Hospitalization Durations and Remission Rates of Patients in a Psychiatry Clinic

2016 ◽  
Vol 33 (S1) ◽  
pp. S522-S523
Author(s):  
R. Tutuncu ◽  
H. Kullakçı ◽  
B. Hakan ◽  
A. Algul ◽  
A. Ates ◽  
...  
Keyword(s):  
Service Delivery ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Psychiatric Service ◽  
Contributing Factors ◽  
Psychiatry Clinic ◽  
Hospitalization Period ◽  
Remission Rates ◽  
Duration Of Hospitalization ◽  
Competing Interest

ObjectiveThe duration of hospitalization is related to many well-documented factors in literature. However, little is known about psychiatric patients and psychiatric service delivery in non-Western developing countries. It is supposed that major contributing factors in discharge are remission rates and functional levels. Therefore, this naturalistic preliminary study aimed at analyzing and describing the hospitalization duration and remission rates of a psychiatric population treated in the mental health inpatient facility.MethodsA total of 88 male patients, who were hospitalized in a psychiatry clinic were included in the study. They were evaluated at admission and before discharge using the Brief Psychiatric Rating Scale (BPRS) and the Clinic Global Impression Scale (CGI). Other variables, including length of stay, number of previous admissions, demographic characteristics, and diagnosis were also assessed.ResultsMean of the total scores on BPRS were declined from 24.95 to 13, and the mean CGI scores were declined from 3.85 to 2.04 during hospitalization period. Mean length of hospitalization was 7.91 days.ConclusionOur study shows that patients are discharged from the hospital with approximately 50% decrease in symptom severity. Such research can contribute to understand better, the needs of psychiatric patients, and help to develop continuously improved service delivery and optimize therapeutic options.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Who are the Europeans admitted to psychiatric hospital in Tunisia?

2017 ◽  
Vol 41 (S1) ◽  
pp. S698-S698
Author(s):  
U. Ouali ◽  
K. Ben Neticha ◽  
R. Jomli ◽  
A. Ouertani ◽  
F. Nacef
Keyword(s):  
Psychiatric Care ◽  
Psychiatric Patients ◽  
Insurance Coverage ◽  
University Hospital ◽  
Public Authorities ◽  
Early Action ◽  
Duration Of Hospitalization ◽  
History Of ◽  
Competing Interest ◽  
Almost All

IntroductionA large number of foreign travellers and expatriates visits or lives in Tunisia.ObjectivesTo explore socio-demographic, clinical and therapeutic characteristics of European patients admitted to psychiatric care in Tunisia.MethodsThis is a retrospective, descriptive study on all European patients admitted to Razi psychiatric university hospital, which is situated at the outskirts of the capital Tunis, between 2000 and 2015.ResultsA total of 44 Europeans was admitted. Most frequent nationalities were: French and Germans (19 and 16 patients). The stay in Tunisia was mainly due to pathologic travel (17 subjects) and tourism (13 subjects). In total, 25 patients travelled without being accompanied. Average age was 51.3 years with extremes from 16 to 78 years. A history of psychiatric disorder was found in 15 patients, of whom almost all had stopped treatment. A majority (19 patients) was diagnosed with bipolar I disorder, and 8 patients suffered from schizophrenia. Average duration of hospitalization was 19 days. A total of, 22 patients were repatriated for medical reasons. Major difficulties during hospitalization were the language barrier, difficulties to contact family members or former treating psychiatrists for further information on the patient and his medical history, and the lack of insurance covering repatriation for medical reasons.ConclusionPsycho-education and early action on the precipitating factors could help to prevent psychiatric illness or relapse in these patients. Furthermore, attention of public authorities should be drawn to incomplete insurance coverage in many psychiatric patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Incidence of dissociative stupor and possession in a private psychiatry clinic

2017 ◽  
Vol 41 (S1) ◽  
pp. S570-S570
Author(s):  
D. Dua ◽  
P. Dua
Keyword(s):  
Longitudinal Study ◽  
Psychiatric Patients ◽  
Uttar Pradesh ◽  
Dissociative Disorder ◽  
Psychiatry Clinic ◽  
Dissociative Symptoms ◽  
Conversion Disorders ◽  
Icd 10 ◽  
Competing Interest ◽  
Dissociative Stupor

IntroductionDissociative and conversion disorders are reported to have a present incidence of about 85–100per 1000 by different studies, which are very few. The present research is a part of a longitudinal study of 15 years but here; only 3 years are represented, which could be briefly analyzed.ObjectiveLatest reports suggest a decline in incidence of hysteria (conversion and dissociation) and this research just tries to reconfirm.MethodsAll new patients attending a private psychiatry OPD in a small township of India at Lakhimpur Kheri in Uttar Pradesh, were screened to identify cases of dissociative disorder according to ICD 10, F44.2 and F44.3 from the 1st of January 2016 to 31st of October 2016 (10 months). These screened cases, only those presenting with fits of unconsciousness and possession, were analyzed and compared with the previous years for the same period.ResultsOut of a total of 3671 patients seen, (2122 males and 1549 females) a total of 319 presented with the above mentioned symptoms (58 males and 261 females) about 87 per 1000 of psychiatric patients.ConclusionThe results, when compared with two previous years for the same period were quite similar, 2015 getting incidence of 97 per 1000 and 2014, an incidence of 89 per 1000. The inference thus is that there does not seem to be any decline of incidence and the figure would be much higher if both conversion and dissociative symptoms are included – a really serious situation.Disclosure of InterestThe authors have not supplied their declaration of competing interest.

scholarly journals Factors affecting hallucinations in patients with delirium

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masako Tachibana ◽  
Toshiya Inada ◽  
Masaru Ichida ◽  
Norio Ozaki
Keyword(s):  
Rating Scale ◽  
Detailed Examination ◽  
Individual Factors ◽  
Visual Hallucinations ◽  
Angiotensin Ii Receptor ◽  
Contributing Factors ◽  
Factors Affecting ◽  
Receptor Blockers ◽  
Benzodiazepine Withdrawal ◽  
Exogenous Substances

AbstractDelirium develops through a multifactorial process and include multiple subtypes with different pathological factors. To refine the treatment and care for delirium, a more detailed examination of these subtypes is needed. Therefore, this study aimed to explore the factors affecting delirium in cases in which hallucinations are conspicuous. In total, 602 delirium cases referred to the psychiatry department at a general hospital between May 2015 and August 2020 were enrolled. The Delirium Rating Scale-revised-98 was used to assess perceptual disturbances and hallucinations in patients with delirium. Multiple regression analysis was applied to determine whether individual factors were associated with the hallucinations. A total of 156 patients with delirium (25.9%) experienced hallucinations, with visual hallucinations being the most common subtype. Alcohol drinking (p < 0.0005), benzodiazepine withdrawal (p = 0.004), and the use of angiotensin II receptor blockers (p = 0.007) or dopamine receptor agonists (p = 0.014) were found to be significantly associated with hallucinations in patients with delirium. The four factors detected in this study could all be reversible contributing factors derived from the use of or withdrawal from exogenous substances.

Delivering water services during protracted armed conflicts: How development agencies can overcome barriers to collaboration with humanitarian actors

2019 ◽  
Vol 101 (912) ◽  
pp. 1067-1089
Author(s):  
Edoardo Borgomeo
Keyword(s):  
Service Delivery ◽  
Armed Conflict ◽  
Armed Conflicts ◽  
Sub Saharan Africa ◽  
Contributing Factors ◽  
Emergency Relief ◽  
Organizational Goals ◽  
Post Conflict ◽  
Development Agencies ◽  
Sub Saharan

AbstractThis note discusses the challenges of water service delivery before, during and after protracted armed conflict, focusing on barriers that may impede successful transition from emergency to development interventions. The barriers are grouped according to three major contributing factors (three “C”s): culture (organizational goals and procedures), cash (financing practices) and capacity (know-how). By way of examples, the note explores ways in which development agencies can overcome these barriers during the three phases of a protracted armed conflict, using examples of World Bank projects and experiences in the Middle East and Sub-Saharan Africa. Before the crisis, development agencies need to work to prevent armed conflict. In a situation of active armed conflict or when conflict escalates, development agencies need to remain engaged as much as possible, as this will speed up post-conflict recovery. When conflict subsides, development agencies need to balance the relative effort placed on providing urgently needed emergency relief and water supply and sanitation services with the effort placed on re-establishing sector oversight roles and capacity of local institutions to oversee and manage service delivery in the long term.

scholarly journals Structured Evaluation of Rehabilitation Programs Outcomes in Psychiatry: Application of a Recovery-Centered Model

2021 ◽  
Author(s):  
Simone Vanzetto ◽  
Matteo Zabotto ◽  
Federica Fasciana ◽  
Alberto Varinelli ◽  
Giovanna Cirnigliaro ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Psychosocial Functioning ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Evaluation Model ◽  
Rehabilitation Program ◽  
Wilcoxon Test ◽  
Global Functioning ◽  
Outcome Indicator ◽  
Indicator Model

AbstractRehabilitation is oriented to psychiatric patients’ recovery through specific techniques and structured projects, not yet fully standardized, carried out in territorial services. This study aims to apply an operational structured outcome indicator model (hospitalizations, continuity of care, LAI treatment adherence, working support) through a recovery-centered model in a rehabilitation community in Milan. This observational-retrospective study included 111 patients from a University High Assistance Rehabilitation Community (C.R.A.) based in Milan. Psychopathological and psychosocial functioning was evaluated with Kennedy Axis V, Brief Psychiatric Rating Scale (BPRS), Life Skills Profile (LSP), AR module of the VADO scale. Statistical analyses were performed using SPSS software version 19. Student t test and Wilcoxon Test were used to analyze quantitative variables, while McNemar test for qualitative variables. The minimum level of significance was set at 0.05 (p <0.05). The results showed that CRA rehabilitation program led to significant improvement in global functioning in terms of hospitalization reduction; improved continuity of care; stable adherence to psychopharmacological treatment with Long Acting Injectable (LAI) antipsychotics; stable employment maintenance during the year following discharge from the CRA. This study confirmed the utility of a structured outcome indicator model and highlighted its feasibility in daily clinical context of a rehabilitative community. Our results supported the effectiveness of a community-based rehabilitation program to improve individual functioning and clinical stability. However, further studies are required to better achieve the development of a recovery-oriented rehabilitation model and rigorously define an outcomes evaluation model.

The Clinician’s Subjective Experience during the Interaction with Adolescent Psychiatric Patients: Validity and Reliability of the Assessment of Clinician’s Subjective Experience

2021 ◽  
pp. 1-8
Author(s):  
Angelo Picardi ◽  
Sara Panunzi ◽  
Sofia Misuraca ◽  
Chiara Di Maggio ◽  
Andrea Maugeri ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Subjective Experience ◽  
Rating Scale ◽  
Mood State ◽  
Psychiatric Patients ◽  
Temporal Stability ◽  
Young Patients ◽  
Reliability And Validity ◽  
Mental States ◽  
Validity And Reliability

<b><i>Introduction:</i></b> The last decade has witnessed a resurgence of interest in the clinician’s subjectivity and its role in the diagnostic assessment. Integrating the criteriological, third-person approach to patient evaluation and psychiatric diagnosis with other approaches that take into account the patient’s subjective and intersubjective experience may bear particular importance in the assessment of very young patients. The ACSE (Assessment of Clinician’s Subjective Experience) instrument may provide a practical way to probe the intersubjective field of the clinical examination; however, its reliability and validity in child and adolescent psychiatrists seeing very young patients is still to be determined. <b><i>Methods:</i></b> Thirty-three clinicians and 278 first-contact patients aged 12–17 years participated in this study. The clinicians completed the ACSE instrument and the Brief Psychiatric Rating Scale after seeing the patient, and the Profile of Mood State (POMS) just before seeing the patient and immediately after. The ACSE was completed again for 45 patients over a short (1–4 days) retest interval. <b><i>Results:</i></b> All ACSE scales showed high internal consistency and moderate to high temporal stability. Also, they displayed meaningful correlations with the changes in conceptually related POMS scales during the clinical examination. <b><i>Discussion:</i></b> The findings corroborate and extend previous work on adult patients and suggest that the ACSE provides a valid and reliable measure of the clinician’s subjective experience in adolescent psychiatric practice, too. The instrument may prove to be useful to help identify patients in the early stages of psychosis, in whom subtle alterations of being with others may be the only detectable sign. Future studies are needed to determine the feasibility and usefulness of integrating the ACSE within current approaches to the evaluation of at-risk mental states.

Antipsychotic Medication Adherence Scale (AMAS): Development and preliminary psychometric properties

2016 ◽  
Vol 33 (S1) ◽  
pp. s258-s259
Author(s):  
M.J. Martins ◽  
A.T. Pereira ◽  
C.B. Carvalho ◽  
P. Castilho ◽  
A.C. Lopes ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Psychometric Properties ◽  
Antipsychotic Medication ◽  
Convergent Validity ◽  
Rating Scale ◽  
Statistical Analysis Plan ◽  
Different Types ◽  
Adherence Scale ◽  
Relevant Variables ◽  
Competing Interest

IntroductionAlthough being highly consensual that antipsychotic adherence is an important outcome predictor in psychosis, existing reviews have found mean rates of adherence around 40–60%. Several aspects, such as patient-related, medication-related, environmental-related variables have been described as important predictors.AimsThis study aim is to develop, administer and present preliminary psychometric properties of a new scale for antipsychotic medication adherence that includes different types of predictors (clinical, psychosocial, and practical among others).MethodsThe “AMAS” was developed by a multidisciplinary team and was based on recent research on factors influencing antipsychotic adherence. The scale evolved from multiple drafts and experts were contacted in order to improve the final version. Over 50 patients with a diagnosis of a psychotic-spectrum disorder taking antipsychotic medication will be assessed with the “AMAS” and the Medication Adherence Rating Scale. Additionally, each patient's psychiatrist will fill in a form with demographic and clinical variables (such as type of symptoms, previous adherence problems, current adherence, insight and other relevant variables).ResultsThis is an ongoing study and the sample is still being collected (scheduled finish date: February/2016). Our statistical analysis’ plan includes: reliability analysis (Chronbach's alpha, alpha if item deleted, inter item correlations and covariances and item-total correlations); validity (convergent validity); factorial analysis.ConclusionsIt is hypothesized that the “AMAS” will be a practical, reliable and valid unidimentional instrument with clinical utility assessing adherence to antipsychotics. The “AMAS” can be also useful in assessing intervention targets (e.g. psychoterapeutical, psychoeducational) to enhance adherence.Disclosure of interestThe authors have not supplied their declaration of competing interest.

A tribute to Johann Gottlieb Burckhardt-Heussler (1836–1907), the pioneer of psychosurgery

2016 ◽  
Vol 33 (S1) ◽  
pp. S553-S553 ◽  
Author(s):  
M. Arts ◽  
P. Michielsen ◽  
S. Petrykiv ◽  
L. de Jonge
Keyword(s):  
Significant Contribution ◽  
Psychiatric Patients ◽  
Brain Regions ◽  
Medical Community ◽  
Psychiatric Illnesses ◽  
Scientific Papers ◽  
Show Evidence ◽  
Competing Interest ◽  
Chronic Psychiatric Patients ◽  
Deep Brain

IntroductionJohann Gottlieb Burckhardt-Heussler was a Swiss psychiatrist, who pioneered controversial psychosurgical procedures. Burckhardt-Heussler extirpated various brain regions from six chronic psychiatric patients under his care. By removing cortical tissue he aimed to relieve the patients of symptoms, including agitation, rather than effect a cure.ObjectivesTo present the scientific papers of Johann Gottlieb Burckhardt-Heussler on psychosurgery.AimsTo review available literature and to show evidence that Burckhardt-Heussler made a significant contribution to the development of psychosurgery.MethodsA biography and private papers are presented and discussed, followed by a literature review.ResultsThe theoretical basis of Burckhardt-Heussler's psychosurgical procedure was influenced by the zeitgeist and based on his belief that psychiatric illnesses were the result of specific brain lesions. His findings were ignored by scientists to make them disappear into the mists of time, while the details of his experiments became murky. Decades later, it was the American neurologist Walter Freeman II, performing prefrontal lobotomies since 1936, who found it inconceivable that the medical community had forgotten Burckhardt-Heussler and who conceded that he was familiar with, and probably even influenced by, Burckhardt's work.ConclusionIt is partly thanks to Burckhardt-Heussler's pioneering work that modern psychosurgery has gradually evolved from irreversible ablation to reversible stimulation techniques, including deep brain stimulation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Remdesivir Treatment for COVID 19 in Pregnant Patients with Moderate to Severe Symptoms: Serial Case Report

2021 ◽  
Vol 13 (2) ◽  
pp. 437-443
Author(s):  
Yudianto Budi Saroyo ◽  
Amanda Rumondang ◽  
Irene Sinta Febriana ◽  
Achmad Kemal Harzif ◽  
Rima Irwinda
Keyword(s):  
Adverse Effects ◽  
Adverse Events ◽  
Pregnant Women ◽  
Clinical Symptoms ◽  
Recovery Period ◽  
Rapid Improvement ◽  
Major Health Problem ◽  
Hospitalization Period ◽  
Duration Of Hospitalization ◽  
Novel Coronavirus

Introduction: Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) infection that causes novel Coronavirus Disease 2019 (COVID-19) has become a major health problem worldwide and been declared a pandemic since March 2020 by WHO. One special population that poses a challenge is pregnant women with COVID-19. There have not been many studies related to COVID-19 in pregnancy. In this study, we present five serial cases of Remdesivir treatment for COVID-19 in pregnant women with moderate to severe symptoms. Case Illustration: We briefly describe five serial cases being treated with Remdesivir therapy during hospitalization. Four cases were delivered by cesarean section, and one was delivered vaginally in gestation week 37. All cases showed a shortened duration of hospitalization, rapid improvement in clinical symptoms, and no adverse events were observed in mothers, fetuses, and neonates. Discussion: Remdesivir, an inhibitor RNA Polymerase, has been used in COVID-19 treatment and is known to shorten recovery time in nonpregnant women. Some studies have shown no adverse effects on Remdesivir for pregnant women. Based on randomized control trial (RCT) during the Ebola epidemic, Remdesivir was safe to use for pregnant women. All cases showed reduced hospitalization time and better clinical outcomes without maternal, fetal, or neonatal adverse events. Conclusion: Remdesivir protocol for pregnant women with moderate to severe symptoms of COVID-19 has resulted in better clinical improvement with a shorter recovery period and no adverse effects during the hospitalization period. Further studies and RCT are warranted to evaluate the biosafety and effects of Remdesivir in pregnant women.

Comparison of Self-reported to Observational Agitation Scales

2017 ◽  
Vol 41 (S1) ◽  
pp. S151-S151
Author(s):  
L. Zun ◽  
L. Downey
Keyword(s):  
Psychiatric Patients ◽  
Likert Scale ◽  
The Self ◽  
Assessment Tools ◽  
Self Assessment ◽  
Convenience Sample ◽  
Ed Visits ◽  
Competing Interest ◽  
A Prospective Study ◽  
Age Range

BackgroundIncreasingly, psychiatric patients are presenting to the emergency department (ED) with agitation. ED staff rarely, if ever, use scale to assess agitation or use any self-assessment tools to determine a patient's level of agitation.ObjectivesTo evaluate the relationship between a patient's self-reported level of agitation and other validated agitation assessment tools.MethodsThis is a prospective study using a convenience sample of patients presenting to the ED with a psychiatric complaint. This study was conducted in an urban, inner-city trauma level 1 center with 55,000 ED visits a year. After obtaining consent, a research fellow administered observational tools, PANSS-EC and ACES and BAM and Likert scale self assessment tools on arrival to the ED. SPSS version 24 was used. The study was IRB approved.ResultsA total of 139 patients were enrolled. The most common ED diagnoses were depression, schizophrenia, or bipolar. Majority of patients were African-American (59%), falling in the 25–44 year old age range (56%) 52% male. Self-reported agitation was rated as moderate to high in 72.4% of these patients on the Likert scale and 76.3% on the BAM. There was a significant correlation between the self-reported score versus the BAM (F = 11.2, P = 0.00). However, the self-reported scores were significantly different from the scores assessed by observational tools (P < 0.05).ConclusionsED providers should assess a patient's self-reported level of agitation because a patient could be feeling markedly agitated without expressing outward signs detected by observational tools.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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