Evaluations of Competency of Patients with Organic Mental Disorder

1997 ◽  
Vol 80 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Tarak Vasavada ◽  
Prakash S. Masand ◽  
George Nasra

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.

2015 ◽  
Vol 96 (2) ◽  
pp. 157-161
Author(s):  
S N Popov ◽  
I N Vinnikova

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.


CNS Spectrums ◽  
1997 ◽  
Vol 2 (4) ◽  
pp. 50-53
Author(s):  
Prakash Masand ◽  
Tarak Vasavada ◽  
George Nasra

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.


Doctor Ru ◽  
2021 ◽  
Vol 20 (5) ◽  
pp. 62-66
Author(s):  
S.N. Popov ◽  
◽  
I.N. Vinnikova ◽  
A.S. Berezkin ◽  
◽  
...  

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.


1988 ◽  
Vol 152 (5) ◽  
pp. 625-628 ◽  
Author(s):  
A. Marneros

The frequency of schizophrenic first-rank symptoms (FRS) were investigated in 1698 patients with an organic mental disorder (OMD) according to Schneider's and DSM-III criteria: 7% of the patients with OMD had FRS, compared with 47% of schizophrenic patients. However, the frequency of FRS depends on the state of consciousness and on the aetiology of the OMD: 20% of the patients with clear consciousness had FRS, but only 1.5% of those with clouded consciousness. In cases of some aetiologically defined groups of OMD, such as post-ictal epileptic psychoses or alcoholic hallucinosis, the frequency of FRS is similar to that in cases of schizophrenia. FRS appear to be psychotic reaction patterns whose substrate-related basis extends across the whole spectrum of endogenous and exogenous psychoses.


1993 ◽  
Vol 5 (1) ◽  
pp. 33-48 ◽  
Author(s):  
Ingmar Skoog ◽  
Lars Nilsson ◽  
Sten Landahl ◽  
Bertil Steen

The prevalence of mental disorders was studied in a representative sample of 85-year-old living in Gothenburg, Sweden, (n=494). All subjects were examined by a psychiatrist, whose diagnoses were defined according to the DSM-III-R criteria. In the sample, the prevalence of dementia was 29.8%, and of any other mental disorder was 24.3%. Psychotic disorders were present in 4.7%, depressive disorders in 12.6%, and anxiety disorders in 10.5%. Anxiety disorders were more common in women than in men. Of all subjects, 42.5% used a psychotropic drug (men 30.1%, women 47.6%, p<0.001), 34.2% used anxiolytic-sedatives, 14.0% used antidepressants, and 5.7% used neuroleptics. Women used significantly more anxiolytic-sedatives and antidepressants than did men. Of those with no mental disorders, 29.1% used a psychotropic drug. Although the prescription of psychotropic drugs was high, only one fifth of those with depressive disorders received antidepressant drug therapy and one tenth of those with psychotic disorders received neuroleptics.


2019 ◽  
Author(s):  
Wen-Yin Chen ◽  
Sheng-Jean Huang ◽  
Chin-Kuo Chang ◽  
Chun-Hung Pan ◽  
Sheng-Shiang Su ◽  
...  

Abstract Background: Home care case management (CM) is the main intervention for patients with severe mental disorders (SMDs) requiring outreach care. The present study investigated the long-term mortality outcome and associated risk factors in patients who received home care CM. Methods: In this nationwide study, we enrolled patients who received home care CM (n=10255) between January 1, 1999, and December 31, 2010; data of these patients were derived from a Taiwan health insurance database. We calculated the standardized mortality ratio (SMR) as the ratio of observed deaths in the study cohort to expected deaths in the general population and presented by diagnosis. Multivariate regression was performed to assess independent risk factors for mortality. Results: Among 10255 patients who received home care CM, 1409 died during the study period; the overall SMR was 3.13. Specifically, patients with organic mental disorder had the highest SMR (4.98), followed by those with schizophrenia (3.89), major depression (2.98), and bipolar disorder (1.97). After adjustment for confounding factors in the multivariate analysis, patients with organic mental disorder or dementia had the highest risk of mortality, whereas the mortality risk in patients with schizophrenia was comparable to that in patients with bipolar disorder or major depression. Deceased patients had a significantly higher proportion of acute or chronic physical illnesses, including cancer, chronic hepatic disease, and pneumonia. Conclusion: This study presented the gap of mortality in patients with SMDs receiving home care CM in Taiwan. We highlight the need for more effective strategies to improve medical care for this specified population.


2021 ◽  
Vol 24 (1) ◽  
pp. 23-29
Author(s):  
Svetlana V Kiryukhina ◽  
Olga V Gulina ◽  
Vyacheslav G Podsevatkin ◽  
Galina N Kukina ◽  
Yevgeniya Yu Yurasova ◽  
...  

Background. The trend of recent years is a steady increase in mental illness among the population. according to the statistics of the ministry of health of the russian federation, mental disorders were classified as socially significant diseases in russia in 2018. Thus, the absolute number of patients with a first-time diagnosis of a mental disorder who applied for counseling and treatment in the Russian Federation in 2018 was 379818, which is 3.4% more than in 2017. [20,21,22,23,24] the number of patients with a first-time diagnosis of " mental disorder (except for diseases related to the use of psychoactive substances)" taken under dispensary observation in the republic of mordovia in the same year was 35.5 per 100,000 population. In addition, mental illnesses are in third place among disabling diseases, second only to malignant neoplasms and diseases of the circulatory system. In the structure of repeated disability by class of diseases, this group of diseases is 9%, and the lion's share falls on people of working age. Thus, there is a steady increase in mental illnesses, as well as disability due to them [1], [3]. The question arises of the need to study the patterns of disability formation in order to further develop theories and concepts of ways to protect human health, prevent disability, assess the rehabilitation potential and prognosis, develop rehabilitation measures that improve social adaptation and integration of patients in the family and society. The aim- study of the patterns of disability formation due to organic mental disorders in the Republic of Mordovia, taking into account age characteristics and severity of disability, which is important for the development of comprehensive measures for the prevention of morbidity, early diagnosis and rehabilitation of this group of people. Materials and methods. The analysis included information from the statistical collections of Rosstat and approved forms of state statistics No. 7-sobes for 2019. The data of all first-time persons recognized as disabled due to mental disorders in the Republic of Mordovia for 2014-2019 on the basis of the ITU information base for the Republic of Mordovia are analyzed using a continuous method. Results. Having analyzed the data of all first-time persons recognized as disabled due to mental disorders in the Republic of Mordovia for 2014-2019 on the basis of the ITU information base for the Republic of Mordovia, it was concluded that a significant place in the structure of disability is occupied by organic mental disorders. The percentage of people with organic mental disorders among those first recognized as disabled 18 years and older over the past five years is significant and stable, ranging from 20.1 (in 2017) to 25.1 (in 2014). In the structure of patients who were diagnosed with disability with this diagnosis, there is a predominance of repeated patients over primary ones (by 23.6 %), and it should be noted that this pathology is more common in men (71% of the total number of persons (or in the population) with the above diagnosis). Patients with both primary and re-recognized disabilities with a diagnosis of "Organic mental disorder" were more often assigned to the third group of disability (62% of cases among primary, 57.4% among repeated). Also, the third group of disability prevails regardless of the patient's gender. The study of age-related features of disability due to organic mental disorders in the Republic of Mordovia in 2019 showed that organic mental disorders are most often found in the working-age population. In addition, the proportion of young people (from 18 years to 44 years) is high, it is 59.2% for men, 50% for women. Conclusions. Given the steady increase in mental illness and disability as a result of it, it is necessary to study the theories and concepts of medical and social expertise and rehabilitation of patients suffering from mental disorders. The role of fundamental and applied research in the field of medical and social expertise and medical and social rehabilitation is significant in order to create ways to protect human health, prevent disability, and develop factors that improve social adaptation and integration of patients in the family and society. in order to develop such concepts, it is necessary to study the structure of disability, the patterns of formation, and the peculiarities of the influence of age and gender factors.


1991 ◽  
Vol 25 (2) ◽  
pp. 243-254 ◽  
Author(s):  
Louise N. Seward ◽  
Graeme C. Smith ◽  
Geoffrey W. Stuart

We studied the concordance of physicians with the recommendations of psychiatric consultants in a sample of 270 consultations in a 400-bed general hospital. Of the patients about whom a consultation was sought, 37% had a past psychiatric history, and 67% were on psychotropic drugs. Twelve percent had Organic Mental Disorder, 35% Affective Disorder, and for 24% no DSM-Ill diagnosis could be made. The psychiatrist made psychotropic drug recommendations in 62%, and the physicians' concordance with this recommendation was 86%. The physician's discharge summary included a diagnosis which concorded with the psychiatrist's diagnosis in 53% of files. The psychiatrist recommended further investigations in only 5.2% of files.


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