Validación de la versión española de la psychiatric research interview for substance and mental disorders (PRISM)

Background. We examined correlates of past year suicidal thoughts and behavior (STB) and described past year treatment experiences among young people who inject drugs (PWID). Methods. Participants were 570 adults (18-25 years) who injected primarily heroin. Interviews were conducted at field stations operated by Community Outreach Intervention Projects in Chicago, Illinois (USA). Interviewers administered the Psychiatric Research Instrument for Substance and Mental Disorders. Substance use and mental disorders were based on DSM-IV diagnostic criteria. Past year STB was based on multiple questions. Results. Sixteen percent of men and 25% of women reported STB in the past year. In multivariable analysis, STB was associated with non-heterosexual orientation, foster care, and being raised by two parents. Primary major depression, post-traumatic stress disorder, other anxiety disorders, and borderline personality disorder had independent effects on suicidality. Among those reporting past year STB (n=111), 83% ever received mental health treatment, while 44% did so in the past year. While 24% of respondents indicated that at least one treatment matched their needs very well, 30% reported treatment that did not match their needs at all. The most common reason for ending treatment was program completion (about 50%) while getting better was endorsed by about 25%. Nearly half reported ending treatment due to a bad experience, logistical issues, or expense. Conclusions. Young PWID are at high risk for suicidal behavior and their mental health treatment experiences often do not meet their needs. There is a pressing need for more integrated substance use and mental health treatment.

Download Full-text

NARSAD: a decade of support for psychiatric research [interview by John A Talbott]

Psychiatric Services ◽

10.1176/ps.48.12.1533 ◽

1997 ◽

Vol 48 (12) ◽

pp. 1533-1534

Keyword(s):

Psychiatric Research ◽

Research Interview

Download Full-text

Early systematic communication between physician, patient and employer to promote return to work

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1362 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

P Nordling ◽

L Nordeman ◽

I M Skoglund ◽

C Björkelund ◽

G Hensing

Keyword(s):

Primary Care ◽

Mental Disorders ◽

Return To Work ◽

Usual Care ◽

Common Mental Disorders ◽

Pragmatic Trial ◽

Organizational Factors ◽

Psychiatric Research ◽

Related Factors ◽

Physician Patient

Abstract Background In the sickness absence and return-to-work process communication between stakeholders is beneficial but difficult to achieve. Addressing work-related issues early in the process could support decision making. The aim of this study was to test if early systematic communication about work and health between physician, patient/employee and employer facilitated by a communication tool, the Capacity Note, was feasible for patients with common mental disorders (CMD) in primary care. Methods In a pragmatic trial, physicians at primary health care centers (PHCCs) were randomized to control/intervention physician and were responsible for identifying eligible patients. In addition to usual care, intervention patients used the Capacity Note with their physician and were then instructed to use it with their employer and return it to the physician. Control patients received usual care. A study log book and sick leave data for each PHCC were used for process evaluation purposes. Results Eighteen of 24 PHCCs in the region were contacted; eight participated. At study start, 434 patients filled the basic inclusion criteria. Of these, 93 were identified as eligible by the physicians and were asked to participate. Around 40% declined participation, most commonly due to lack of energy or hesitation to talk to the employer. The final sample included 56 patients. Of the 28 intervention patients nine (32%) completed the intervention. Conclusions The study was negatively affected by suboptimal research conditions in primary care (e.g. severe time constraints). Also, the patients' hesitation to participate highlights the sensitivity of the topic and the difficulties in doing research in this vulnerable patient group. Thus, the feasibility was hampered by both organizational and patient related factors. It is of utmost importance to improve possibilities for social psychiatric research in primary care given the high prevalence of CMD and associated reduced capacity to work. Key messages Discussing health-related issues with the employer was seen as a sensitive matter among patients with common mental disorders. Research on best practices for sickness certification and return-to-work was difficult to achieve due to both personal and organizational factors.

Download Full-text