scholarly journals Elderly patients with no previous psychiatric history: suicidality and other factors relating to psychiatric acute admissions

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Hallvard Lund-Heimark ◽  
Eirik Kjelby ◽  
Lars Mehlum ◽  
Rolf Gjestad ◽  
Geir Selbæk ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Psychiatric History ◽  
Cross Sectional ◽  
Somatic Comorbidity ◽  
Somatic Disorders ◽  
The Common ◽  
Cognitive Problems ◽  
Acute Admissions

Background The common recommendation that adults with onset of mental illness after the age of 65 should receive specialised psychogeriatric treatment is based on limited evidence. Aims To compare factors related to psychiatric acute admission in older adults who have no previous psychiatric history (NPH) with that of those who have a previous psychiatric history (PPH). Method Cross-sectional cohort study of 918 patients aged ≥65 years consecutively admitted to a general adult psychiatric acute unit from 2005 to 2014. Results Patients in the NPH group (n = 526) were significantly older than those in the PPH group (n = 391) (77.6 v. 70.9 years P < 0.001), more likely to be men, married or widowed and admitted involuntarily. Diagnostic prevalence in the NPH and PPH groups were 49.0% v. 8.4% (P < 0.001) for organic mental disorders, 14.6% v. 30.4% (P < 0.001) for psychotic disorders, 30.2% v. 55.5% (P < 0.001) for affective disorders and 20.7% v. 13.3% (P = 0.003) for somatic disorders. The NPH group scored significantly higher on the Health of the Nation Outcome Scale (HoNOS) items agitated behaviour; cognitive problems; physical illness or disability and problems with activities of daily living, whereas those in the PPH group scored significantly higher on depressed mood. Although the PPH group were more likely to report suicidal ideation, those in the NPH group were more likely to have made a suicide attempt before the admission. Conclusions Among psychiatric patients >65 years, the subgroup with NPH were characterised by more physical frailty, somatic comorbidity and functional and cognitive impairment as well as higher rates of preadmission suicide attempts. Admitting facilities should be appropriately suited to manage their needs.

scholarly journals Relationship Pattern of Personality Disorder Traits in Major Psychiatric Disorders: A Cross-Sectional Study

2021 ◽  
pp. 025371762199953
Author(s):  
Bhavneesh Saini ◽  
Pir Dutt Bansal ◽  
Mamta Bahetra ◽  
Arvind Sharma ◽  
Priyanka Bansal ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Psychiatric Disorders ◽  
Psychotic Disorders ◽  
Age Of Onset ◽  
Psychiatric Patients ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Sectional Study ◽  
Cross Sectional ◽  
Neurotic Disorders

Background: Normal personality development, gone awry due to genetic or environmental factors, results in personality disorders (PD). These often coexist with other psychiatric disorders, affecting their outcome adversely. Considering the heterogeneity of data, more research is warranted. Methods: This was a cross-sectional study on personality traits in psychiatric patients of a tertiary hospital, over 1 year. Five hundred and twenty-five subjects, aged 18–45 years, with substance, psychotic, mood, or neurotic disorders were selected by convenience sampling. They were evaluated for illness-related variables using psychiatric pro forma; diagnostic confirmation and severity assessment were done using ICD-10 criteria and suitable scales. Personality assessment was done using the International Personality Disorder Examination after achieving remission. Results: Prevalence of PD traits and PDs was 56.3% and 4.2%, respectively. While mood disorders were the diagnostic group with the highest prevalence of PD traits, it was neurotic disorders for PDs. Patients with PD traits had a past psychiatric history and upper middle socioeconomic status (SES); patients with PDs were urban and unmarried. Both had a lower age of onset of psychiatric illness. Psychotic patients with PD traits had higher and lower PANSS positive and negative scores, respectively. The severity of personality pathology was highest for mixed cluster and among neurotic patients. Clusterwise prevalence was cluster C > B > mixed > A (47.1%, 25.2%, 16.7%, and 11.4%). Among subtypes, anankastic (18.1%) and mixed (16.7%) had the highest prevalence. Those in the cluster A group were the least educated and with lower SES than others. Conclusions: PD traits were present among 56.3% of the patients, and they had many significant sociodemographic and illness-related differences from those without PD traits. Cluster C had the highest prevalence. Among patients with psychotic disorders, those with PD traits had higher severity of psychotic symptoms.

scholarly journals Traditional faith healers as referral sources: A hospital-based descriptive study

2018 ◽  
Vol 7 (2) ◽  
pp. 46-50
Author(s):  
D.K. Thapa ◽  
N. Lamichhane ◽  
S. Subedi
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Psychotic Disorders ◽  
Psychiatric Patients ◽  
Descriptive Study ◽  
Mental Illnesses ◽  
General Observation ◽  
Cross Sectional ◽  
Faith Healer ◽  
Common Notion

Introduction: Mental illnesses are commonly linked with a higher disability and burden of disease than many physical illnesses. But despite that fact, it is a general observation that a majority of patients with mental disorder never seek professional help. To elaborate further, the widely prevalent magico-religious beliefs associated with mental illness and lower literacy, poses significant social obstacles in seeking appropriate health care for psychiatric patients. In general, mental illness is seen as related to life stresses, social or family conflicts and evil spirits and the concept of biological causes of mental illness is rare even among the educated. The idea that illness and death are due to malevolent spirits is common notion that is shared practically by all level of society from the so-called primitive to modern industrialized societies, thus indicating the strong influences of cultural background. When there is a magico- religious concepts of disease causation, there is tendency to consult indigenous healers. Therefore, the patients with mental illness often either visit or are taken to faith healers by their relatives. The objective of the study was to determine the various psychiatric cases that were referred by the traditional faith healers to the authors. Material and Method: This is a cross- sectional, hospital- based descriptive study, conducted at the Psychiatric outpatient department of Pokhara Om Hospital, Pokhara, Kaski, Nepal for the period of one year, from June 2016 to May 2017. The total of 35 cases, referred by the traditional faith healers was included in the study. Subjects of any age, any gender, any literacy level, any caste, from any locality and religious background were included in the study after their consent. Subjects who refused to consent were not included in the study. The psychiatric diagnosis was based on the complete history and examination and ICD- 10 DRC criteria. Results: Though the sample size is small, it is interesting to note that patients with various kinds of mental disorders were referred by traditional faith healers. There were patients suffering from neurotic disorders, psychotic disorders, mood disorders, seizure, substance use disorder, intellectual disability etc seeking the treatment from traditional faith healers. Among the cases referred, predominantly were female and neurotic cases. Most patients were educated. Conclusion: The study shows that patients with various mental disorders visit traditional faith healer. This area surely requires further in-depth look as traditional faith healers can be an important source of referral of psychiatric patients.

scholarly journals Tobacco Use, Dependence and Psychiatric Co-Morbidities Among Patients Admitted in Psychiatry Ward

2018 ◽  
Vol 6 (2) ◽  
pp. 54-59
Author(s):  
S Limbu ◽  
DR Shakya ◽  
N Sapkota ◽  
R Gautam ◽  
L Paudel
Keyword(s):  
Psychiatric Disorders ◽  
Nicotine Dependence ◽  
Tobacco Use ◽  
Psychotic Disorders ◽  
Psychiatric Patients ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Holistic Management ◽  
Common Diagnosis

Introduction: Nicotine dependent individuals among the tobacco users are in greater risk of having tobacco related disease and psychiatric co-morbidities. There is little information about the tobacco use and nicotine dependence among psychiatric patients in developing countries including Nepal. This study was done to estimate the prevalence of tobacco use, the level of nicotine dependence among the users and the psychiatric disorder specific prevalence among tobacco users admitted in psychiatry ward.Material And Method: A cross-sectional study was conducted in In-patient setting of Department of Psychiatry, BPKIHS. Ninety cases (size) were enrolled. The Fagerström Test for Nicotine Dependence (FTND) was applied to assess the level of nicotine dependence and the Mini International Neuropsychiatric Interview (M.I.N.I.) for diagnosis of Psychiatric disorders.Results: The prevalence of tobacco use was 62.2%. Tobacco use was more common among males (p value< 0.05).Smokeless form was the commonest form of tobacco. Majority of tobacco users had moderate nicotine dependence and had started the use in adolescence and in their 20s. Psychotic disorders were the most common diagnosis among the admitted patients.Conclusion: Tobacco use is common in patients with psychiatric disorders. Nicotine dependence should be looked into for holistic management. Treatment approaches should be tailored in tobacco users with comorbid psychiatric disorders, as this specific population has high prevalence of tobacco use and higher nicotine dependence. J Psychiatrists’ Association of Nepal Vol. 6, No. 2, 2017, Page: 54-59

Borderline Personality Disorder

2018 ◽  
pp. 245-270
Author(s):  
Carol S. North ◽  
Sean H. Yutzy
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Suicide Attempts ◽  
Controlled Trial ◽  
Borderline Personality ◽  
Historical Background ◽  
Self Mutilation ◽  
History Of ◽  
The Common ◽  
Cognitive Problems

Borderline personality disorder is a fairly recent label of a variously conceptualized phenomenon which has been characterized by affective instability and emotional crises, cognitive problems, impulsivity, and intense and unstable personal relationships. This chapter reviews the historical background, epidemiology, and clinical picture (including comorbidity) of borderline personality disorder. Although progress toward validation of this diagnosis has been made, the current definition does not appear to meet the accepted gold standard criteria for a syndrome that is currently considered valid (and reliable). The natural history of what is known is reviewed, as well as the common complications, including self-mutilation and suicide attempts. Treatment remains challenging at best, with few interventions meeting rigorous randomized controlled trial standards.

Unexpected Death of Psychiatric Patients: Suicide, Misadventure, Accident or Unsolved Mystery?

1997 ◽  
Vol 37 (3) ◽  
pp. 210-214 ◽  
Author(s):  
Emad Salib ◽  
Ann Joseph ◽  
Sheila Cawley
Keyword(s):  
Suicide Attempts ◽  
Psychiatric Treatment ◽  
Psychiatric Patients ◽  
Psychiatric History ◽  
Unexpected Death ◽  
Related Condition ◽  
Condition Method ◽  
Duration Of Illness ◽  
History Of ◽  
Main Factors

We examined the association between the psychiatric history of patients who were the subjects of a coroner's inquest and the recorded verdict, in a seven-year retrospective review. A suicide verdict was less frequently returned on patients who had inpatient psychiatric treatment compared to other unexpected deaths. History and diagnosis of an alcohol-related condition, method of death and intimation of intent were the main factors that appeared to be associated with the coroner's verdict. Age, sex, duration of illness, time and number of admissions, previous suicide attempts and treatment received did not appear to be significantly associated with the recorded verdict.

Tobacco Use and Dependence among Psychiatry Out-Patients of a Health Institute in Eastern Nepal

2019 ◽  
Vol 2 (1) ◽  
pp. 68-76
Author(s):  
Suren Limbu ◽  
D R Shakya ◽  
N Sapkota ◽  
R Gautam Joshi
Keyword(s):  
Nicotine Dependence ◽  
Tobacco Use ◽  
Psychiatric Patients ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Control And Prevention ◽  
The Common ◽  
Psychiatry Disorders ◽  
The Relationship ◽  
Psychiatric Problems

Background: Assessment of nicotine dependence among tobacco users is essential as highly dependent individuals have greater risk of developing tobacco related physical and psychiatric problems. There is little information about the tobacco use and nicotine dependence among psychiatric patients in developing countries, including Nepal. Objectives: To estimate the prevalence of tobacco use, the level of nicotine dependence and the psychiatric disorder specific prevalence among tobacco users visiting a psychiatry out-patient department. Materials and methods: A cross-sectional study was conducted in Out-patient setting of Department of Psychiatry, B. P. Koirala Institute of Health Sciences (BPKIHS). Ninety cases (calculated sample size) were enrolled. The Fagerström Test for Nicotine Dependence (FTND) was applied to assess the level of nicotine dependence and the Mini International Neuropsychiatric Interview (MINI) for diagnosis of Psychiatric disorders. Results: The prevalence of tobacco use was 55.6%. Tobacco use was more common among males (pvalue < 0.05). Smokeless form was the common form of tobacco. Majority of them had started their consumption in their adolescence. Most users had moderate nicotine dependence. Major depressive disorder and Alcohol dependence were the most common diagnoses among tobacco users. Conclusion: More than half of the psychiatry out-patients consumed tobacco. Future studies that help to understand the relationship and possible mechanism of increased tobacco use in patients with psychiatry disorders are required. Tobacco control and prevention strategies should be initiated targeting vulnerable populations such as male gender and adolescent.

scholarly journals The Differential Impact of Lockdown Measures Upon Migrant and Female Psychiatric Patients – A Cross-Sectional Survey in a Psychiatric Hospital in Berlin, Germany

2021 ◽  
Vol 12 ◽  
Author(s):  
James K. Moran ◽  
Joachim Bretz ◽  
Johanna Winkler ◽  
Stefan Gutwinski ◽  
Eva J. Brandl ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Psychiatric Patients ◽  
Migration Background ◽  
Media Consumption ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Differential Vulnerability ◽  
Patient Groups ◽  
Related Stress ◽  
Effects Of Media

The COVID-19 pandemic could have major effects on already vulnerable individuals with psychiatric disorders. It is important to assess how different patient groups respond to stress related to the pandemic, and what additional factors influence it, including family-related stress, migration background, and sex. We conducted a survey in a sample of 294 psychiatric patients in a large outpatient clinic in Berlin, measuring level of distress in relation to COVID-19 lockdown as well as family-related distress. We also measured potential influencing factors such as media consumption and medical support. In the migration background group, we found that women had more lockdown related psychological distress than men. This was not apparent in those patients with a German background. We found that females were more strongly affected by family-related distress, particularly those with a migration background. People with PTSD were most strongly affected by family-related distress, whereas people with psychotic disorders and addiction reported the least distress. There were no effects of media consumption. There were no differences in ability to abide by the lockdown related restrictions across diagnoses. Our results support earlier findings on differential vulnerability of diagnostic groups to these stressors. Thus, clinicians can optimize treatment by taking family-related stressors into account particularly for females and people with a migrant background.

scholarly journals Multidisciplinary and differentiated approach in the treatment of psychotic disorders with comorbid somatic states

2021 ◽  
pp. 52-56
Author(s):  
Yevgen Oprya ◽  
Mykhailo Pustovoit
Keyword(s):  
Psychological Functioning ◽  
Psychotic Disorders ◽  
Clinical Course ◽  
Clinical Manifestations ◽  
Psychopathological Symptoms ◽  
Somatic Comorbidity ◽  
Complex Therapy ◽  
Somatic Disorders ◽  
The Stability

The article presents the results of a comprehensive clinical and psychopathological study of the features of clinical manifestations of psychotic patients with schizophrenia with somatic disorders. It has been proven that disorders in schizophrenia are associated with a negative clinical-psychopathological and socio-personal prognosis, leading to increase of severity of psychopathological symptoms and a decrease in the level of socio-psychological functioning. The identified features of the clinical course have become the leading target features, a system of multidisciplinary and differentiated approach in the complex therapy of patients taking into account somatic comorbidity has been developed and implemented in practice. The proposed system is a set of activities, including a combination of pharmacotherapeutic, psychoeducational, psychotherapeutic and psychosocial activities, selected taking into account the specifics of the psychopathological process modified by somatic pathology. According to the results of testing, its effectiveness has been proven, and it has been established that its use can significantly improve the condition of patients and their level of socio-psychological functioning, increase the stability of remission and reduce the number of hospitalizations.

scholarly journals DELIBERATE SELF-POISONING IN SOUTH ODISHA: STUDY OF ITS CLINICAL PROFILE AND OUTCOME

2020 ◽  
pp. 169-173
Author(s):  
SACHIDANANDA NAYAK ◽  
BIJAYA KUMAR BEHERA ◽  
KESHABA CHANDRA BUDULA ◽  
SRITAM ACHARYA
Keyword(s):  
Suicide Attempts ◽  
Age Group ◽  
Significant Morbidity ◽  
Aluminum Phosphide ◽  
Cross Sectional ◽  
Medical College ◽  
Global Issue ◽  
The World ◽  
The Common ◽  
Overall Mortality

Objective: Deliberate self-poisoning is a serious global issue that contributes to significant morbidity and mortality all over the world. The present study was conducted with an objective to identify the common agents used for self-poisoning prevalent in South Odisha and to determine the common clinical features and outcome of such cases. Methods: This cross-sectional observational study was conducted on 200 patients with deliberate self-poisoning belonging to the age group of 15–70 years over a period of 2 years from August 2017 to September 2019 in Maharaja Krishna Chandra Gajapati Medical College and Hospital, Berhampur, Odisha, India. All the above-mentioned patients admitted to the hospital, were treated with specific antidotes according to the poison ingested. Results were analyzed using appropriate standard statistical methods such as mean, standard deviation, and percentage. Results: Out of 200 patients, majority were female (65%, n=130) and 35% (n=70) were male; mean age was 38.9 (±16.8) years. Organophosphates, aluminum phosphide, glyphosate, organochlorines, and carbamates were the most common pesticides used as poisoning agents (74.5%, n=149) followed by plant poisons (7%, n=14) which included yellow oleander seed. Overall mortality in our study was 12.5%. Conclusion: Pesticides and plant poisons were the common agents used in our study for deliberate self-poisoning. Young persons, illiterates, and housewives were commonly involved in suicide attempts. Organophosphate caused majority of deaths.

Suicides and Suicide Attempts Among Psychiatric Hospital Inpatients in Iran

2019 ◽  
Vol 15 (3) ◽  
pp. 215-222
Author(s):  
Saeed Shoja Shafti ◽  
Alireza Memarie ◽  
Masomeh Rezaie ◽  
Masomeh Hamidi
Keyword(s):  
Suicidal Behavior ◽  
Serum Lipids ◽  
Psychotic Disorders ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Density Lipoprotein ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Significant Difference

Background: Suicidal behavior is seen in the context of a variety of mental disorders. While many believe that, in general, first-episode psychosis is a particularly high-risk period for suicide, no general agreement regarding higher prevalence of suicide in first-episode psychosis is achievable. Objective: In the present study, suicides and suicide attempts among psychiatric in-patients have been evaluated to assess the general profile of suicidal behavior among native psychiatric inpatients and any relationship between serum cholesterol level and suicidal behavior. Methods: Five acute academic wards, which have been specified for admission of first episode adult psychiatric patients, and five acute non-academic wards, which have been specified for admission of recurrent episode adult psychiatric patients, were selected for the current study. All inpatients with suicidal behavior (successful suicide and attempted suicide, in total), during the last five years (2013-2018), were included in the present investigation. Also, the assessment of serum lipids, including triglyceride, cholesterol, low-density lipoprotein and high-density lipoprotein, was done , for comparing the suicidal subjects with non-suicidal ones. Results: Among 19160 psychiatric patients hospitalized in Razi psychiatric hospital during a sixtymonths period, 63 suicidal behaviors, including one successful suicide and sixty-two suicide attempts, were recorded by the safety board of hospital. The most frequent mental illness was bipolar I disorder, which was significantly more prevalent in comparison with other mental disorders (p<0.04, p<0.02, p<0.007, and p<0.003 in comparison with schizophrenia, depression, personality disorders and substance abuse, respectively). Self-mutilation, self-poisoning and hanging were the preferred methods of suicide among 61.11%, 19.44% and 19.44% of cases, respectively. In addition, no significant difference was evident between the first admission and recurrent admission inpatients, totally and separately, particularly with respect to psychotic disorders. Besides, with respect to different components of serum lipids, no specific or significant pattern was evident. Conclusion: While in the present study, the suicidal behavior was significantly more evident in bipolar disorder in comparison with other psychotic or no-psychotic disorders, no significant difference was evident between the first admission and recurrent admission of psychiatric inpatients. Moreover, no significant relationship between suicidal behavior and serum lipids was found .

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