Paliperidone Palmitate Study in Patients With Personality Disorder

2016 ◽  
Vol 33 (S1) ◽  
pp. S505-S505
Author(s):  
M.A. Gutierrez Ortega ◽  
D.P. María Dolores ◽  
M.A. Manuel ◽  
M.M. Esther
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Hospital Admissions ◽  
Average Length ◽  
Paliperidone Palmitate ◽  
Emergency Visits ◽  
Actual Clinical Practice ◽  
Average Length Of Stay ◽  
Psychopharmacological Treatment ◽  
Competing Interest

IntroductionPersonality disorders are chronic affectation of mood, impulsivity, aggression and anxiety. It is thought to have biological factors related to the development of personality disorders.AimsTo evaluate and compare the efficacy of injectable paliperidone in actual clinical practice of patients diagnosed with Personality Disorder, compared to other treatments.MethodsWe conducted a descriptive, restrospective and observational study from January 2012 to June 2015 including all the patients who are treated with paliperidone palmitate extended-release injectable suspension with a diagnosis of Personality Disorder according to DSM 5. We included patients with at least 12 months of treatment and the results were compared with respect to the 12 months prior to taking said drug. Variables studied: medical diagnosis, hospital admissions, average length of stay, total number of emergency visits or other devices, maintenance doses.ResultsWe recruited 14 patients (7 women and 7 men) with a mean age of 36.2. 64.29% of patients had borderline personality disorder; 21.43% unspecified personality disorder. The mean dose of maintenance treatment is 105.357. Before the treatment, the quantity of total number of hospital admission are 1.14 versus 0.429 after treatment. The number of stay is also decreased from 13.7 to 3.5; like emergency room visits or to other devices. 78.57% of patients continue to psychopharmacological treatment. Fifty percent of patients undergoing treatment with another antipsychotic (P < 0.05).ConclusionsThe present results show that paliperidone palmitate can be an effective way to control the most characteristic symptoms of Personality Disorders, and reducing emergency visits, hospitalisations and other devices.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A New Look at Personality Disorders Treatments

2016 ◽  
Vol 33 (S1) ◽  
pp. S506-S506
Author(s):  
S. Neves ◽  
J. Tudela
Keyword(s):  
Personality Disorder ◽  
Personality Traits ◽  
Personality Disorders ◽  
Evidence Base ◽  
Primary Treatment ◽  
Adjunctive Treatment ◽  
Original Research ◽  
Sociocultural Change ◽  
Effective Interventions ◽  
Competing Interest

IntroductionMental illness develops and is inseparable from the sociocultural context. The Disturbances may exhibit different symptoms in different cultures. In personality disorders, there is a pathological expansion of normal traits that often demonstrate a sociocultural change. The quality of life of these patients can improve with certain treatments, which appears to be relevant to be achieved.MethodSearch on Pubmed and Medline for original research or review articles published in English or Portuguese in the last 10 years. It used a combination of terms: “personality”, “treatment”, “personality disorder”, “borderline”, “antissocial”, “pharmacotherapy”, and other named personality disorders.Objectives/AimSearch the evidence base and the new perspectives for the effective treatment of personality disorders.ResultsThe same personality traits may be adaptive or non-adaptive in different contexts. So, without changing these characteristics, patients can learn to use them more effectively. In other words, although the therapy did not change the personality traits, it can be modified in the way they affect the behavioral expression.ConclusionsPsychological or psychosocial intervention is recommended as the primary treatment for borderline personality disorder and pharmacotherapy is only advised as an adjunctive treatment. The amount of research about the underlying, abnormal, psychological or biological processes leading to the manifestation of a disordered personality is increasing, which could lead to more effective interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Recent Critical Trends in Mental Hospital Admissions in the Oxford Region

1962 ◽  
Vol 108 (452) ◽  
pp. 59-67 ◽  
Author(s):  
A. Barr ◽  
D. Golding ◽  
R. W. Parnell
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Mental Hospital ◽  
Hospital Admissions ◽  
Average Length ◽  
Time Study ◽  
Ministry Of Health ◽  
Mental Hospitals ◽  
Average Length Of Stay ◽  
One Year

The statistics on mental hospitals published by the Ministry of Health (1957) show that the average length of stay for admissions to mental hospitals decreased in the period 1952–1956. According to the Registrar-General's Mental Health Supplement (1961) there was an average saving, between 1951 and 1958, of sixteen days for men and thirteen days for women, among patients staying less than one year. But these figures for stay only relate to the patients discharged each year, irrespective of the year of their admission, and furthermore we do not know what happens to particular groups such, for example, as schizophrenics. Although remarkable changes are occurring at the present time, study of them is hampered by lack of appropriate and up-to-date information.

scholarly journals Musculoskeletal malignant neoplasms hospitalisation in Victoria

2015 ◽  
Vol 1 (1) ◽  
pp. 33
Author(s):  
Timothy Ore
Keyword(s):  
Rural Communities ◽  
Hospital Readmission ◽  
Readmission Rate ◽  
Hospital Admissions ◽  
Average Length ◽  
Malignant Neoplasms ◽  
Factors Associated ◽  
Admission Rates ◽  
Average Length Of Stay ◽  
Disability Support

The paper describes factors associated with 2,605 hospital admissions for musculoskeletal malignant neoplasms (MMN) over oneyear. The rates per 10,000 population increased significantly (t=5.3, p<.01) with age, with men (4.5 per 10,000 population, 95% CI 4.1-5.0) at greater risk than women (3.3 per 10,000 population, 95% CI 2.8-3.7). The 30-day readmission rate was 19%, thethird highest of all admission categories. The average length of stay was significantly (t=4.5, p<.01) shorter in the metropolitanarea (8.2 days) than in rural communities (10.8 days). The age-standardised rates varied inversely (r=-0.28) with socioeconomicstatus. Communities with high MMN admission rates had high rates of heart failure admissions (r=0.35), alcohol consumption(r=0.34) and receiving Disability Support Pension (r=0.32). There was a significant (t=13.8, p<.001) monthly variability inMMN hospitalisation rates. As a leading cause of hospital readmission and disability, the condition requires closer analysis.

scholarly journals Comparison of three antimicrobial strategies in diabetic foot infections post-amputation

2019 ◽  
Vol 6 ◽  
pp. 204993611986454
Author(s):  
Samarth P. Shah ◽  
Ana Negrete ◽  
Timothy Self ◽  
Jaclyn Bergeron ◽  
Jennifer D. Twilla
Keyword(s):  
Patient Outcomes ◽  
Diabetic Foot ◽  
Hospital Admissions ◽  
Average Length ◽  
Primary Diagnosis ◽  
Antimicrobial Treatment ◽  
Optimal Route ◽  
Average Length Of Stay ◽  
Diabetic Foot Infections ◽  
Selection Of

Background: The 2012 Infectious Disease Society of America (IDSA) guidelines recommend antimicrobial treatment of diabetic foot infections (DFIs) post-amputation, but the optimal route and duration are poorly defined. Objective: The objective of this study was to determine whether the selection of a specific antimicrobial treatment modality affected hospital and patient outcomes. Methods: This was a retrospective review of hospital admissions of adults admitted to ourhealthcare system with a primary diagnosis of DFIs post-amputation. The groups were separated into patients who received intravenous antimicrobials (IV), oral antimicrobials (PO), or no antimicrobials (NA). Outcomes included average length of stay among others. Results: Of the 200 patients screened, 120 patients were included (IV n = 72; PO n = 20; NA n = 28). No statistically significant differences were identified in average LOS (IV = 9.97 ± 5.85, PO = 8.83 ± 7.37, NA = 9.33 ± 5.91 days; p = 0.73). However, post-operative (post-op) LOS was significantly shorter in the PO group (PO = 3.43 ± 2.56, IV = 7.34 ± 5.95, NA = 5.81 ± 4.18 days; p = 0.0001). Conclusion: The results of our study indicate that a PO antimicrobial treatment strategy post amputation for DFIs has the potential to decrease post-op LOS without increasing the risk of readmission. Based on the results of our study, we feel consideration should be given to transition to oral antimicrobials soon after amputation to facilitate discharge and decrease the utilization of intravenous antimicrobials.

Psychopharmacological Treatment of Personality Disorders

2015 ◽  
Author(s):  
M. Mercedes Perez-Rodriguez ◽  
Larry J. Siever
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Personality Disorders ◽  
Borderline Personality ◽  
Mood Stabilizers ◽  
Omega 3 ◽  
Psychopharmacological Treatment ◽  
Limited Effectiveness ◽  
Second Generation Antipsychotics

Despite the lack of approval by the U.S. Food & Drug Administration, drugs are used widely to treat personality disorders, particularly borderline personality disorder, based on their effects known from clinical trials in other psychiatric disorders (off-label use). The role of medications in personality disorders is limited to moderate effects on some but not all of the symptom domains. There are no medications available that improve the global severity of any personality disorder as a whole. In borderline personality disorder, evidence is strongest for second-generation antipsychotics and mood stabilizers, while dietary supplements like omega-3 fatty acids hold some promise. However, medications have limited effectiveness and are still viewed as adjunctive to other forms of treatment, particularly psychotherapy.

Personality Traits and Disorders Among Adult ADHD Patients: Is Borderline Personality Disorder as Common as we Expect?

2017 ◽  
Vol 41 (S1) ◽  
pp. S258-S258 ◽  
Author(s):  
F. Oliva ◽  
S. Bramante ◽  
A. Portigliatti Pomeri ◽  
C. Carezana ◽  
G. Nibbio ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Traits ◽  
Personality Disorders ◽  
Adult Adhd ◽  
Borderline Personality ◽  
Personality Profiles ◽  
High Prevalence ◽  
Cluster A ◽  
Competing Interest ◽  
Low Prevalence

IntroductionPatients with Attention Deficit/Hyperactivity Disorder (ADHD) have shown a high risk to develop a DSM cluster B (i.e., Borderline, OR = 13.16; Antisocial, OR = 3.03; Narcissistic, OR = 8.69) and DSM Avoidant personality disorder (OR = 9.77). Similarly, higher rates of DSM cluster B personality disorder were found among adult ADHD patients (6-25%) than general population. Although some authors investigated the prevalence of personality traits and disorders among adult ADHD patients, no studies have been yet reported about the assessment of Millon's Evolution-Based Personality profiles in adult ADHD patients.AimsTo explore the prevalence of personality traits and disorders among adult ADHD patients.MethodsMillon's personality traits and disorders were assessed in a consecutive sample of 35 adult ADHD outpatients accessing the Service for Adult ADHD of the AOU San Luigi Gonzaga (Orbassano, TO) using the Millon Clinical Multiaxial Inventory–III (MCMI-III).ResultsAccording to the MCMI-III manual, ADHD patients in our sample showed more frequently both Cluster C and Cluster A traits and disorders, with a high prevalence of avoidant/depressive (8.6%/14.3%) and negativistic/self-defeating (20%/5.7%) personality disorders. Conversely, we found a low prevalence of Narcissistic (5.7%) and Histrionic (5.7%) traits, and no patient showed Borderline personality traits or disorder.ConclusionsUnexpectedly, the dimensional assessment of adult ADHD personality reveals a high prevalence of cluster C and cluster A personality traits and disorders, and a low prevalence of cluster B personality disorders.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Efficiency of Acute Care Bed Utilization in Newfoundland and Labrador

1998 ◽  
Vol 11 (3) ◽  
pp. 15-19 ◽  
Author(s):  
Michael Doyle ◽  
Brendan J. Barrett ◽  
Jackie McDonald ◽  
Jerry McGrath ◽  
Patrick S. Parfrey
Keyword(s):  
Length Of Stay ◽  
Acute Care ◽  
Newfoundland And Labrador ◽  
Hospital Admissions ◽  
Average Length ◽  
National Data ◽  
Inappropriate Use ◽  
Average Length Of Stay ◽  
Evaluation Protocol ◽  
Canadian Institute

Hospital efficiency is closely related to utilization levels and length of stay. This study determined whether inappropriate bed utilization in Newfoundland was related to inefficiency or inadequate access to alternative services. It also compared Canadian Institute for Health Information (CIHI) data to our survey to determine whether they provide comparable information for monitoring efficiency. Inappropriate acute care days were identified using a modified Appropriateness Evaluation Protocol. Average length of stay (ALOS) by service for each of the province's acute care institutions was also reviewed from 1993–94 to 1995–96 using the CIHI database. Hospital admissions were inappropriate in 14.2 percent of 2,007 cases. Of the 14,194 days of care, 22.8 percent were inappropriate, with most (16.4 percent) being avoidable with better use of existing resources. Of the inappropriate days, 49.2 percent related to physicians' functions. The provincial ALOS fell from 5.70 days in 1993–94 to 5.39 days in 1995–96, but remains 10.5 percent above the national average. CIHI national data for ALOS by service correlated with the percent of inappropriate days by service (r=0.57). Excess bed utilization remains because of the inappropriate use of existing services, and almost half of the total inappropriate days in hospital could be influenced by physicians. CIHI data on LOS can be used to target services or physicians for focused intervention.

A Residential Psychiatric Approach for Forensic Patients: The Experience of “Tiziano” Facility

2017 ◽  
Vol 41 (S1) ◽  
pp. S151-S151
Author(s):  
C. Cargioli ◽  
L. Polese ◽  
G. Macchia
Keyword(s):  
Personality Disorder ◽  
Mentally Ill ◽  
Criminal Behavior ◽  
Average Length ◽  
National Health System ◽  
Mentally Ill Offenders ◽  
Psychiatric Facility ◽  
Affective Psychosis ◽  
Forensic Patients ◽  
Average Length Of Stay

IntroductionItalian forensic mental hospitals closed on March 31st, 2014 and offenders sentenced to need a psychiatric care are restrained in facilities. Since 2002, the residential psychiatric facility “Tiziano” (Aulla, Massa-Carrara) hosts forensic patients, on appointment with national health system and compulsorily admitted by the justice system.MethodsThis descriptional and prospective study provides a thorough report on the main epidemiological, clinical, and criminological features of 60 mentally ill offenders hosted in the “Tiziano” facility between 2002 and June 2016.ResultsMost forensic patients were male (90%, n = 54; average age: 33 years). Sixty percent of subjects (n = 36) had a clinical diagnosis of psychosis (19.4% affective psychosis, 72.2% non-affective psychosis, 8.4% organic psychosis), and about one third of them (31.6%, n = 19) had a personality disorder (63.1%, n = 12, antisocial personality disorder, 42.1%, n = 8, borderline personality disorder, 21.0%, n = 4 other personality disorders). Mental insufficiency was diagnosed in 11.6% (n = 7) of subjects, while substance use disorder affected 35.0% (n = 21) and alcohol use disorder 26.6% (n = 16). Forty-nine patients (81.7%) had committed serious crimes against people; 15% (n = 9) were murderers or attempted murderers, and 46.7% (n = 28) had committed more crimes. The average length of stay is 22 months.ConclusionsTo date, there are no data about long-term follow-up and clinical outcome of mentally ill offenders restrained in Italian psychiatric facilities. Additional studies are needed to assess psychopathology and differentiate treatment according to diagnosis, and to identify risk factors of relapse for criminal behavior relapse.

Personality Disorders and Suicide Attempts

2016 ◽  
Vol 33 (S1) ◽  
pp. S506-S506
Author(s):  
O.W. Muquebil Ali Al Shaban Rodriguez ◽  
J.R. López Fernández ◽  
C. Huergo Lora ◽  
S. Ocio León ◽  
M.J. Hernández González ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Disorders ◽  
Suicide Attempts ◽  
Obsessive Compulsive ◽  
Dsm 5 ◽  
Patterns Of Behavior ◽  
Cluster A ◽  
Competing Interest ◽  
Clear Relation ◽  
Clinical Cases

IntroductionThe personality disorders are defined according to the DSM-5 like “an enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's cultures. These patterns develop in adolescence and the beginning of adulthood, and are associated with significant distress or disability”. The personality disorders can be a risk factor for different processes of the psychiatric pathology like suicide. The personality disorders are classified in 3 groups according to the DSM-5:– cluster A (strange subjects): paranoid, schizoid and schizotypal;– cluster B (immature subjects): antisocial, bordeline, histrionic and narcissistic;– cluster C (frightened subjects): avoidant, dependent and obsessive-compulsive.AimsTo describe the influence of personality disorders in suicide attempts.MethodologyExhibition of clinical cases.ResultsIn this case report, we exhibit three clinical cases of suicide attempts which correspond to a type of personality disorder belonging to each of the three big groups of the DSM-5 classification, specifically the paranoid disorder of the cluster A, the disorder borderline of cluster B and the obsessive compulsive of cluster C.ConclusionsThe personality disorders have a clear relation with the suicide attempts, increasing this influence in some of them, especially the borderline personality disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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