scholarly journals Improving acute care for adolescents and young adults on medical admission units: The interventions that matter

2016 ◽  
Vol 15 (3) ◽  
pp. 157-160
Author(s):  
CA Whicher ◽  
◽  
Rajiv Shah ◽  
H Gleeson ◽  
Louella Vaughan ◽  
...  

It had become a familiar routine. My seventh admission with diabetic ketoacidosis (DKA) in a year. Each time I was admitted it was the same; a DKA protocol, a diabetes specialist nurse visit, and a few questions from the doctors checking if “everything is okay?” On each admission, I would be discharged home after a couple of days. We all knew I’d be back again within a month or two.

2020 ◽  
Vol 17 ◽  
Author(s):  
Tetine Sentell ◽  
So Yung Choi ◽  
Lance Ching ◽  
Michelle Quensell ◽  
L. Brooke Keliikoa ◽  
...  

2021 ◽  
Author(s):  
Nicole K. Gibbings ◽  
Paul A. Kurdyak ◽  
Patricia A. Colton ◽  
Baiju R. Shah

Objective: To determine the risk of diabetic ketoacidosis (DKA) and all-cause mortality among adolescents and young adults with type 1 diabetes with and without an eating disorder. <p>Research Design and Methods: Using population-level healthcare administrative data covering the entire population of Ontario, Canada, all people with type 1 diabetes aged 10 to 39 as of January 2014 were identified. Individuals with a history of eating disorders were age/sex matched 10:1 with individuals without eating disorders. All individuals were followed for 6 years for hospitalization/emergency department visits for diabetic ketoacidosis, and for all-cause mortality.</p> <p>Results: We studied 168 people with eating disorders and 1680 age/sex-matched people without eating disorders. Among adolescents and young adults with type 1 diabetes, 168 (0.8%) had a history of eating disorders. The crude incidence of diabetic ketoacidosis was 112.5 per 1,000 patient-years in people with eating disorders, versus 30.8 in people without eating disorders. After adjustment for baseline differences, the subdistribution hazard ratio comparing people with and without eating disorders was 3.30 (95% confidence interval 2.58-4.23, p<0.0001). All-cause mortality was 16.0 per 1,000 person-years in people with eating disorders, versus 2.5 in people without eating disorders. The adjusted hazard ratio was 5.80 (95% confidence interval 3.04-11.08, p<0.0001). </p> <p>Conclusions: Adolescents and young adults with type 1 diabetes and eating disorders have more than triple the risk of diabetic ketoacidosis and nearly 6-fold increased risk of death compared to their peers without eating disorders.</p>


2021 ◽  
Author(s):  
Nicole K. Gibbings ◽  
Paul A. Kurdyak ◽  
Patricia A. Colton ◽  
Baiju R. Shah

Objective: To determine the risk of diabetic ketoacidosis (DKA) and all-cause mortality among adolescents and young adults with type 1 diabetes with and without an eating disorder. <p>Research Design and Methods: Using population-level healthcare administrative data covering the entire population of Ontario, Canada, all people with type 1 diabetes aged 10 to 39 as of January 2014 were identified. Individuals with a history of eating disorders were age/sex matched 10:1 with individuals without eating disorders. All individuals were followed for 6 years for hospitalization/emergency department visits for diabetic ketoacidosis, and for all-cause mortality.</p> <p>Results: We studied 168 people with eating disorders and 1680 age/sex-matched people without eating disorders. Among adolescents and young adults with type 1 diabetes, 168 (0.8%) had a history of eating disorders. The crude incidence of diabetic ketoacidosis was 112.5 per 1,000 patient-years in people with eating disorders, versus 30.8 in people without eating disorders. After adjustment for baseline differences, the subdistribution hazard ratio comparing people with and without eating disorders was 3.30 (95% confidence interval 2.58-4.23, p<0.0001). All-cause mortality was 16.0 per 1,000 person-years in people with eating disorders, versus 2.5 in people without eating disorders. The adjusted hazard ratio was 5.80 (95% confidence interval 3.04-11.08, p<0.0001). </p> <p>Conclusions: Adolescents and young adults with type 1 diabetes and eating disorders have more than triple the risk of diabetic ketoacidosis and nearly 6-fold increased risk of death compared to their peers without eating disorders.</p>


Author(s):  
Marc Allroggen ◽  
Peter Rehmann ◽  
Eva Schürch ◽  
Carolyn C. Morf ◽  
Michael Kölch

Abstract.Narcissism is seen as a multidimensional construct that consists of two manifestations: grandiose and vulnerable narcissism. In order to define these two manifestations, their relationship to personality factors has increasingly become of interest. However, so far no studies have considered the relationship between different phenotypes of narcissism and personality factors in adolescents. Method: In a cross-sectional study, we examine a group of adolescents (n = 98; average age 16.77 years; 23.5 % female) with regard to the relationship between Big Five personality factors and pathological narcissism using self-report instruments. This group is compared to a group of young adults (n = 38; average age 19.69 years; 25.6 % female). Results: Grandiose narcissism is primarily related to low Agreeableness and Extraversion, vulnerable narcissism to Neuroticism. We do not find differences between adolescents and young adults concerning the relationship between grandiose and vulnerable narcissism and personality traits. Discussion: Vulnerable and grandiose narcissism can be well differentiated in adolescents, and the pattern does not show substantial differences compared to young adults.


Crisis ◽  
2009 ◽  
Vol 30 (3) ◽  
pp. 115-119 ◽  
Author(s):  
Stephanie De Munck ◽  
Gwendolyn Portzky ◽  
Kees Van Heeringen

Background: Notwithstanding the epidemiological studies indicating an increased risk of attempted suicide among adolescents and young adults, there is a scarcity of international studies that examine long-term epidemiological trends in rates and characteristics of this vulnerable group. Aims: This article describes the results of a 9-year monitoring study of suicide attempts in adolescents and young adults referred to the Accident and Emergency Department of the Gent University Hospital (Belgium). Methods: Between January 1996 and December 2004, trends, sociodemographic, and methodrelated characteristics of suicide attempts were assessed by a psychiatrist on data sheets. Results: Attempted suicide rates declined from 1996 to 2001 and then rose until 2004, but did not exceed previous rates. During the 9 years of monitoring, there was a preponderance of female suicide attempters, except for 1997. Rates of attempts and of fatal suicide were negatively correlated. Significantly more males than females deliberately injured themselves. Younger attempters, especially females, significantly more often poisoned themselves with analgesics. In nearly one in five attempts, alcohol was used in combination with other methods, and alcohol intake was more commonly observed in older suicide attempters. Nearly half of the adolescents were identified as repeaters. Conclusions: The results of this study warrant further monitoring of trends and characteristics of young suicide attempters.


2017 ◽  
Vol 33 (2) ◽  
pp. 123-128 ◽  
Author(s):  
Anne van Alebeek ◽  
Paul T. van der Heijden ◽  
Christel Hessels ◽  
Melissa S.Y. Thong ◽  
Marcel van Aken

Abstract. One of the most common personality disorders among adolescents and young adults is the Borderline Personality Disorder (BPD). The objective of current study was to assess three questionnaires that can reliably screen for BPD in adolescents and young adults (N = 53): the McLean Screening Instrument for BPD (MSI-BPD; Zanarini et al., 2003 ), the Personality Diagnostic Questionnaire 4th edition – BPD scale (PDQ-4 BPD; Hyler, 1994 ), and the SCID-II Patient Questionnaire – BPD scale (SCID-II-PQ BPD). The nine criteria of BPD according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV; APA, 1994 ) were measured with the Structural Clinical Interview for DSM-IV Axis II disorders – BPD scale (SCID-II; First, Spitzer, Gibbon, Williams, & Benjamin, 1995 ). Correlations between the questionnaires and the SCID-II were calculated. In addition, the sensitivity and specificity of the questionnaires were tested. All instruments predicted the BPD diagnosis equally well.


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