RESULTSSixty-three patients made up the analysis cohort (92% Caucasian, 52% female, mean age 11.8 years, average follow-up time 15.4 months). Dural augmentation was performed in 92% of patients. Of the 63 patients, 48 reported preoperative symptoms and 42 had a preoperative syrinx. From baseline, overall CHIP scores significantly improved over time (from 0.71 to 0.78, p < 0.001). Significant improvement in CHIP scores was seen in patients presenting at baseline with neck/back pain (p = 0.015) and headaches (p < 0.001) and in patients with extremity numbness trending at p = 0.064. Patients with syringomyelia were found to have improvement in CHIP scores over time (0.75 to 0.82, p < 0.001), as well as significant improvement in all 4 components. Additionally, improved CHIP scores were found to be significantly associated with age in patients with cervical (p = 0.009) or thoracic (p = 0.011) syrinxes.CONCLUSIONSThe study data show that the CHIP is an effective instrument for measuring HRQOL over time. Additionally, the CHIP was found to be significantly correlated to changes in symptomatology, a finding indicating that this instrument is a clinically valuable tool for the management of CM-I.


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