Competency Evaluations on the Psychiatric Consultation Service

AbstractThe authors retrospectively reviewed the charts of all patients seen by the Psychiatric Consultation Service at their institution between January 1, 1989 to December 31, 1992. A total of 94 patients were evaluated for competency (study group). These were compared with 88 diagnostically matched patients (control group) who were assessed for reasons other than competency during the same time period. Patients in the study group were more likely to be black, less likely to be prescribed psychotropics, and more likely to be consulted upon later on during the course of their hospitalization. Among patients assessed for competency (study group) those patients judged to be incompetent were more likely to be older, have organic mental disorders (OMD), be prescribed psychotropics, and have longer hospital stays. Amongst patients in the study group, geriatric patients (> 60) when compared with nongeriatric patients were more likely to be female, Caucasian, and have OMD and multiple medical illnesses.

Download Full-text

Evaluations of Competency of Patients with Organic Mental Disorder

Psychological Reports ◽

10.2466/pr0.1997.80.1.107 ◽

1997 ◽

Vol 80 (1) ◽

pp. 107-113 ◽

Cited By ~ 1

Author(s):

Tarak Vasavada ◽

Prakash S. Masand ◽

George Nasra

Keyword(s):

African American ◽

Mental Disorders ◽

Mental Disorder ◽

Psychotropic Drugs ◽

Comparison Group ◽

Study Group ◽

Psychiatric Consultation ◽

Consultation Service ◽

Organic Mental Disorder ◽

Organic Mental Disorders

The authors retrospectively reviewed the charts of all patients ( N = 903) seen by the Psychiatric Consultation Service from January 1, 1989 through December 31, 1991. A total of 74 patients had a diagnosis of organic mental disorders (delirium, dementia, or both). Of these, 32 patients were evaluated for competency (Study group), while the remaining 42 were evaluated for reasons other than competency (Comparison group). Patients in the Study group were more likely to be African American and less likely to be prescribed psychotropic drugs than the Comparison group. The majority of patients with organic mental disorder (87.5%) evaluated for competency were judged to be incompetent.

Download Full-text

Changes in organic mental disorders features in persons who have repeatedly committed socially dangerous acts

Kazan medical journal ◽

10.17750/kmj2015-157 ◽

2015 ◽

Vol 96 (2) ◽

pp. 157-161

Author(s):

S N Popov ◽

I N Vinnikova

Keyword(s):

Mental Disorders ◽

Mental Disorder ◽

Disease Duration ◽

Comparison Group ◽

Clinical Manifestations ◽

Main Group ◽

Control Group ◽

Study Group ◽

Organic Mental Disorder ◽

Organic Mental Disorders

Aim. Comparative analysis of the changes in clinical manifestations of organic mental disorders in persons who have repeatedly committed socially dangerous acts, and in patients without recurrence of misconduct.Methods. 93 patients with organic mental disorders who have committed socially dangerous acts and were declared as mentally insane and in whom compulsory medical measures assigned to them by the court were used were examined. Patients who have committed repeated socially dangerous acts after treatment were included in the main group (30 persons), patients who does not commit repeated socially dangerous acts were allocated to the comparison group (63 persons).Results. In the main group, patients with organic delusional disorder (F06.2, 20% vs 11.1%) dominated. In the control group, the share of patients with dementia of mixed origin (F02) was 22.2%, and in the main group - only 3.3%. In the main group, the prevalence of patients with psychotic conditions within the organic mental disorder was 43.3% versus 30.2% in the comparison group. At that, the rate of progression varied only slightly. The proportion of patients with no previously recorded episodes of decompensation was higher in the control group - 46.0% versus 13.3% in the study group. A few patients in both groups (10%) were supervised and regularly visited a psychiatrist. The number of patients who were not supervised or who attended psychiatrist rare was almost the same (46.7 and 47.6% in the study group and control group, respectively). At that, in the control group 12.7% of patients were not supervised due to the short disease duration (patients with dementia). There were a few more patients with a disease duration of more than 10 years in the comparison group - 54.0%, whereas in the study group - 43.3%.Conclusion. There is a number of differences in clinical manifestations of organic mental disorder and their changes over time, affecting the criminogenic risk of this population; an integrated approach to disease prevention, which can lead to an improvement in the criminal forecast, is needed.

Download Full-text

Therapeutic benefit of aripiprazole-olanzapine combination in the treatment of senile Alzheimer’s disease complicated by mental disorders

Tropical Journal of Pharmaceutical Research ◽

10.4314/tjpr.v19i2.29 ◽

2020 ◽

Vol 19 (2) ◽

pp. 441-446

Author(s):

Na Zheng ◽

Ning Wang ◽

Ji-Min Jia

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Mental Disorders ◽

Clinical Efficacy ◽

Lower Incidence ◽

Adverse Reactions ◽

Study Groups ◽

Therapeutic Benefit ◽

Control Group ◽

Study Group

Purpose: To determine the clinical efficacy of aripiprazole-olanzapine combination treatment in elderly Alzheimer’s disease complicated with mental disorders. Methods: Ninety-two elderly patients with Alzheimer’s disease and mental disorders who were admitted to Binzhou People's Hospital, were enrolled in the study. They were randomized into control and study groups. Control group was treated with olanzapine, while the study group was treated with aripiprazole as an adjuvant therapy in addition to olanzapine. The clinical efficacy, scores on different scales (MMSE, ADAS-cog, CDR, ADL, NPI and CMAI), and incidence of adverse reactions were determined. Results: The overall degree of response was significantly higher in the study group than in the control group (p < 0.05). There were no significant differences in MMSE, ADAS-cog, CDR, ADL, NPI and CMAI scores between the two groups before treatment (p > 0.05). The MMSE score of the study group was significantly higher than that of the control group, and the scores in the other scales in the study group were significantly lower after treatment (p < 0.05). The study group had significantly lower incidence of adverse reactions than control group (p < 0.05). Conclusion: Aripiprazole-olanzapine combination has significant therapeutic benefit in the treatment of elderly Alzheimer’s disease patients complicated with mental disorders. It promotes recovery of neurological function, as well as produces a lower incidence of adverse reactions. Keywords: Aripiprazole, Olanzapine, Alzheimer’s disease, Mental disorders

Download Full-text

Clinical and Social Characteristics of Patients with Schizophrenia and Organic Mental Conditions Who Committed a Repeated Socially Dangerous Act

Doctor Ru ◽

10.31550/1727-2378-2021-20-5-62-66 ◽

2021 ◽

Vol 20 (5) ◽

pp. 62-66

Author(s):

S.N. Popov ◽

◽

I.N. Vinnikova ◽

A.S. Berezkin ◽

◽

...

Keyword(s):

Risk Factors ◽

Drug Abuse ◽

Mental Disorders ◽

Comparison Group ◽

Social Characteristics ◽

Study Group ◽

Organic Mental Disorders ◽

Group A ◽

Alcohol And Drug Abuse ◽

Group B

Study Objective: To compare clinical and social characteristics of patients with schizophrenia and organic mental conditions who committed a repeated socially dangerous acts (SDAs), not only in order to compare, but also to identify specific SDA risk factors. Study Design: comparative study. Materials and Methods. The study included 86 schizophrenia patients (study group) and 45 patients with organic mental conditions who committed SDAs, were found insane and were forced to undergo various court-appointed therapies for 2 and more times. In this study, we used the clinical psychopathologic method with due account to psychopathology and clinical statistic method as the main methods. Study Results. Hereditary load study demonstrated that in the study group (А) 35 (40.7%) out of 86 patients had hereditary exogenous conditions (pi < 0.05), while in controls (B) 9 (20%) out of 45 patients had such conditions (pi < 0.01). The number of patients without hereditary load was comparable in both groups: 45 (52.3%) vs. 24 (53.3%), respectively. In schizophrenia patients, only 6 (7%) patients had confirmed hereditary endogenous conditions, while in comparison group (B) this value was 9 (20%). Combined hereditary load was recorded only in controls: 3 (6.6%) patients. Almost all patients in comparison group (B) did not have a place work (44 (97.8%); pi < 0.01), while in the study group (A) the unemployed made 44 (51.1%). During the study, 45 (52.3%) patients in group (A) had associated bad habits (alcohol and drug abuse); 14 (16.3%) patients had both alcohol and drug abuse. 23 comparison group (B) patients had various bad habits; combined abuses were recorded in 8 (17.8%) cases. Alcohol and drug abuse were not diagnosed in 20 (23.2%) patients in study group and in 4 (8.9%) patients in controls. Conclusion. Data analysis demonstrates the clinical-social factors are noted in study groups and affect criminal behaviour and a probability of repeated SDAs in the future (with identification of factors specific for each nosological factor group). We have also identified differences in risk factors of a repeated SDA between patients with organic mental disorders and schizophrenia. Keywords: schizophrenia, organic mental disorders, repeated socially dangerous acts.

Download Full-text

Does additional weekend and holiday physiotherapy benefit geriatric patients with hip fracture? — A case-historical control study

Hong Kong Physiotherapy Journal ◽

10.1142/s1013702521500104 ◽

2021 ◽

pp. 1-10

Author(s):

Dennis Kim Chung Mo ◽

Ken Kin Ming Lau ◽

Donna Mei Yee Fung ◽

Bosco Hon Ming Ma ◽

Titanic Fuk On Lau ◽

...

Keyword(s):

Hip Fracture ◽

Length Of Stay ◽

Functional Outcomes ◽

Geriatric Patients ◽

Historical Control ◽

Hospital Length Of Stay ◽

Lower Percentage ◽

Control Group ◽

Study Group ◽

Rehabilitation Hospital

Objective: To evaluate the new service model of additional weekend and holiday physiotherapy (PT) by comparing functional outcomes and hospital length of stay between a group of geriatric patients with hip fracture receiving daily PT training and a group of geriatric patients with hip fracture receiving weekdays PT training. Methods: A retrospective case-historical control chart review was conducted and a total of 355 patients were identified. Between-group comparisons were done on functional outcomes including Modified Functional Ambulation Classification (MFAC), Elderly Mobility Scale (EMS), Modified Barthel Index (MBI) and process outcome in terms of length of stay (LOS) in hospitals. Results: With similar characteristics, patients who received weekend and holiday PT training had a significant higher percentage of MFAC Category III and a significant lower percentage of MFAC Category II ([Formula: see text]) and significant higher MBI scores ([Formula: see text] deviation, median; Study group: [Formula: see text] points, 51 points; Control group: [Formula: see text] points, 43 points; [Formula: see text]) upon admission to rehabilitation hospital. A similar trend in EMS scores (Study group: [Formula: see text] points, 7 points; Control group: [Formula: see text] points, 6 points; [Formula: see text]) and MBI scores (Study group: [Formula: see text] points, 68 points; Control group: [Formula: see text] points, 64 points; [Formula: see text]) were observed upon discharge from the rehabilitation hospital. The average LOS in acute hospitals remained static (Study group: [Formula: see text] days, 7 days; Control group: [Formula: see text] days, 6 days; [Formula: see text]). The average LOS in rehabilitation hospital (Study group: [Formula: see text] days, 20 days; Control group: [Formula: see text] days, 23 days; [Formula: see text]) and total in-patient LOS (Study group: [Formula: see text] days, 26 days; Control group: [Formula: see text] days, 28 days; [Formula: see text]) were significantly reduced. A higher percentage of days having PT training during hospitalization in rehabilitation hospital was shown with the implementation of new service (Study group: 89.1%; Control group: 65.9%, [Formula: see text]). Conclusion: Additional weekend and holiday PT training in post-operative acute and rehabilitation hospitalization benefits geriatric patients with hip fracture in terms of improved training efficiency, where hospital LOS was shortened with more PT sessions, without any significant impacts on functional outcome.

Download Full-text

Evaluation of dental health among adolescents with mental disorders

Vojnosanitetski pregled ◽

10.2298/vsp180717156d ◽

2020 ◽

Vol 77 (8) ◽

pp. 852-858

Author(s):

Vladan Djordjevic ◽

Mila Jovanovic ◽

Sanja Colic ◽

Milena Stasevic ◽

Amina Asotic ◽

...

Keyword(s):

Dental Caries ◽

Mental Disorders ◽

Dental Health ◽

Mean Value ◽

World Health ◽

Control Group ◽

Childhood And Adolescence ◽

Study Group ◽

Dmf Index ◽

The Mean

Background/Aim. According to the World Health Organization (WHO), there is an increasing prevalence of mental disorders among children and adolescents worldwide. Previous studies have shown that people with mental disorders, regardless age, have an increased prevalence of dental caries due to several reasons. The aim of this study was to determine prevalence of dental caries in adolescents with mental disorders and to consider possible risk factors that might contribute to their current dental health status. Methods. The study was conducted as an observational cross-sectional study. The study group comprised 70 randomly selected hospitalized adolescents with mental disorders. The control group comprised 70 randomly chosen mentally healthy adolescents. They were matched to the study group by gender and age. All the participants were subjected to targeted dental examination according to criteria recommended by the WHO. Collection of data related to mental disorders of the study group was obtained from the patient?s medical records. All collected data were organized and analyzed by descriptive statistical parameters and regression models. Results. Majority of the study group patients were diagnosed with schizophrenia, schizotypal and delusional disorders (F20-F29), as well as behavioral and emotional disorders usually occurring in childhood and adolescence (F90-F98). Almost 90% of them were treated with antipsychotics of the second generation, as monotherapy or in combination with first-generation antipsychotics. Adolescents with mental disorders had significantly more carious and extracted teeth and three times less filled teeth than mentally healthy adolescents in the control group. The mean value of the decay-missing-filled teeth (DMF) index in the study group patients was also significantly higher than the mean value of DMF index in the control group subjects. Conclusion. It seems that mental disorder among adolescents mainly affects oral health indirectly, decreasing motivation of patients in maintaining oral hygiene.

Download Full-text

A case-control study on thyroid surgery in geriatric patients

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20213272 ◽

2021 ◽

Vol 7 (9) ◽

pp. 1403

Author(s):

Rita Gama ◽

Mónica Teixeira ◽

Pedro Oliveira ◽

Fernanda Castro ◽

Artur Condé

Keyword(s):

Thyroid Surgery ◽

Thyroid Disease ◽

Geriatric Patients ◽

Case Control Study ◽

Imaging Finding ◽

Case Control ◽

Control Group ◽

Study Group ◽

Thyroid Pathology ◽

Control Study

Background: With the progressive aging of the population, thyroid pathology with surgical indication occurs at increasingly advanced ages. The authors aim was to analyze the forms of presentation of thyroid disease and rate of complications of thyroid surgery performed in geriatric patients and to compare it to the same parameters in younger patients.Methods: This was a 7 year retrospective case-control study, with patients who underwent thyroid surgery. The study group included patients above 65 years old and a control group under 65 years old, who underwent thyroidectomy.Results: A total of 81 patients were included. The mean volume of thyroid nodules at presentation was significantly higher in the study group compared to the control group, regarding the disease presentation, it was an accidental imaging finding in 59% of patients of the study group, while in the control group there were more compressive symptoms at presentation. The rate of postoperative complications in geriatric patients was 29% versus 20% in the control group, a difference that was not statistically significant.Conclusions: Given the high number of comorbidities presented by geriatric patients, the symptoms of thyroid disease can be undervalued, explaining the greater number of accidental imaging findings and the greater volume of nodules at the time of surgery. Our results show that geriatric thyroid surgery is safe and has acceptable postoperative morbidity. The detection of thyroid pathology in these patients is a greater challenge, which can obscure symptoms, delay diagnosis and worsen prognosis.

Download Full-text

An early contact with the baby: Benefit for the mother

Medicinski pregled ◽

10.2298/mpns0812576d ◽

2008 ◽

Vol 61 (11-12) ◽

pp. 576-579 ◽

Cited By ~ 8

Author(s):

Gordana Djordjevic ◽

Bozidar Jovanovic ◽

Momcilo Djordjevic

Keyword(s):

Blood Loss ◽

Control Group ◽

Study Group ◽

Positive Component ◽

The Third ◽

Sanitary Napkin ◽

Time Period

Introduction Numerous studies on the early contact between mother and the baby and the time they spend together-common stay stress the fact that these are invaluable for the mothers, infants, family and society in general. The objective of the research. The objective of the research was to establish whether mother benefits from the early contact with her baby and the importance of the time period they spend and share together. Materials and methods The study group consisted of 216 mothers that spend the time with their babies and had the early contact with the babies as well, and the control group consisted of 216 mothers that were detached from their babies. Puerpera were observed in the aspects of the uterus involution, post delivery hemogramme on the third day after the childbirth, sanitary napkin consumption and the hospitalization length. Results For the study group the following was significant: less of the bad uterus involution, less of the post delivery anemia measured in the hemoglobin values and in the number of erythrocytes, less of the sanitary napkin consumption and the shorter hospitalization length. Discussion The early contact and the time spent with their babies after the childbirth influence the less blood loss analyzed by post delivery hemogramme, better uterus involution, less of the sanitary napkin consumption analyzed in the first three days after the childbirth and the shorter hospitalization length. The positive component of the breastfeeding oxytocic reflex is probably responsible for these effects. Conclusion Puerpera benefit from the early contact and the time spent with their babies.

Download Full-text

’Endoscopy assisted distal locking of intramedullary nail’, a new experimental technique to reduce the radiation exposure during the distal locking of the intramedullary nails.

10.21203/rs.3.rs-203296/v1 ◽

2021 ◽

Author(s):

Serkan Davut ◽

Yunus Doğramacı

Keyword(s):

Radiation Exposure ◽

Exposure Time ◽

Shaft Fracture ◽

Long Bone ◽

Control Group ◽

Study Group ◽

Distal Locking ◽

Time Period ◽

Group 10 ◽

Time Required

Abstract Introduction: The gold standart for treating a lower extremity long bone shaft fracture is closed reduction and internal fixation using the locking intramedullary nailing. The fracture is stable if the nail is locked distally and proximally. Usually all the aiming devices are successfull to lock the proximal but not with the distal screws. Distal locking step is the main source for radiation exposure during this type of surgery. In this study we tried to reduce the radiation exposure using an intra-nail endoscopic visualisation and illumination method for distal locking.Methods: 20 fresh bovine tibia bone were included in this study. Two groups each with 10 samples were prepared. We applied a standart nailing process in both groups, the study group (10 sample) locked by the new technic ''Intranail endoscopic illumination and visualisation locking method'' and the control group (10 sample) were locked by the free hand fluoroscopic guidance technic. We measured the surgical period time and the radiation exposure time required for distal locking procedure in both groups.Results: The radiation exposure time was statistically significantlly lower in the study group comparing to the control group. Also the time period required for distal locking in the study group were statistically significantly lower than the control group.With the use of the intranail endoscopic illumination guidance and visualisation assistance technic, the mean period time required for distal locking procedure reduced from 477,5 to 223,5 seconds (p < 0,001). The radiation exposure dramatically reduced from 13,5 to 2 seconds (p < 0,001 ). The attempt number reduced from 6,5 to 2 times (p < 0,001).Conclusions: This study showed that using a simple intranail endoscopic visualisation and illumination guidance will make the distal locking step safer by reducing the radiation exposure time and also reduce the surgical period.

Download Full-text

Psychiatric disorders and psychiatric consultation in a general hospital: a case- control study

Brazilian Journal of Psychiatry ◽

10.1590/s1516-44462003000100005 ◽

2003 ◽

Vol 25 (1) ◽

pp. 18-25 ◽

Cited By ~ 6

Author(s):

Sumaia Inaty Smaira ◽

Florence Kerr-Corrêa ◽

José Onildo B Contel

Keyword(s):

Mental Disorders ◽

General Hospital ◽

Rating Scale ◽

Demographic Data ◽

Case Control ◽

Self Report ◽

Control Group ◽

Psychiatric Consultation ◽

Health Team ◽

Group I

INTRODUCTION: Psychiatric consultation (PC) has been considered an efficient tool to develop research, to track and to give assistance benefiting patients, health professionals and the institution. However, it has not been much used in Brazil. Although 30 to 50% of general hospital (GH) inpatients may present a psychiatric disorder, only 1 to 12% of them are referred to assessment. The aims of this study were: to assess mental disorders in a GH; to identify which of these patients are sent to psychiatric care; to verify alleged reasons for referral to psychiatric consultation, and to examine the relationship between PC and psychiatric learning (during medical school and residence). METHODS: A case-control patient study was conducted (47 cases and 94 controls) to analyze in detail the following variables: socio-demographic; clinical; degree of information (about the disease and diagnostic/therapeutic procedures), and relationship between patient and health team. Psychiatric diagnoses were made according to the ICD-10 criteria. The Self Report Questionnaire (SRQ), the CAGE and Brief Psychiatric Rating Scale (BPRS) were used as well as a specifically designed questionnaire to collect clinical and demographic data. RESULTS: Behavioral alterations, either of elation or of depression, were the main for requesting a PC ; 95.8% of the cases and 27.7% of the controls had a mental disorder. Organic mental disorders and alcohol-related disorders were the most frequent diagnoses in group I (cases), while anxiety, depressive and alcohol-related disorders were predominant in group II (controls). Control group patients were better informed and more able to establish an appropriate relationship with the health team than case patients. The logistic regression showed CAGE-positive patients having 12.85 times greater risk of being referred to PC, followed by unemployed patients (2.44 times more PC referrals). DISCUSSION: The SRQ and CAGE were quite useful in the screening of possible patients and might be important for medical students to learn and use as generalists. Further research is needed to verify if and how the newly-established service will improve the diagnostic and treatment skills of our students.

Download Full-text