Changing Pattern of Clinical Profile of First Contact Patients Attending Outpatient Services At the General Hospital Psychiatric Units In India Over the Last 50 Years

2016 ◽  
Vol 33 (S1) ◽  
pp. S487-S487
Author(s):  
M. Sood ◽  
R. Ranjan ◽  
R.K. Chadda ◽  
S. Khandelwal
Keyword(s):  
General Hospital ◽  
Psychotic Disorders ◽  
Somatoform Disorders ◽  
Indian Society ◽  
Outpatient Services ◽  
Number Of Patients ◽  
Psychiatric Units ◽  
Organic Brain ◽  
Competing Interest ◽  
First Contact

IntroductionOver the last eight decades, general hospital psychiatric units (GHPUs) have become important mental health service set-ups in India. This period has seen a large number of radical changes in the Indian society. In this background, it is important to know if it had any effects on the patients attending the GHPUs.MethodologyA total of five hundred subjects, attending a GHPU were recruited prospectively for the study. The subjects were assessed using a semi-structured proforma. A comparison was made with similar studies conducted in GHPU settings over the last 5 decades.ResultsNeurotic, stress related and somatoform disorders was the commonest diagnostic group (33%) followed by psychotic disorders (17%) and mood disorders (15%). The finding is broadly similar to the studies done at different times in the last 5 decades. However, there were lesser number of patients with mental retardation, organic brain syndrome and seizure disorder.ConclusionThe study highlights the strengths of GHPU set-ups like inter-speciality referrals, fewer stigmas, patients travelling from far off places to seek treatment and involvement of family in the care of mentally ill.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Impacts of the COVID-19 epidemic on the department of stomatology in a tertiary hospital: a case study in the General Hospital of the Central Theater Command, Wuhan, China

2020 ◽  
Author(s):  
Qingshan Dong ◽  
Angelica Kuria ◽  
Yanming Weng ◽  
Yu Liu ◽  
Yang Cao
Keyword(s):  
General Hospital ◽  
Health Information System ◽  
Tertiary Hospital ◽  
Rank Test ◽  
Clinical Services ◽  
Outpatient Services ◽  
Number Of Patients ◽  
Tertiary Hospitals ◽  
Dental Profession ◽  
The Difference

Objectives: The aim of this study is to depict the impacts of COVID-19 pandemic on the clinical services and academic activities in the department of stomatology of a tertiary hospitals in Wuhan, China. Methods: We obtained historical data of the Department of Stomatology from the Health Information System of the General Hospital of Central Theater Command, Wuhan, China between January 2018 and June 2020. Line plots were used to illustrate temporal trend of the variables. Mean ± standard deviation and median with interquartile range were used to summarize the variables. The Kruskal-Wallis equality-of-populations rank test was used to compare the difference between groups. Results: A significant decrease was noted in the monthly average number of patients seeking the outpatient services for the year 2020. The monthly numbers of patients seeking outpatient services were decreased by two thirds from 2018 to 2020. The number of emergency cases also decreased significantly by 64% in 2020. The monthly number of teaching hours decreased from 3.8 ± 1.5 in 2018 and 4.7 ± 1.4 in 2019 to 1.7 ± 1.9 in 2020. The number of interns also decreased more than 70% in 2020. Conclusions: The impacts of COVID 19 in the stomatology clinic were significant with notable decreases in clinical services and education offered to the stomatology students. We must find solutions to keep as many as needed dental profession stay on thriving and to remain on the frontline of healthcare.

Psychopharmacotherapy in a Multy-type Hospital

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
P. Pyrkov
Keyword(s):  
Mental Disorders ◽  
General Hospital ◽  
Psychotic Disorders ◽  
Psychiatric Service ◽  
List Type ◽  
Psychiatric Facility ◽  
Amnesic Syndrome ◽  
Number Of Patients ◽  
Short Time ◽  
Mental And Behavioral Disorders

Introduction:The increasing number of patients with comorbide mental disorders, who were staying in multy-type hospitals, necessitates the organization of psychiatric service, which includes psychopharmacotherapy.Results:Observations were performed during 25 years in a multy-type emergency hospital.Indications for psychopharmacotherapy were:1.Organic (somatogenic) mental disorders (F06) - 61%, among them are: organic delirium ((F05, 8) - 25%, organic hallucinosis (F06.0) - 10%, organic amnesic syndrome (F04) - 27%, organic anxiety phobic disorder with agitation (F06.4) - 9%.2.Mental and behavioral disorders due to psychoactive substance use (F10 - 19%, F10.03 -12%, F10.31 - 6%, F11.21 - 1%.3.Neurotic depression with suicidal behaviour (accomplished parasuicide) (F43, 24) - 1%.4.Anorexia nervosa (F50.0) - 3%.5.Dementia (F00-F02) - 16%.The examination showed that short-time (up to 10-15 days) psychotic disorders could be reduced with parenteral introduction of the Diazepam 2ml 2-3 times/day.The use of Nootropics (Pyracetam 20% 10-20ml, Cerebryl 250ml iv) and B vitamins stimulated reduction of psychosis.Any of patients wasn't moved to the residential psychiatric facility.We didn't use neuroleptics cause their iatrogenic activity by organic psychosis and incompatibility with some somatotropic medicaments, employing by multiplex somatic disorder.Conclusion:Optimization of the psychopharmacotherapy in general hospital requires a regular psychiatrist on its staff. The treatment of the patient in the general hospital seems to be economic and moral effective.

scholarly journals Prevalence of Anxiety and Depression amongst Patients presenting with Non-inflammatory Vaginal Discharge.

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sayed Shah Khalid ◽  
Shafqat Huma ◽  
Usman Amin Hotiana ◽  
Muhammad Tariq ◽  
Muhammad Nadeem
Keyword(s):  
Vaginal Discharge ◽  
Psychotic Disorders ◽  
Reproductive Age ◽  
Anxiety And Depression ◽  
Military Hospital ◽  
Outpatient Services ◽  
Cross Sectional ◽  
Health Related ◽  
Organic Brain ◽  
Clinically Significant

Background: Abnormal vaginal discharge/leucorrhea amongst women of reproductive age group(15-49) is a frequently encounteredcomplaint especially across South-east Asia. It is commonly associated with tremendous stress, anxiety and depression. The currentstudy was planned to determine the prevalence of anxiety and depression amongst such patients.Objective: To stydy, the prevalence of anxiety and depression as a cause of vaginal discharge in young women.Design: Descriptive, cross-sectional studyPlace and duration of study: Combined Military Hospital,Kohat, for a period of 3 months from June 2015 till September 2015.Material and Methods: 62 consecutive patients presenting with non-infectious, chronic, leucorrhea were inducted from GynecologyOutpatient Department, Combined Military Hospital. As per the inclusion criteria for this study, any female aged 1845 years presentingto Gynaecology outpatient services with chronic non-infective vaginal discharge was eligible for the study. Patients with comorbidmental retardation, psychotic disorders, or organic brain syndromes were excluded.Their basic demographic details were recorded through a sociodemographic proforma and then Hospital Anxiety and Depression Scalewas administered orally in the native language to the participants.The data was entered in the computer and analysed using SPSS 22.0. and results interpreted accordingly.Results: 26(42.6%) of cases were normal, 10(16.4%) had borderline anxiety symptoms, and 25(41%) cases had abnormal/severeanxiety; regarding depression, it was found that 34(55.7%) were normal cases, 11(18%) borderline and 16 (26.2%) wereabnormal/severe according to Hospital and anxiety scale.Conclusion: Clinically significant anxiety and depression are frequently reported in patients presenting with chronic leucorrhea.Appropriate and timely management of these could be better health related outcomes.

The effect of a mental hospital strike on general hospital psychiatric services

1984 ◽  
Vol 14 (4) ◽  
pp. 913-921 ◽  
Author(s):  
Ross M. G. Norman ◽  
Ashok K. Malla
Keyword(s):  
General Hospital ◽  
Suicidal Behaviour ◽  
Mental Hospital ◽  
Hospital Admissions ◽  
Occupational Status ◽  
General Hospitals ◽  
Hospital Units ◽  
Number Of Patients ◽  
Psychiatric Units ◽  
The Impact

SynopsisData collected from 6043 psychiatric in-patient records were analysed to assess the impact of a strike at a mental hospital on in-patient services in general hospital psychiatric units in St John's, Newfoundland, Canada. As a whole, during the strike general hospital units showed an increase in the number of involuntary admissions, the number of prior mental hospital admissions of patients, and indications of violent or suicidal behaviour; and a decrease in the occupational status of patients admitted and the prescription of minor tranquillizers. There was also evidence of considerable variation between general hospitals in the extent to which their admission pattern changed during the strike and the permanence of some of the strike effects. The data indicate that all patients showing violent or suicidal behaviour who would normally have been admitted to the mental hospital were treated in the general hospital units during the strike. On the other hand, a large number of patients diagnosed with schizophrenia, personality disorder or mental retardation, who normally would have been admitted to the mental hospital, apparently went without hospitalization during the strike. A substantial proportion of this latter group would usually have been admitted involuntarily.

Socio-Demographic and Clinical Features of Patients Referred to Emergency Room Psychiatric Consultation Between 2006 and 2015. A Comparison Between Migrants and Natives

2017 ◽  
Vol 41 (S1) ◽  
pp. S294-S294
Author(s):  
E. Gambaro ◽  
C. Vecchi ◽  
C. Gramaglia ◽  
F. Bert ◽  
C. Delicato ◽  
...  
Keyword(s):  
Clinical Features ◽  
High Frequency ◽  
Suicide Attempts ◽  
Demographic Data ◽  
Psychiatric Consultation ◽  
Migrant Population ◽  
Outpatient Services ◽  
Self Injury ◽  
Competing Interest ◽  
First Contact

In recent decades, Italy has become a desirable destination for immigrants. It should be noted that the organization of mental health services in Italy strongly relies on outpatient services, while the psychiatric wards usually accommodate patients in acute phases of their disorder. Nonetheless, migrants’ first contact often happen in a psychiatry ward when they are in a severe and acute psychopathological condition. The research was performed in the Emergency Department (ED) of the Maggiore della Carità Hospital, Novara, Italy. We collected data about 3781 consecutive patients, 3247 Italian natives and 421 migrants, assessed in the ER of the Maggiore della Carità Hospital, and referred to psychiatric assessment after ER triage. From 1st January 2006 to 31st December 2007, only data for migrant patients were available. From 1st January 2008 to 31st December 2015, data were available for all consecutive patients assessed in the ER. An experienced psychiatrist assessed patients with a clinical interview, including the assessment of suicidal intent, suicidal behaviors and attempts. The psychiatrist filled in for each patient a data sheet, reporting demographic data and clinical features. The high frequency of substance use disorders was higher in the migrant population than in the native one. The request for psychiatric consultation for self-injury behaviors was more frequent in migrants and also suicide attempts were more common. Nonetheless, being a migrant was not a predictor of suicide attempt in our sample.Several differences were found between migrants and natives in socio-demographic, clinical and treatment variables. Clinical implications will be discussed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychiatric comorbidities in temporal lobe epilepsy: A case study

2017 ◽  
Vol 41 (S1) ◽  
pp. S474-S474
Author(s):  
L. Jouini ◽  
U. Ouali ◽  
R. Zaouche ◽  
R. Jomli ◽  
Y. Zgueb ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Psychotic Disorders ◽  
Psychiatric Symptoms ◽  
Complete Disappearance ◽  
Therapeutic Implications ◽  
Self Harm ◽  
Competing Interest

IntroductionPsychiatric disorders frequently occur in patients with temporal lobe epilepsy (TLE) (70%). This combination further reduces the quality of life of patients as diagnosis is difficult and therapeutic opportunities are often missed.ObjectivesThe aim of this case study is to show the possible association between TLE and psychiatric semiology and its therapeutic implications.MethodsPresentation of the clinical case of Mr BH who experienced psychosis like symptoms, was finally diagnosed with TLE and put under anti-epileptic drugs.ResultsMr BH, aged 22, with no family or personal history, was admitted for aggressive behavior, self-harm, pyromania, and depression. Three years prior to onset of psychiatric symptoms, he reports episodes of pulsatile- left-temporal headache followed by hypertonic movements of the neck. Symptoms were intermittently followed by total amnesia or impaired consciousness. The patient explained symptoms by an inner presence that he called “his twin” and to whom he attributed those behaviors contrary to his will. The discovery of bilateral hippocampal atrophy in magnetic resonance imaging with a normal electroencephalography suggested the diagnosis of TLE with post-ictal psychotic disorders. Patient was put initially on diazepam and olanzapine with partial improvement. Association of valproate led to progressive but then complete disappearance of symptoms and so confirmed our diagnosis.ConclusionsIt is often difficult to attach psychiatric symptoms to epilepsy. The diagnosis should be done on a set of clinical, radiological and electrical arguments.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychogeriatric Care in the General Hospital*

1981 ◽  
Vol 26 (5) ◽  
pp. 334-336 ◽  
Author(s):  
Joel Sadavoy
Keyword(s):  
General Hospital ◽  
Psychiatric Care ◽  
Treatment Approach ◽  
The Elderly ◽  
Term Therapy ◽  
Psychiatric Ward ◽  
Short Term ◽  
General Hospitals ◽  
Organic Brain

This study examines treatment outcome in 52 psychogeriatric patients to help determine the role of the general hospital in psychiatric care of the elderly. The author reviewed the charts of all patients 65 years of age and over admitted to the psychiatric ward from 1974 to 1978. Approximately 80% of this group showed symptom remission. Treatment failures correlated closely with the presence of major organic brain syndrome. Despite an average age of 73.4 years and a high proportion of widowed patients only 10 patients needed new placements on discharge. The author discusses the reluctance of general hospitals to treat the psychogeriatric patient despite the high success rate, the merits of such an active treatment approach and the effect of short-term therapy programs on the treatment of this group.

Clinical manifestations in patients with acute and transient psychosis

2016 ◽  
Vol 33 (S1) ◽  
pp. S363-S364
Author(s):  
Á. López Díaz ◽  
A. Soler Iborte ◽  
S. Galiano Rus ◽  
J.L. Fernández González ◽  
J.I. Aznarte López
Keyword(s):  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Clinical Manifestations ◽  
Retrospective Chart Review ◽  
International Classification Of Diseases ◽  
Exact Test ◽  
Chi Squared ◽  
Classification Of Diseases ◽  
Icd 10 ◽  
Competing Interest

IntroductionThe term, acute and transient psychosis, is comprehended as a heterogeneous group of disorders, which share, as a common feature, the abrupt and brief deployment of typical psychotic behaviour, either polymorph, delusional, or schizophreniform. This diversity of symptoms may also be present in other psychotic disorders, for which, some authors question its reliability.ObjetiveTo analyse the clinical manifestations present in acute and transient psychotic disorders (ATPD), and determine the differences between its different subcategories.MethodRetrospective chart review study of adult patients admitted in our psychiatric unit between 2011 and 2015, with a mean diagnosis of ATPD at hospital discharge. Diagnostic criteria was according to the International Classification of Diseases (ICD-10). Symptoms were divided under operative procedures, as set out in psychopatologic descriptions. For methodological reasons, statistical analysis was conducted between polymorphic features group (PM) and nonpolymorphic group (NPM). Chi-squared test and Fisher's exact test (as appropriate) were performed, using MedCalc software.ResultsThirty-nine patients met the inclusion criteria. Acute polymorphic psychotic disorder with and without symptoms of schizophrenia (39%), acute schizophrenia-like psychotic disorder (20%), acute predominantly delusional psychotic disorder (23%), other and NOS (18%). There were statistically significant differences between PM and NPM groups in emotional turmoil (>PM, P = 0.0006), grossly disorganized or abnormal motor behaviour (>PM, P = 0.0038), and type of onset (sudden >PM, P = 0.0145).ConclusionCurrently, the same concept encompasses two categories (PM and NPM) to be differentiated. The ATPD construct is under review, due its long-term instability.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A case of acute and transient psychosis–What to expect?

2016 ◽  
Vol 33 (S1) ◽  
pp. S364-S365
Author(s):  
M. Oliveira ◽  
J. Rebelo ◽  
A.S. Costa ◽  
C. Santos
Keyword(s):  
Psychotic Disorders ◽  
Fast Response ◽  
International Classification Of Diseases ◽  
Acute Onset ◽  
Antipsychotic Treatment ◽  
Duration Of Treatment ◽  
Diagnostic Stability ◽  
Affective Symptoms ◽  
Classification Of Diseases ◽  
Competing Interest

IntroductionThe Tenth Revision of the International Classification of Diseases (ICD-10) introduced the category of Acute and transient psychotic disorders (ATPD), that assimilate clinical concepts such as the French Bouffée Délirante, Kleist and Leonhard's cycloid psychosis, and the scandinavian reactive psychosis.Methods and aimsThe authors present a clinical case of ATPD and a literature review based on PubMed/MEDLINE, using the keywords: “acute and transient psychotic disorder”, “prognosis” and “diagnostic stability”, aiming to discuss the main challenges regarding the diagnosis, treatment and prognosis.ResultsThe patient is a male with 37 years old with two previous psychotic episodes (with 2.5 years of interval), both with an acute onset (of 7 and 3 days respectively), and a fast response to antipsychotic treatment, with periods of complete symptom's remission. He maintains treatment with 6 mg of paliperidone. In the literature, we found scarce information on ATPD. Though several variables have been described as having influence on the prognosis (gender, pre-morbid functioning, acute onset and presence of affective symptoms), this topic remains controversial. Another difficult aspect about ATPD seems to be its low diagnostic stability, with diagnosis changing mostly to Schizophrenia, Schizoaffective disorder and Bipolar disorder. Duration of treatment after complete remission of symptoms is another controversial aspect of this disease.ConclusionsATPD seems to have low diagnostic stability and poor research investment, and so it represents a challenge for psychiatrists on managing these patients in terms of treatment and follow-up plan. Further studies should be held regarding prognosis and treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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