scholarly journals Risk Factors for Revolving Door in Children and Adolescents with Psychiatric Disorders

2021 ◽  
Vol 10 (21) ◽  
pp. 5004
Author(s):  
Barbara D’Aiello ◽  
Deny Menghini ◽  
Roberto Averna ◽  
Milena Labonia ◽  
Stefano Vicari
Keyword(s):  
Risk Factors ◽  
Children And Adolescents ◽  
Psychiatric Hospitalization ◽  
Psychiatric Patients ◽  
Severity Of Illness ◽  
Revolving Door ◽  
Psychiatric Ward ◽  
Emotional Symptoms ◽  
Post Discharge ◽  
Clinical Conditions

Revolving Door (RD) is a frequent phenomenon afflicting children and adolescents with psychiatric diagnoses. Nevertheless, risk factors for RD are still a matter of debate. To better understand RD phenomenon, we conducted a retrospective study on 224 children and adolescents (165 females and 59 males, aged 6–16 years) with a psychiatric hospitalization, taking the multiple risk factors together. At this aim, 108 patients with multiple hospitalizations and 116 patients with only one hospitalization were compared on demographic characteristics, clinical conditions, psychiatric ward stay, and post-discharge management factors. More than half of psychiatric patients were readmitted within three months of discharge. RD patients presented greater severity of illness, needed longer stays, and were more frequently placed in residential facilities than non-RD patients. Non-suicidal self-injurious and adoption were the main predictors of RD. Clinical instruments that detected behavioural and emotional symptoms, suicidal ideation severity, and level of impairment of the person’s functioning were useful to identify patients at high risk for RD. In conclusion, our findings pointed out that several risk factors have to be considered to better understand and, in the future, prevent RD phenomenon.

scholarly journals Examining changes in parent-reported child and adolescent mental health throughout the UK’s first COVID-19 national lockdown.

2021 ◽  
Author(s):  
Jasmine Raw ◽  
Polly Waite ◽  
Samantha Pearcey ◽  
Cathy Creswell ◽  
Adrienne Shum ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Children And Adolescents ◽  
Conduct Problems ◽  
Emotional Symptoms ◽  
Mixture Modelling ◽  
Growth Mixture ◽  
Health Trajectories ◽  
Growth Mixture Modelling ◽  
Over Time

Background The COVID-19 pandemic has significantly changed the lives of children and adolescents, forcing them into periods of prolonged social isolation and time away from school. Understanding the psychological consequences of the UK’s lockdown for children and adolescents, the associated risk factors, and how trajectories may vary for children and adolescents in different circumstances is essential so that the most vulnerable children and adolescents can be identified and appropriate support can be implemented. Methods Parents and carers (n = 2988) in the U.K. with children and adolescents aged between 4 and 16 years completed an online survey about their child’s mental health. Growth curve analysis was used to examine the changes in conduct problems, hyperactivity/inattention and emotional symptoms between the end of March/beginning of April and July using data from four monthly assessments. Additionally, growth mixture modelling identified mental health trajectories for conduct problems, hyperactivity/inattention and emotional symptoms separately and subsequent regression models were used to estimate predictors of mental health trajectory membership. Results Overall levels of hyperactivity and conduct problems increased over time whereas emotional symptoms remained relatively stable, though declined somewhat between June and July. Change over time varied according to child age, the presence of siblings, and with Special Educational Needs (SEN)/ Neurodevelopmental Disorders (ND). Subsequent growth mixture modelling identified three, four and five trajectories for hyperactivity/inattention, conduct problems and emotional symptoms, respectively. Though many children maintained “stable3low” symptoms, others experienced elevated symptoms by July. These children were more likely to have a parent/carer with higher levels of psychological distress, to have SEN/ND, or to be younger in age. Conclusions The findings support previous literature and highlight that certain risk factors were associated with poorer mental health trajectories for children and adolescents during the pandemic.

Factors associated with homelessness referrals for an acute young adult psychiatric unit

2020 ◽  
pp. 002076402097023
Author(s):  
Alexander Dymond ◽  
Grace Branjerdporn
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Young Adult ◽  
Length Of Stay ◽  
Bipolar Affective Disorder ◽  
Psychiatric Ward ◽  
Chart Audit ◽  
Post Discharge ◽  
Acute Presentation ◽  
Clinical Risk

Background: Homelessness is correlated with significant mental illness. Homelessness is a key psychosocial issue leading to significant use of hospital resources outside medical intervention. Aim: This study examines the characteristics, post-discharge pathway and length of stay of individuals presenting with homelessness in an acute young adult psychiatric ward. Method: Prospective chart audit was conducted to assess the demographic information, acute presentation, clinical risk and length of stay for homelessness referrals to Social Work. Participants ( N = 88) were aged 18 to 25 years old and admitted to a tertiary level psychiatric ward specifically for this age group. Acute risk presentations of all psychiatric conditions, such as Schizophrenia, Emotionally Unstable Personality Disorder, Bipolar Affective Disorder, Drug Induced Psychosis and Anorexia Nervosa, may be admitted to the unit. Descriptive statistics, one sample t-tests and Pearson’s correlations were completed. Results: No homeless patient was accommodated by local area services due to lack of availability. Change in homelessness status tended to worsen during hospitalisation, with 24% having worse accommodation upon discharge compared to 13% who improved. Length of stay was significantly longer for homeless patients compared to non-homeless patients, but not when excluding the length of time spent attempting to address homeless risk. Homeless patients presenting with an eating disorder acute presentation spent longer time in hospital, and those with psychotic acute presentations had more dynamic risk factors. Length of stay and static risk factors were positively correlated with government mental health community follow-up. Conclusion: Hospitalisation is not an effective intervention for homelessness and the Gold Coast Mental Health units are not resourced or linked to provide accommodation outcomes in a positive or economic manner. Future consideration should be given to health and community resources around homelessness, including health-specific housing interventions and community mental health teams incorporating homelessness risk vulnerability into their ongoing clinical risk mitigation.

Suicide by psychiatric patients: Nature of risk, risk categorisation and preventability

2019 ◽  
Vol 59 (4) ◽  
pp. 255-264
Author(s):  
Nilamadhab Kar ◽  
Tulika Prasad
Keyword(s):  
Risk Factors ◽  
Perceived Risk ◽  
Psychiatric Patients ◽  
Complex Mixture ◽  
Considerable Proportion ◽  
Post Discharge ◽  
Psychiatric Admission ◽  
Modifiable Factors ◽  
Common Risk Factors ◽  
Risk Categorisation

This study considers risk factors associated with suicide by psychiatric patients, the perceived risk at last contact and risk categorisation and reflects upon the potential for prevention. Information regarding 63 consecutive suicides known to mental health services in Wolverhampton, UK, over a 15-year period was collected as part of an audit using a semi-structured questionnaire covering sociodemographic and clinical risk factors, along with information about preventability. A complex mixture of historical, enduring and current risk factors was observed. In addition to common risk factors, a considerable proportion had histories of multiple co-morbid psychiatric (52.5%) and physical diagnoses (27.6%) and psychiatric admission (70.5%). Common suicide methods included hanging (36.5%) and poisoning (36.5%). Most suicides occurred in the post-discharge months up to around two years (75.8%). Although a range of psychopathologies and suicidal cognitions were observed at the last clinical contact, the immediate suicide risk was considered low (46.2%) or not present (38.5%) in the majority of cases. Clinicians suggested various factors that could have made suicides less likely. Clinical assessment can identify risk factors, but categorisation may not be indicative of the outcome. A focus on modifiable factors, with support for psychosocial and clinical issues, may assist with prevention.

In-Patient and Post-Discharge Suicides in Tyrol 2004–2011

2017 ◽  
Vol 41 (S1) ◽  
pp. S292-S292
Author(s):  
E.A. Deisenhammer ◽  
E.M. Behrndt ◽  
G. Kemmler ◽  
C. Haring ◽  
C. Miller
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
High Risk Population ◽  
Post Discharge ◽  
Patient Status ◽  
History Of ◽  
Competing Interest ◽  
Commit Suicide

IntroductionPsychiatric patients constitute a high-risk population for suicide. In-patient status and the period after discharge are of particular interest concerning risk assessment.ObjectiveTo assess risk factors for in-patient and post-discharge suicides.MethodsThe Tyrol suicide register was linked with the registers of three psychiatric departments/hospitals of the region. Suicides were categorized according to whether the suicide was committed during a hospital stay or within 12 weeks after discharge or whether the suicide subject had not recently been hospitalized. Groups were compared with regard to demographic and clinical variables. Further, case-control comparisons were performed for the in-patient and post-discharge groups.ResultsDuring the study period (2004–2011) 30 in-patients, 89 post-discharge and 592 not recently hospitalized suicides were identified. Groups differed in terms of gender distribution, history of suicide attempts, warning signals and suicide methods. Compared with controls matched for a number of variables, in-patient suicides were significantly more suicidal and depressed at admission, reported more often a recent life event and showed less often aggressive behavior and plans for the future. Post-discharge suicides had more often a history of attempted suicide, depressive and thought disorder symptomatology, a ward change and an unplanned discharge and less often a scheduled appointment with a non-psychiatric physician.ConclusionsSuicide victims differ with regard to whether they die during, shortly after or not associated with a hospitalization. Compared to controls there are specific risk factors for those who commit suicide during a hospital stay and within 12 weeks after discharge.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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.

QUANTITATIVE AND QUALITATIVE CHARACTERISTICS OF METASTASES IN REGIONAL LYMPH NODES - RISK FACTORS FOR THE RECURRENCE OF PAPILLARY THYROID CANCER IN CHILDREN AND ADOLESCENTS

2018 ◽  
Vol 64 (2) ◽  
pp. 159-165
Author(s):  
Mikhail Fridman ◽  
Svetlana Mankovskaya ◽  
Olga Krasko
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Lymph Nodes ◽  
Children And Adolescents ◽  
Papillary Thyroid Cancer ◽  
Papillary Thyroid ◽  
Regional Lymph Nodes ◽  
Cancer In Children ◽  
Qualitative Characteristics

Among the factors determining the relapse/persistence of papillary thyroid cancer in children and adolescents the most important are the age of the patient (p= 0.003), the presence of concomitant background pathology (p

Comparison of Risk Factors of Falling for Psychiatric Inpatients and General Ward Inpatients Who Had Fallen

2021 ◽  
pp. 107839032110330
Author(s):  
Wen P. Chang ◽  
Hsiu J. Jen
Keyword(s):  
Risk Factors ◽  
Multinomial Logistic Regression ◽  
Psychiatric Patients ◽  
Length Of Hospital Stay ◽  
Psychiatric Inpatients ◽  
General Ward ◽  
Prevention Measures ◽  
Risk Of Falling ◽  
Multinomial Logistic Regression Analysis ◽  
Risk Factors For Falling

BACKGROUND: For psychiatric patients, the issue of falling is complex. OBJECTIVE: The objective of this study was to compare the risk factors for falling in psychiatric inpatients and general ward inpatients who had fallen. METHODS: The researchers first derived official fall records for 122 psychiatric inpatients and then selected 122 psychiatric inpatients who had not fallen as well as 122 general ward patients who had fallen, matched for gender, age, and length of hospital stay at the time of the fall incident. RESULTS: After controlling other variables, multinomial logistic regression analysis revealed that psychiatric inpatients who had fallen and had dizziness (odds ratio [OR] = 7.11, p < .001), had an unsteady gait (OR = 1.97, p = .030), or were not using aids (OR = 0.42, p = .042) were at greater risk of falling than those who had not fallen. The researchers also found that general ward inpatients who had fallen and had higher Charlson Comorbidity Index scores (OR = 1.77, p < .001), were clear-headed (OR = 27.15, p = .001), had dizziness (OR = 11.55, p < .001), were unable to walk (OR = 64.28, p < .001), or were using aids (OR = 3.86, p = .001) were at greater risk of falling than those who had not fallen before. CONCLUSIONS: The causes of falling among psychiatric inpatients and general ward inpatients are different. Medical personnel should understand the medications and attributes of patients for an accurate assessment of their risk factors for falling and thus implement fall prevention measures and health education to reduce falls.

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