Patient-controlled hospital admission for patients with severe mental disorders: a nationwide prospective multicentre study

2018 ◽  
Vol 137 (4) ◽  
pp. 355-363 ◽  
Author(s):  
C. T. Thomsen ◽  
M. E. Benros ◽  
T. Maltesen ◽  
L. H. Hastrup ◽  
P. K. Andersen ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Multicentre Study ◽  
Hospital Admission ◽  
Severe Mental Disorders ◽  
Prospective Multicentre Study

scholarly journals Patient-controlled hospital admission for patients with severe mental disorders: study protocol for a nationwide prospective multicentre study

BMJ Open ◽  
2016 ◽  
Vol 6 (9) ◽  
pp. e013088 ◽  
Author(s):  
Christoffer Torgaard Thomsen ◽  
Michael Eriksen Benros ◽  
Lene Halling Hastrup ◽  
Per Kragh Andersen ◽  
Domenico Giacco ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Multicentre Study ◽  
Hospital Admission ◽  
Study Protocol ◽  
Severe Mental Disorders ◽  
Prospective Multicentre Study

Substance use disorders and violent behaviour in patients with severe mental disorders: A prospective, multicentre study

2020 ◽  
Vol 54 (12) ◽  
pp. 1212-1223
Author(s):  
Cesare Cavalera ◽  
Clarissa Ferrari ◽  
Giorgio Bianconi ◽  
Viola Bulgari ◽  
Valentina Candini ◽  
...  
Keyword(s):  
Substance Use ◽  
Mental Disorders ◽  
Substance Use Disorders ◽  
Well Being ◽  
Community Safety ◽  
Aggressive Behaviors ◽  
Severe Mental Disorders ◽  
Violent Behaviour ◽  
Prospective Multicentre Study ◽  
Verbal Assault

Objective: The relationship between alcohol and substance use and the risk of violence exhibited by patients with mental disorders is under-researched. This prospective cohort study aims to compare patients with severe mental disorders and with different substance use behaviors in terms of sociodemographic and clinical characteristics, hostility, impulsivity and aggressive behaviors. Furthermore, this study aims to assess differences in violent behaviors during a 1-year monitoring follow-up. Methods: A total of 378 participants with severe mental disorders from Italian residential facilities and from four Departments of Mental Health (244 outpatients and 134 residential patients) were enrolled. Participants were categorized as Persons with Current Substance Use, Persons with Former Substance Use and Persons with Non-Substance Use. All these patients underwent a complex multidimensional assessment, including the lifetime and current substance use; a subsample of outpatients was also assessed with a laboratory substance assay including the testing for specific substances. We assessed the differences among these three groups in hostility, impulsivity and aggressive behaviors. Results: The results of the close 1-year monitoring show a significantly higher risk of violence for patients with severe mental disorders Persons with Current Substance Use compared to Persons with Former Substance Use and Persons with Non-Substance Use. Persons with Current Substance Use showed significantly higher scores for irritability, negativism and verbal assault compared to Persons with Non-Substance Use. Persons with Former Substance Use showed significantly higher scores for lifetime history of aggressive behaviors compared with patients with Persons with Non-Substance Use. Conclusion: These findings suggest that patients with comorbid mental illness and substance use disorders should be referred for specific interventions to reduce aggressive behavior and ensure patient well-being and community safety.

scholarly journals Young age and the risk of violent behaviour in people with severe mental disorders: prospective, multicentre study

BJPsych Open ◽  
2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Rocco Micciolo ◽  
Giorgio Bianconi ◽  
Luisa Canal ◽  
Massimo Clerici ◽  
Maria Teresa Ferla ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Rating Scale ◽  
Age Groups ◽  
Anger Expression ◽  
Young Age ◽  
Severe Mental Disorders ◽  
Violent Behaviour ◽  
Specific Level ◽  
Prospective Multicentre Study ◽  
Social Settings

Background During adolescence and young adulthood people appear to be more prone to violent behaviour. A greater tendency to violent behaviour appears to be associated with hyperactivity, impulsivity and low tolerance for frustration and provocation in social settings. Aims This prospective cohort study aimed to evaluate rates of violent behaviour among young people with mental disorders, compared with older age groups. Method A total of 340 individuals with severe mental disorders (125 living in residential facilities and 215 out-patients) were evaluated at baseline with the SCID-I and II, Brief Psychiatric Rating Scale, Specific Level of Functioning scale, Brown–Goodwin Lifetime History of Aggression scale, Buss–Durkee Hostility Inventory, Barratt Impulsiveness Scale and State–Trait Anger Expression Inventory-2. Aggressive behaviour was rated every 15 days with the Modified Overt Aggression Scale (MOAS). Results The sample comprised 28 individuals aged 18–29 years, 202 aged 30–49 and 110 aged 50 and over. Younger age was associated with a personality disorder diagnosis, substance use disorder, being single and employed. These results were confirmed even controlling for the gender effect. The patterns of the cumulative MOAS mean scores showed that younger (18–29 years old) individuals were significantly more aggressive than older (≥50) ones (P < 0.001). Conclusions This study highlights how young age in people with severe mental disorders is correlated with higher levels of impulsivity, anger and hostility, confirming previous analyses. Our results may assist clinicians in implementing early interventions to improve anger and impulsivity control to reduce the risk of future aggressive behaviours.

scholarly journals Geriatric fracture centre vs usual care after proximal femur fracture in older patients: what are the benefits? Results of a large international prospective multicentre study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e039960
Author(s):  
Michael Blauth ◽  
Alexander Joeris ◽  
Elke Rometsch ◽  
Kathrin Espinoza-Rebmann ◽  
Pannida Wattanapanom ◽  
...  
Keyword(s):  
Adverse Events ◽  
Multicentre Study ◽  
Usual Care ◽  
Proximal Femur ◽  
Interdisciplinary Treatment ◽  
Proximal Femur Fracture ◽  
Geriatric Fracture ◽  
Femur Fractures ◽  
Prospective Multicentre Study ◽  
Registration Number

ObjectiveThe aim of this study was to determine the effect of treatment in geriatric fracture centres (GFC) on the incidence of major adverse events (MAEs) in patients with hip fractures compared with usual care centres (UCC). Secondary objectives included hospital-workflow and mobility-related outcomes.DesignCohort study recruiting patients between June 2015 and January 2017. Follow-up was 1 year.SettingInternational (six countries, three continents) multicentre study.Participants281 patients aged ≥70 with operatively treated proximal femur fractures.InterventionsTreatment in UCCs (n=139) or GFCs (n=142), that is, interdisciplinary treatment including regular geriatric consultation and daily physiotherapy.Outcome measuresPrimary outcome was occurrence of prespecified MAEs, including delirium. Secondary outcomes included any other adverse events, time to surgery, time in acute ward, 1-year mortality, mobility, and quality of life.ResultsPatients treated in GFCs (n=142) had a mean age of 81.9 (SD, 6.6) years versus 83.9 (SD 6.9) years in patients (n=139) treated in UCCs (p=0.013) and a higher mean Charlson Comorbidity Index of 2.0 (SD, 2.1) versus 1.2 (SD, 1.5) in UCCs (p=0.001). More patients in GFCs (28.2%) experienced an MAE during the first year after surgery compared with UCCs (7.9%) with an OR of 4.56 (95% CI 2.23 to 9.34, p<0.001). Analysing individual MAEs, this was significant for pneumonia (GFC: 9.2%; UCC: 2.9%; OR, 3.40 (95% CI 1.08 to 10.70), p=0.027) and delirium (GFC: 11.3%; UCC: 2.2%, OR, 5.76 (95% CI 1.64 to 20.23), p=0.002).ConclusionsContrary to our study hypothesis, the rate of MAEs was higher in GFCs than in UCCs. Delirium was revealed as a main contributor. Most likely, this was based on improved detection rather than a truly elevated incidence, which we interpret as positive effect of geriatric comanagement.Trial registration numberClinicalTrials.gov: NCT02297581.

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