The Psychiatric Evaluation of Air Crew

2016 ◽  
pp. 149-166
Keyword(s):  
Psychiatric Evaluation

Applying Bowen Theory to Psychiatric Assessment and Disposition in the ED

2021 ◽  
pp. 107839032098763
Author(s):  
Kathleen B. Kerr
Keyword(s):  
Psychiatric Hospitalization ◽  
Theoretical Orientation ◽  
Admission Rate ◽  
Hospitalization Rate ◽  
The Other ◽  
Psychiatric Evaluation ◽  
Bowen Theory ◽  
Management Service ◽  
Psychiatric Assessment ◽  
Psychiatric Hospitalizations

BACKGROUND: A number of variables have been shown to influence whether an individual who experiences an emergency psychiatric assessment is admitted to a psychiatric hospital. This study focused on the theoretical orientation of the assessing clinician as a possibly influential variable. The theoretical orientation being studied was Bowen family systems theory or Bowen theory (Bt). Overall the Bt perspective looks at the family as the primary crucible that generates symptoms but at the same time as the natural unit and the best built-in resource to deal with those symptoms. AIMS: This study examined whether the theoretical orientation of the nurse psychiatric assessor would affect her inpatient admission rate of patients seen for psychiatric evaluation in an emergency department (ED). METHOD: A clinician/researcher with extensive experience applying Bt in clinical practice worked in a Crisis Management Service providing psychiatric evaluation and disposition in a busy community hospital ED. Given Bt’s emphasis on the system rather than individual pathology, the clinician researcher hypothesized that her psychiatric hospitalization rate would be lower than the other clinical nurse specialists. A retrospective chart review analyzed 1 year of cases from all referrals that might have resulted in psychiatric hospitalizations ( n = 1,801). RESULTS: The clinician/researcher’s psychiatric hospitalization rate was significantly lower ( p = .004) than the other clinicians. CONCLUSION: An approach to psychiatric assessment in the ED applied a Bt perspective in a way that significantly reduced psychiatric hospitalizations.

Descriptive Study of Adjustment Disorders in a Mental Health Unit.

2017 ◽  
Vol 41 (S1) ◽  
pp. S607-S607
Author(s):  
L. González ◽  
B. Pecino ◽  
C. Gomez ◽  
M. Anibarro ◽  
C. Ortigosa
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Care Physician ◽  
Psychiatric Evaluation ◽  
Adjustment Disorders ◽  
Health Unit ◽  
Social Difficulties ◽  
Current Employment Status ◽  
Competing Interest ◽  
Mental Health Unit

IntroductionAdjustment disorders are a common psychiatric disorder in primary care and mental health units, with point prevalence estimates ranging from 0.9% to 2.3%. These disorders have been recently defined as a stress response syndrome in the fifth edition of the DSM, causing emotional and social difficulties and also a large economic burden on society.ObjectivesThe aim of this descriptional study was to analyse the socio-demographic characteristics and treatment of the patients diagnosed with adjustment disorders in the first visit in a mental health unit.MethodsThe study sample consisted of 128 patients admitted for a psychiatric consultation in a mental health unit in Alicante (Spain) from their primary care physician, between February and July 2016. Variables of gender, age, current employment status, diagnosis and treatment were measured. Data analysis was conducted using SPSS software.ResultsThe data from 31 patients who were diagnosed with adjustment disorders meant a 24% of the sample. The median age was 47 years old in the adjustment disorders group. Among those with adjustment disorders, 61% were women, and 52% of them were unemployed. Almost 60% of them had at least one pychotropic prescription and only 22% were derived to psychology.ConclusionsAdjustment disorders are considered as an intermediate category between no mental disorder and affective disorders. Most authors recommend to start with a psychotherapeutic intervention. Despite starting with medication has not proved effectiveness in the studies, most of the patients had at least one psychotropic prescription before the psychiatric evaluation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Psychopathologic aspects of obesity: Psychodiagnostic evaluations of bariatric surgery applicants

2011 ◽  
Vol 26 (S2) ◽  
pp. 714-714
Author(s):  
S. Chiappini ◽  
E. Righino ◽  
C. Ciciarelli ◽  
M. Pettorruso ◽  
G. Conte
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Psychiatric Symptoms ◽  
Psychiatric Evaluation ◽  
Psychiatric Interview ◽  
Negative Factor ◽  
Surgical Evaluation ◽  
A Current ◽  
Transoral Gastroplasty

IntroductionPsychiatrists play an important role as members of the bariatric surgery team. A preoperative psychiatric evaluation is considered as part of a mandatory workup before approving surgery.AimsThis evaluation focuses on the identification of any pre-existing psychiatric disorders among candidates for TOGa[1], a new experimental technique of bariatric surgery, and their correlations with post surgical weight loss.Method45 obese patients underwent a psychiatric interview and several psycho diagnostic questionnaires (SCL-90; HAM-D; HAM-A; EDI; TAS).A follow-up was set each 3 months.ResultsWe found that 34.1% of surgery candidates had a current diagnosis of depression; the majority showed anxiety symptoms. We also documented dissatisfaction about body shape, desire of slimness, fear of maturity, perfectionism, bulimia and binge eating disorder. Other frequent psychiatric symptoms were somatization, sensitivity, obsession and compulsion. After 3 months from surgery we found that the best weight loss was associated to low score in HAM-A, high score in hanger-hostility item (SCL-90) and low score in sensitiveness item (SCL-90).ConclusionThe diagnosis of a psychiatric pathology during the pre-surgical evaluation can be considered a predictive negative factor for the outcome of the surgery. The predictive positive factors are firstly the nonexistence of psychiatric symptoms, secondly the high score in sensitiveness-insight item (SCL-90) and the high score in the ability to express feelings. [1] (TransOral Gastroplasty)

Embedding DBT Skills Training Within a Transactional-Ecological Framework to Reduce Suicidality in a Navajo Adolescent Female

2016 ◽  
Vol 16 (1) ◽  
pp. 76-92 ◽  
Author(s):  
Brieanne K. Kohrt ◽  
Tory M. Lincoln ◽  
Artemio D. Brambila
Keyword(s):  
Protective Factors ◽  
Dialectical Behavior Therapy ◽  
Family System ◽  
Extended Family ◽  
Psychiatric Inpatient ◽  
Skills Training ◽  
The United States ◽  
Mindfulness Practice ◽  
Psychiatric Evaluation ◽  
Ecological Framework

American Indian/Alaska Native (AI/AN) youth have higher rates of suicidality than any other ethnic or cultural group in the United States. Dialectical behavior therapy (DBT) is an evidence-based treatment that has been found to reduce suicidality in adolescents, but there is little literature speaking to its efficacy with the AI/AN population. The transactional-ecological model of suicidality helps identify protective factors that can be bolstered at the individual, familial, community, and spiritual levels to reduce suicidality and suicidal contagion in AI/AN youth. The current study examines a case where DBT was culturally adapted and embedded within a transactional-ecological framework to treat a 14-year-old Navajo female with Major Depressive Disorder with psychotic features who presented to a psychiatric inpatient facility following a suicide attempt. The patient’s wish to die was motivated by her belief that her death could lead to positive changes in an extended family system plagued by historical trauma, alcoholism, suicide, and domestic violence. Ongoing assessment was conducted using the Suicide Status Form (SSF), Suicide Probability Scale (SPS), Reasons for Living Scale for Adolescents (RFL-A), and the DBT diary card. Navajo healing traditions were used in conjunction with DBT skills training and enhancement of ecological protective factors. Initial reduction in depression and suicidality was complicated by an increase in homicidal ideation. A comprehensive psychiatric evaluation was completed, and treatment was modified through medication changes, increased mindfulness practice, bolstering support systems, and engagement in a Navajo healing ceremony. Implications for clinicians treating suicidality in Navajo youth are discussed.

Disability and psychiatric disorders in an urban community: measurement, prevalence and outcomes

1998 ◽  
Vol 28 (3) ◽  
pp. 509-517 ◽  
Author(s):  
S. S. BASSETT ◽  
G. A. CHASE ◽  
M. F. FOLSTEIN ◽  
D. A. REGIER
Keyword(s):  
Psychiatric Disorders ◽  
Service Utilization ◽  
Adult Population ◽  
Diagnostic Category ◽  
Psychiatric Evaluation ◽  
Chronic Medical Conditions ◽  
Medical Conditions ◽  
Sampling Weights ◽  
Co Morbidity ◽  
Specific Disability

Background. The purpose of this analysis was to examine: (1) the prevalence of psychiatric disorders among disabled people, using seven different measures of disability; (2) variation in disability between and within psychiatric diagnostic categories; and (3) relationship of diagnosis and disability to health service utilization.Method. Data were drawn from Phase I and Phase II of the Eastern Baltimore Mental Health Survey, part of the Epidemiologic Catchment Area Program (ECA) conducted in 1980–1 to survey mental morbidity within the adult population. A total of 810 individuals received both a household interview and a standardized clinical psychiatric evaluation. Estimated prevalence rates were computed using appropriate survey sampling weights.Results. Prevalence of disability ranged from 2·5 to 19·5%, varying with specific disability measure. Among those classified as disabled by any of the measures examined, 56 to 92% had a psychiatric disorder and serious chronic medical conditions were present in the majority of these cases (54 to 78%). Disability was expressed differently among the various diagnostic groups. Diagnostic category and disability were significant independent predictors of medical service utilization and receipt of disability payments.Conclusions. The majority of disabled adults living in the community have diagnosable psychiatric disorders, with the majority of these individuals suffering from significant chronic medical conditions as well, thus making co-morbidity the norm.

Modifying the psychiatric evaluation for older adults: at tool for medical learners

2021 ◽  
Vol 29 (4) ◽  
pp. S82
Author(s):  
Erin Ranum ◽  
Andrew Baumgartner ◽  
William J Burke ◽  
Steven Wengel
Keyword(s):  
Older Adults ◽  
Psychiatric Evaluation

scholarly journals AWARENESS, STRESS, ANXIETY, AND DEPRESSION AMONG HYPERTENSIVE PATIENTS ATTENDING CARDIAC OUTPATIENT DEPARTMENT IN A SUPER SPECIALTY HOSPITAL

2016 ◽  
Vol 9 (5) ◽  
pp. 62
Author(s):  
Sushil Kumar Sharma ◽  
Vineeta Sawhney
Keyword(s):  
Support Services ◽  
Outpatient Department ◽  
Anxiety And Depression ◽  
Psychiatric Evaluation ◽  
Hypertensive Patients ◽  
Stress Scale ◽  
Medical College ◽  
Hypertension Awareness ◽  
Health Disorders ◽  
Anxiety Depression

ABSTRACTObjective: Hypertension is a major risk factor for cardiovascular disease and its association with negative emotions may increase their risk forthe development of mental health disorders. The main objective of the study was to assess the awareness, stress, anxiety, and depression amonghypertensive patients attending cardiac outpatient department (OPD).Methods: This study was conducted in cardiac OPD of Super Speciality Hospital associated with Government Medical College, Jammu, for a period of1-month commencing from 1st October to 31 October 2015. Hypertensive patients were given a questionnaire regarding socio-demographic profile,risk factors, and awareness for high blood pressure, and prevalence of stress, anxiety, and depression was assessed using a structured validatedquestionnaire DASS-21 [depression, anxiety, and stress scale-21].stResults: It was observed that most (72.5%) of the patients were aware of symptoms and its complications and regarding psychological symptomsmild to severe depressive symptoms were present in 10%, anxiety in 70%, and stress in 10% of patients.Conclusion: There is need of psychiatric evaluation and counseling in these patients and support services to be made available to these patients.Keywords: Hypertension, Awareness, Stress, Anxiety, Depression, Depression; anxiety and stress scale-21.

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