A Rating Scale of the Mental State: For Use in the Chronic Population of the Psychiatric Hospital

1967 ◽  
Vol 113 (502) ◽  
pp. 941-949 ◽  
Author(s):  
A. D. Harris ◽  
F. J. J. Letemendia ◽  
P. J. A. Willems
Keyword(s):  
Psychiatric Hospital ◽  
Mental State ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Present Communication ◽  
Chronic Patients ◽  
Long Period ◽  
Standard Text ◽  
Uniform Manner

The assessment of change in psychiatric patients is never easy. The problem is accentuated in the chronic inhabitants of psychiatric hospitals, since the period of treatment and observation may have to be prolonged, and the changes found may be small and gradual. A rating scale can be of value, in recording findings in a uniform manner and in preserving the observations from selective amnesia, so making comparison possible over a long period. In the present communication we report a scale devised by two of us (F.J.J.L. and A.D.H.) for use with chronic patients. This scale summarizes the relevant parts of the examination of mental state found in standard text books of psychiatry, and we have tried to avoid presuppositions about the meaning or distribution of symptoms.

Characteristics of Psychiatric Hospital Absconders

1989 ◽  
Vol 154 (3) ◽  
pp. 368-371 ◽  
Author(s):  
Arden Randall Tomison
Keyword(s):  
Length Of Stay ◽  
Psychiatric Hospital ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Total Length ◽  
One Year ◽  
Lay Public

Absence of patients without leave is common in psychiatric hospitals, and causes anxiety to staff, relatives, and the lay public. Such incidents are difficult to predict. This study attempted to identify the characteristics of patients absconding from a UK hospital over one year. Numbers were small, as those patients discharged against advice and failing to return from leave were excluded. Absconders were predominantly male, young, compulsorily admitted, and discharged with a diagnosis of schizophrenia. They tended to be single, had many previous admissions, and a longer total length of stay, and the police were more often involved in their admission. Reasons for absconding and the implications for management of newly admitted psychiatric patients are discussed.

Collected and Neglected: Are Oxford Hostels for the Homeless Filling up with Disabled Psychiatric Patients?

1990 ◽  
Vol 157 (2) ◽  
pp. 269-272 ◽  
Author(s):  
P. Garety ◽  
R. M. Toms
Keyword(s):  
Mental State ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Homeless People ◽  
Psychiatric Inpatients ◽  
Deviant Behaviour ◽  
Severely Handicapped ◽  
Psychiatric Rating ◽  
Psychiatric Rating Scale

“Objective – To assess the severity of psychiatric symptoms among residents of hostels for homeless people. Design – Survey of residents in two hostels in Oxford, comprising three weeks of background fieldwork, a demographic questionnaire, and rating behaviour over two weeks with a behavioural rating scale (REHAB) and mental state with the brief psychiatric rating scale. Setting – Two hostels for homeless people in Oxford. Subjects – 146 Medium to long term residents, of whom 48 were selected by hostel workers by the following criteria: continuous residence for at least two months, signs of persistent severe mental disability, and difficulty in coping independently in the community. Two subjects died during the study; three (previously long term psychiatric inpatients) declined to be assessed on the psychiatric scale. Main outcome measure – Behavioural disturbance and mental state. Results – Only a third of the total sample had been born in Oxfordshire. Subjects had been accepted into the hostel either by arrangement with the local psychiatric service (22) or straight off the streets (26); 43 had had a previous (non-drug related) psychiatric admission. Subjects were significantly more likely than other residents to have spent longer (> 80 weeks) in a hostel in the past three years (p<0.02). With reference to norms for deviant behaviour, the 46 subjects assessed showed considerable deviant behaviour (average weekly scores: 0(11 subjects), 1 (14), 2–3 (16), and ≥4 (5)) not significantly different from that expected in moderately to severely handicapped psychiatric inpatients (χ2 = 1 · 3, df = 3, p > 0 · 7); 22 had scores equivalent to those in most severely handicapped inpatients. Of the 43 subjects assessed with the psychiatric rating scale, 16 had symptoms of neurosis, 29 of florid psychosis, and 32 of a deficit state. Symptoms of deficit state were positively correlated with ratings of low social activity on the behavioural scale (Spearman's rank correlation coefficient 0 · 30, p = 0 · 03). Conclusions – Hostels are having to care for long term severely affected psychiatric patients discharged into the community. The suitability of the services offered to such subjects should be assessed.”

scholarly journals Psychiatric Services and Teaching during the Covid-19 Pandemic in Romania

2021 ◽  
Author(s):  
Ioana Valentina Micluţia
Keyword(s):  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Bipolar Disorders ◽  
Psychiatric Hospitals ◽  
Chronically Ill ◽  
Emergency Rooms ◽  
Chronic Patients ◽  
Borderline Disorder ◽  
Self Harm ◽  
Outpatient Settings

The Covid-19 pandemic has been declared in Romania on the 16th March 2020.The medical system reacted promptly: chronic patients had to be discharged within 48 h and further scheduled admittances were postponed, adequate epidemiological measures and circuits were organized. Anxiety, insomnia, frustration, binge eating, domestic violence were reported. The majority respected the general advises but soon, persons selected their information sources rather from social media, being victims of the infodemia and peculiar conspirationist theories. A new disorder has been described: coronaphobia. The psychiatric hospitals and outpatient settings had to reduce or innactivate their activity, switch as much as possible to TelePsychiatry. Psychiatry admittances were: onsets of psychosis, relapses of schizophrenia and alcohol, other psychoactive substances abuses, intoxications, and withdrawal states. Later, there were depressions, bipolar disorders, suicide attempts, self-harm in borderline disorder, dementia and delirium. Due to the closure of outpatient units for several months, patients visited the Emergency rooms. Personnel experienced burnout and new psychiatric pathology developed in the aftermath of Covid-19 infection. A big relief occurred with the initial vaccination of the medical staff and seniors, chronically ill persons, psychiatric patients being again left behind. Medical teaching shifted entirely to online and in 2021 the hybrid teaching system has been employed.

Loss of motivation and frustration for visitor surgeons in provincial health centers or psychiatric hospitals in Greece

2017 ◽  
Vol 41 (S1) ◽  
pp. S378-S379
Author(s):  
I. Christodoulou ◽  
E. Pogonidou ◽  
C. Pogonidis ◽  
C. Charalambous
Keyword(s):  
Health Center ◽  
Psychiatric Hospital ◽  
National Health System ◽  
Psychiatric Hospitals ◽  
Health Centers ◽  
Surgical Patients ◽  
The Core ◽  
Long Period ◽  
Competing Interest ◽  
To Receive

IntroductionThe core workplace for a surgeon is the operating theatre. Secondary duties may include visits to small health centers for outpatient examinations and visitor work to psychiatric hospitals.ObjectiveThe objective of our study is to highlight the mistakes of management that lead to half-empty provincial health centers and psychiatric hospitals.MethodsPresentation of the 2-year-experience of a surgeon visitor in provincial health centers and in a large psychiatric hospital in Greece.ResultsThe provincial health center of Lagada needs at least 4 surgeons to serve; too many patients to be examined or/and operated in 2–3 hours only. Subsequently problems arise, as simultaneously in the emergencies department a surgical eye for an abdominal pain or a bad looking leg is needed every 15 minutes. The health center of Koufalia needs 3 hours of driving per day for 3–8 surgical patients only. The psychiatric hospital offered work for 3 surgeons 5 days a week for a long period of time. During 2012–2014, only one surgeon visited the hospital once a week. The work needed to be done may kill the surgeon or force him to receive antidepressants in order to keep his functions alive.ConclusionsNot a hint of scientific motivation for two years is a strong reason for a surgeon to avoid the duty to provincial health centers and psychiatric hospitals which is obligatory according to our national health system Laws until two years are completed for newly appointed surgeons. Managers might encourage surgeons if some balancing convenience was offered.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Assessment and Progress of Long-Stay and Elderly Psychiatric Patients: The Predictive Validity of a Ward Behaviour Questionnaire

1975 ◽  
Vol 127 (2) ◽  
pp. 149-156 ◽  
Author(s):  
Michael Clarke ◽  
Jane Waller ◽  
Barbara Webster
Keyword(s):  
Psychiatric Hospital ◽  
Predictive Validity ◽  
Nursing Staff ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Screening Technique ◽  
Additional Information ◽  
Behaviour Rating ◽  
Organic Psychoses

SummaryThis paper describes an attempt to validate a behaviour rating scale used to predict the likelihood of discharge among elderly and long-stay patients in a psychiatric hospital. The scale measured behaviour on the ward as rated by nursing staff. The scale was a sensitive predictor of discharge among those with a low score (indicating least disability), except for patients with organic psychoses. However, many patients with low scores were not discharged. In order to improve the scale's use as a screening technique additional information was considered. The significance of the findings is discussed.

Nutritional Intervention May Improve Body Mass Index of Malnourished Hospitalized Psychiatric Patients – A Preliminary Observation

2019 ◽  
Vol 18 (3) ◽  
pp. 256-259
Author(s):  
Hou Y.C. ◽  
Hsieh Y.L. ◽  
Tzeng I.S. ◽  
Kuo C.Y.
Keyword(s):  
Body Weight ◽  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Nutritional Intervention ◽  
Nutrition Intervention ◽  
Calorie Intake ◽  
Psychiatric Ward ◽  
Increased Risk ◽  
Total Calorie ◽  
Total Calorie Intake

Malnutrition is an important issue in hospitalized patients. Poor nutrition may lead to increased risk of morbidity and death, impaired mental and physical conditions, apathy, depression, self-neglect, increased risk of medical complications, increased risk of pressure ulcers, reduced immune response, delayed wound healing, longer hospital stays, and reduced quality of life. However, few studies have investigated malnutrition in psychiatric patients. Psychiatric patients are known to have an increased risk of malnutrition, but psychiatric hospitals rarely conduct physical examinations and nutritional assessments. In this preliminary study, patients from a psychiatric ward of the Taipei Tzu Chi Hospital were chosen using the Malnutrition Universal Screening Tool. We used the before-and-after analysis to test the effect of a nutrition intervention on the selected parameters. We found that patients who had an impaired nutritional status showed significant increases in body weight (mean: 43.6 ± 7.5 vs. 46.5 ± 8.2 kg; P < 0.001), BMI (mean: 16.8 ± 2.0 vs. 17.9 ± 2.1 kg/m2; P < 0.001), and total calorie intake (mean: 1128 ± 230 vs. 1378 ± 320 Kcal; P < 0.001). Nutritional intervention significantly improved body weight, BMI, and total calorie intake. Nutritional intervention may help prevent malnutrition and improve the management of psychiatric patients.

scholarly journals Family involvement and patient-experienced improvement and satisfaction with care: a nationwide cross-sectional study in Danish psychiatric hospitals

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie Louise Svendsen ◽  
Trine Ellegaard ◽  
Karoline Agerbo Jeppesen ◽  
Erik Riiskjær ◽  
Berit Kjærside Nielsen
Keyword(s):  
Psychiatric Hospital ◽  
Hospital Care ◽  
Psychiatric Hospitals ◽  
Cross Sectional Study ◽  
Satisfaction With Care ◽  
Sectional Study ◽  
Cross Sectional ◽  
Caregiver Relationship ◽  
Patient Reported ◽  
Caregiver Involvement

Abstract Background Randomised controlled trials suggest that family therapy has a positive effect on the course of depression, schizophrenia and anorexia nervosa. However, it is largely unknown whether a positive link also exists between caregiver involvement and patient outcome in everyday psychiatric hospital care, using information reported directly from patients, i.e. patient-reported experience measures (PREM), and their caregivers. The objective of this study is to examine whether caregiver-reported involvement is associated with PREM regarding patient improvement and overall satisfaction with care. Methods Using data from the National Survey of Psychiatric Patient Experiences 2018, we conducted a nationwide cross-sectional study in Danish psychiatric hospitals including patients and their caregivers who had been in contact with the hospital (n = 940 patients, n = 1008 caregivers). A unique patient identifier on the two distinct questionnaires for the patient and their caregiver enabled unambiguous linkage of data. In relation to PREM, five aspects of caregiver involvement were analysed using logistic regression with adjustment for patient age, sex and diagnosis. Results We consistently find that high caregiver-reported involvement is statistically significantly associated with high patient-reported improvement and overall satisfaction with care with odds ratios (OR) ranging from 1.69 (95% confidence interval (CI) 0.95–2.99) to 4.09 (95% CI 2.48–6.76). This applies to the following aspects of caregiver-reported involvement: support for the patient-caregiver relationship, caregiver information, consideration for caregiver experiences and the involvement of caregivers in decision making. No statistically significant association is observed regarding whether caregivers talk to the staff about their expectations for the hospital contact. Conclusion This nationwide study implies that caregiver involvement focusing on the patient-caregiver relationship is positively associated with patient improvement and overall satisfaction with care in everyday psychiatric hospital care.

scholarly journals Structured Evaluation of Rehabilitation Programs Outcomes in Psychiatry: Application of a Recovery-Centered Model

2021 ◽  
Author(s):  
Simone Vanzetto ◽  
Matteo Zabotto ◽  
Federica Fasciana ◽  
Alberto Varinelli ◽  
Giovanna Cirnigliaro ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Psychosocial Functioning ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Evaluation Model ◽  
Rehabilitation Program ◽  
Wilcoxon Test ◽  
Global Functioning ◽  
Outcome Indicator ◽  
Indicator Model

AbstractRehabilitation is oriented to psychiatric patients’ recovery through specific techniques and structured projects, not yet fully standardized, carried out in territorial services. This study aims to apply an operational structured outcome indicator model (hospitalizations, continuity of care, LAI treatment adherence, working support) through a recovery-centered model in a rehabilitation community in Milan. This observational-retrospective study included 111 patients from a University High Assistance Rehabilitation Community (C.R.A.) based in Milan. Psychopathological and psychosocial functioning was evaluated with Kennedy Axis V, Brief Psychiatric Rating Scale (BPRS), Life Skills Profile (LSP), AR module of the VADO scale. Statistical analyses were performed using SPSS software version 19. Student t test and Wilcoxon Test were used to analyze quantitative variables, while McNemar test for qualitative variables. The minimum level of significance was set at 0.05 (p <0.05). The results showed that CRA rehabilitation program led to significant improvement in global functioning in terms of hospitalization reduction; improved continuity of care; stable adherence to psychopharmacological treatment with Long Acting Injectable (LAI) antipsychotics; stable employment maintenance during the year following discharge from the CRA. This study confirmed the utility of a structured outcome indicator model and highlighted its feasibility in daily clinical context of a rehabilitative community. Our results supported the effectiveness of a community-based rehabilitation program to improve individual functioning and clinical stability. However, further studies are required to better achieve the development of a recovery-oriented rehabilitation model and rigorously define an outcomes evaluation model.

The Clinician’s Subjective Experience during the Interaction with Adolescent Psychiatric Patients: Validity and Reliability of the Assessment of Clinician’s Subjective Experience

2021 ◽  
pp. 1-8
Author(s):  
Angelo Picardi ◽  
Sara Panunzi ◽  
Sofia Misuraca ◽  
Chiara Di Maggio ◽  
Andrea Maugeri ◽  
...  
Keyword(s):  
Clinical Examination ◽  
Subjective Experience ◽  
Rating Scale ◽  
Mood State ◽  
Psychiatric Patients ◽  
Temporal Stability ◽  
Young Patients ◽  
Reliability And Validity ◽  
Mental States ◽  
Validity And Reliability

<b><i>Introduction:</i></b> The last decade has witnessed a resurgence of interest in the clinician’s subjectivity and its role in the diagnostic assessment. Integrating the criteriological, third-person approach to patient evaluation and psychiatric diagnosis with other approaches that take into account the patient’s subjective and intersubjective experience may bear particular importance in the assessment of very young patients. The ACSE (Assessment of Clinician’s Subjective Experience) instrument may provide a practical way to probe the intersubjective field of the clinical examination; however, its reliability and validity in child and adolescent psychiatrists seeing very young patients is still to be determined. <b><i>Methods:</i></b> Thirty-three clinicians and 278 first-contact patients aged 12–17 years participated in this study. The clinicians completed the ACSE instrument and the Brief Psychiatric Rating Scale after seeing the patient, and the Profile of Mood State (POMS) just before seeing the patient and immediately after. The ACSE was completed again for 45 patients over a short (1–4 days) retest interval. <b><i>Results:</i></b> All ACSE scales showed high internal consistency and moderate to high temporal stability. Also, they displayed meaningful correlations with the changes in conceptually related POMS scales during the clinical examination. <b><i>Discussion:</i></b> The findings corroborate and extend previous work on adult patients and suggest that the ACSE provides a valid and reliable measure of the clinician’s subjective experience in adolescent psychiatric practice, too. The instrument may prove to be useful to help identify patients in the early stages of psychosis, in whom subtle alterations of being with others may be the only detectable sign. Future studies are needed to determine the feasibility and usefulness of integrating the ACSE within current approaches to the evaluation of at-risk mental states.

scholarly journals Variables Associated with the Use of Coercive Measures on Psychiatric Patients in Spanish Penitentiary Centers

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
E. Girela ◽  
A. López ◽  
L. Ortega ◽  
J. De-Juan ◽  
F. Ruiz ◽  
...  
Keyword(s):  
Mentally Ill ◽  
Psychiatric Patients ◽  
Psychiatric Inpatient ◽  
Psychiatric Hospitals ◽  
Coercive Measure ◽  
Coercive Measures ◽  
External Assessment ◽  
Mechanical Restraint ◽  
The Family ◽  
Inpatient Units

We have studied the use of coercive medical measures (forced medication, isolation, and mechanical restraint) in mentally ill inmates within two secure psychiatric hospitals (SPH) and three regular prisons (RP) in Spain. Variables related to adopted coercive measures were analyzed, such as type of measure, causes of indication, opinion of patient inmate, opinion of medical staff, and more frequent morbidity. A total of 209 patients (108 from SPH and 101 from RP) were studied. Isolation (41.35%) was the most frequent coercive measure, followed by mechanical restraint (33.17%) and forced medication (25.48%). The type of center has some influence; specifically in RP there is less risk of isolation and restraint than in SPH. Not having had any previous imprisonment reduces isolation and restraint risk while increases the risk of forced medication, as well as previous admissions to psychiatric inpatient units does. Finally, the fact of having lived with a partner before imprisonment reduces the risk of forced medication and communication with the family decreases the risk of isolation. Patients subjected to a coercive measure exhibited a pronounced psychopathology and most of them had been subjected to such measures on previous occasions. The mere fact of external assessment of compliance with human rights slows down the incidence of coercive measures.

Sign in / Sign up

Export Citation Format

Share Document