Describing the assistance, the basis for improvement

IntroductionConsultation-liaison (CL) psychiatry is a branch of psychiatry that study and treat mental health of patients with other medical or surgical conditions. The assistance between hospitals and health services is heterogeneous.Aims and objectivesFor this reason, the objective of our research is to define the clinical characteristics from our CL service and check out the quality relationship with the applicant service, for improving future assistance.MethodsWe made a descriptive analysis of clinical variables from the patients who received assistance during 2 months by the CL service from the hospital del Mar, Barcelona. We got the frequencies and we used the Chi2 test for the comparison between variables: Diagnosis, appearance in the report and treatment in the report.ResultsTotal of the sample: 42 patients, 61.9% women. Mean age: 55.1 years. Psychiatric diagnosis was present before the assistance on 57.1% of the patients. The most frequent diagnosis was Adjustment Disorder (47.6%) and more than one diagnosis was made in the 14.3%. Near the half of the patients required only primary care assistance after the discharge from the hospital. In the 68.3% of the reports appeared information about CL assistance and the indicated treatment didn’t appear in all the reports. Statistically significant differences weren’t found in the comparisons.ConclusionsAdjustment Disorder is supposed to be the most common psychiatric diagnosis in our CL psychiatry service, as we found in the reviewed literature. The results reveal that relationships between services can be improved. More studies must be done for completing information in this issue.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Descriptive Study of Adjustment Disorders in a Mental Health Unit.

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.956 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S607-S607

Author(s):

L. González ◽

B. Pecino ◽

C. Gomez ◽

M. Anibarro ◽

C. Ortigosa

Keyword(s):

Mental Health ◽

Primary Care ◽

Care Physician ◽

Psychiatric Evaluation ◽

Adjustment Disorders ◽

Health Unit ◽

Social Difficulties ◽

Current Employment Status ◽

Competing Interest ◽

Mental Health Unit

IntroductionAdjustment disorders are a common psychiatric disorder in primary care and mental health units, with point prevalence estimates ranging from 0.9% to 2.3%. These disorders have been recently defined as a stress response syndrome in the fifth edition of the DSM, causing emotional and social difficulties and also a large economic burden on society.ObjectivesThe aim of this descriptional study was to analyse the socio-demographic characteristics and treatment of the patients diagnosed with adjustment disorders in the first visit in a mental health unit.MethodsThe study sample consisted of 128 patients admitted for a psychiatric consultation in a mental health unit in Alicante (Spain) from their primary care physician, between February and July 2016. Variables of gender, age, current employment status, diagnosis and treatment were measured. Data analysis was conducted using SPSS software.ResultsThe data from 31 patients who were diagnosed with adjustment disorders meant a 24% of the sample. The median age was 47 years old in the adjustment disorders group. Among those with adjustment disorders, 61% were women, and 52% of them were unemployed. Almost 60% of them had at least one pychotropic prescription and only 22% were derived to psychology.ConclusionsAdjustment disorders are considered as an intermediate category between no mental disorder and affective disorders. Most authors recommend to start with a psychotherapeutic intervention. Despite starting with medication has not proved effectiveness in the studies, most of the patients had at least one psychotropic prescription before the psychiatric evaluation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Adolescent units: a need for change?

Psychiatric Bulletin ◽

10.1192/pb.27.8.292 ◽

2003 ◽

Vol 27 (8) ◽

pp. 292-294 ◽

Cited By ~ 4

Author(s):

Tim Calton ◽

Jon Arcelus

Keyword(s):

Mental Health ◽

Psychiatric Diagnosis ◽

Adjustment Disorder ◽

General Purpose ◽

Clinical Implications ◽

Violent Behaviour ◽

Mental Health Act

Aims and MethodTo describe the characteristics and diagnoses of patients admitted to a general adolescent psychiatric in-patient unit. We describe the age, gender and psychiatric diagnosis of the patient, as well as whether the patient exhibited violent behaviour in the ward, whether he/she needed to be transferred to a different service and whether he/she was admitted under a section of the Mental Health Act 1983.ResultsPatients were evenly distributed in terms of gender, with most being 14–16 years old. Diagnoses were varied with adjustment disorder predominating, but could be separated into four main groups. Levels of violence were high, being associated with detention under the Mental Health Act 1983, and often resulted in transfer to another service.Clinical ImplicationsThe needs of certain adolescents admitted to a general-purpose adolescent unit may not be best met in this environment. Current services must change to meet the needs of their patients. There may be a need for greater specialisation.

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Comparative Study Between Preferential Consultations And Most Common Diagnoses

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1639 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S451-S451

Author(s):

C. Manso Bazús ◽

J. Valdes Valdazo ◽

E. Garcia Fernandez ◽

L.T. Velilla Diez ◽

J. Min Kim ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Observational Study ◽

Affective Disorders ◽

Primary Care Physicians ◽

The Other ◽

Health Care Burden ◽

Competing Interest ◽

The One

IntroductionTo the specialized attention arrives as preferred patients with minor diagnosis.ObjectiveWe do a relation between the type (normal/preferential) derivation of the first consultations and their corresponding diagnosis.MethodologyRetrospective observational study with data gathered during 3 months, which handle 2 variables: on the one hand, type of derivation and on the other, effected diagnosis.ResultsThe most frequent diagnosis found are adaptative disorders and affective disorders, corresponding to 45.45% and 9.1%, respectively of preferred leads.ConclusionsAlmost half of preferential queries (consultations) could be treated in first instance by primary care physicians releasing mental health care burden.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Improving mental health services in a local area — an exploratory study

Australian Health Review ◽

10.1071/ah040292 ◽

2004 ◽

Vol 28 (3) ◽

pp. 292 ◽

Cited By ~ 6

Author(s):

Terry Buchan ◽

Duncan P Boldy

Keyword(s):

Mental Health ◽

Primary Care ◽

Mental Illness ◽

Mental Health Services ◽

Health Services ◽

Exploratory Study ◽

Local Area ◽

People With Mental Illness ◽

Improved Model ◽

Made In

The change in the focus of care for people with mental illness from hospital to community has been far from uniformly successful for a variety of reasons. A review of the development of mental health services suggests that the views of doctors and the responses of administrative systems are significant forces in shaping the development of services. This study explored the attitudes of general practitioners, psychiatrists and administrators, with a view to establishing areas of congruence in order to move towards an improved model of service delivery. Recommendations are made in the areas of primary care psychiatry, access, communication and education.

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Coordinating primary care and mental health

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.613 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s496-s496

Author(s):

V.Martí Garnica ◽

M.D. Ortega Garcia ◽

M.A. Bernal Lopez ◽

J.R. Russo de Leon ◽

S. Marin Garcia

Keyword(s):

Mental Health ◽

Primary Care ◽

Primary Care Physicians ◽

Mental Health Problems ◽

Interdisciplinary Approach ◽

Social Situation ◽

Subsequent Treatment ◽

Appropriate Treatment ◽

Specialized Care ◽

Competing Interest

Through the analysis of a case report to analyze the importance of the coordination between primary care and mental health service for a better management of an outpatient. It is known that primary care is the gateway to the patient in the health system. Therefore, the role of physicians headers is essential for diagnosis, for the start of drug treatment and referral to specialized care. It is known that one of every four patients have mental health problems. To meet the standards of primary care, physicians should ensure personalized assistance, integrated, continuous and permanent. Therefore, in relation to the accessibility of patients, it is essential to establish the diagnosis as soon as possible and initiate appropriate treatment to alleviate the symptoms of this type of psychiatric disorders and should track patients and their caregivers. For all this, it is essential that there is proper coordination between primary and specialty care in mental health. The interdisciplinary approach in these situations can assist the patient and family from a holistic perspective. This approach strengthens and reinforces the subsequent treatment, not only care but also evolutionary. Thus arises the interdisciplinary work as an opportunity to access the new and complex this social situation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Risk factor for suicide attempt in a general hospital

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1808 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s890-s890

Author(s):

B. Mures ◽

N.G. Lluis ◽

O.G. Luis ◽

A.P. Iñigo ◽

M.H. German ◽

...

Keyword(s):

Risk Factor ◽

Suicide Attempt ◽

General Hospital ◽

Clinical Characteristics ◽

Suicide Attempts ◽

Adjustment Disorder ◽

Common Method ◽

Multiple Drug ◽

Progressive Change ◽

Competing Interest

IntroductionA major risk factor for suicide is suicide attempts. The aim of the present study was to assess risk factors for nonfatal suicide attempts. Suicide attempt with high lethality have been interacting with certain clinical and demographic factors such as age, sex, psychopathology and adverse events, among others.MethodsObservational, descriptive and retrospective study of people who was admitted to a general hospital after suicide attempt.AimThe aim of this study was to determinate variable associated to high risk of suicide. Describe and analyze demographic and clinical characteristics associated with serious suicide attempts as well as the methods used.ResultsOf a total of 504, 23 patients was admitted after suicide attempt, 61% male, mean age 54.1; 60% required ICU; the most common method consisted of multiple drug intake 40%, 30% associated with toxic, mostly alcohol. Predominant summer and diagnosis of adjustment disorder.ConclusionAs is the case with suicides prevails male and summer. As to the most common method has been from medication, both men and women. We were surprised diagnosis of the most common reactions to stress. We conclude that the findings could guide a progressive change in the presuicidal pathology.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Non-Attendance at Initial Appointments in an Outpatient Mental Health Centre

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1777 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S485-S485

Author(s):

S. Ramos Perdigues ◽

S. Gasque Llopis ◽

S. Castillo Magaña ◽

Y. Suesta Abad ◽

M. Forner Martínez ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Social Services ◽

Mental Health Problems ◽

Mental Health Center ◽

Health Centre ◽

Outpatient Mental Health ◽

Use Of Resources ◽

Mental Health Centre ◽

Competing Interest

IntroductionNon-attendance at initial appointments is an important problem in outpatient settings and has consequences, such as decreased efficient use of resources and delayed attention to patients who attend their visits, and that compromises quality of care.ObjectivesTo identify and describe the characteristics of patients who do not attend the first appointment in an adult outpatient mental health center, located in Barcelona.MethodRetrospective study. The sample was made up from all patients who had a first appointment during 2014 in our outpatient mental health centre. Socio-demographic and clinical data (type of first appointment, reason for consultation, origin of derivation, priority, history of mental health problems) were described. The results were analyzed using the SPSS statistical package.ResultsA total of 272 patients were included. Twenty-six per cent did not attend their first appointment; with mean age 39.75 years and 51.4% were male. Most frequent problems were anxiety (41.7%), depression (26.4%) and psycosis and behavioural problems (11.2%). The origin was primary care (83.3%), social services (4.2%) and emergencies (2.8%). Most of them were not preferent or urgent (86.1%). The 51.4% of non-attendees had history or psychiatric problems and 13.9% nowadays are patients of our mental health centre.ConclusionsIt is important to develop mechanisms that can reduce the incidence of first non-attended appointments. In our case, most of them are attended by primary care so we can establish better communication with our colleagues and try to contact to the patients prior to the date of the appointment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Descriptive analysis of demand in a mental health-primary care liaison department

European Neuropsychopharmacology ◽

10.1016/s0924-977x(17)31367-6 ◽

2017 ◽

Vol 27 ◽

pp. S746

Author(s):

B. Mata Sáenz ◽

L. Nuevo Femández ◽

L.M. Asensio Aguerri ◽

L. Cabanillas Carrillo ◽

L. Beato Fernández

Keyword(s):

Mental Health ◽

Primary Care ◽

Descriptive Analysis

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Adolescent units: a need for change?

Psychiatric Bulletin ◽

10.1017/s0955603600002750 ◽

2003 ◽

Vol 27 (08) ◽

pp. 292-294 ◽

Cited By ~ 2

Author(s):

Tim Calton ◽

Jon Arcelus

Keyword(s):

Mental Health ◽

Psychiatric Diagnosis ◽

Adjustment Disorder ◽

General Purpose ◽

Clinical Implications ◽

Violent Behaviour ◽

Mental Health Act

Aims and Method To describe the characteristics and diagnoses of patients admitted to a general adolescent psychiatric in-patient unit. We describe the age, gender and psychiatric diagnosis of the patient, as well as whether the patient exhibited violent behaviour in the ward, whether he/she needed to be transferred to a different service and whether he/she was admitted under a section of the Mental Health Act 1983. Results Patients were evenly distributed in terms of gender, with most being 14–16 years old. Diagnoses were varied with adjustment disorder predominating, but could be separated into four main groups. Levels of violence were high, being associated with detention under the Mental Health Act 1983, and often resulted in transfer to another service. Clinical Implications The needs of certain adolescents admitted to a general-purpose adolescent unit may not be best met in this environment. Current services must change to meet the needs of their patients. There may be a need for greater specialisation.

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Analysis of geographical distribution of referrals to psychiatry from primary care

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.858 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S576-S576

Author(s):

B. Mata Saenz ◽

V. Muñoz Martinez ◽

L. Nuevo Fernández ◽

E. Lopez Lavela ◽

L.M. Asensio Aguerri

Keyword(s):

Mental Health ◽

Primary Care ◽

Prospective Study ◽

Geographical Distribution ◽

Significant Relationship ◽

Geographical Origin ◽

Demographic Data ◽

Place Of Residence ◽

Area 5 ◽

Competing Interest

IntroductionThe distribution of the demand from primary care in the mental health units could be a way of facilitating the coordination and improving the attention to patients. For this reason, in our unit we have made a repartition of the areas among the different psychiatrists.ObjectivesTo analyze if there was a correlation between the geographical origin of the patients or their primary care areas and the referrals, and between them and their attendance.MethodsThis is an epidemiological, analytic, prospective study of patients referred to our department. The following variables were collected: (1) referral protocol, (2) reason, (3) demographic data (origin, gender, age), (4) Primary Care area, (5) attendance to appointment, (6) diagnosis impression and (7) destination of referral. The SPSS 19.0 was used to analyze the data.ResultsA total of 1048 patients were sampled. A statistically significant relationship hasn’t been found between place of residence, primary care area or areas of distribution in the Unit and attendance (Chi2). If we analyze the population of each distribution, we can describe similar percentages depending on the size of these.ConclusionsAlthough a different distribution and a relationship is thought between some areas and the attendance or the number of referrals, we didn’t find out them in our sample.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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