Psychiatric Emergency Service use in Coimbra University Hospitals: Results from a 6-Month Cross-Sectional Study Sample

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
J. Cerejeira ◽  
H. Firmino ◽  
I. Boto ◽  
H. Rita ◽  
G. Santos ◽  
...  

Aim:The Psychiatric Emergency Service (PES) is an important part of the mental health care system for the management of acute conditions requiring prompt intervention representing also a significant part of workload of specialists and trainees. The objective of this study was to characterize the clinical features of patients observed in PES of Coimbra University Hospitals.Method:During the first 6 months of 2008, demographic and clinical data were obtained for all patients observed by the first author of the study, together with a specialist in Psychiatry.Results:The sample consisted of 159 patients, 103 females and 56 males. Mean age was 45,9 ± 18,367 years. The majority of patients presented in the emergency room either alone (56,6%) or with a first degree relative (34,6%) by self-initiative and having a past psychiatric history (71,1%). Disturbing mood symptoms (depression, anxiety or both) were the motive of assessment in 58% of patients but several other causes were reported including behavioural symptoms, agitation, psychosis, drug or alcohol related disorders, sleep and cognitive disorders. Average Clinical Global Impression was 4,12 ± 1,177. After the psychiatric assessment, several diagnosis were made namely Major Depressive Episode (14,5%), Adaptation Disorders (13,9%), Schizophrenia and related disorders (13,8%), Anxiety Disorder Not Otherwise Specified (11,9%) and Drug or Alcohol related disorders (8,2%). Most patients were discharged without referral (50,3%).Conclusion:A significant percentage of patients went to the PES for conditions that could have been treated by a primary care physician or in an outpatient clinic setting.

2005 ◽  
Vol 11 (3) ◽  
pp. 4 ◽  
Author(s):  
Don AB Wilson ◽  
Alan J Flisher ◽  
Mark Welman

Objective. To document and compare the characteristics of patients assessed at a psychiatric emergency service (PES) during April and May of 1988 and 1998.Design. Two cross-sectional surveys.Setting. Groote Schuur Hospital (GSH), Cape Town.Subjects. Patients assessed at the PES, GSH.Outcome measures. These were occupational status, referral source, distance travelled to get to the hospital, and diagnosis.Results. Nine hundred and twenty-five patients made 1 081 visits to the unit during a 2-month period in 1988, while during a similar period in 1998, 364 patients made 477 visits. In the latter period the patients were significantly more likely to be skilled workers or students/scholars, to be referred from within GSH or other health facilities, to have travelled less than 10 km to get to the hospital, and to be suffering from a mood disorder or suicidality (and less likely to be suffering from a substance use disorder).Conclusions. The differences between the two time periods indicate that changes in policy during the period 1988 - 1998 may have impacted on the patient profile at the PES at GSH. It is important to document such changes with a view to informing service planning for both tertiary referral centres and other levels of care.


2005 ◽  
Vol 56 (6) ◽  
pp. 691-698 ◽  
Author(s):  
Cynthia A. Claassen ◽  
T. Michael Kashner ◽  
Saundra K. Gilfillan ◽  
Gregory L. Larkin ◽  
A. John Rush

2020 ◽  
Vol 71 (5) ◽  
pp. 440-446
Author(s):  
Daniel Poremski ◽  
Peizhi Wang ◽  
Margaret Hendriks ◽  
Josephine Tham ◽  
Doris Koh ◽  
...  

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 375-382
Author(s):  
Remco F. P. de Winter ◽  
Mirjam C. Hazewinkel ◽  
Roland van de Sande ◽  
Derek P. de Beurs ◽  
Marieke H. de Groot

Abstract. Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Results: Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Limitations: Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Conclusions: Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.


Thorax ◽  
2020 ◽  
Vol 75 (12) ◽  
pp. 1089-1094 ◽  
Author(s):  
Adrian Shields ◽  
Sian E Faustini ◽  
Marisol Perez-Toledo ◽  
Sian Jossi ◽  
Erin Aldera ◽  
...  

ObjectiveTo determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.DesignA cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.SettingUniversity Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.Participants545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.InterventionParticipants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.Main outcome measureProportion of participants demonstrating infection and positive SARS-CoV-2 serology.ResultsThe point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).Conclusions and relevanceWe identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuji Nishizaki ◽  
Keigo Nozawa ◽  
Tomohiro Shinozaki ◽  
Taro Shimizu ◽  
Tomoya Okubo ◽  
...  

Abstract Background The general medicine in-training examination (GM-ITE) is designed to objectively evaluate the postgraduate clinical competencies (PGY) 1 and 2 residents in Japan. Although the total GM-ITE scores tended to be lower in PGY-1 and PGY-2 residents in university hospitals than those in community-based hospitals, the most divergent areas of essential clinical competencies have not yet been revealed. Methods We conducted a nationwide, multicenter, cross-sectional study in Japan, using the GM-ITE to compare university and community-based hospitals in the four areas of basic clinical knowledge“. Specifically, “medical interview and professionalism,” “symptomatology and clinical reasoning,” “physical examination and clinical procedures,” and “disease knowledge” were assessed. Results We found no significant difference in “medical interview and professionalism” scores between the community-based and university hospital residents. However, significant differences were found in the remaining three areas. A 1.28-point difference (95% confidence interval: 0.96–1.59) in “physical examination and clinical procedures” in PGY-1 residents was found; this area alone accounts for approximately half of the difference in total score. Conclusions The standardization of junior residency programs and the general clinical education programs in Japan should be promoted and will improve the overall training that our residents receive. This is especially needed in categories where university hospitals have low scores, such as “physical examination and clinical procedures.”


1991 ◽  
Vol 45 (2) ◽  
pp. 119-127 ◽  
Author(s):  
Joachim Knop ◽  
Ulf Søgaard ◽  
Anne Stub Sørensen ◽  
Vilhelm Schultz ◽  
Ellen Hasselbalch ◽  
...  

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