scholarly journals Screening for Psychiatric Comorbidities and Psychotherapeutic Assessment in Inpatient Epilepsy Care: Preliminary Results of an Implementation Study

2021 ◽  
Vol 15 ◽  
Author(s):  
Rosa Michaelis ◽  
Sabine Schlömer ◽  
Anja Lindemann ◽  
Vanessa Behrens ◽  
Wenke Grönheit ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Anxiety Disorder ◽  
Mental Health Care ◽  
Psychiatric Treatment ◽  
Treatment Plan ◽  
Epileptic Seizures ◽  
Standardized Interview ◽  
Therapeutic Recommendations

Background: Anxiety and depression remain underdiagnosed in routine clinical practice in up to two thirds of epilepsy patients despite significant impact on medical and psychosocial outcome. Barriers to adequate mental health care for epilepsy and/or psychogenic non-epileptic seizures (PNES) include a lack of integrated mental health specialists and standardized procedures. This naturalistic study outlines the procedures and outcome of a recently established psychotherapeutic service.Methods: Routine screening included the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E, cut-off value > 13) and Generalized Anxiety Disorder scale (GAD-7, cut-off value > 5). Positively (above cut-off in at least one questionnaire) screened patients were seen for a standardized interview for mental health disorders and the development of a personalized treatment plan. PNES patients were seen irrespective of their screening score. Resources were provided to support self-help and access to psychotherapy. Patients were contacted 1 month after discharge to evaluate adherence to therapeutic recommendations.Results: 120 patients were screened. Overall, 56 of 77 positively screened patients (77%) were found to have a psychiatric diagnosis through standardized interview. More epilepsy patients with an anxiety disorder had previously been undiagnosed compared to those with a depressive episode (63% vs. 30%); 24 epilepsy patients (62%) with a psychiatric comorbidity and 10 PNES patients (59%) were not receiving any mental health care. At follow-up, 16/17 (94%) epilepsy patients and 7/7 PNES patients without prior psychiatric treatment were adhering to therapeutic recommendations.Conclusion: Integrating mental health specialists and establishing standardized screening and follow-up procedures improve adherence to mental health care recommendations in epilepsy and PNES patients.

scholarly journals Adherence to mental health care and caregiver-patient relationship after diagnosis of psychogenic non-epileptic seizures: Longitudinal follow-up study

Seizure ◽  
2020 ◽  
Vol 80 ◽  
pp. 227-233 ◽  
Author(s):  
Mélanie Fettig ◽  
Wissam El-Hage ◽  
Irina Klemina ◽  
Julien Biberon ◽  
Bertrand de Toffol ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Epileptic Seizures ◽  
Patient Relationship ◽  
Follow Up Study

scholarly journals Community mental health care after self-harm: A retrospective cohort study

2016 ◽  
Vol 51 (7) ◽  
pp. 727-735 ◽  
Author(s):  
Matthew J Spittal ◽  
Fiona Shand ◽  
Helen Christensen ◽  
Lisa Brophy ◽  
Jane Pirkis
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Community Mental Health ◽  
Health Services ◽  
Mental Health Care ◽  
Psychiatric Inpatient ◽  
Community Mental Health Services ◽  
Community Mental Health Care ◽  
Self Harm

Objective: Presentation to hospital after self-harm is an opportunity to treat underlying mental health problems. We aimed to describe the pattern of mental health contacts following hospital admission focusing on those with and without recent contact with community mental health services (connected and unconnected patients). Methods: We undertook a data linkage study of all individuals admitted as a general or psychiatric inpatient to hospital after self-harm in New South Wales, Australia, between 2005 and 2011. We identified the proportion of admissions where the patient received subsequent in-person community mental health care within 30 days of discharge and the factors associated with receipt of that care. Results: A total of 42,353 individuals were admitted to hospital for self-harm. In 41% of admissions, the patient had contact with a community mental health service after discharge. Patients connected with community mental health services had 5.33 (95% confidence interval = [5.09, 5.59]) times higher odds of follow-up care than unconnected patients. Other factors, such as increasing age and treatment as a psychiatric inpatient, were associated with lower odds of follow-up community care. Conclusion: Our study suggests that full advantage is not being taken of the opportunity to provide comprehensive mental health care for people who self-harm once they have been discharged from the inpatient setting. This is particularly the case for those who have not previously received community mental health care. There appears to be scope for system-level improvement in the way in which those who are treated for self-harm are followed up in the community.

Effectiveness of Prompt Mental Health Care: Preliminary results from a randomized controlled trial

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Knapstad ◽  
L V Lervik ◽  
S M M Saether ◽  
L E Aaroe ◽  
O R F Smith
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Randomized Controlled Trial ◽  
Mental Health Care ◽  
Controlled Trial ◽  
Sensitivity Analyses ◽  
Depression And Anxiety ◽  
Symptoms Of Depression ◽  
Randomized Controlled

Abstract Background Prompt Mental Health Care (PMHC) service is a Norwegian initiative, adapted from the English ‘Improved Access to Psychological Therapy’ (IAPT), aimed at improving access to primary care treatment for anxiety and depression. Thus far, both PMHC and IAPT have been evaluated by cohort studies only. Albeit yielding promising results, the extent to which these are attributable to the treatment thus remains unsettled. This study investigates the effectiveness of PMHC compared to treatment as usual (TAU) at six months follow-up. Methods Randomized controlled trial with parallel assignment in two PMHC sites from November 2015 to March 2018. Participants were 681 adults (aged ≥18 years) considered for admission to PMHC due to anxiety and/or mild to moderate depression. These were randomly assigned on a 70:30 ratio. Main outcomes were recovery rates and changes in symptoms of depression and anxiety between baseline and follow-up. Primary outcome data were available for 73%/67% in the PMHC/TAU group. Sensitivity analyses based on observed patterns of missingness were conducted. Results A reliable recovery rate of 58.5% was observed in the PMHC group and 31.9% in the TAU group, yielding a between-group effect size (ES) of 0.61 [95% CI 0.37-0.85, p<.001]. The differences in degree of improvement between PMHC and TAU yielded an ES of -0.88 [95% CI -1.23-0.43, p < 0.001] for symptoms of depression and -0.60 [95% CI -0.90-0.30, p < 0.001] for symptoms of anxiety in favour of PMHC. All sensitivity analyses pointed in the same direction with small variations in point estimates. Findings were slightly more robust for depressive than anxiety symptoms. Conclusions The PMHC treatment was substantially more effective than TAU in alleviating symptoms of anxiety and depression. This adaptation of IAPT is considered a viable supplement to existing health services to increase access of effective treatment for adults who suffer from anxiety and mild to moderate depression. Key messages This study is the first to evaluate the effectiveness of an IAPT-like treatment model in terms of a randomized controlled trial. Prompt Mental Health Care was substantially more effective than TAU in alleviating symptoms of depression and anxiety at 6-months follow-up.

Outcome of patients dropping out from community-based mental health care: a 6-year multiwave follow-up study

2007 ◽  
Vol 116 (s437) ◽  
pp. 42-52 ◽  
Author(s):  
M. Ruggeri ◽  
G. Salvi ◽  
C. Bonetto ◽  
A. Lasalvia ◽  
L. Allevi ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Dropping Out ◽  
Community Based ◽  
Follow Up Study

Attitudes toward Psychology, Psychiatry and Mental Illness in the Central Eastern Cape of South Africa

1996 ◽  
Vol 26 (4) ◽  
pp. 221-225 ◽  
Author(s):  
Christopher R. Stones
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Service Providers ◽  
Psychiatric Treatment ◽  
First Year ◽  
Eastern Cape ◽  
Medical Practitioners ◽  
General Medical Practitioners

A survey of attitudes held by a large sample of university students as well as by smaller samples of psychologists, general medical practitioners, members of the public, psychiatric hospital staff and patients in the central eastern Cape toward mental illness and mental health-care service providers was conducted during the early part of 1994. It was found that marked differences existed between the different samples and that the extent of a person's knowledge about mental illness, as well as the degree of contact with mental-health professionals and their services, were important influences on the attitudes of respondents. In particular, third-year psychology students tended to be more negatively disposed to psychiatric treatment than those students in their first year of study. Conversely, the attitudes of final-year students toward the discipline of psychology were more positive than those held by students in their first year of studying psychology. Within both the student and the patient samples, only a small minority indicated that they would first seek help from general medical practitioners if they were ever to contemplate taking their own lives or if they were seriously mentally ill. Psychiatric patients and service providers indicated their confidence in psychiatric treatment and the psychiatrist was considered to be the most appropriate professional to deal with mental illness. Members of the general public were found to be more optimistic than psychologists about the efficacy of psychological and psychiatric treatment, but less so than general medical practitioners. Although mental health-care professionals were viewed in a favourable light, most respondents indicated that they would nevertheless prefer to approach a friend in times of psychological distress.

scholarly journals Étude de relance auprès des détenus fédéraux traités en milieu psychiatrique : description des antécédents, du séjour, des rechutes et des récidives

Criminologie ◽  
2005 ◽  
Vol 21 (2) ◽  
pp. 27-61 ◽  
Author(s):  
Sheilagh Hodgins ◽  
Mireille Cyr ◽  
Jean Paquet ◽  
Pierre Lamy
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Population ◽  
Mental Health Care ◽  
Criminal Recidivism ◽  
Severe Mental Disorders ◽  
Maximum Security ◽  
Penal Institutions ◽  
The Impact

While severe mental disorders have consistently been shown to be more prevalent among inmates of penal institutions than among the general population, the provision of mental health within jails, prisons and penitentiaries has always been, and continues to be, problematic. The present investigation was designed to examine the impact on patients of one organizational model of mental health care for penitentiary inmates. Ninety-nine men who were transferred from a penitentiary to a maximum security hospital for varying periods of time were followed for three years after discharge. Relapse and criminal recidivism were documented from official files. Interviews were conducted at the end of the follow-up period in order to examine subject's level of social functionning and mental state. Specific conclusions are drawn about the way in which mental health care was provided and the benefit which accrued to the patients.

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