Sample records for psychiatrically hospitalized children

  1. Transitioning Children from Psychiatric Hospitals to Schools: The Role of the Special Educator (United States)

    Simon, Joan B.; Savina, Elena A.


    Over a quarter of a million U.S. students each year reside for a period of time in a psychiatric inpatient hospital setting to receive mental health treatment. Following inpatient treatment, most children are transitioned from the hospital into a regular school setting. Little is known about how these transitions are managed by hospital or school…

  2. A crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome. (United States)

    Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T


    Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.

  3. Psychotropic drug effects contributing to psychiatric hospitalization of children: a preliminary study. (United States)

    Fialkov, M J; Hasley, S


    Over an 11-month period on a Children's Psychiatric Unit 5% of 60 first admissions for hospitalization were apparently associated with adverse effects of psychotropic medication. Forty (66%) of the first admissions had used, prior to hospitalization, a wide variety of drugs including stimulants, major and minor tranquilizers, anticonvulsants, antidepressants and over-the-counter drugs containing antihistamines and analgesics. It is suggested that inappropriate and injudicious use of psychotropic medications may be associated with unanticipated adverse behavioral effects, which can result in deterioration of a child's functioning to the point of necessitating psychiatric hospitalization. Early identification of these unwanted psychotropic effects has diagnostic, prognostic, economic, and legal implications.

  4. Changing patterns of psychiatric inpatient care for children and adolescents in general hospitals, 1988-1995. (United States)

    Pottick, K J; McAlpine, D D; Andelman, R B


    The authors examine patterns in utilization of psychiatric inpatient services by children and adolescents in general hospitals during 1988-1995. National Hospital Discharge Survey data were used to describe utilization patterns for children and adolescents with primary psychiatric diagnoses in general hospitals from 1988 to 1995. During the study period, there was a 36% increase in hospital discharges and a 44% decline in mean length of stay, resulting in a 23% decline in the number of bed-days, from more than 3 million to about 2.5 million. The number of nonpsychotic major depressive disorders increased significantly. Discharges from public hospitals have declined, and those from proprietary hospitals have risen. Concurrently, the role of private insurance declined and the role of Medicaid increased. During the period of study, the mean and median length of stay declined most for children and adolescents who were hospitalized in private facilities and those covered by private insurance. Across the United States, the mean length of stay declined significantly; this decline was almost 60% in the West. Discharges also declined in the West, in contrast to the Midwest and the South, where they significantly increased. Increased numbers of discharges and decreased length of stay may reflect evolving market forces and characteristics of hospitals. Further penetration by managed care into the public insurance system or modifications in existing Medicaid policy could have a profound impact on the availability of inpatient resources.

  5. Sluggish cognitive tempo is associated with suicide risk in psychiatrically hospitalized children. (United States)

    Becker, Stephen P; Withrow, Amanda R; Stoppelbein, Laura; Luebbe, Aaron M; Fite, Paula J; Greening, Leilani


    Although identified as a significant public health concern, few studies have examined correlates of suicide risk in school-aged children. Recent studies show a relation between sluggish cognitive tempo (SCT) symptoms and a range of adverse outcomes linked to suicidal ideation, including depression, emotion dysregulation, lowered self-esteem, and peer problems/social withdrawal, yet no study to date has examined SCT in relation to suicide risk. We tested the hypothesis that SCT would be associated with suicide risk in a sample of 95 psychiatrically hospitalized children (74% male; 62% black) between the ages of 8 and 12 (M = 10.01, SD = 1.50). Parents completed measures of their child's psychiatric symptoms, including SCT and depression, as well as a measure of their own psychopathology. Children completed measures assessing loneliness and depression. Both parents and children completed measures of suicide risk. White children reported greater suicide risk than nonwhite children. After controlling for demographic characteristics, loneliness, parental psychopathology, and correlated psychiatric symptoms, including both parent- and child self-reported depressive symptoms, SCT remained uniquely associated with children's suicide risk. Results were consistent across both parent and child measures of suicide risk. This multi-informant study provides strong preliminary support for an association between SCT symptoms and suicide risk in psychiatrically hospitalized children, above and beyond loneliness, depression, and demographic characteristics. Findings are discussed in the context of the interpersonal theory of suicide. Additional studies are needed to replicate and extend these findings, with a particular need for studies that examine the cognitive processes and daydreaming content of individuals displaying elevated SCT symptomatology. © 2016 Association for Child and Adolescent Mental Health.

  6. [Children's Psychiatric Hospital Dr. Juan N. Navarro: 50 years of attention to the mental health of children and adolescents in Mexico]. (United States)

    Márquez-Caraveo, Maria Elena; Arroyo-García, Eduardo; Granados-Rojas, Armida; Ángeles-Llerenas, Angélica


    The activities concerning mental health care of psychiatric disorders during more than 50 years of service (1966-2016) at the Children's Psychiatric Hospital "Dr. Juan N. Navarro" (HPI), as well as the progressive development of teaching and research, have contributed to its positioning as a leading institution in medical care of high specialization. This has been possible through the training of human resources that focus the quality of care to the children and their families. The hospital has progressed towards diagnostic and therapeutic care of outpatients through the creation of specialized clinics (emotions, behavior, development, adolescence, among others) and the development of more actualized and integral therapeutic programs (behavioral psychotherapy, cognitive behavioral, psychodynamic; individual, group, family, etc.). In the field of education, the hospital has been the most important institution in the training of child psychiatrists in Mexico and its recognition as a research interdisciplinary center has grown.


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    Full Text Available Introduction: Severe Psychiatricillness is accompanied by gross disturbances in patient's occupational role. This study presents a comparative picture of work performance before and after psychiatric hospitalization. Method: Subjects comprised 440 psychiatric admitters from Noor Medical center - Isfahan - Iran, who were followed from November 1999 to November 2000. Their work adjustment was measured by means of Weiss man's index. Data were computer analyzed using SPSS by running paired t- student and ANOVA. Results: Majority of the patients (53 % were without permanent sources of income before psychiatric hospitalization, about 12 percent of those who were working prior to hospitalization lost their job after being discharged from hospital. Better work adjustment before hospitalization was positively correlated with better work adjustment after discharge for working patients (r =0/66. Working ability of the patients after discharge was lesser than before the attack f9r patients with regular and irregular job (P < 001. Discussion: Job loss or poor working ability after psychiatric admission reported by several researchers and has bean confirmed in this study as well. These observatoins have been discussed in view of the current socio economic problems in the society and nature of psychiatric disturbances.

  8. [Long-term psychiatric hospitalizations]. (United States)

    Plancke, L; Amariei, A


    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  9. Children’s Psychiatric Hospital Dr. Juan N. Navarro: 50 years of attention to the mental health of children and adolescents in Mexico


    María Elena Márquez-Caraveo; Eduardo Arroyo-García; Armida Granados-Rojas; Angélica Ángeles-Llerenas


    The activities concerning mental health care of psychiatric disorders during more than 50 years of service (1966-2016) at the Children’s Psychiatric Hospital “Dr. Juan N. Navarro”(HPI), as well as the progressive development of teaching and research, have contributed to its positioning as a leading institution in medical care of high specialization. This has been possible through the training of human resources that focus the quality of care to the children and their families. The hospital ha...

  10. Inpatient Suicide in a Chinese Psychiatric Hospital (United States)

    Li, Jie; Ran, Mao-Sheng; Hao, Yuantao; Zhao, Zhenhuan; Guo, Yangbo; Su, Jinghua; Lu, Huixian


    Little is known about the risk factors for suicide among psychiatric inpatients in China. In this study we identified the risk factors of suicide among psychiatric inpatients at Guangzhou Psychiatric Hospital. All psychiatric inpatients who died by suicide during the 1956-2005 period were included in this study. Using a case-control design, 64…

  11. [Mentally Ill Parents in Psychiatric Hospitals]. (United States)

    Markwort, Ilka; Schmitz-Buhl, Mario; Christiansen, Hanna; Gouzoulis-Mayfrank, Euphrosyne


    Offsprings of psychiatric patients are burdened and they are at risk of developing a mental disorder themselves. All admissions in a psychiatric hospital within a period of 6 months were screened for parenthood of underaged children. They were given standardized questionnaires for child behavior (SDQ), parenting behavior and subjective need for help in parenting. 21.5 % (N = 439) of the patients had underaged children, 194 patients participated in the study. They considered their children as having more psychological/behavioral problems than a control group (N = 97). Patients with personality or affective disorders and patients with a high level of psychiatric comorbidity rated their children most problematic. Although patients did not differ from controls in the evaluation of their parenting style, they expressed a higher need for help in parenting. Parenting and education issues need to be considered in the treatment of mentally ill patients. Effective support could be a relief for families and help to prevent mental disorders in offsprings. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Prevalence of Attention Deficit Hyperactivity among Children Attending Outpatient Clinic in Psychiatric Teaching Hospital in Erbil City (United States)

    Shakir, Lana Nabeel; Sulaiman, Karwan Hawez


    Background and objectives: Attention deficit hyperactivity disorder is one of the common psychiatric disorder in childhood and it affects on children socially and academically. The aim of this study is to find out the prevalence of Attention deficit hyperactivity disorder among the studied population, describe its association with certain…

  13. Association of the World War II Finnish Evacuation of Children With Psychiatric Hospitalization in the Next Generation. (United States)

    Santavirta, Torsten; Santavirta, Nina; Gilman, Stephen E


    Although there is evidence that adverse childhood experiences are associated with worse mental health in adulthood, scarce evidence is available regarding an emerging concern that the next generation might also be affected. To compare the risk of psychiatric hospitalization in cousins whose parents were vs were not exposed to the Finnish evacuation policy that involved a mean 2-year stay with a Swedish foster family. This multigenerational, population-based cohort study of Finnish individuals and their siblings born between January 1, 1933, and December 31, 1944, analyzed the association of evacuee status as a child during World War II in the first generation with the risk of psychiatric hospitalization among offspring in the second generation. Evacuee status during World War II was determined using the Finnish National Archive's registry of participants in the Finnish evacuation. Data on evacuee status were linked to the psychiatric diagnoses in the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012, for offspring (n = 93 391) born between January 1, 1950, and December 31, 2010. Sex-specific Cox proportional hazards regression models were used to estimate hazard ratios for risk of psychiatric hospitalization during the follow-up period. Because offspring of evacuees and their nonevacuated siblings are cousins, the Cox proportional hazards regression models included fixed effects to adjust for confounding factors in families. Data analysis was performed from June 15, 2016, to August 26, 2017. Parental participation in the evacuation during World War II (coded 1 for parents who were evacuated and placed in foster care and 0 for those not evacuated). Offspring's initial admission to the hospital for a psychiatric disorder, obtained from the Finnish Hospital Discharge Register from January 1, 1971, through December 31, 2012. Of the 93 391 study persons, 45 955 (49.2%) were women and 47 436 (50.8) were men; mean (SD) age in

  14. Do attachment representations predict depression and anxiety in psychiatrically hospitalized prepubertal children? (United States)

    Goodman, Geoff; Stroh, Martha; Valdez, Adina


    Thirty-six prepubertal inpatients were videotaped completing five stories thematically related to attachment experiences and classified by their attachment representations. Children also completed the Children's Depression Inventory and Diagnostic Interview for Children and Adolescents-Revised. Mothers completed demographic questionnaires. Percentage of secure (B) attachment was only about one tenth of the normative percentage, anxious-ambivalent (C) attachment was between two and three times the normative percentage, and disorganized (D) attachment was almost twice the normative percentage. Both D attachment and the total number of disorganized story responses were associated with negative self-esteem and clinical-range depression. Anxious-avoidant (A) attachment decreased the likelihood, while C and D attachment increased the likelihood, of separation anxiety disorder. Clinical intervention needs to focus on the meaning of parental relationships represented in the child's mind, specifically the negative self-esteem and separation anxiety associated with the lack of felt security provided by the parents.

  15. Children’s Psychiatric Hospital Dr. Juan N. Navarro: 50 years of attention to the mental health of children and adolescents in Mexico

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    María Elena Márquez-Caraveo


    Full Text Available The activities concerning mental health care of psychiatric disorders during more than 50 years of service (1966-2016 at the Children’s Psychiatric Hospital “Dr. Juan N. Navarro”(HPI, as well as the progressive development of teaching and research, have contributed to its positioning as a leading institution in medical care of high specialization. This has been possible through the training of human resources that focus the quality of care to the children and their families. The hospital has progressed towards diagnostic and therapeutic care of outpatients through the creation of specialized clinics (emotions, behavior, development, adolescence, among others and the development of more actualized and integral therapeutic programs (behavioral psychotherapy, cognitive behavioral, psychodynamic; individual, group, family, etc.. In the field of education, the hospital has been the most important institution in the training of child psychiatrists in Mexico and its recognition as a research interdisciplinary center has grown.

  16. The effect of menstruation on psychiatric hospitalization. (United States)

    Weston, Jaclyn; Speroni, Karen Gabel; Ellis, Terri; Daniel, Marlon G


    This study evaluated the effect of menstruation on psychiatric hospitalization. We conducted a retrospective chart review of the medical records of 177 women who met the eligibility criteria. Data collected included demographic details, primary and secondary diagnoses, date of last menstrual period (LMP), medication adherence, psychiatric hospitalization length of stay, previous psychiatric admissions (including those related to menstruation), discharge referrals, and readmissions. The majority of women were admitted for major depression, were single, Caucasian, and had a mean age of 34. A disproportionate percentage (37%) of women had their LMP within 5 days of psychiatric hospitalization (p = 0.0006). The overall average length of stay was 4.37 days, and 48.3% had a previous psychiatric admission. Medication adherence was routinely not documented (77.4%). Psychiatric hospitalizations for women are significantly greater within 5 days of their LMP. Nursing education and improved documentation are warranted to decrease the potential for readmission. Copyright 2012, SLACK Incorporated.

  17. Psychiatric referrals in two general hospitals.

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    Doongaji D


    Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.

  18. Use of the Suicide Status Form-II to investigate correlates of suicide risk factors in psychiatrically hospitalized children and adolescents. (United States)

    Romanowicz, Magdalena; O'Connor, Stephen S; Schak, Kathryn M; Swintak, Cosima C; Lineberry, Timothy W


    Suicide is the third leading cause of death in the United States for youth 12-17 years or age. Acute psychiatric hospitalization represents a clear worst point clinically and acute suicide risk is the most common reason for psychiatric admission. We sought to determine factors associated with differences in individual suicide risk assessment for children and adolescents during acute psychiatric admission. Study participants were 1153 youth consecutively admitted to an inpatient psychiatry unit who completed a self-administered Suicide Status Form (SSF) within 24h of admission. Additional information on suicide risk factors was obtained through medical chart abstraction. Females reported significantly greater psychological pain, stress, hopelessness, and self-hate on the SSF and were significantly more likely to have made a suicide attempt just prior to the index hospital admission (OR=1.59, SE=0.29; CI=1.12-2.26), report a family history of suicide (OR=2.02, SE=0.33; CI=1.47-2.78), and had experienced a greater number of inpatient psychiatry admissions related to suicidal ideation (RR=1.33, SE=0.13; CI=1.10-1.61). High school aged youth and those with a primary diagnosis of depression displayed consistently elevated SSF scores and risk factors for suicide compared to comparison groups. Diagnosis was determined through chart abstraction. Responses to access to firearm question had missing data for 46% of the total sample. Systematic administration of a suicide-specific measure at admission may help clinicians improve identification of suicide risk factors in youth in inpatient psychiatry settings. © 2013 Elsevier B.V. All rights reserved.

  19. The medication process in a psychiatric hospital

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    Soerensen, Ann Lykkegaard; Lisby, Marianne; Nielsen, Lars Peter


    Purpose: To investigate the frequency, type, and potential severity of errors in several stages of the medication process in an inpatient psychiatric setting. Methods: A cross-sectional study using three methods for detecting errors: (1) direct observation; (2) unannounced control visits in the w......Purpose: To investigate the frequency, type, and potential severity of errors in several stages of the medication process in an inpatient psychiatric setting. Methods: A cross-sectional study using three methods for detecting errors: (1) direct observation; (2) unannounced control visits...... in the wards collecting dispensed drugs; and (3) chart reviews. All errors, except errors in discharge summaries, were assessed for potential consequences by two clinical pharmacologists. Setting: Three psychiatric wards with adult patients at Aalborg University Hospital, Denmark, from January 2010–April 2010...... process are common in psychiatric wards to an extent which resembles error rates in somatic care. Despite a substantial proportion of errors with potential to harm patients, very few errors were considered potentially fatal. Medical staff needs greater awareness of medication safety and guidelines related...

  20. 42 CFR 424.13 - Requirements for inpatient services of hospitals other than psychiatric hospitals. (United States)


    ... other than psychiatric hospitals. 424.13 Section 424.13 Public Health CENTERS FOR MEDICARE & MEDICAID... other than psychiatric hospitals. (a) Content of certification and recertification. Medicare Part A pays for inpatient hospital services of hospitals other than psychiatric hospitals only if a physician...

  1. Sleep Problems and Their Relationship to Maladaptive Behavior Severity in Psychiatrically Hospitalized Children with Autism Spectrum Disorder (ASD). (United States)

    Sannar, Elise M; Palka, Tamara; Beresford, Carol; Peura, Christine; Kaplan, Desmond; Verdi, Mary; Siegel, Matthew; Kaplan, Shir; Grados, Marco


    We examined the relationship between sleep duration and awakenings to Aberrant Behavior Checklist-Community (ABC-C) and Autism Diagnostic Observation Schedule (ADOS-2) scores in hospitalized youth with ASD and behavioral disturbance. Participants included 106 patients with a stay of at least 10 nights. Sleep in the hospital was recorded by staff observation. Higher scores on the ABC-C (irritability, stereotypy, and hyperactivity subscales) at admission were significantly associated with fewer minutes slept during the last five nights of hospitalization. There was no association between total awakenings and ABC-C scores or ADOS-2 comparison scores. Improved understanding of the relationship between sleep quality and maladaptive behavior in this challenging cohort of patients with ASD is vital to the definition and design of future effective interventions.

  2. Physician recruitment in Ontario Provincial Psychiatric Hospitals. (United States)

    Draper, R; Galbraith, D; Frost, B


    Recruitment of Physicians/Psychiatrists to staff the Ontario Provincial Psychiatric Hospitals remains an ongoing problem despite the introduction of measures such as University Affiliation and Incentive Grants. Historically there has been heavy reliance upon Foreign Medical Graduates (GOFM's) who have been denied the possibility of professional mobility and advancement because of restrictive licences. Recent changes in regulations have severely restricted the recruitment of GOFM's. During 1987, details of all physicians employed in the provincial hospitals during the preceeding five years were entered into a computerized data base. This paper presents some initial analyses which indicate that Canadian graduates have provided low levels of service, especially outside major urban centres, quite insufficient to replace the GOFM's. These findings raise urgent social and professional concerns.

  3. Psychiatric units in Brazilian general hospitals: a growing philanthropic field. (United States)

    Botega, Neury José


    Some countries, mainly in North America and Europe, have adopted psychiatric wards in the general hospital as an alternative to the classic psychiatric hospital. In Brazil there are 6,169 general hospitals, 1.3% of which with a psychiatric unit. This service strategy is scarcely developed in the country and comprises only 4% of all psychiatric admissions. There was no information on the facilities and functioning of the psychiatric units in general hospitals. To determine the main characteristics of psychiatric units in Brazilian general hospitals and to assess the current trends in the services provided. A mailing survey assessed all 94 Brazilian general hospitals which made psychiatric admissions. A two-page questionnaire was designed to determine the main characteristics of each institution and of the psychiatric unit. Seventy-nine (84%) questionnaires were returned. In contrast to the 1970s and 1980s, in the last decade the installation of psychiatric units has spread to smaller philanthropic institutions that are not linked to medical schools. A fifth of hospitals admit psychiatric patients to medical wards because there is no specialist psychiatric ward. They try to meet all the local emergency demands, usually alcohol-dependent patients who need short term admission. This could signal the beginning of a program through which mental health professionals may become an integral part of general health services. The inauguration of psychiatric wards in philanthropic hospitals, as well as the admission of psychiatric patients in their medical wards, is a phenomenon peculiar to this decade. The installation of psychiatric services in these and other general hospitals would overcome two of major difficulties encountered: prejudice and a lack of financial resources.

  4. Elements of Successful School Reentry after Psychiatric Hospitalization (United States)

    Clemens, Elysia V.; Welfare, Laura E.; Williams, Amy M.


    Psychiatric hospitalization is an intensive intervention designed to stabilize adolescents who are experiencing an acute mental health crisis. Reintegrating to school after discharge from psychiatric hospitalization can be overwhelming for many adolescents (E. V. Clemens, L. E. Welfare, & A. M. Williams, 2010). The authors used a consensual…

  5. Neuropathological research at the "Deutsche Forschungsanstalt fuer Psychiatrie" (German Institute for Psychiatric Research) in Munich (Kaiser-Wilhelm-Institute). Scientific utilization of children's organs from the "Kinderfachabteilungen" (Children's Special Departments) at Bavarian State Hospitals. (United States)

    Steger, Florian


    During National Socialism, the politically motivated interest in psychiatric genetic research lead to the founding of research departments specialized in pathological-anatomical brain research, the two Kaiser Wilhelm-Institutes (KWI) in Berlin and Munich. The latter was indirectly provided with brain material by Bavarian State Hospitals, to three of which "Kinderfachabteilungen" (Special Pediatric Units) were affiliated. As children became victims of the systematically conducted child "euthanasia" in these Special Pediatric Units, this paper will address the question whether and to which extent the organs from victims of child "euthanasia" were used for (neuro-) pathological research at the KWI in Munich. By means of case studies and medical histories (with focus on the situation in Kaufbeuren-Irsee), I will argue that pediatric departments on a regular base delivered slide preparations, that the child "euthanasia" conduced in these departments systematically contributed to neuropathological research and that slide preparations from victims of child "euthanasia" were used in scientific publications after 1945.

  6. [Nurturance of children during inpatient psychiatric treatment of their parents]. (United States)

    Kölch, Michael; Schmid, Marc


    About a third of all inpatients in psychiatric hospitals are parents of children aged below 18 years. The mental illness of a parent and especially the need of inpatient treatment burdens families. This study was contributed to assess parental stress, behavioural and emotional problems of the children and the needs of psychiatric inpatients for support. Barriers and hindrances as well as positive experience with support for their children were assessed. All psychiatric hospitals in a county with about 1.5 million inhabitants in South-West Germany participated in this study. From 643 inpatients after drop-out 83 (54 female, 29 male) patients with non full aged children were questioned with inventories as the SDQ, the PSS and further assessments. Diagnoses and biographic data were assessed by the documentation of the German Association of psychiatry and psychotherapy. Parents reported about an increased level of stress by parenthood (PSS mean 41.9, SD 9.4). Psychopathology of the children influenced the stress of the mentally ill parents. 40% of the patients are dissatisfied with the care of their children during their inpatient treatment, but 51% have strong resentments against the youth welfare custodies and do not ask for support. Our results prove the high negative attitude of mentally ill parents against youth welfare service which must be reduced by active information policy and offers in collaboration with the treating psychiatrist of the parents.

  7. The dignity of the child in a psychiatric hospital

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    Błażej Kmieciak


    Full Text Available The right to respect the dignity of children using medical services in psychiatric units is regulated among other by the Patients’ Rights act and the Patients’ Rights Ombudsman act, Physician and Dentist Professions Act and the Medical Ethics Code. Although since 1994 the Mental Health Protection Act has existed, some information appears about the violation of the dignity of the child in psychiatric hospitals. Material and methods: Analysis of the information obtained from different sources (the media, the Internet, from patients and/or their legal guardians, peror Psychiatric Hospital Patients’ Ombudsman allowed to draw up a list of repeated situations in psychiatric units for children and adolescents where the dignity of the juvenile/minor patient may be violated. Results: The most frequently reported issues are: reduction of the minor/juvenile patients’ access to “privileges” (such as direct contacts with colleagues, lack of privacy (such as controls in toilets and bathrooms, irregularities during the use of direct coercion, lack of regular access to a mobile phone, the Internet, stereo equipment, lack of juvenile/minor patients’ consent for treatment (including the double permission, engaging the patients to cleaning work, and medical staff’s interventions of educational and corrective character (the patients perceive this as the use of penalties. Discussion: It was found out that the reaction of a minor/juvenile psychiatric unit patient or her/his carers to the detachment from her/his surroundings, favourite activities or things, and educational interventions are related to precise determination of diagnostic and therapeutic procedures and rules prevalent in the group, privileges, consequences, and application of behavioural effects in the form of negative reinforcements (so-called penalties and positive reinforcements (rewards. A strong response to infringement of the rules may be perceived by the patients as a violation of

  8. Improving Psychiatric Hospital Care for Pediatric Patients with Autism Spectrum Disorders and Intellectual Disabilities

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    Robin L. Gabriels


    Full Text Available Pediatric patients with autism spectrum disorders (ASD and/or intellectual disabilities (ID are at greater risk for psychiatric hospitalization compared to children with other disorders. However, general psychiatric hospital environments are not adapted for the unique learning styles, needs, and abilities of this population, and there are few specialized hospital-based psychiatric care programs in the United States. This paper compares patient outcomes from a specialized psychiatric hospital program developed for pediatric patients with an ASD and/or ID to prior outcomes of this patient population in a general psychiatric program at a children’s hospital. Record review data indicate improved outcomes for patients in the specialized program of reduced recidivism rates (12% versus 33% and decreased average lengths of inpatient stay (as short as 26 days versus 45 days. Available data from a subset of patients (=43 in the specialized program showed a decrease in irritability and hyperactivity behaviors from admission to discharge and that 35 previously undetected ASD diagnoses were made. Results from this preliminary study support specialized psychiatric care practices with this population to positively impact their health care outcomes.

  9. Superficial mycoses among psychiatric patients in Mathari hospital ...

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    Terbinafin was the most effective antifungal while ketoconazole was the least effective. Conclusion: All patients admitted at Mathari hospital should be screened for fungal infection and treated. Terbinafin can be used as first line treatment of dermatomycosis after screening all psychiatric patients in Mathari Mental hospital.

  10. [Philanthropic general hospitals: a new setting for psychiatric admissions]. (United States)

    Larrobla, Cristina; Botega, Neury José


    To understand the process that led Brazilian philanthropic general hospitals to implement psychiatric units and to describe the main characteristics and therapeutic approaches of these services. Ten institutions in three Brazilian states (Minas Gerais, São Paulo e Santa Catarina) were assessed in 2002. Forty-three semi-structured interviews were carried out with health professionals who worked at the hospitals to collect data on service implementation process, therapeutic approaches and current situation. The interviews were audio-recorded and their content was analyzed. There was no mental hospital in the cities where the institutions were located. In five hospitals, psychiatric patients were admitted to general medical wards because there was no psychiatric unit. The therapeutic approach in six hospitals was based on psychopharmacological treatment. Due to lack of resources and more appropriate therapeutic planning, the admission of patients presenting psychomotor agitation increases resistance against psychiatric patients in general hospitals. Financial constraints regarding laboratory testing is still a challenge. There is no exchange between local authorities and hospital administrators of these institutions that are compelled to exceed the allowed number of admissions to meet the demand of neighboring cities. The need for mental health care to local populations combined with individual requests of local authorities and psychiatrists made possible the implementation of psychiatric units in these localities. In spite of the efforts and flexibility of health professional working in these institutions, there are some obstacles to be overcome: resistance of hospital community against psychiatric admissions, financial constraints, limited professional training in mental health and the lack of a therapeutic approach that goes beyond psychopharmacological treatment alone.

  11. Improving the smoking patterns in a general hospital psychiatric unit

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    Celso Iglesias García


    Full Text Available Objectives: The purpose of the present paper is to evaluate the effects of a smoking ban in a general hospital psychiatric unit. Methods: We study the effects of smoking ban in 40 consecutive psychiatric inpatients. The staff registered socio-demographic and tobacco-related variables. We also registered any kind of behavioral effects of smoking ban.Results: The patients were willing to stop smoking during their hospital stay (with or without nicotine replacement with two mild behavioural incidences registered throughout the study. Conclusions: The benefits of non-smoking policy in a psychiatric unit can be significant. The introduction of smoking bans in psychiatric inpatients settings is possible and safe.

  12. 42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals. (United States)


    ... requirements for psychiatric hospitals. 482.62 Section 482.62 Public Health CENTERS FOR MEDICARE & MEDICAID... staff requirements for psychiatric hospitals. The hospital must have adequate numbers of qualified...) Standard: Director of inpatient psychiatric services; medical staff. Inpatient psychiatric services must be...


    Directory of Open Access Journals (Sweden)

    Robsmeire Calvo Melo Zurita


    Full Text Available The psychiatric emergency is used to treat people with mental disordersworking 24 hours followed the new model of mental health care recommended by theMinistry of Health, creating care options, with a focus centered on reintegration of the patientto their social and family. The study aimed to characterize the hospitalizations of patients inthe Psychiatric Emergency Municipal Hospital of Maringa in the period January 2009 to June2010. Were selected and included a total of 1548 hospitalizations, behavioral disorder due toalcohol use. Predominance in male admissions with 88.6%, the predominant age group inboth sexes was 41-51 years with 59.75%, with the majority of hospitalizations of patientsliving in Maringá. Referred to the Psychiatric Hospital were46.18% of hospitalizations,diagnosed mostly in mental and behavioral disorders due to alcohol use,CID-10 F10, with720 (46.51% of admissions. The legal framework of the Psychiatric Reform, ratified,guaranteeing the universal right to access and assistance as well as to its completeness;decentralization of the service model, configuring networks care more attentive toinequalities, setting fair and democratic way of their actions to needs of the population

  14. Job satisfaction of nurses who work in private psychiatric hospitals. (United States)

    Aronson, Keith R


    This study assessed the job satisfaction of nurses who work in private psychiatric hospitals. In 1998 and 1999 an anonymous employee satisfaction survey was completed by all 3,024 employees of 39 for-profit psychiatric hospitals owned by the same hospital corporation. Of this total, 546 were registered nurses (RNs). Generally RNs reported fair levels of satisfaction. They reported high levels of pride in their hospitals but low levels of satisfaction with the parent company. Differences in satisfaction were noted as a function of work shift, supervisory role, work setting, and tenure. RNs were less satisfied than employees in all other hospital job classifications. RNs' low level of satisfaction relative to other positions is concerning.

  15. A period prevalence study of being a parent in a secure psychiatric hospital and a description of the parents, the children and the impact of admission on parent-child contact. (United States)

    Argent, Sarah Elizabeth; Riddleston, Laura; Warr, Jodie; Tippetts, Hannah; Meredith, Zoe; Taylor, Pamela Jane


    Most secure psychiatric hospital patients are of childbearing age, but their parental status is minimally researched. The aim of the study is to describe the parent patients in one regional secure hospital and explore post-admission child-parent contact. A 9-year records survey of a complete secure hospital admissions cohort was conducted. Nearly half of the cohort of 165 patients (46%) were parents. Parent patients were less likely than childless patients to have diagnostic co-morbidity or to have received childhood mental health care but were more likely to have committed a homicide/life-threatening index offence with family or friend victims. Men, whether fathers or not, and childless women were unlikely ever to have harmed a child, but it was more likely than not that mother patients had. Records indicated minimal discussion about childlessness. Ninety-four (60%) of the 157 children involved were under 18 years on parental admission. Adult children who had been living with the parent patient before the parent's admission invariably maintained contact with them afterwards, but nearly half (48%) of such under 18-year-olds lost all contact. The only characteristic related to such loss was the index offence victim having been a nuclear family member. As the discrepancy in whether or not parent patients and their children continued contact with each other after the parent's admission seemed to depend mainly on the child's age and his or her resultant freedom to choose, acquisition of accurate data about affected children's perspective on visiting seems essential. Given that parent patients had experienced relative stability in interpersonal relationships and had rarely had childhood disorders, parenting support in conjunction with treatment seems appropriate. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  16. [Brief psychiatric hospitalization: a possible way, a strategy to evolve?]. (United States)

    Goullieux, E; Loas, G


    The process of disinstitutionalization combined with the economic reality is responsible for the great upheaval in taking care of psychiatric patients. The repercussions are worldwide, national, and local concerning the Philippe Pinel Psychiatric Hospital (Amiens, Somme) place of this work. So the psychiatrists of this institution have to do with the following datas: a reduction of the admissions between 1991 et 1998 (around 1,5%) and a provided reduction of the hospitalization capacities upper to 40% for the following two years! Then the connection with these two figures requires the development of new therapeutic strategies, with the existing means. In this peculiar context, a study has been carried on over 2 years: 49 psychiatric patients who benefited from a brief hospitalization (less than 48 hours) have been followed up. The interest proceeds from the high frequency of the type of clinical situation which concerns 12,5% of the admissions in the studied psychiatric department. In the same time, a pilot group of 49 patients has been drawn lots among all the admissions during the same time: patients who benefited from a more traditional hospitalization (about twelve days), with strictly a same psychiatric diagnosis as in the first group, using the ICD 10 classification. The emphasis was focussed on the patient's psychiatric curing process into the 2 groups; we have compared the item rehospitalizations in a psychiatric hospital (through the number of rehospitalization, the number of days of rehospitalization, and the necessity - or not - of a rehospitalization) with the object of estimating the benefit, the inefficiency, or even the negligence of proposing a brief hospitalization. We have also studied socio-environmental datas, antecedents and effective psychiatric follow-up into the two groups. Concerning the diagnosis, mental disorders related to alcohol abuse (F10) are the most frequent (49%) into the group brief hospitalization , which diverges from the usual

  17. 42 CFR 482.60 - Special provisions applying to psychiatric hospitals. (United States)


    ... 42 Public Health 5 2010-10-01 2010-10-01 false Special provisions applying to psychiatric... HOSPITALS Requirements for Specialty Hospitals § 482.60 Special provisions applying to psychiatric hospitals. Psychiatric hospital must— (a) Be primarily engaged in providing, by or under the supervision of a doctor of...

  18. Psychiatric Effects of Military Deployment on Children and Families (United States)

    James, Trenton


    Deployments in the United States military have increased greatly in the past 10 years. Families and children are psychiatrically affected by these deployments, and recent studies are clarifying these effects. This article focuses on the psychiatric effects of deployment on children and uses a composite case example to review the use of play therapy to treat children who are having psychiatric issues related to the deployment of one or both parents. PMID:22468239

  19. The association of cannabis use on inpatient psychiatric hospital outcomes. (United States)

    Rylander, Melanie; Winston, Helena R; Medlin, Haley; Hull, Madelyne; Nussbaum, Abraham


    The associations between cannabis use and psychosis are well documented in numerous studies. There is a need to evaluate the impact of cannabis use on inpatient psychiatric utilization and outcomes. To evaluate the impact of cannabis use on psychiatric hospital outcomes. This study was conducted between April 20, 2015 and October 20, 2015. All patients (n = 120) admitted to Denver Health with psychotic symptoms were administered a urine toxicology screening testing for the presence of 11-nor-9-carboxy-Δ 9 -tetrahydrocannabinol (THC-COOH, the active metabolite of cannabis). Patients with positive tests were compared to those with negative tests on several measures, including length of stay, presence or lack of 30-day readmission, Brief Psychotic Rating Scale (BPRS) score, and use of antipsychotics and/or sedatives/anxiolytics. There were 120 patients. Twenty nine were women and 91 were men. Patients testing positive for THC-COOH had a shorter length of stay compared to patients testing negative for THC-COOH, after adjusting for age, prior psychiatric admissions, history of a psychotic-spectrum disorder, and comorbid additional substance use (p = 0.02). There were no differences in 30-day readmissions, 30-day post-discharge presentation to the Denver Health psychiatric emergency department, BPRS scores, and medication administration. Patients presenting with psychotic symptoms and cannabis use require shorter inpatient psychiatric hospitalizations. This study is the first to quantify this observation and highlights the need for future clinical decision-making tools that would ideally correlate cannabis use with the degree of potential need for expensive and scarce mental health resources, such as psychiatric hospitalization.

  20. Correlation between Anger and Job Motivation among Psychiatric Nurses in Kashan Psychiatric Hospital

    Directory of Open Access Journals (Sweden)

    Kouchaki E.


    Full Text Available Abstract Aims: In general, nurses who work in department of psychiatric are in fact interacting with emotional disorders of patients once providing their care services. higher levels of job motivation and satisfaction can markedly foster service improvement. The aim of this study was to evaluate the correlation between anger and job motivation in nurses of a psychiatric hospital. Instrument & Methods: In this cross-sectional descriptive research in 2014, all 50 psychiatry nurses working at Kargarnejad Hospital of Kashan City, Iran, were entirely studied. A demographical questionnaire, the Anger Multiple Scale and the Job Motivation Scale were used for data gathering. Data were analyzed by SPSS 19 software using Pearson correlation coefficient. Findings: The mean score of anger was 3.01±0.36 and of job motivation was 1.70±0.86. There was a significant relationship between job motivation and the number of family members and conditions of employment of nurses (p=0.001. There was a significant inverse relationship between scores of anger and job motivation of psychiatry nurses of the hospital (r=-0.712; p=0.001. Conclusion: There is a relationship between anger and job motivation in nurses of Kashan Psychiatric hospital.

  1. Violence, Burnout and Minor Psychiatric Disorders in Hospital Work

    Directory of Open Access Journals (Sweden)

    Daiane Dal Pai

    Full Text Available OBJECTIVE Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. METHODS Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. RESULTS Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001, among nursing auxiliaries/technicians (p=0.014 and was associated with minor psychiatric disorders (p<0.05, as exposure to different forms of violence increased the chances of these disorders by 60% (CI 95%: 1.2-2.1. The three Burnout dimensions were also associated to violence at work (p<0.05. CONCLUSION Health workers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders.

  2. Violence, Burnout and Minor Psychiatric Disorders in Hospital Work

    Directory of Open Access Journals (Sweden)

    Daiane Dal Pai


    Full Text Available OBJECTIVE Identifying the violence suffered by the health team workers and their association with Burnout and minor psychiatric disorders. METHODS Cross-sectional study with 269 health team professionals of a public hospital in southern Brazil. Data were collected through the use of the Survey Questionnaire: Workplace Violence in the Health Sector, Maslach Inventory Burnout and Self-Report Questionnaire. RESULTS Workplace violence struck 63.2% of workers, prevailing mostly in women (p = 0.001, among nursing auxiliaries/technicians (p=0.014 and was associated with minor psychiatric disorders (p<0.05, as exposure to different forms of violence increased the chances of these disorders by 60% (CI 95%: 1.2-2.1. The three Burnout dimensions were also associated to violence at work (p<0.05. CONCLUSION Health workers experience violence in the workplace and this exposure is associated with Burnout symptoms and minor psychiatric disorders.

  3. Admission of people with dementia to psychiatric hospitals in Japan: factors that can shorten their hospitalizations. (United States)

    Morikawa, Takako; Maeda, Kiyoshi; Osaki, Tohmi; Kajita, Hiroyuki; Yotsumoto, Kayano; Kawamata, Toshio


    People exhibiting serious behavioural and psychological symptoms of dementia are usually voluntarily or involuntarily committed to psychiatric hospitals for treatment. In Japan, the average hospital stay for individuals with dementia is about 2 years. Ideally, individuals should be discharged once their symptoms have subsided. However, we see cases in Japan where individuals remain institutionalized long after behavioural and psychological symptoms of dementia are no longer apparent. This study will attempt to identify factors contributing to shorter stays in psychiatric hospitals for dementia patients. Questionnaires consisting of 17 items were mailed to 121 psychiatric hospitals with dementia treatment wards in western Japan. Out of 121 hospitals that received the questionnaires, 45 hospitals returned them. The total number of new patient admissions at all 45 hospitals during the month of August 2014 was 1428, including 384 dementia patients (26.9%). The average length of stay in the dementia wards in August 2014 was 482.7 days. Our findings revealed that the rate of discharge after 2 months was 35.4% for the dementia wards. In addition, we found that the average stay in hospitals charging or planning to charge the rehabilitation fee to dementia patients was significantly shorter than in hospitals not charging the rehabilitation fee. In Japan, dementia patients account for over 25% of new admissions to psychiatric hospitals with dementia wards. The average length of stay in a psychiatric hospital dementia ward is more than 1 year. A discharge after fewer than 2 months is exceedingly rare for those in a dementia ward compared with dementia patients in other wards. If institutions focus on rehabilitation, it may be possible to shorten the stay of dementia patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

  4. Psychiatric Symptoms in Children with Gross Motor Problems (United States)

    Emck, Claudia; Bosscher, Ruud J.; van Wieringen, Piet C. W.; Doreleijers, Theo; Beek, Peter J.


    Children with psychiatric disorders often demonstrate gross motor problems. This study investigates if the reverse also holds true by assessing psychiatric symptoms present in children with gross motor problems. Emotional, behavioral, and autism spectrum disorders (ASD), as well as psychosocial problems, were assessed in a sample of 40 children…

  5. Psychiatric morbidity in school children who suffered a stampede

    Directory of Open Access Journals (Sweden)

    Manjeet S Bhatia


    Full Text Available Background: Stampede is described as a sudden movement of a mass of people in response to a particular circumstance or stimulus. Human stampedes are quite often reported from crowded places like places of worship, sporting events, political rallies, etc. There are reports of development of posttraumatic stress disorder, depressive and anxiety symptoms in children and adolescents subsequent to both natural and man-made disasters. The present tragedy struck in a Government Secondary School in Delhi on September 9, 2009. The study describes the long-term psychiatric morbidity in children following stampede. Materials and Methods: The study was conducted by the department of psychiatry of a tertiary care hospital. A total of 38 children (all adolescent girls were registered at the casualty of the hospital and 1 absconded, 5 were brought dead. A total of 32 children were included in the study. After first assessment in the casualty, subsequent assessments at 8 weeks and 6 months were done using semi-structured performa, GHQ and Child′s reaction to traumatic event scale (CRTES-Revised. Data was analyzed using SPSS version 17. Results: The age-group of the children were 12-20 years(mean 14.3, all girls, studying in grades - VII to X Eight weeks follow up GHQ score was high in 27 (87%. On CRTESQ-R scale, 22 children were in high distress group (71%. Twenty-two children had symptoms of PTSD and five were in moderate distress group. Eleven children also had a comorbid diagnosis of depressive disorder, six had phobic disorder and generalized anxiety disorder. There were statistically significant differences in mean GHQ scores at baseline and at 6 months follow up. There was also significant decrease in CRTESQ-R scale scores between baseline and 6 months. Conclusion: The children who were victims of stampede warrant the need for long-term intervention.

  6. Medical Student Education in State Psychiatric Hospitals: A Survey of US State Hospitals. (United States)

    Nurenberg, Jeffry R; Schleifer, Steven J; Kennedy, Cheryl; Walker, Mary O; Mayerhoff, David


    State hospitals may be underutilized in medical education. US state psychiatric hospitals were surveyed on current and potential psychiatry medical student education. A 10-item questionnaire, with multiple response formats, was sent to identified hospitals in late 2012. Ninety-seven of 221 hospitals contacted responded. Fifty-three (55%) reported current medical student education programs, including 27 clinical clerkship rotations. Education and training in other disciplines was prevalent in hospitals both with and without medical students. The large majority of responders expressed enthusiasm about medical education. The most frequent reported barrier to new programs was geographic distance from the school. Limited resources were limiting factors for hospitals with and without current programs. Only a minority of US state hospitals may be involved in medical student education. While barriers such as geographic distance may be difficult to overcome, responses suggest opportunities for expanding medical education in the state psychiatric hospitals.

  7. [Psychiatric disorders and neurological comorbidity in children with intellectual disability]. (United States)

    Wriedt, Elke; Wiberg, Anja; Sakar, Vehbi; Noterdaeme, Michele


    This article gives an overview of the consultant child and adolescent psychiatric services in the region of Upper Bavaria (Germany). The data of 257 children and adolescents with intellectual disability and psychiatric disorders were evaluated. About 14% of the children with ID in special schools or day care centers, and 40% of the children with ID in residential care showed a definite psychiatric disorder. The most frequently diagnosed disorders were adjustment disorders, hyperkinetic disorders and conduct disorders, as well as emotional problems and pervasive developmental disorders. Children with severe intellectual disability had more additional somatic disorders and were more impaired in their psychosocial functions. The results show the need for psychiatric services for children and adolescents with intellectual disability and psychiatric disorders. The development and implementation of integrative and interdisciplinary models is necessary to allow for adequate medical care for these patients.

  8. Association of Electroconvulsive Therapy With Psychiatric Readmissions in US Hospitals. (United States)

    Slade, Eric P; Jahn, Danielle R; Regenold, William T; Case, Brady G


    Although electroconvulsive therapy (ECT) is considered the most efficacious treatment available for individuals with severe affective disorders, ECT's availability is limited and declining, suggesting that information about the population-level effects of ECT is needed. To examine whether inpatient treatment with ECT is associated with a reduction in 30-day psychiatric readmission risk in a large, multistate sample of inpatients with severe affective disorders. A quasi-experimental instrumental variables probit model of the association correlation of ECT administration with patient risk of 30-day readmission was estimated using observational, longitudinal data on hospital inpatient discharges from US general hospitals in 9 states. From a population-based sample of 490 252 psychiatric inpatients, a sample was drawn that consisted of 162 691 individuals with a principal diagnosis of major depressive disorder (MDD), bipolar disorder, or schizoaffective disorder. The key instrumental variable used in the analysis was ECT prevalence in the prior calendar year at the treating hospital. To examine whether ECT's association with readmissions was heterogeneous across population subgroups, analyses included interactions of ECT with age group, sex, race/ethnicity, and diagnosis group. The study was conducted from August 27, 2015, to March 7, 2017. Readmission within 30 days of being discharged. Overall, 2486 of the 162 691 inpatients (1.5%) underwent ECT during their index admission. Compared with other inpatients, those who received ECT were older (mean [SD], 56.8 [16.5] vs 45.9 [16.5] years; P Electroconvulsive therapy may be associated with reduced short-term psychiatric inpatient readmissions among psychiatric inpatients with severe affective disorders. This potential population health effect may be overlooked in US hospitals' current decision making regarding the availability of ECT.

  9. [Who is rehospitalized in a psychiatric hospital? Psychiatric hospitalization rates and social indicators in the Zurich canton (Switzerland)]. (United States)

    Rüesch, P; Meyer, P C; Hell, D


    There are two approaches in the research on the relation between social conditions and mental disorder: The ecological approach is concerned with characteristics of the social composition of a certain geographical area and their relation to the frequency of disorders, whereas for the individualistic view variables of the psychosocial background of the individual are of interest. This study is on the risk for psychiatric admission (first and re-admission). While considering variables of the social context of the community as well as of the background of the individual, it tries to take into account both the ecological and the individualistic view of the relationship between social conditions and (treated) mental disorder. The sample of the study includes data of 4021 psychiatric inpatients treated in 1997 in one of the seven psychiatric hospitals of the Swiss canton of Zurich as well as data of social context of the 171 communities of the canton of Zurich. The psychiatric first and re-admission rates of the community can be predicted by the following variables of its social context: 1. pro portion of foreigners, 2. urban character of the living area, 3. population density. Two other variables are of relevance only for the prediction of first admissions: 4. proportion of one-person households and 5. local tax rate. However, further results of the study show that correlations between variables of the social context and psychiatric admission rate of the community cannot be interpreted as risks for the individual.

  10. Refugee children have fewer contacts to psychiatric healthcare services

    DEFF Research Database (Denmark)

    Barghadouch, Amina; Kristiansen, Maria; Jervelund, Signe Smith


    and psychiatrists in private practice. Results: Between 1 January 1996 and 30 June 2012, 3.5 % of the refugee children accessed psychiatric healthcare services compared to 7.7 % of the Danish-born children. The rate ratio of having any first-time psychiatric contact was 0.42 (95 % CI 0.40–0.45) among refugee boys...... and 0.35 (95 % CI 0.33–0.37) among refugee girls, compared to Danish-born children. Figures were similar for those accessing private psychologists or psychiatrists, emergency room, inpatient and outpatient services. Conclusions: Refugee children used fewer psychiatric healthcare services than Danish...

  11. [Hospital legislation in the Federal Republic of Germany and its effects on psychiatric hospitals (author's transl)]. (United States)

    Zumpe, V


    The article discusses the hospital laws of several land governments enacted subsequent to the hospital financing law of the Federal Government, in respect of the influence exercised by these laws on the internal structure of the hospital. The fact that the laws apply to all kinds of hospitals, and hence also to big psychiatric hospitals, is considered a disadvantage for psychiatric care. Such care is obviously hampered, on the one hand, by the legislative demand for departmentalization of the individual fields according to specialist subjects, representing a setup which is opposed to the realization of patient care in accordance with the requirements of the communities and citizens who expect to be cared for on an individual and not on a schematic basis, whereas, on the other hand, the new structures of management stipulated by the law do not provide for the inclusion of representatives of the new groups of professions now engaged in psychiatric activities. The model of regrouping the hospital structure into sectors instead of medical specialist departments, is presented and contrasted with the proposed model. It is recommended to arrange for representation of the non-medical and non-nursing professions in the managing boards, as well as to take into account the sociotherapeutico-rehabilitative interests as forming part of the conceptual approach to care in psychiatric hospitals, via special hospital committees.

  12. Psychiatric disorders in children attending a Nigerian primary care unit: functional impairment and risk factors

    Directory of Open Access Journals (Sweden)

    Tunde-Ayinmode Mosunmola


    Full Text Available Abstract Background There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians. Methods A cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7 and 30% of low scorers (score  In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity. Results It was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p  Conclusions Child psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of

  13. [Psychopathology of anxiety-phobic disorders that led to hospitalization in a psychiatric hospital]. (United States)

    Chugunov, D A; Schmilovitch, A A

    To study the psychopathology of anxiety-phobic disorders and motives of hospitalization of patients in a psychiatric hospital. One hundred and thirty-two patients were examined, 72 patients of the main group were admitted to general psychiatric departments, 60 patients of the control group in the sanatorium psychiatric departments. Clinical-psychopathological, follow-up, psychometric and statistical methods were used. Patients with hospital anxiety-phobic disorders had agoraphobia with panic disorder, social phobias, hypochondriacal phobias, specific phobias and multiple phobias. The main reasons for hospitalization were: the intensity of anxiety-phobic disorders, contrast content of phobias, multiplicity of anxiety-phobic disorders, ambulance calls, personality accentuations and rental aims.

  14. Association between childhood abuse and psychiatric morbidities among hospitalized patients

    Directory of Open Access Journals (Sweden)

    Kshirod Kumar Mishra


    Full Text Available Background: Childhood abuse has been linked with increased risk of adult psychiatric disorders including major depression, substance abuse, anxiety disorders, posttraumatic stress disorder, and personality disorders. However, only a few from India attempted to study long-term consequences of childhood abuse. Our study aimed to understand the role of physical, sexual, and emotional abuse along with psychiatric co-morbidities in hospitalized patients. Materials and Methods: Patients admitted to psychiatric inpatient services in the age group of 14-45 years for the 1 st time were evaluated for a history of physical, sexual, and emotional abuse on the basis of retrospective chart review. Semi-structured Performa was used to evaluate the patient with a history of child abuse, and they were diagnosed according to International Classification of Diseases-10 diagnostic criteria. Result: The prevalence of child abuse in our inpatient services was 43.29%; emotional abuse (61.9% was most commonly reported among patient followed by physical (21.43% and sexual abuse (16.67%. We observed a significant difference in terms of length of hospital stay between abuse (10.29 ± 6.01 days and nonabuse group (5.90 ± 2.43 days (t = 4.902, df = 95, P < 0.0001. The boys experienced physical abuse at a younger age (7.43 ± 2.50 years than girls (13.50 ± 0.70 years. The sexual abuse and emotional abuse were reported at a younger age in girls than boys. We found high prevalence of substance use disorders (40.47%, psychosis (19.04%, and mood disorder (28.57% among abuse group. Conclusions: The study findings highlight the developing importance of the different forms of abuse on adult psychiatric diagnosis in India. The abused patients are at high risk of the development of psychiatric disorder than the nonabuse group. The increased length of hospitalization among abused group reflects severity and complexity of child abuse. The early detection of social factors

  15. [Public music concerts in a psychiatric hospital: effects on public opinion and as therapy for patients]. (United States)

    Takasaka, Y; Yokota, O; Tanioka, T; Nagata, K; Yasuoka, K; Toda, H


    We investigate the effects of music therapy concerts, which were held 60 times over a four year period, 1992 to 1996, in Geiyo Psychiatric Hospital, Kochi Prefecture and found that; 1) Musicians who performed at the concerts were not only from Kochi prefecture but also from other prefectures (10 times) and from four foreign countries (7 times). 2) Live concerts in a small hall had a positive influence on patients and drew the patient's attention and interest away from their hallucinations and delusions to the real world. Moreover, the concerts provided the patients with chances to acquire social graces such as being well-groomed. 3) Explanations by the musicians, interviews with the musicians and the seasonal choruses accompanied by the musicians were helpful to give the patients motives for recovering communication skills and to interact with society. 4) Inquiries to the patients about the concerts indicated discrepancies between the poor observed estimations during the concerts (83.3%) and the good subjective impressions expressed by the patients (82.0%), suggesting that the patients were not good at expressing their internal emotions through facial expressions or attitudes. 5) Many citizens including children came to the concerts and/or gave aid to the hospital because the concerts were open to the public and we suggest that this contributed to improving the general publics' image of psychiatric hospitals. Questionnaires revealed that 90% of people in a control group had a bad image of psychiatric hospitals in Japan, but only 32% of the members of the general public who attended our concerts had a bad image of psychiatric hospitals. In addition, the revolving ratio of the hospital beds rose from 0.4 to 1.2 over the four years, which also suggests a beneficial effect on the patients.

  16. [Level of Development of Clinical Ethics Consultation in Psychiatry - Results of a Survey Among Psychiatric Acute Clinics and Forensic Psychiatric Hospitals]. (United States)

    Gather, Jakov; Kaufmann, Sarah; Otte, Ina; Juckel, Georg; Schildmann, Jan; Vollmann, Jochen


    The aim of this article is to assess the level of development of clinical ethics consultation in psychiatric institutions in North Rhine-Westphalia. Survey among medical directors, directors of nursing and administrative directors of all psychiatric acute clinics and forensic psychiatric hospitals in North Rhine-Westphalia. 113 persons working in psychiatric acute clinics responded (reponse rate: 48 %) and 13 persons working in forensic psychiatric hospitals (response rate 54 %). We received at least one response from 89 % of all psychiatric acute clinics and from 100 % of all forensic psychiatric hospitals. 90 % of the responding psychiatric acute clinics and 29 % of the responding forensic psychiatric hospitals have already implemented clinical ethics consultation. Clinical ethics consultation is more widespread in psychiatric institutions than was hitherto assumed. Future medical ethics research should therefore give greater attention to the methodology and the quality of clinical ethics consultation in psychiatric practice. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Relational Aggression in Children with Preschool-Onset Psychiatric Disorders (United States)

    Belden, Andy C.; Gaffrey, Michael S.; Luby, Joan L.


    Objective: The role of preschool-onset (PO) psychiatric disorders as correlates and/or risk factors for relational aggression during kindergarten or first grade was tested in a sample of 146 preschool-age children (age 3 to 5.11 years). Method: Axis-I diagnoses and symptom scores were derived using the Preschool Age Psychiatric Assessment.…

  18. Maternal or paternal suicide and offspring's psychiatric and suicide-attempt hospitalization risk. (United States)

    Kuramoto, S Janet; Stuart, Elizabeth A; Runeson, Bo; Lichtenstein, Paul; Långström, Niklas; Wilcox, Holly C


    We examined whether the risk for psychiatric morbidity requiring inpatient care was higher for offspring who experienced parental suicide, compared with offspring of fatal accident decedents, and whether the association varied according to the deceased parent's gender. Children and adolescents (0-17 years of age) who experienced maternal (N = 5600) or paternal (N = 17,847) suicide in 1973-2003 in Sweden were identified by using national, longitudinal, population-based registries. Cox regression modeling was used to compare psychiatric hospitalization risks among offspring of suicide decedents and propensity score-matched offspring of accident decedents. Offspring of maternal suicide decedents had increased risk of suicide-attempt hospitalization, after controlling for psychiatric hospitalization for decedents and surviving parents, compared with offspring of maternal accidental decedents. Offspring of paternal suicide decedents had similar risk of suicide-attempt hospitalization, compared with offspring of accident decedents, but had increased risk of hospitalization attributable to depressive and anxiety disorders. The magnitude of risks for offspring suicide-attempt hospitalization was greater for those who experienced maternal versus paternal suicide, compared with their respective control offspring (interaction P = .05; offspring of maternal decedents, adjusted hazard ratio: 1.80 [95% confidence interval: 1.19-2.74]; offspring of paternal decedents, adjusted hazard ratio: 1.14 [95% confidence interval: 0.96-1.35]). Maternal suicide is associated with increased risk of suicide-attempt hospitalization for offspring, beyond the risk associated with maternal accidental death. However, paternal suicide is not associated with suicide-attempt hospitalization. Future studies should examine factors that might differ between offspring who experience maternal versus paternal suicide, including genetic or early environmental determinants.

  19. Worsening psychosis induced by varenicline in a hospitalized psychiatric patient. (United States)

    DiPaula, Bethany A; Thomas, Michele D


    Varenicline is a novel treatment for smoking cessation; however, the agent has not been well studied in a population with severe mental illness. Varenicline can reportedly cause neuropsychiatric adverse effects, some resulting in hospitalizations and/or suicides. We describe a case of clinician-observed, worsening psychotic symptoms in a patient with chronic mental illness who was receiving varenicline. A 45-year-old woman with bipolar disorder, mixed type with psychotic features, was admitted to a psychiatric hospital due to acute decompensation after she discontinued her drug therapy. Because of the facility's smoke-free policy, the patient was not permitted to smoke cigarettes during her hospitalization. Over the next several weeks, her condition was stabilized with psychotropic drugs. Her symptoms improved, and plans were made for her discharge. Varenicline was prescribed to manage her nicotine cravings. After 2 days of treatment, staff members noted worsening of the patient's psychotic symptoms and agitation. Varenicline was discontinued, the patient's mental status returned to baseline, and she was subsequently discharged. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 7) between the patient's worsening psychosis and her varenicline therapy. This case report provides valuable support of previously published cases that demonstrate the risk of exacerbation of psychotic symptoms with varenicline use in patients with severe mental illness. With proper assessment and management of varenicline-induced neuropsychiatric effects, health care professionals can provide an important role in helping to prevent and manage worsening psychiatric symptoms.

  20. [The attitudes nurses working at psychiatric hospitals in Turkey have towards forensic psychiatric patients and the associated factors]. (United States)

    Baysan Arabacı, Leyla; Çam, M Olcay


    To determine the attitudes nurses working at psychiatric hospitals in Turkey have towards forensic psychiatric patients and the associated factors. This cross-sectional study included 620 nurses working at 8 psychiatric hospitals in Turkey that completed ≥80% of the Nurses' Attitudes Towards Forensic Psychiatric Patients Scale (NAFPPS). Data were evaluated based on number-percentage distribution, and the relationship between variables was examined via t-test, variance analysis, and correlation analysis. Mean age of the nurses was 34.37 ± 7.48 years and 79.4% were female. Mean NAFPPS total and subscale scores were as follows: Xtotal = 69.07 ± 12.46 (max: 125); Xfeelingthreatened = 15.98 ± 3.61 (max: 30); Xtrust = 20.49 ± 5.24 (max: 20); Xsocialdistance = 10.45 ± 3.33 (max: 20); Xwillingnesstoprovidecare = 22.31 ± 4.25 (max: 40). Gender, place of employment, method of obtaining current position, employment status, level of satisfaction working as a psychiatric nurse, history of providing treatment to forensic psychiatric patients, having knowledge of Turkish laws regarding the treatment of forensic psychiatric patients, and thinking that nurses should treat forensic psychiatric patients were correlated with the nurses' attitudes towards forensic psychiatric patients, whereas age, marital status, place of longest residence, level of education, duration of working in the profession, and duration at current hospital were not. Despite the fact that the nurses working at 8 psychiatric hospitals in Turkey considered forensic psychiatric patients threatening, didn't trust them, and had a tendency to be socially distant with them, they had a moderate level of willingness to provide them proper care.

  1. Predicting psychiatric readmission: sex-specific models to predict 30-day readmission following acute psychiatric hospitalization. (United States)

    Barker, Lucy Church; Gruneir, Andrea; Fung, Kinwah; Herrmann, Nathan; Kurdyak, Paul; Lin, Elizabeth; Rochon, Paula A; Seitz, Dallas; Taylor, Valerie H; Vigod, Simone N


    Psychiatric readmission is a common negative outcome. Predictors of readmission may differ by sex. This study aimed to derive and internally validate sex-specific models to predict 30-day psychiatric readmission. We used population-level health administrative data to identify predictors of 30-day psychiatric readmission among women (n = 33,353) and men (n = 32,436) discharged from all psychiatric units in Ontario, Canada (2008-2011). Predictor variables included sociodemographics, health service utilization, and clinical characteristics. Using derivation data sets, multivariable logistic regression models were fit to determine optimal predictive models for each sex separately. Results were presented as adjusted odds ratios (aORs) and 95% confidence intervals (CI). The multivariable models were then applied in the internal validation data sets. The 30-day readmission rates were 9.3% (women) and 9.1% (men). Many predictors were consistent between women and men. For women only, personality disorder (aOR 1.21, 95% CI 1.03-1.42) and positive symptom score (aOR 1.41, 95% CI 1.09-1.82 for score of 1 vs. 0; aOR 1.44, 95% CI 1.26-1.64 for ≥ 2 vs. 0) increased odds of readmission. For men only, self-care problems at admission (aOR 1.20, 95% CI 1.06-1.36) and discharge (aOR 1.44, 95% CI 1.26-1.64 for score of 1 vs. 0; aOR 1.79, 95% CI 1.17-2.74 for 2 vs. 0), and mild anxiety rating (score of 1 vs. 0: aOR 1.30, 95% CI 1.02-1.64, derivation model only) increased odds of readmission. Models had moderate discriminative ability in derivation and internal validation samples for both sexes (c-statistics 0.64-0.65). Certain key predictors of psychiatric readmission differ by sex. This knowledge may help to reduce psychiatric hospital readmission rates by focusing interventions.

  2. Psychiatric disorders and clinical correlates of suicidal patients admitted to a psychiatric hospital in Tokyo

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    Ishimoto Kayo


    Full Text Available Abstract Background Patients admitted to a psychiatric hospital with suicidal behavior (SB are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan. Method 155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined. Results The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD. SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range of the total number of SBs in the lifetime history was 7 (1-141. Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified. Conclusions Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission

  3. Physician Prescribing Practices of Vitamin D in a Psychiatric Hospital. (United States)

    Mulcahy, Kimberly B; Trigoboff, Eileen; Opler, Lewis; Demler, Tammie Lee


    Vitamin D supplementation has become an increasingly popular prescribing practice, despite our limited knowledge of both the definition and degree of deficiency as well as the expected benefits or risks of exogenous administration. Many of the hypothesized benefits of vitamin D supplementation include a variety of improvements in mental health; however, these claims are not consistently or robustly supported by current research. In this paper, we provide a brief overview of what is currently known about vitamin D deficiency and about outcomes of supplementation as well as a summary of the data relative to prescribing practices for inpatients in an urban psychiatric hospital.

  4. [Psychiatric Hospital San Juan de Dios. One hundred years later]. (United States)

    Cocula-León, Horacio


    Mental health and psychiatric diseases have always attracted people's and health authorities' attention due to its magical approach, the lack of knowledge that surrounds them, and, at the same time, the religious fear they provoke. Both have played an important role in the history of humanity, of public health politics, and of physicians. The places where psychiatric patients were treated are of historical interest, because through the historical knowledge we can identify an approach from the science and the health policies that prevailed in each age. At the beginning of the 20th century, it was developed in México a new model of hospital care attention to psychiatric patients. La Casa de Salud San Juan de Dios para Pacientes Alienados is an example; the concept "alienated patients" suggests a social and cultural perspective. This paper presents a chronological type description of one of the major institutions involved in mental health care in México. Similarly, it shows a review of the events that affected the religious order San Juan de Dios from 1901 to 2012, when the hospitaller order was reinstated in México and established the Casa de Salud San Juan de Dios para Pacientes Alienados in the town of Zapopan, Jalisco, institution that exists up to the present day and keeps participating in the mental health care in the state of Jalisco, with the current name of Servicios de Salud San Juan de Dios.

  5. Organization development in a psychiatric hospital: creating desirable changes. (United States)

    Cope, D; Cox, S


    The organization of the way in which hospitals and hospital staff provide a service to patients is obviously of critical importance to their effectiveness, yet it is clear that rigidities and inappropriate and ineffective procedures frequently intrude. It is commonly held that changing hospitals as organizations is difficult to acomplish, and indeed, reported attempts at such change reflect this. The project reported here was a successful attempt at changing a number of different aspects of the culture of a psychiatric hospital which included managerial practices and structure, aspects of patient care, multidisciplinary team work, and staff development. The present paper concentrates on some specific outcomes at ward level. The general pattern for bringing about change involves the collection of (valid) data and then feeding this back to the staff involved so that they can take appropriate action. The data discussed here concerned ward nursing staff's attitude to the 'climate' of the hospital, their job satisfaction and aspects of patient care. This was fed back to nursing, managerial and medical staff, and action plans were agreed to overcome the difficulties highlighted. Outcomes have included the production of ward and unit objectives and changes in treatment programmes and aspects of patient care on the wards.

  6. Mortality among inpatients of a psychiatric hospital: Indian perspective. (United States)

    Shinde, Shireesh Shatwaji; Nagarajaiah; Narayanaswamy, Janardhanan C; Viswanath, Biju; Kumar, Naveen C; Gangadhar, B N; Math, Suresh Bada


    The objective of this study is to assess mortality and its correlates among psychiatric inpatients of a tertiary care neuropsychiatric hospital. Given the background that such a study has never been undertaken in India, the findings would have a large bearing on policy making from a mental health-care perspective. The medical records of those psychiatric inpatients (n = 333) who died during their stay at the National Institute of Mental Health and Neurosciences in past 26 years (January 1983 to December 2008) constituted the study population. During the 26 years, there were a total of 103,252 psychiatric in-patient admissions, out of which 333 people died during their inpatient stay. Majority (n = 135, 44.6%) of the mortality was seen in the age group of 21-40 years. Most of the subjects were males (n = 202, 67%), married (n = 172, 56.8%) and from urban areas (n = 191, 63%). About, 54% of the subjects had short inpatient stay (history of physical illness. Leading cause of death were cardiovascular system disorders (n = 132, 43.6%), followed by respiratory system disorders (n = 45, 14.9%), nervous system disorders (n = 30, 9.9%) and infections (n = 31, 10.1%). In 21 (7%), cause of death was suicide. Identifying the factors associated with the death of inpatients is of utmost importance in assessing the care in a neuropsychiatric hospital and in formulating better treatment plan and policy in mental health. The discussion focuses on the analysis of different factors associated with inpatient mortality.

  7. Frequency of ICD-10 psychiatric diagnosis in children with intellectual disability in Lahore, Pakistan & Caregivers Perspective. (United States)

    Imran, Nazish; Azeem, Muhammad Waqar; Sattar, Ahsan; Bhatti, Mohammad Riaz


    Association between Intellectual disability (ID) and psychiatric disorders in children & adolescents is well established but there is a paucity of published studies from Pakistan on this topic. The main aim of the study was to assess the frequency of ICD-10 psychiatric diagnosis in the hospital outpatient sample of children with ID in Lahore, Pakistan as well as to find out which challenging behaviors, caregivers find difficult to manage in this setup. Socio-demographic information was collected, Wechsler Intelligence Scale for Children-Revised & ICD-10 diagnostic criteria was used to assess children (age range 6 - 16 years) with suspected ID along with identification of behaviors found to be difficult to manage by caregivers. 150 children were assessed with mean age of 10.7 years (males 70 %). Majority (72%) had mild ID while 18.7% and 9.3% had moderate and severe ID respectively. Thirty percent of children met the criteria for any psychiatric diagnosis, the most common being Oppositional Defiant Disorder (14%) and Hyperkinetic Disorders (10%). Verbal and physical aggression, school difficulties, socialization problems, inappropriate behaviors (e.g. disinhibition), sleep & feeding difficulties were the significant areas identified by the caregivers as a cause of major concern. Significantly high prevalence of ICD-10 psychiatric diagnosis in children with ID was found in Lahore, Pakistan. Support services for these children should be responsive not only to the needs of the child, but also to the needs of the family.

  8. An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy

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    Margari Francesco


    Full Text Available Abstract Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs. Information was focused on diagnosis (DSM-IV, reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS, the Modified Overt Aggression Scale (MOAS and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30. Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs completed both admission and discharge visits. A severe psychotic episode with (19.1% or without (47.7% aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge and depression (12.9% at admission and 14.7% at discharge were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0% patients had episodes of aggressiveness at admission and 8 (1.7% at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%, 686 (94.2% and 676 (92.9%. The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%, typical anti-psychotics (48.3%, 57.0%, 49.6%, atypical anti-psychotics (35.6%, 41.8%, 39.8% and antidepressants (40.9%, 48.8%, 43.2%. Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20

  9. A 5-year retrospective study of demographic, anamnestic, and clinical factors related to psychiatric hospitalizations of adolescent patients

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    Di Lorenzo R


    Full Text Available Rosaria Di Lorenzo,1 Nina Cimino,2 Elena Di Pietro,3 Gabriella Pollutri,4 Vittoria Neviani,5 Paola Ferri2 1Service of Psychiatric Diagnosis and Treatment, Department of Mental Health, AUSL Modena, Modena, 2School of Nursing, University of Modena and Reggio Emilia, 3School of Neuro-Psychiatry, 4School of Psychiatry, University of Modena and Reggio Emilia, 5 “The Medlar”, Villa Igea Hospital, Modena, Italy Background: Psychiatric emergencies of children and adolescents have greatly increased during the last years, but this phenomenon has not been studied in detail. The aim of this study was to analyze the correlation between acute psychiatric hospitalizations of adolescents and selected variables to highlight risk factors for psychiatric emergencies. Methods: This retrospective research was conducted in the acute psychiatric public ward, Service of Psychiatric Diagnosis and Treatment (SPDT, and in the residential facility for adolescents, “The Medlar”, located in Modena. The sample was constituted by all adolescent patients (n=101, age range 14–18 who had acute hospitalizations (n=140 in SPDT and had been successively transferred to “The Medlar” (n=83, from February 2, 2010 to January 31, 2015. From clinical charts, we extracted demographic and anamnestic characteristics of patients and clinical variables related to hospitalizations. Data were statistically analyzed. Results: Sixty-one percent of our patients lived with one divorced parent, with adoptive or immigrant family, or in institutions; 51% had experienced stressful events during childhood; 81% had a normal intellective level, but only 6% presented regular school performance. Parental psychiatric illness was negatively related, in a statistically significantly way, with onset age of adolescent mental disorders (coefficient -2.28, 95% confidence interval [CI]: -3.53 to 1.01, P<0.001, single linear regression; odds ratio: 4.39, 95% CI: 1.43–13.47, P<0.010, single logistic

  10. Bedding, not boarding. Psychiatric patients boarded in hospital EDs create crisis for patient care and hospital finances. (United States)

    Kutscher, Beth


    As the supply of psychiatric beds dwindles, hospitals are devising innovative ways handle psych patients who come through the emergency department. Some collaborate with other hospitals, use separate pysch EDs or refer patients to residential treatment centers.

  11. Body Awareness in Preschool Children with Psychiatric Disorder (United States)

    Simons, J.; Leitschuh, C.; Raymaekers, A.; Vandenbussche, I.


    The purpose of this study was to investigate the body awareness of preschool children with a psychiatric disorder as measured by the test imitation of gestures (Berges & Lezine, 1978), using the subsections for pointing to body parts (passive vocabulary) and naming body parts (active vocabulary). Seventy-seven children from 37 to 72 months of age…

  12. Psychiatric Comorbidity in Children with New Onset Epilepsy (United States)

    Jones, Jana E.; Watson, Ryann; Sheth, Raj; Caplan, Rochelle; Koehn, Monica; Seidenberg, Michael; Hermann, Bruce


    The aim of this study was to characterize the distribution, timing, and risk factors for psychiatric comorbidity in children with recent onset epilepsy. Children aged 8 to 18 years with recent onset epilepsy (less than 1 year in duration) of idiopathic etiology (n=53) and a healthy comparison group (n=50) underwent a structured psychiatric…

  13. The process of whistleblowing in a Japanese psychiatric hospital. (United States)

    Ohnishi, Kayoko; Hayama, Yumiko; Asai, Atsushi; Kosugi, Shinji


    This study aims to unveil the process of whistleblowing. Two nursing staff members who worked in a psychiatric hospital convicted of large-scale wrongdoing were interviewed. Data were analyzed using a modified grounded theory approach. Analysis of the interviews demonstrated that they did not decide to whistleblow when they were suspicious or had an awareness of wrongdoing. They continued to work, driven by appreciation, affection, and a sense of duty. Their decision to whistleblow was ultimately motivated by firm conviction. Shortly after whistleblowing, wavering emotions were observed, consisting of a guilty conscience, fear of retribution, and pride, which subsequently transformed to stable emotions containing a sense of relief and regret for delayed action. It is necessary for nurses to recognize that their professional responsibility is primarily to patients, not to organizations. Nurses should also have professional judgment about appropriate allegiance and actions.

  14. Coping Strategies of Family Members of Hospitalized Psychiatric Patients

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    Phyllis M. Eaton


    Full Text Available This exploratory research paper investigated the coping strategies of families of hospitalized psychiatric patients and identified their positive and negative coping strategies. In this paper, the coping strategies of 45 family members were examined using a descriptive, correlational, mixed method research approach. Guided by the Neuman Systems Model and using the Family Crisis Oriented Personal Evaluation Scales and semistructured interviews, this paper found that these family members used more emotion-focused coping strategies than problem-focused coping strategies. The common coping strategies used by family members were communicating with immediate family, acceptance of their situation, passive appraisal, avoidance, and spirituality. The family members also utilized resources and support systems, such as their immediate families, mental health care professionals, and their churches.

  15. Inter-hospital Cross-validation of Irregular Discharge Patterns for Young vs. Old Psychiatric Patients (United States)

    Mozdzierz, Gerald J.; Davis, William E.


    Type of discharge (irregular vs. regular) and length of time hospitalized were used as unobtrusive measures of psychiatric patient acceptance of hospital treatment regime among two groups (18-27 years and 45 years and above) of patients. (Author)

  16. Relational Aggression in Children with Preschool Onset (PO) Psychiatric Disorders (United States)

    Belden, Andy C.; Gaffrey, Michael S.; Luby, Joan L.


    Objective The role of preschool onset (PO) psychiatric disorders as correlates and/or risk factors for relational aggression during kindergarten or 1st grade was tested in a sample of N = 146 preschool-age children (3 to 5.11). Method Axis-I diagnoses and symptom scores were derived using the Preschool Age Psychiatric Assessment. Children’s roles in relational aggression as aggressor, victim, aggressive-victim, or non-aggressor/non-victim were determined at preschool and again 24 months later at elementary school entry. Results Preschoolers diagnosed with PO-psychiatric disorders were 3 times as likely as the healthy preschoolers to be classified aggressors, victims, or aggressive-victims. Children diagnosed with PO-disruptive, depressive, and/or anxiety disorders were at least 6 times as likely as children without PO-psychiatric disorders to become aggressive-victims during elementary school after covarying for other key risk factors. Conclusions Findings suggested that PO-psychiatric disorders differentiated preschool and school-age children’s roles in relational aggression based on teacher-report. Recommendations for future research and preventative intervention aimed at minimizing the development of relational aggression in early childhood by identifying and targeting PO-psychiatric disorders are made. PMID:22917202

  17. Prevalence of psychiatric disorders among children of different ethnic origin.


    Zwirs, B.W.; Burger, H.; Schulpen, T.W.J.; Wiznitzer, M.; Fedder, H.; Buitelaar, J.K.


    The present study assesses the population prevalence of DSM-IV disorders among native and immigrant children living in low socio-economic status (SES) inner-city neighborhoods in the Netherlands. In the first phase of a two-phase epidemiological design, teachers screened an ethnically diverse sample of 2041 children aged 6-10 years using the Strengths and Difficulties Questionnaire (SDQ). In the second phase, a subsample of 253 children was psychiatrically examined, while their parents were i...

  18. [After the Action T4 : "Regionalized euthanasia" in the Günzburg Psychiatric Hospital]. (United States)

    Söhner, F; V Cranach, M; Fangerau, H; Becker, T


    In Bavarian psychiatric hospitals approximately 15,000 people with mental handicaps and mental illnesses were killed after the so-called Action T4. The Heil- und Pflegeanstalt (psychiatric hospital) Günzburg was a so-called Zwischenanstalt (interim institution). The aim of the study was to analyze its role in carrying out "regionalized euthanasia". Based on defined criteria the patient records of deceased patients at the Günzburg Psychiatric Hospital between July 1941 and December 1943 were analyzed to establish whether criteria for "regionalized euthanasia" were fulfilled. During the study period 45 patients at the Günzburg Psychiatric Hospital probably died following actions by direct or indirect intention to kill using malnutrition, neglect, medication overdose or a combination of these actions. The Günzburg Psychiatric Hospital was involved in "regionalized euthanasia".

  19. Refugee children have fewer contacts to psychiatric healthcare services: an analysis of a subset of refugee children compared to Danish-born peers. (United States)

    Barghadouch, Amina; Kristiansen, Maria; Jervelund, Signe Smith; Hjern, Anders; Montgomery, Edith; Norredam, Marie


    Studies show a high level of mental health problems among refugee children. This study examined whether a subset of refugee children living in Denmark accessed psychiatric healthcare services more than those born in the country. This study compared 24,427 refugee children from Asia, The Middle East, Sub-Saharan Africa and former Yugoslavia, who obtained residency in Denmark between 1 January 1993 and 31 December 2010 with 146,562 Danish-born children, matched 1:6 on age and sex. The study looked at contacts with psychiatric hospitals as well as psychologists and psychiatrists in private practice. Between 1 January 1996 and 30 June 2012, 3.5 % of the refugee children accessed psychiatric healthcare services compared to 7.7 % of the Danish-born children. The rate ratio of having any first-time psychiatric contact was 0.42 (95 % CI 0.40-0.45) among refugee boys and 0.35 (95 % CI 0.33-0.37) among refugee girls, compared to Danish-born children. Figures were similar for those accessing private psychologists or psychiatrists, emergency room, inpatient and outpatient services. Refugee children used fewer psychiatric healthcare services than Danish-born children. This may indicate that refugee children experience barriers in accessing psychiatric healthcare systems and do not receive adequate assessment of their mental health and subsequent referral to specialist services.

  20. Satisfaction of patients hospitalised in psychiatric hospitals: a randomised comparison of two psychiatric-specific and one generic satisfaction questionnaires

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    Cléopas Agatta


    Full Text Available Abstract Background While there is interest in measuring the satisfaction of patients discharged from psychiatric hospitals, it might be important to determine whether surveys of psychiatric patients should employ generic or psychiatry-specific instruments. The aim of this study was to compare two psychiatric-specific and one generic questionnaires assessing patients' satisfaction after a hospitalisation in a psychiatric hospital. Methods We randomised adult patients discharged from two Swiss psychiatric university hospitals between April and September 2004, to receive one of three instruments: the Saphora-Psy questionnaire, the Perceptions of Care survey questionnaire or the Picker Institute questionnaire for acute care hospitals. In addition to the comparison of response rates, completion time, mean number of missing items and mean ceiling effect, we targeted our comparison on patients and asked them to answer ten evaluation questions about the questionnaire they had just completed. Results 728 out of 1550 eligible patients (47% participated in the study. Across questionnaires, response rates were similar (Saphora-Psy: 48.5%, Perceptions of Care: 49.9%, Picker: 43.4%; P = 0.08, average completion time was lowest for the Perceptions of Care questionnaire (minutes: Saphora-Psy: 17.7, Perceptions of Care: 13.7, Picker: 17.5; P = 0.005, the Saphora-Psy questionnaire had the largest mean proportion of missing responses (Saphora-Psy: 7.1%, Perceptions of Care: 2.8%, Picker: 4.0%; P P Conclusion Despite differences in the intended target population, content, lay-out and length of questionnaires, none appeared to be obviously better based on our comparison. All three presented advantages and drawbacks and could be used for the satisfaction evaluation of psychiatric inpatients. However, if comparison across medical services or hospitals is desired, using a generic questionnaire might be advantageous.

  1. Emergency psychiatric care for children and adolescents: a literature review. (United States)

    Janssens, Astrid; Hayen, Sarah; Walraven, Vera; Leys, Mark; Deboutte, Dirk


    Over the years, increasing numbers of children and adolescents have sought help for acute psychiatric problems. The responses to this treatment-seeking behavior are heterogeneous in different settings and nations. This review aimed to provide an answer to the questions "which care should be offered to children and adolescents presenting with a psychiatric emergency or crisis and how should it be organized." We committed a literature review to find out if any recommendations can be made regarding the organization of emergency care for children and adolescents with acute mental health problems. The lack of a clear definition of emergencies or urgencies hampered this review; we note the differences between adult and child or adolescent psychiatry. The theoretical models of care found in the literature are built up from several process and structural components, which we describe in greater detail. Furthermore, we review the main service delivery models that exist for children and adolescents. Currently, emergency psychiatric care for children and adolescents is practiced within a wide range of care models. There is no consensus on recommended care or recommended setting for this population. More research is needed to make exact recommendations on the standardization of psychiatric care for young people in emergency settings.

  2. The opinion of patients with mental disorder about tobacco and its prohibition in psychiatric hospitalization

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    Renata Marques de Oliveira


    Full Text Available Objective: To identify the opinion of patients with mental disorder about tobacco and its prohibition during psychiatric hospitalization. Method: An exploratory study with 96 patients smokers with mental disorders hospitalized in a psychiatric ward of a general hospital. The interviews were conducted individually, using an instrument designed for this study. The content from the interviews was recorded, transcribed and submitted to a thematic content analysis. Results: The patients with mental disorder were identified as perceiving smoking during the psychiatric hospitalization as a help to support the difficulties in socialization and in the lack of activities. The permission for smoking is seen as a signal of respect to their needs. The subjects mentioned to not accept the total smoking prohibition. Conclusion: Tobacco helps to face difficulties and conflicts in the psychiatric hospitalization. There is resistance regarding the possibility to totally withdraw the smoking permission during hospitalization.

  3. Prevalence of Cigarette Smoking in Schizophrenic Patients Compared to Other Hospital Admitted Psychiatric Patients


    Ziaaddini, Hassan; Kheradmand, Ali; Vahabi, Mostafa


    Background: This study aimed to estimate the prevalence of cigarette smoking and some of the related factors among schizophrenic and other hospitalized psychiatric patients. Methods: This was a cross-sectional study on 120 patients hospitalized in Shahid Beheshti hospital in Kerman in 2005. Patients were equally devided in two groups of schizophrenia and other psychiatric disorders. Sampling was based on statistical census and data were collected using a questionnaire including 27 questions o...

  4. Determinants of quality of life in children with psychiatric disorders

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    Bastiaansen, D.; Koot, H.M.; Ferdinand, R.F.


    Objective: To assess factors that, in addition to childhood psychopathology, are associated with Quality of Life (QoL) in children with psychiatric problems. Methods: In a referred sample of 252 8 to 18-year-olds, information concerning QoL, psychopathology and a broad range of child, parent, and

  5. Daily weather variables and affective disorder admissions to psychiatric hospitals (United States)

    McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard


    Numerous studies have reported that admission rates in patients with affective disorders are subject to seasonal variation. Notwithstanding, there has been limited evaluation of the degree to which changeable daily meteorological patterns influence affective disorder admission rates. A handful of small studies have alluded to a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (heat waves in particular), wind direction and sunshine. We used the Kruskal-Wallis test, ARIMA and time-series regression analyses to examine whether daily meteorological variables—namely wind speed and direction, barometric pressure, rainfall, hours of sunshine, sunlight radiation and temperature—influence admission rates for mania and depression across 12 regions in Ireland over a 31-year period. Although we found some very weak but interesting trends for barometric pressure in relation to mania admissions, daily meteorological patterns did not appear to affect hospital admissions overall for mania or depression. Our results do not support the small number of papers to date that suggest a link between daily meteorological variables and affective disorder admissions. Further study is needed.

  6. Communication difficulties in children identified with psychiatric problems


    Helland, Wenche Andersen


    Several studies have pointed to an overlap between different developmental psychopathological conditions and language impairments, and difficulties with communication have been identified in children of various diagnostic backgrounds. This thesis is based on three empirical studies, and the purposes are to investigate communication difficulties as reported by parents, in children identified with psychiatric problems as well as to evaluate a Norwegian adaptation of the Children’...

  7. Nurses' work-related stress in China: a comparison between psychiatric and general hospitals. (United States)

    Qi, Yun-Ke; Xiang, Yu-Tao; An, Feng-Rong; Wang, Jing; Zeng, Jiao-Ying; Ungvari, Gabor S; Newhouse, Robin; Yu, Doris S F; Lai, Kelly Y C; Ding, Yan-Ming; Yu, Liuyang; Zhang, Xiang-Yang; Chiu, Helen F K


    Little is known about the level of work-related stress in nurses in China.This study compared the level of work-related stress between female nurses working in psychiatric and general hospitals in China. A descriptive comparative cross-sectional design was used.A consecutive sample of nurses from two psychiatric hospitals (N = 297) and a medical unit (N = 408) of a general hospital completed a written survey including socio-demographic data and a measure of work-related stress (Nurse Stress Inventory). Compared to the nurses working in the general hospital, those working in the psychiatric setting had a higher level of stress in the domains of working environment and resources (p working experience, and working in psychiatric hospitals were associated with high work-related stress (b = .2, p work-related stress, specific stress management workshops and effective staff supportive initiatives for Chinese nurses are warranted.

  8. Self-Esteem of 8-14-Year-Old Children with Psychiatric Disorders: Disorder- and Gender-Specific Effects. (United States)

    Stadelmann, Stephanie; Grunewald, Madlen; Gibbels, Charlotte; Jaeger, Sonia; Matuschek, Tina; Weis, Steffi; Klein, Annette Maria; Hiemisch, Andreas; von Klitzing, Kai; Döhnert, Mirko


    In this study, we investigated the relation between global and domain-specific self-esteem and psychiatric disorders. A sample of 577 children aged 8-14 years was recruited via psychiatric hospitals and from the general population. Parents were given a diagnostic interview to assess children's psychiatric diagnoses (current/past). Parents and children completed questionnaires on child symptoms. Children completed a questionnaire on global and domain-specific self-esteem (scales: scholastic competence, social acceptance, athletic performance and physical appearance, global self-esteem). Self-esteem of children with current psychiatric disorders was lower than that of healthy controls (η p 2 between 0.01 and 0.08). Concerning scholastic competence, social acceptance and global self-esteem, children with past psychiatric disorders scored also lower than healthy controls. Different current psychiatric disorders showed specific but small effects on dimensions of self-esteem (β between -0.08 and 0.19). Moreover, we found a gender × group interaction, indicating that girls with depressive and adjustment disorders were specifically impaired in their global self-esteem and perception of their physical appearance. Findings might help clinicians to focus on particular domains of self-esteem during the diagnostic process and to define adequate treatment goals.

  9. The relation of parental alcoholism to the prevalence of suicide attempts among hospitalized psychiatric adolescents

    Directory of Open Access Journals (Sweden)

    Katarzyna Krajewska


    Full Text Available Suicide is the third cause of death at the age group 10–19 in the world. There are inter multiple risk factors of suicidal behaviours. In the case of children of alcoholics the increased number of suicide attempts is explained by genetic predisposition and accumulation of environmental risk factors. The aim of this study is to check whether parental alcoholism is associated with the number and repetition of suicide attempts and the age at which the first suicide attempt occurred among hospitalized psychiatric adolescents. Material and methods: A retrospective analysis – based on medical documentation – of 119 patients aged 13–18, treated during 2013–2014 at the Department of Adolescent Psychiatry in Łódź for: schizophrenia, schizotypal and delusional disorders, mood disorders, neurotic, stress-related and somatoform disorders, behavioural and emotional disorders according to ICD-10. The exclusion criteria were other psychiatric diagnoses, incomplete family history and lack of information about intended self-harm behaviours. The patients were selected at random. The number and repetition of suicide attempts, the age at which the first suicide attempt occurred, parental alcoholism and family history of suicidal behaviours were examined. Analyses were carried out using Statistica 9.1. Results: Parental alcoholism did not statistically significantly affect (p > 0.05the prevalence or repetition of suicide attempts among psychiatrically treated adolescents. The first suicide attempts were not made by adolescents – also considering the gender, diagnosis, and familial suicidal behaviours. Conclusions: In almost half of the examined psychiatrically hospitalized adolescents at least one parent met the parental alcoholism criteria. Suicide attempts occurred in over 50% of the examined patients, with somewhat higher incidence in girls whose parents met the parental alcoholism criteria, as compared to those without parental alcoholism

  10. Mental Disorders among Children and Adolescents Admitted to a French Psychiatric Emergency Service

    Directory of Open Access Journals (Sweden)

    Laurent Boyer


    Full Text Available The aim of this study was to describe the characteristics of children and adolescents admitted to the psychiatric emergency department (ED of a French public teaching hospital over a six-year study period (2001–2006. Data for all episodes of care in the psychiatric ED from January 1, 2001, to December 31, 2006, delivered to adolescents aged less than 18 years were retrospectively analyzed. During the six-year study period, 335 episodes of care in the psychiatric ED were experienced by 264 different adolescents. They accounted for 2.0% of the 16,754 care episodes of the ED; 164 patients (62.1 were female and the average age was 16.5 (SD = 1.6. The neurotic, stress-related, and somatoform disorders were the most frequent (25.4% and concerned mainly anxiety disorders (15.2%. The frequency of the absence of psychiatric diagnosis (22.7% was high. A total of 48 children and adolescents (18.2% benefited from more than one episode of care. Several factors were associated to a higher number of visits to the ED: substance use, schizophrenia, disorders of adult personality and behaviour, disorders occurring in childhood and adolescence, and dual diagnosis. In conclusion, mental health disorders in children and adolescents are a serious problem associated with several potentially modifiable factors.

  11. Defining the Needs of Patients with Intellectual Disabilities in the High Security Psychiatric Hospitals in England (United States)

    Thomas, S. D.; Dolan, M.; Johnston, S.; Middleton, H.; Harty, M. A.; Carlisle, J.; Thornicroft, G.; Appleby, L.; Jones, P.


    Previous studies have suggested that a substantial proportion of the patients with intellectual disabilities (ID) in the high security psychiatric hospitals (HSPHs) should be transferred to more appropriate services to cater for their specific needs in the longer term. The individual and placement needs of high secure psychiatric patients detained…

  12. An analysis of acute admissions to a general hospital psychiatric unit

    African Journals Online (AJOL)

    Rapid turnover of patients in a general hospital psychiatric unit demands stabilization and discharge as soon as possible. It is likely that patients are being prematurely discharged because of this pressure. Aim: The study sought to analyse admissions to an acute psychiatric unit with a view to determining the demographic ...

  13. Hospital staff responses to workplace violence in a psychiatric hospital in Taiwan. (United States)

    Chen, Wen-Ching; Hwu, Hai-Gwo; Wang, Jung-Der


    We surveyed 222 nurses, nursing assistants, and clerks at a psychiatric hospital in Taiwan on responses to workplace violence, treatment of violent patients, and reporting behavior. Staff reported 78 incidents of physical violence (PV), 113 of verbal abuse (VA), 35 of bullying/ mobbing (BM), 21 of sexual harassment (SH), and 10 of racial harassment (RH) over the course of one year. Among affected staff, only 31% of those experiencing PV and consequences, especially for BM, and shame for SH. Reliable systems for responding to and reporting patient violence should be developed.

  14. Pain prevalence in hospitalized children

    DEFF Research Database (Denmark)

    Walther-Larsen, S; Pedersen, M T; Friis, S M


    admitted the same day. The single most common painful procedure named by the children was needle procedures, such as blood draw and intravenous cannulation. CONCLUSION: This study reveals high pain prevalence in children across all age groups admitted to four Danish university hospitals. The majority......BACKGROUND: Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. METHODS: This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric...... patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed. RESULTS: Two hundred and thirteen children (37%) responded that they had experienced...

  15. [Mortality of psychiatric patients. A retrospective cohort study of in-patients at the Psychiatric Hospital of Reggio Emilia]. (United States)

    Ballone, E; Contini, G


    The authors report the results of historical cohort study in long-term patients of psychiatric hospitals in Reggio Emilia. The cohort was formed by 790 patients hospitalized before 1978, and has been followed-up until 31/12/'89. The results of the study are: 269 subjects deceased (34%); 117 discharges (14.8%) and 411 (52.1%) still in hospital on 1/1/'90. An excess mortality was observed in the cohort. Mortality appears to be particularly high among young patient and females.

  16. [Treatment of sleep disorders in children with a psychiatric diagnosis]. (United States)

    Godbout, Roger


    Health sciences suffer from insomnia: experts too often concentrate their efforts on the wake state. Fortunately enough, some of them have taken the road towards the "Dark Third of Life": sleep. This article gives an historical account of the development of the first Canadian sleep disorders laboratory and clinic specifically and selectively designed for children and adolescents with a psychiatric diagnosis. It then stresses the importance of sleep in children bearing a psychiatric diagnosis and summarizes therapeutic strategies. Data-on-file and selective review of literature. An innovative scheme matching sleep psychologists and psychiatrists with expertise in neurodevelopmental disorders led to the creation of a sleep research laboratory on mental health disorders. The initial research projects on the sleep and dreams of patients with schizophrenia and persons with autism are summarized. The Sleep Disorders Clinic for Children and Adolescents was then created at the Hôpital Rivière-des-Prairies, leading to much needed activities focused on youth. Indeed, sleep disorders show a high prevalence in children with a psychiatric diagnosis and the literature shows that these children have an increased sensitivity for diurnal effects of poor sleep. The main sleep-relevant issues at stake are reviewed, including the high frequency of sleep disorders in pedopsychiatric patients. Clinical challenges are described and the operating mode of the Sleep Disorders Clinic is illustrated. Sleep disorders and their effects on daytime functioning need to be assessed in children with a psychiatric diagnosis in order to generate a full clinical picture. Appropriate tools and know-how are readily available in order to achieve this goal.

  17. Hospitalization of adolescents for psychiatric and substance abuse treatment. Legal and ethical issues. (United States)

    Schwartz, I M


    It has been estimated that as many as 12%-15% of the nations 63 million children are in need of mental health treatment. We have a responsibility to do everything we can to see to it that these children receive the services they need. Unfortunately, there is mounting evidence that a significant proportion of our health care resources are being misspent on the unnecessary and inappropriate hospitalization of children and youths in psychiatric and substance abuse treatment programs. More alarming is the evidence of poor quality programs, abusive practices, and greed. The intense competition to capture a "share of the market" and turn a profit or keep a nonprofit hospital from closing its doors is contributing to unprofessional and unethical advertising and public relations practices. In the end these practices will reflect poorly on the broader mental health and health care community. Hopefully, the stakeholders in the system will recognize these problems and assume a leadership role in turning the situation around. If not, we can expect intervention from forces outside the system (e.g., courts, elected public officials, public interest groups, the business community, and child advocates).

  18. Association of nail biting and psychiatric disorders in children and their parents in a psychiatrically referred sample of children

    Directory of Open Access Journals (Sweden)

    Ghanizadeh Ahmad


    Full Text Available Abstract Background Nail biting (NB is a very common unwanted behavior. The majority of children are motivated to stop NB and have already tried to stop it, but are generally unsuccessful in doing so. It is a difficult behavior to modify or treat. The objective of this study was to investigate the prevalence of co-morbid psychiatric disorders in a clinical sample of children with NB who present at a child and adolescent mental healthcare outpatient clinic and the prevalence of psychiatric disorders in their parents. Method A consecutive sample of 450 referred children was examined for NB and 63 (14% were found to have NB. The children and adolescents with nail biting and their parents were interviewed according to DSM-IV diagnostic criteria. They were also asked about lip biting, head banging, skin biting, and hair pulling behaviors. Results Nail biting is common amongst children and adolescents referred to a child and adolescent mental health clinic. The most common co-morbid psychiatric disorders in these children were attention deficit hyperactivity disorder (74.6%, oppositional defiant disorder (36%, separation anxiety disorder (20.6%, enuresis (15.6%, tic disorder (12.7% and obsessive compulsive disorder (11.1%. The rates of major depressive disorder, mental retardation, and pervasive developmental disorder were 6.7%, 9.5%, 3.2%, respectively. There was no association between the age of onset of nail biting and the co-morbid psychiatric disorder. Severity and frequency of NB were not associated with any co-morbid psychiatric disorder. About 56.8% of the mothers and 45.9% of the fathers were suffering from at least one psychiatric disorder. The most common psychiatric disorder found in these parents was major depression. Conclusion Nail biting presents in a significant proportion of referrals to a mental healthcare clinic setting. Nail biting should be routinely looked for and asked for in the child and adolescent mental healthcare setting

  19. Treatment profiles in a Danish psychiatric university hospital department

    DEFF Research Database (Denmark)

    Okkels, Niels; Mogensen, Rasmus Beyer; Crean, Lea Catherine


    BACKGROUND: Despite concerns about rising treatment of psychiatric patients with psychotropic medications and declining treatment with psychotherapy, actual treatment profiles of psychiatric patients are largely unknown. AIMS: To describe patterns in the treatment of patients in a large psychiatric......-eight patients (94%) used psychotropic medication, 37 (19%) as monotherapy, and 148 (74%) in combination with non-pharmacological therapy. Ninety-seven (49%) had psychotherapy and 104 (52%) social support. Among inpatients, 21 (64%) had physical therapy, and 10 (30%) electroconvulsive therapy. In total, 163 (82...... widely across all settings and patient categories. However, psychotropic medication clearly dominates as the most frequently applied treatment....

  20. How common are errors in the medication process in a psychiatric hospital?

    DEFF Research Database (Denmark)

    Sørensen, Ann Lykkegaard; Mainz, Jan; Lisby, Marianne

    frequency, type and potential clinical consequences of errors in all stages of the medication process in an inpatient psychiatric setting. Methods and materials: A cross-sectional study in two general psychiatric wards and one acute psychiatric ward. Participants were eligible psychiatric in......-hospital patients (n=67), physicians prescribing drugs and ward staff (nurses and nurses assistants) dispensing and administering drugs. The study was carried out using 3 methods of investigation – an observational study, an unannounced control visit and an audit of medical records. Medication errors were evaluated...

  1. The subjective experience of psychiatric hospitalization : a case study approach / Mark Edward de la Rey


    De la Rey, Mark Edward


    The aim of the research was to explore the subjective experience of patients admitted to a psychiatric hospital. Sub-aims were to explore how these experiences relate to self management, stress and psychological well-being. This study was motivated by research literature that documents a wide variety of negative experiences by patients. A recent psychiatric patient survey conducted in England and Wales (Mind, 2004) found that more than 50% of respondents indicated that hospital...

  2. A prospective study of smoking in young women and risk of later psychiatric hospitalization

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M


    It is not known whether smoking is a risk factor for mental disorders. Aims: To investigate the prospective associations between cigarette smoking in pregnant women and a range of psychiatric hospital diagnoses.......It is not known whether smoking is a risk factor for mental disorders. Aims: To investigate the prospective associations between cigarette smoking in pregnant women and a range of psychiatric hospital diagnoses....

  3. Psychiatric characterization of children with genetic causes of hyperandrogenism. (United States)

    Mueller, Sven C; Ng, Pamela; Sinaii, Ninet; Leschek, Ellen W; Green-Golan, Liza; VanRyzin, Carol; Ernst, Monique; Merke, Deborah P


    Very little is known about the mental health status in children with genetic causes of hyperandrogenism. This study sought to characterize psychiatric morbidity in this group. Children (8-18 years) with the diagnosis of classic congenital adrenal hyperplasia (CAH) or familial male precocious puberty (FMPP) underwent a semi-structured psychiatric interview, the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. According to sex and the literature, incidence of identified psychopathology was compared between the two endocrinological groups. We evaluated 72 patients: 54 CAH (21 females) and 18 FMPP. Twenty-four (44.4%) CAH patients and 10 (55.6%) FMPP patients met the criteria for at least one lifetime psychiatric diagnosis. Attention-deficit hyperactivity disorder (ADHD) was present in 18.2% of CAH males, 44.4% of FMPP males, and one case (4.8%) in CAH females. A high rate of anxiety disorders was also found in all the three groups (17-21%). Relative to females with CAH, the FMPP patients exhibited higher rates of ADHD. Age at diagnosis and the treatment modalities were not associated with psychopathology. Rates of psychiatric disorder, specifically ADHD and anxiety disorders, were higher than in the general population. Although anxiety disorders may occur at an increased rate in children with chronic illness, androgens may contribute to higher risk for psychopathology in pediatric patients with genetic cause of excess androgen. Early diagnosis and treatment of childhood hyperandrogenism is essential for optimal development. The results suggest that assessment for psychiatric disorders should be part of the routine evaluation of these patients.

  4. Potentially inappropriate prescribing in older patients admitted to psychiatric hospital

    NARCIS (Netherlands)

    Rongen, S.; Kramers, C.; O'Mahony, D.; Feuth, T.; Olde Rikkert, M.G.M.; Ahmed, A.I.A.


    OBJECTIVES: The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness.

  5. Competence to consent to voluntary psychiatric hospitalization: a test of a standard proposed by APA. American Psychiatric Association. (United States)

    Appelbaum, B C; Appelbaum, P S; Grisso, T


    In the wake of the U.S. Supreme Court's 1990 decision in Zinermon v. Burch, renewed attention has been given to capacities patients must have to be considered competent to consent to voluntary hospitalization. An American Psychiatric Association (APA) task force suggested that strong policy interests support the establishment of a low threshold for competence in this situation. The study examined whether, as previous research suggested, patients would have difficulty meeting even this lenient standard. One hundred voluntarily hospitalized psychiatric patients were read two brief paragraphs, one explaining the purposes of psychiatric hospitalization and and the other explaining policies for discharge. The paragraphs' readability measured about eighth-grade level. After each paragraph, participants were read two sets of questions, one testing recall of the presented information and the other testing recognition of the information in a true-false format. The scores of patients grouped by selected demographic and clinical variables were compared. The vast majority of patients were able to comprehend the information that the APA task force suggested was relevant to their decision. However, a subgroup of patients who were initially admitted involuntarily had significantly poorer performance and may constitute a group who need special educational efforts focused on the consequences of voluntary admission.

  6. Posttraumatic stress disorder in hospitalized adolescents: psychiatric comorbidity and clinical correlates. (United States)

    Lipschitz, D S; Winegar, R K; Hartnick, E; Foote, B; Southwick, S M


    To describe the diagnostic comorbidity and clinical correlates of posttraumatic stress disorder (PTSD) in adolescent psychiatric inpatients. Seventy-four adolescent inpatients were given a structured diagnostic interview, the revised version of the Diagnostic Interview for Children and Adolescents, and a battery of standard self-report measures to assess general trauma exposure, posttraumatic stress symptoms, suicidal behavior, dissociation, and depression. Ninety-three percent of subjects reported exposure to at least one traumatic event such as being a witness/victim of community violence, witnessing family violence, or being the victim of physical/sexual abuse. Thirty-two percent of subjects met diagnostic criteria for current PTSD, with sexual abuse cited as the most common traumatic stressor in 69% of PTSD cases. Girls were significantly more likely to develop PTSD than boys, although the total number of types of trauma did not differ by gender. Compared with psychiatric controls, male youngsters with PTSD were significantly more likely to have comorbid diagnoses of eating disorders, other anxiety disorders, and somatization disorder. Furthermore, male and female youngsters with PTSD were significantly more likely to have attempted suicide and report greater depressive and dissociative symptoms. In clinical populations of hospitalized adolescents exposed to multiple forms of trauma, PTSD is a common, but highly comorbid disorder. Specific multimodal assessments and treatments targeted to both PTSD and its comorbidity profile are warranted.

  7. [Validity of the Child Psychiatric Hospital Teacher Questionnaire for the assessment of ADHD. Teacher's version]. (United States)

    Ulloa, R E; Narváez, M R; Arroyo, E; del Bosque, J; de la Peña, F


    Teacher's rating scales for the evaluation of attention deficit and superactivity disorder (TDAH) and conduct disorders have been shown to be useful and valid tools. The Child Psychiatric Hospital Teacher Questionnaire (CPHTQ) of the Hospital Psiquiátrico Infantil Dr. Juan N. Navarro was designed for the assessment of ADHD symptoms, externalizing symptoms and school functioning difficulties of children and adolescents. Internal consistency, criterion validity, construct validity and sensitivity of the scale to changes in symptom severity were evaluated in this study. The scale was administered to 282 teachers of children and adolescents aged 5 to 17 years who came to a unit specialized in child psychiatry. The validity analysis of the instrument showed that the internal consistency measured by Cronbach's alpha was 0.94. The factorial analysis yielded 5 factors accounting for 59.1% of the variance: hyperactivity and conduct symptoms, predatory, conduct disorder, inattentive, poor functioning and motor disturbances. The CPHTQ scores on the scale showed positive correlation with the Clinical Global impression (CGI) scale in the patients' response to drug treatment. The CPHTQ shows adequate validity characteristics that demonstrate its utility in the evaluation of patients with ADHD and its comorbidity with other behavior disorders.

  8. Practice Parameter for the Psychiatric Assessment and Management of Physically Ill Children and Adolescents (United States)

    Journal of the American Academy of Child & Adolescent Psychiatry, 2009


    An introduction for any medical health clinician on the knowledge and skills that are needed for the psychiatric assessment and management of physically ill children and adolescents is presented. These parameters are presented to assist clinicians in psychiatric decision making.

  9. Children's psychological responses to hospitalization. (United States)

    Vessey, Judith A


    The data-based literature addressing children's psychological responses to hospitalization was reviewed using methods outlined by Cooper (1989). Using a developmental science perspective, early research was reviewed and a model of variables that contribute to children's responses was constructed. This model consists of three major foci, including maturational and cognitive variables (developmental level, experience, coping style), ecological variables (family and hospital milieu), and biological variables (inborn factors and pathophysiology). Coping serves as the overarching framework for examining these variables and their contributions to children's responses to hospitalization. A variety of theoretical perspectives from the social sciences have been used, with psychoanalytic and stress and adaptation theories predominating. The majority of the research used simple case study, descriptive, or pre- and post-test designs. Methodologic issues were common. Little qualitative work has been done. Future research directions call for studies to adopt new theoretical and empirical models that are methodologically rigorous and clinically relevant and that embrace the precepts of developmental science.

  10. Death of Dementia Patients in Psychiatric Hospitals and Regional Supply of Psychiatric Services: Study of the National Data from 1996 to 2014 in Japan. (United States)

    Nakanishi, Miharu; Niimura, Junko; Yamasaki, Syudo; Nishida, Atsushi


    Japan designates psychiatric inpatient care for behavior management of individuals with dementia and for helping dementia patients discharge to home. However, there has been no examination of the effectiveness of this strategy. The present study investigated the association between dementia and the discharge destination of patients in psychiatric hospitals. Data from the National Patient Survey, which is a nationally representative cross-sectional survey of inpatient care, were used. The 96,420 patients with dementia or other mental illness who were discharged from psychiatric hospitals in September of every 3 years from 1996 to 2014 were included in analyses. Of the 96,420 discharged patients, 13,823 had dementia as the primary disease. Of the 13,823 dementia patients, 3,865 (28.0%) were discharged to home, 3,870 (28.0%) were admitted to a facility or other care settings, 3,574 (25.9%) were admitted to another hospital, and 2,514 (18.2%) died. Patients were more likely to die in psychiatric hospital if their primary disease was dementia, and they had resided in a region that provided fewer home visits for psychiatric nursing care or had available a larger number of psychiatric hospital beds per capita. Psychiatric inpatient care may be ineffective as a treatment for the challenging behaviors of dementia. A community mental health system for behavior management should be constructed in parallel with a reduction in the number of hospital beds allotted for psychiatric care.

  11. Minor psychiatric disorders in mothers and asthma in children. (United States)

    Barreto do Carmo, Maria Beatriz; Neves Santos, Darci; Alves Ferreira Amorim, Leila Denise; Fiaccone, Rosemeire Leovigildo; Souza da Cunha, Sergio; Cunha Rodrigues, Laura; Barreto, Mauricio L


    Recent studies have shown that asthma represents a major health issue not only in children of developed countries but also in urban centers in some middle-income countries. Brazil has one of the highest prevalences of asthma worldwide. Recently, interest has grown in the relationship between psychosocial factors and asthma. This article examines the relationship between maternal mental disorders and the prevalence of asthma in low-income children from an inner city area of Salvador in the state of Bahia, Brazil, and is part of the SCAALA program (Social Change, Allergy and Asthma in Latin America). A total of 1,087 children between the ages of 5 and 12 were investigated, together with their mothers. The mothers' mental health was evaluated using the SRQ-20, an instrument for the psychiatric screening of minor psychiatric disorders (depression, anxiety and somatic complaints). The prevalence of asthma was investigated using the ISAAC survey, a standardized, validated questionnaire for asthma and other allergic diseases. Cases were defined as asthma if the patient reported having had wheezing in the previous 12 months in addition to at least one of the following: having asthma, wheezing while exercising, waking during the night because of wheezing, or having had at least four episodes of wheezing in the previous 12 months. Atopy was defined as a positive skin prick test to allergens. The presence of minor psychiatric disorders in the mothers was significantly associated with the presence of asthma in the children, and this association was consistent with all forms of asthma, irrespective of whether it was atopic or nonatopic. Future studies should be carried out to further investigate this association and the potential biological mechanisms involved. Programs for asthma control should include strategies for stress reduction and psychological support for the families of asthmatic children.

  12. Significance of personality disorders in the face of drop-outs from psychiatric hospitalizations. The case of selected psychiatric units. (United States)

    Biała, Maja; Kiejna, Andrzej


    The World Health Organization's estimations indicate that about 50% of patients in well-developed countries may not adhere to long-term therapies. In the field of psychiatry, drop-outs from psychiatric treatment are particularly important. Personality disorders are a significant part of this sphere. The aim of this research was to empirically verify the hypothesis regarding the relation between comorbid personality disorders and drop-outs from treatment among patients of psychiatric wards. This study was a prospective cohort study. 110 patients, hospitalized in 3 different psychiatric wards, were included. Personality disorders were assessed with the Structured Clinical Interview For DSM-IV Personality Disorders (SCID-II). The research was financed by the Polish National Science Center (DEC-2011/01/N/NZ5/05364). The response rate was 89.1%. 72.56% of patients suffered from personality disorders (SCID-II) (among them the most prevalent were: personality disorder - not otherwise specified - 40.7% and borderline personality disorder - 12.38%; 22.95% of patients dropped out from treatment). However, occurrence of personality disorders was not relevant for those drop-outs. On the other hand, relationships at the level of certain criteria of borderline personality disorders and passive-aggressive personality have been revealed. These relationships became stronger when considered from the perspective of differences in the organization of treatment at individual wards. Some personality disorders may play an important role in drop-outs from psychiatric treatment. Presented results require further research.

  13. Psychiatric Morbidity (Depression And Anxiety) In Children With ...

    African Journals Online (AJOL)

    (children suffering from psoriasis, acne, urticaria, atopic dermatitis and alopecia), attended the dermatology outpatient clinic at Al Wahda Hospital and Community Health Center, Dema, Libya, from I st Jan. 2006 to May 30,2006. For all children the following were done: full medical history and clinical examination, D-test for ...

  14. Occupational stress, coping strategies, and psychological-related outcomes of nurses working in psychiatric hospitals. (United States)

    Hasan, Abd Alhadi; Elsayed, Sonia; Tumah, Hussein


    Psychiatric nurses experience a wide range of stressful events, evolving from the care of violent, aggressive patients, recurrent relapse, and poor prognosis of mental disorders. The aim of the study was to assess workplace stress, coping strategies, and levels of depression among psychiatric nurses. A descriptive correlation design was conducted on psychiatric nurses working in mental health settings Port-Said, Egypt. Data were collected from 70 nurses at a mental health hospital. The results revealed that psychiatric nurses had moderate levels of work-related stress and depression, and exhibiting different coping strategies. Stress and depression are prevalent among psychiatric nurses. Implementing programs aimed at teaching them how to deal with stress at work and improving their coping strategies and problem-solving skills are recommended. © 2018 Wiley Periodicals, Inc.

  15. Psychiatric Outcomes in Young Children with a History of Institutionalization (United States)

    Bos, Karen; Zeanah, Charles H.; Fox, Nathan A.; Drury, Stacy S.; McLaughlin, Katie A.; Nelson, Charles A.


    Children raised in institutions, considered an extreme example of social deprivation, are one group through which we can better understand the impact of neglect on child health and development. The Bucharest Early Intervention Project (BEIP) is the first randomized, controlled trial of foster care as an intervention for institutionalized children. In this review we describe the mental health outcomes from the BEIP. Specifically, we report findings on attachment styles, attachment disorders, emotional reactivity, and psychiatric symptomatology for children in the BEIP. We describe the impact of the foster care intervention on these outcomes and also describe how outcomes differ by gender and by length of time spent in the institution. In addition, we explore the influence of genetic variation on individual outcomes and recovery from early severe social deprivation, as well as the role of differences in brain development in mediating later psychiatric morbidity. The results from the BEIP confirm and extend the previous findings on the negative sequelae of early institutional care on mental health. The results also underscore the benefit of early family placement for children living in institutions. PMID:21250893

  16. Subjective sleep quality and sleep duration of patients in a psychiatric hospital

    Directory of Open Access Journals (Sweden)

    Matthias J. Müller


    Full Text Available Sleep complaints and sleep disturbances are highly prevalent in patients with psychiatric disorders. During hospitalization the patients’ condition may be even worse but little is known about the subjective sleep quality in psychiatric hospitals. Thus, we have investigated subjective sleep quality and mean sleep duration in patients with different psychiatric disorders at the end of hospitalization. For a period of one year, inpatients of a psychiatric hospital with diagnosis of substance use disorder (SUD, schizophrenia (SCZ, or anxiety/depressive disorders (AND were routinely asked to fill in an easily comprehensible sleep quality questionnaire at the end of their hospitalization. Age, gender, subjective sleep quality, and sleep duration were analyzed; sleep duration was classified according to age-specific recommendations. Data of n=309 patients (age 52.1±17.9y, 56.1% women were analyzed (n=63 SUD, n=50 SCZ, n=196 AND. Mean sleep duration was 7.0±2.0 h; 20.7% of patients had sleep durations below and 4.5% above age-specific recommendations. Non-restorative sleep during hospitalization was reported “almost always” in 38.2% (n=118, and “occasionally” in 30.1% (n=93. Subjective sleep quality was significantly associated with sleep duration (rs=−0.31, P<0.0005, but not with age, gender or diagnostic subgroup. The study showed that a great proportion of patients reported poor subjective sleep quality during hospitalization, regardless of age, gender and psychiatric diagnosis. As sleep quality was significantly associated with short sleep duration, a first step could be to take care to achieve recommended age-specific sleep durations in psychiatric hospitals.

  17. Felt stigma and self-esteem among psychiatric hospital outdoor and community camp attending patients

    Directory of Open Access Journals (Sweden)

    Shantna Kumari


    Full Text Available Background: Self-stigma of people with mental illness is a major obstacle to recovery, limiting opportunities and undermining self-esteem. Aim: The aim of this study is to compare felt stigma and self-esteem in psychiatric patients receiving treatment from hospital outdoor clinic or from Community Outreach Program (COP. Materials and Methods: This cross-sectional study was conducted on psychiatric patients who were on outpatient treatment for at least 6 months, but had never been hospitalized. The study sample included 130 patients receiving outdoor treatment from a Psychiatric Hospital and a matched group of 140 patients receiving treatment from COP of the same hospital. Demographic and clinical details of the patients were recorded on a specially designed proforma. Modified felt stigma scale and Rosenberg self-esteem scale were used to assess stigma and self-esteem, respectively. Results: On the modified felt stigma scale, the mean (±standard deviation [SD] score of psychiatric hospital outpatients (31.89 ± 6.51 was significantly higher than the scores of patients attending COP (29.20 ± 6.80. On Rosenberg self-esteem scale, mean (±SD scores of patients with psychosis (17.98 ± 1.69 was significantly lower compared to scores of patients with epilepsy (21.83 ± 1.60. There was no significant correlation between stigma and self-esteem. Conclusion: As psychiatric hospital outpatients have significantly more self-stigma when compared to patients attending community outreach camps, the availability of more community outreach camps along with educating people about psychiatric illnesses may help in lowering stigma of psychiatric disorders.

  18. Psychiatric disorders in patients with multidrug resistant tuberculosis (MDR-TB in Sardjito Hospital, Yogyakarta, Indonesia

    Directory of Open Access Journals (Sweden)

    Irwan Supriyanto


    Full Text Available Introduction: Tuberculosis has become a chronic debilitating disease in developing countries, particularly after the emergence of multidrug resistant tuberculosis (MDR-TB. Second line treatments for the disease which were subsequently developed were associated with psychiatric disorders among patients. Psychiatric disorder can either be induced by treatment regiments or psychosocial factors. Cycloserine administration is frequently reported to be associated with psychiatric disorders. In this study, we examined the prevalence and characteristics of psychiatric disorders among MDR-TB patients in Sardjito Hospital, Yogyakarta, Indonesia. Methods: In this descriptive study, we studied medical records of MDR-TB patients admitted for MDR-TB treatments to Sardjito Hospital from January 2014 to July 2016 and screened for psychiatric disorders. Results: We found that 32.8% of the patients had psychiatric disorders, some of which had multiple psychiatric diagnoses (14.1%. The diagnoses were medication induced delirium, substance/medication induced psychotic disorder, substance/medication use depressive disorder, depressive type schizoaffective disorder, bipolar I disorder current episode severe manic with psychotic features, mild depression, moderate depression, major depression without psychotic features, major depression with psychotic features, adjustment disorders with mixed anxiety and depressed mood, adjustment disorder with anxiety, acute stress disorder, and insomnia. Psychiatric disorders were significantly associated with cycloserine dose and sex. Psychotic symptoms were significantly associated with sex and level of education. Conclusion: The presence of psychiatric disorders might disturb MDR-TB treatment resulting in poor outcomes. Precaution and prompt managements are required for psychiatric disorders in patients receiving MDR-TB treatment regiments.

  19. Tics and psychiatric comorbidity in children and adolescents. (United States)

    Gadow, Kenneth D; Nolan, Edith E; Sprafkin, Joyce; Schwartz, Joseph


    This study examined comorbid psychiatric symptoms in a large, community-based sample of children and adolescents. The study sample comprised a total of 3006 school children: 413 preschool (3 to 5 years; 237 males, 176 females; mean age 4 years 2 months, SD 8 months), 1520 elementary school (5 to 12 years; 787 males, 733 females; mean age 8 years 2 months, SD 1 year 11 months), and 1073 secondary school children (12 to 18 years; 573 males, 500 females; mean age 14 years 4 months, SD 1 year 10 months), all of whom were attending regular education programs. Children were evaluated with a teacher-completed DSM-IV-referenced rating scale. The sample was divided into four groups: attention-deficit-hyperactivity disorder with tics (ADHD+tics), ADHD without tics (ADHD), tics without ADHD (T), and a comparison group i.e. neither ADHD nor tics (Non). The percentage of children with tic behaviors varied with age: preschool children (22.3%), elementary school children (7.8%), and adolescents (3.4%). Tic behaviors were more common in males than females, regardless of comorbid ADHD symptoms. For many psychiatric symptoms, screening prevalence rates were highest for the ADHD groups (ADHD+tics>ADHD>T>Non). However, obsessive-compulsive and simple and social phobia symptoms were more common in the groups with tic behavior. Findings for a community-based sample show many similarities with studies of clinically referred samples suggesting that teacher-completed ratings of DSM-IV symptoms may be a useful methodology for investigating the phenomenology of tic disorders.

  20. [Limitations and Problems with Treatment of Eating Disorders in a Psychiatric Hospital]. (United States)

    Amayasu, Hideaki; Okubo, Momoe; Itai, Takahiro


    Treating patients who have eating disorders in psychiatric hospitals is difficult for several reasons. The first reason is that there is a shortage of qualified psychiatrists. For each psychiatrist, there are approximately thirty hospitalized patients. In addition to this limited number of psychiatrists, funding in psychiatric hospitals only provides for a limited number of other medical staff when compared with funding available for general hospitals. The second reason is that there is a problem with the national medical treatment fee system. Specifically, in the current system, patients are not permitted to stay in hospitals long-term; outpatient treatment is preferred. The third reason is that psychiatric hospitals are not equipped to deal with patients who have physical illnesses. The following two case studies highlight the problems and limitations associated with treating patients who have eating disorders. Ways in which psychiatric hospitals can collaborate with other organizations, including low enforcement officials, are also considered. Although it is clear that an integrated and collaborative approach is necessary, implementation of such a system is still a long way from being realized, and greater effort is needed to provide patients suffering from eating disorders with the best possible treatment.

  1. Psychiatric hospital nursing staff's experiences of participating in group-based clinical supervision:

    DEFF Research Database (Denmark)

    Buus, Niels; Angel, Sanne; Traynor, Michael


    Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses' experiences of participating in groupbased supervision and identifying psychosocial...... reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense...... of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses....

  2. Psychiatric Disorders and Predictors Hereof Among Refugee Children in Early Adulthood

    DEFF Research Database (Denmark)

    Barghadouch, Amina; Carlsson, Jessica; Norredam, Marie


    Studies show a high level of mental health problems among refugee children and adults. This study aimed to examine psychiatric disorders among refugee children in early adulthood. A total of 15,264 young adult refugees, who obtained residence permission January 1, 1993 to December 31, 2010, were...... matched 1:6 on age and sex with 99,313 Danish-born children. Rate ratios (RR) of having a first-time in- or outpatient hospital diagnosis with an affective (F30-39), psychotic (F29-30), neurotic (F40-48), or any psychiatric disorder (F00-99) according to ICD-10 were computed. Refugees had higher RRs...... of psychotic (RR: 1.81, 95%CI: 1.41-2.32) and nervous (RR: 1.28, 95% CI: 1.14-1.43) disorders compared with Danish-born children. The RRs of having an affective disorder among refugees was 0.74 (95% CI: 0.60-0.90) compared with Danish-born children. Sex, geographical origin, migrant status, household income...

  3. Psychiatric Outcomes at Age Seven for Very Preterm Children: Rates and Predictors (United States)

    Treyvaud, Karli; Ure, Alexandra; Doyle, Lex W.; Lee, Katherine J.; Rogers, Cynthia E.; Kidokoro, Hiroyuki; Inder, Terrie E.; Anderson, Peter J.


    Background: Uncertainty remains about the rate of specific psychiatric disorders and associated predictive factors for very preterm (VPT) children. The aims of this study were to document rates of psychiatric disorders in VPT children aged 7 years compared with term born children, and to examine potential predictive factors for psychiatric…

  4. Determinants of quality of life in children with psychiatric disorders. (United States)

    Bastiaansen, Dennis; Koot, Hans M; Ferdinand, Robert F


    To assess factors that, in addition to childhood psychopathology, are associated with Quality of Life (QoL) in children with psychiatric problems. In a referred sample of 252 8 to 18-year-olds, information concerning QoL, psychopathology and a broad range of child, parent, and family/ social network factors was obtained from children, parents, teachers and clinicians. Poor child, parent, and clinician reported QoL was associated with child psychopathology, but given the presence of psychopathology, also with child factors, such as low self-esteem, and poor social skills, and family/social network factors, such as poor family functioning, and poor social support. In multiple linear regression analyses the importance of parent factors, such as parenting stress, was almost negligible. To increase QoL of children with psychiatric problems, treatment of symptoms is important, but outcome might improve if treatment is also focussed on other factors that may affect QoL. Results are discussed in relation to current treatment programs.

  5. Psychiatric comorbidity in children with autism spectrum disorders: A comparison with children with ADHD

    NARCIS (Netherlands)

    van Steensel, F.J.A.; Bögels, S.M.; de Bruin, E.I.


    The present study was conducted with the aim to identify comorbid psychiatric disorders in children with autism spectrum disorders (ASD) (n = 40) and to compare those comorbidity rates to those in children with attention deficit hyperactivity disorder (ADHD) (n = 40). Participants were clinically

  6. Impact of the Syrian Crisis on the Hospitalization of Syrians in a Psychiatric Setting. (United States)

    Lama, Souaiby; François, Kazour; Marwan, Zoghbi; Sami, Richa


    Determine the impact of the Syrian crisis on the hospitalization of Syrians in a psychiatric setting. All Syrians admitted to a psychiatric hospital in Lebanon between the 1st of January 2009 and the 31st of December 2013 were included. Number of admissions, psychiatric disorders and demographic and clinical data relative to patients were compared between those admitted before and after the crisis. 44 patients were admitted before the crisis and 106 after it. The distribution of diagnosis varied significantly after the crisis (p = 0.056) with the majority of patients being admitted for schizophrenia (37.7 %). The prevalence of suicidal ideation was higher after the crisis (p = 0.03) but suicidal attempts, need for electroconvulsive therapy and length of hospitalization did not differ significantly between both groups. Clinicians should be aware of the possible burden of mental illness in Syrians after the beginning of the Syrian crisis.

  7. Patients who leave the hospital against medical advice: the role of the psychiatric consultant. (United States)

    Holden, P; Vogtsberger, K N; Mohl, P C; Fuller, D S


    Previous studies have identified characteristics of patients who threaten to leave non-psychiatric units against medical advice, but few have described the role of the psychiatric consultant in the patient's decision. This study compared the medical records of 31 patients who threatened to leave the hospital against medical advice (AMA) and who were seen in consultation with the records of AMA-discharged patients who were not seen by a psychiatric consultant. Most patients who received consultations remained hospitalized or were discharged in regular fashion. Those seen soon after admission were most likely to stay. Patients were more likely to remain hospitalized if the consultant's recommendations had a practical, rather than a psychological, orientation.

  8. Psychiatric disorders in Danish children aged 5-7 years

    DEFF Research Database (Denmark)

    Elberling, Hanne; Linneberg, Allan; Ulrikka Rask, Charlotte


    BACKGROUND: Knowledge about the presentation of psychopathology in preschool age and associated risk factors is fundamental to preventive intervention before schooling. AIMS: To investigate the full spectrum of psychiatric diagnoses in general population children at the period of transition from.......4-1.6), respectively. Emotional disorders were found in 2.9% (95%CI: 1.9-40). More boys were diagnosed with PDD, behavioural disorders and tics. No gender differences were found in hyperactivity disorders (HD) and emotional disorders. Co-morbidity was frequent, in particular between HD and PDD, but also between HD...

  9. Hospital Related Stress Among Patients Admitted to a Psychiatric In-patient Unit in India

    Directory of Open Access Journals (Sweden)

    Latha KS


    Full Text Available The psychiatric patient’s attitudes towards hospitalization have found an association between patient perceptions of the ward atmosphere and dissatisfaction. The aim of the study was to determine the aspects of stress related to hospitalization in inpatients admitted to a psychiatric facility. Fifty in-patients of both sexes admitted consecutively to a psychiatric unit in a General Hospital were asked to rate the importance of, and their satisfaction with, 38 different aspects of in-patient care and treatment. Results showed that the major sources of stress were related to having a violent patient near to his/her bed; being away from family; having to stay in closed wards; having to eat cold and tasteless food; losing income or job due to illness, being hospitalized away from home; not able to understand the jargons used by the clinical staff and not getting medication for sleep. A well-differentiated assessment of stress and satisfaction has implications for the evaluation of the quality of psychiatric care and for the improvement of in-patient psychiatric care.

  10. Identification and Evaluation of Abused Children at Imam Hossein Hospital. (United States)

    Arabghol, Fariba; Derakhshanpour, Firooze; Davari Ashtiyani, Rozita; Chimeh, Narges; Panaghi, Layli


    Child abuse is a phenomenon that confronts the child, family, and society with irretrievable physical and mental injuries, and its negative effects continue until adulthood. The present study was conducted to identify and evaluate cases of abused children at a medical center. This is a descriptive-analytic study. The subjects were all children and adolescents who were referred to Imam Hussein hospital within 6 months due to physical or psychiatric reasons and were diagnosed with child abuse and neglect by a child and adolescent psychiatrist. The number of these children was 73. Children and their parents were assessed by schedule for affective disorders and schizophrenia (SADS), Kiddie-SADS, and child abuse and demographic questionnaires. The statistical methods of mean and standard deviation were used to analyze the data. 56 cases (76%) were physically abused, 53 cases (72.6%) were emotionally abused, and 3 cases (12.3%) were neglected. The most common psychiatric disorder in abused children was ADHD (65.8%). The next most common were oppositional defiant disorder, obsessive compulsive disorder, general anxiety disorder, and enuresis. About 80% of the abused children had at least one psychiatric disorder. The most common psychiatric disorders in mothers were general anxiety disorder (34.8%) and depression (33.3%), and in fathers, it was substance abuse (19.7%). Child abuse is a common phenomenon that relates to psychiatric disorders in the abused child or abuser parents. It seems that on-time identification and appropriate interventions can prevent further negative consequences for the child, family, and society.

  11. Prevalence of Comorbid Psychiatric Disorders in Children and Adolescents With Attention Deficit Hyperactivity Disorder

    Directory of Open Access Journals (Sweden)



    Full Text Available Background Attention deficit hyperactivity disorder (ADHD is often associated with other psychological problems. Objectives The present study aimed to study the prevalence of comorbid psychiatric disorders in children and adolescents with ADHD who admitted to Golestan Hospital in Ahvaz. Patients and Methods This was a descriptive/analytic cross-sectional study carried out on 118 outpatient children and adolescents who were selected by convenient sampling. The data were collected using the questionnaire, designed by authors, and were analyzed through descriptive statistics and chi-square test. Results The prevalence of comorbid disorders were as follows: anxiety disorders (48.3%; depression (20.33%; bipolar disorder (17.79%; obsessive-compulsive (47.45%; tic and tourette (35.59%, oppositional defiant disorder (43.22%; conduct disorder (11.01%; urinary incontinence (58.47%; communication disorder (9.32%; and learning disorder (21.18%. There was no significant difference between females and males with respect to the prevalence of comorbid disorders. Conclusions Similar to previous studies, we found some comorbid psychiatric disorders with ADHD. The treatment of the disorder can be improved, by more attention to comorbid psychiatric disorders, early diagnosis of them, and using distinct and specific treatment for everyone.

  12. Social phobia and other psychiatric problems in children with strabismus. (United States)

    Cumurcu, Tongabay; Cumurcu, Birgul Elbozan; Ozcan, Ozlem; Demirel, Soner; Duz, Cem; Porgalı, Esra; Doganay, Selim


    To investigate the rate of social phobia, anxiety, depression, and other psychiatric problems in children with strabismus. Prospective, cross-sectional, case-control study. Forty-two children with strabismus and 47 control subjects 8-13 years of age were enrolled in this study. After the ophthalmologist's examination, all cases were assessed by a psychiatrist based on the structured interview technique of Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version (Kiddie-SADS-PL). The Screen for Child Anxiety Related Emotional Disorders (SCARED) was administered to each subject to evaluate social phobia. All participants completed the Children's Depression Inventory (CDI). Age as well as sex and income were comparable between the strabismus patients and control groups. Social phobia was diagnosed in 8 (19.04%) of the 42 strabismic children and in 1 (2.12%) of the control subjects. The CDI and SCARED (total score, social phobia, separation anxiety) scores of strabismus patients were significantly higher than the control group (p = 0.001, p = 0.004, p = 0.0001, p = 0.05, respectively). A relationship between strabismus in children and social phobia, depression, and anxiety on a symptom basis was underlined by our data. Copyright © 2011. Published by Elsevier Inc.

  13. The Jewish psychiatric hospital, Zofiówka, in Otwock, Poland. (United States)

    Seeman, Mary V


    The T4 euthanasia programme within Nazi Germany has been well researched, but much less is known about the extermination of psychiatric patients in Nazi-occupied territories during the same period. In Poland 20,000 mentally ill patients were deliberately killed during the German occupation. This paper traces the history of one psychiatric hospital, Zofiówka, in Otwock, south-east of Warsaw. The hospital once served the Jewish population of Poland and was the largest, most prestigious neuropsychiatric centre in the country. It is now in ruins and said to be haunted by ghosts. © The Author(s) 2014.

  14. Alcohol consumption and later risk of hospitalization with psychiatric disorders: prospective cohort study

    DEFF Research Database (Denmark)

    Flensborg-Madsen, Trine; Becker, Ulrik; Grønbæk, Morten


    hospital with a psychiatric disorder. The prospective cohort study, the Copenhagen City Heart Study (n=18,146), was used, containing three updated sets of alcohol intake and lifestyle covariates and up to 26 years follow-up. Alcohol intake was measured by self-report while psychiatric disorders were......The potential effects of alcohol intake upon the risk of psychiatric disorders have not often been investigated. The purpose of this study was to investigate, in a population sample, the association between self-reported amount of alcohol intake and the later risk of being registered in a Danish.......31-3.04) compared to women drinking below the sensible drinking limits. For men, the risk functions were slightly U-shaped; thus, a weekly low or moderate alcohol intake seemed to have a protective effect towards developing psychiatric disorders. The findings suggest sex differences in the association between...

  15. Psychiatric side effects of ketamine in hospitalized medical patients administered subanesthetic doses for pain control. (United States)

    Rasmussen, Keith G


    To assess the psychiatric side effects of ketamine when administered in subanesthetic doses to hospitalized patients. It is hypothesized that such effects occur frequently. In this retrospective study, the medical records of 50 patients hospitalized on medical and surgical units at our facility who had continuous intravenous infusions of ketamine for pain or mild sedation were reviewed. Patient progress in the days following the start of ketamine infusion was reviewed and response to ketamine was noted. Twenty-two percent of the patients were noted to have some type of psychiatric reaction to ketamine, including agitation, confusion, and hallucinations. These reactions were relatively short lived, namely, occurring during or shortly after the infusions. No association was found between patient response to ketamine and gender, age, or infusion rate. Awareness of the psychiatric side effects of ketamine is an important consideration for clinicians administering this medication either for pain control or for depressive illness.

  16. Re-building Trust after Physical Restraint During Involuntary Psychiatric Hospitalization. (United States)

    Khatib, Anwar; Ibrahim, Mahajne; Roe, David


    This study attempted to identify the elements which might best minimize the negative consequences of restriction of inpatients and rebuild therapeutic alliance and trust. Through in depth interviews with 15 psychiatric patients who had experience restrained during the last involuntary psychiatric hospitalization. Analysis of the data revealed three major themes with regard to trust between restrained patient and restraining staff members during restriction of the patient's freedom. Duration of Restriction, Contact with a Staff Member while Restrained, Supportive Interactions and Staff's Response to Restricted Patients' Needs were reported by patients as crucial in determining the way restrained is experienced and its later impact. Physical restraint in psychiatric hospitalizations generates many negative feelings and can even be traumatic. The patients interviewed help us learn how to provide more human and therapeutic interactions even in extreme situations of restrain which can be crucial to rebuild therapeutic alliance and trust. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Nurses' information retrieval skills in psychiatric hospitals - are the requirements for evidence-based practice fulfilled? (United States)

    Koivunen, Marita; Välimäki, Maritta; Hätönen, Heli


    Nursing professionals have long recognized the importance to practice of research and the value of research evidence. Nurses still do not use research findings in practice. The purpose of this paper was to describe nurses' skills in using literature databases and the Internet in psychiatric hospitals and associations of nurses' gender, age, and job position with their information retrieval skills. The study was carried out in 2004 among nursing staff (N=183) on nine acute psychiatric wards in two psychiatric hospitals in Finland (n=180, response rate 98%). The Finnish version of the European Computer Driving Licence test (ECDL) was used as a data collection instrument. The study showed that there were clear deficits in information retrieval skills among nurses working in psychiatric hospitals. Thus, nurses' competence does not support the realization of evidence-based practice in the hospitals. Therefore, it is important to increase nurses' information retrieval skills by tailoring continuing education modules. It would be also advisable to develop centralized systems for the internal dissemination of research findings for the use of nursing staff.

  18. Incipient offending among schizophrenia patients after first contact to the psychiatric hospital system

    DEFF Research Database (Denmark)

    Munkner, Runa; Haastrup, Soeren; Joergensen, Torben


    The study examines how age, sex and substance use disorder are associated with the risk of committing a criminal offence. The study explicitly examines the risk after the first contact to the psychiatric hospital system and after the diagnosis of schizophrenia for those with no previous criminal ...

  19. A Functional Model of Quality Assurance for Psychiatric Hospitals and Corresponding Staffing Requirements. (United States)

    Kamis-Gould, Edna; And Others


    A model for quality assurance (QA) in psychiatric hospitals is described. Its functions (general QA, utilization review, clinical records, evaluation, management information systems, risk management, and infection control), subfunctions, and corresponding staffing requirements are reviewed. This model was designed to foster standardization in QA…

  20. Racial Disparities in Mental Health Outcomes after Psychiatric Hospital Discharge among Individuals with Severe Mental Illness (United States)

    Eack, Shaun M.; Newhill, Christina E.


    Racial disparities in mental health outcomes have been widely documented in noninstitutionalized community psychiatric samples, but few studies have specifically examined the effects of race among individuals with the most severe mental illnesses. A sample of 925 individuals hospitalized for severe mental illness was followed for a year after…

  1. Long stay patients in a psychiatric hospital in Lagos, Nigeria | Taiwo ...

    African Journals Online (AJOL)

    Objective: In the face of recently introduced government health reform and the dwindling number of available beds for acutely ill patients, a cross sectional study was carried out on long-stay patients at the 100 years old psychiatric hospital Yaba, Lagos, Nigeria with a view to discharging most of them. Method: Necessary ...

  2. Psychiatric hospital beds and prison populations in South America since 1990: does the Penrose hypothesis apply? (United States)

    Mundt, Adrian P; Chow, Winnie S; Arduino, Margarita; Barrionuevo, Hugo; Fritsch, Rosemarie; Girala, Nestor; Minoletti, Alberto; Mitkiewicz, Flávia; Rivera, Guillermo; Tavares, María; Priebe, Stefan


    In 1939, English mathematician, geneticist, and psychiatrist Lionel Sharples Penrose hypothesized that the numbers of psychiatric hospital beds and the sizes of prison populations were inversely related; 75 years later, the question arises as to whether the hypothesis applies to recent developments in South America. To explore the possible association of changes in the numbers of psychiatric hospital beds with changes in the sizes of prison populations in South America since 1990. We searched primary sources for the numbers of psychiatric hospital beds in South American countries since 1990 (the year that the Latin American countries signed the Caracas Declaration) and compared these changes against the sizes of prison populations. The associations between the numbers of psychiatric beds and the sizes of prison populations were tested using fixed-effects regression of panel data. Economic variables were considered as covariates. Sufficiently reliable and complete data were obtained from 6 countries: Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay. The numbers of psychiatric beds and the sizes of prison populations. Since 1990, the numbers of psychiatric beds decreased in all 6 countries (ranging from -2.0% to -71.9%), while the sizes of prison populations increased substantially (ranging from 16.1% to 273.0%). Panel data regression analysis across the 6 countries showed a significant inverse relationship between numbers of psychiatric beds and sizes of prison populations. On average, the removal of 1 bed was associated with 5.18 more prisoners (95% CI, 3.10-7.26; P = .001), which was reduced to 2.78 prisoners (95% CI, 2.59-2.97; P prison populations remained practically unchanged when income inequality was considered as a covariate (-4.28 [95% CI, -5.21 to -3.36]; P prison populations have increased against a background of strong economic growth. The changes appear to be associated because the numbers of beds decreased more extensively when and

  3. Prenatal Pregnancy Complications and Psychiatric Symptoms: Children with ASD versus Clinic Controls (United States)

    Tudor, Megan E.; DeVincent, Carla J.; Gadow, Kenneth D.


    The current study examined the association between prenatal pregnancy complications (PPC) and childhood psychiatric symptoms in children with an autism spectrum disorder (ASD) and non-ASD children who were referred to a psychiatric clinic (Controls). Parents completed a "DSM-IV"-referenced rating scale and developmental history questionnaire.…

  4. Psychiatric Symptoms in Children Diagnosed with an Autism Spectrum Disorder: An Examination of Gender Differences (United States)

    Worley, Julie A.; Matson, Johnny L.


    In addition to the triad of impairments experienced by children and adolescents diagnosed with Autism Spectrum Disorders (ASD), they often present with symptoms of psychiatric disorders. To date, very few studies have examined gender differences in regards to psychiatric symptoms in children and adolescents diagnosed with an ASD. Thus, the current…

  5. A descriptive analysis of admissions to Amanuel Psychiatric Hospital ...

    African Journals Online (AJOL)

    Schizophrenia and bipolar disorder were the top two discharge diagnoses. The median length of hospital stay (LOS) was 63 days. Diagnosis of schizophrenia and place of residence, i.e. living outside of Addis Ababa independently predicted LOS above the median. Conclusion: Admission data demonstrated a huge mental ...

  6. Lessons learned from the study of masturbation and its comorbidity with psychiatric disorders in children: The first analytic study. (United States)

    Tashakori, Ashraf; Safavi, Atefeh; Neamatpour, Sorour


    The main source of information about children's masturbation is more on the basis of case reports. Due to the lack of consistent and accurate information. This study aimed to determine prevalence and underlying factors of masturbation and its comorbidity with psychiatric disorders in children. In this descriptive-analytical study, among the children referred to the Pediatrics Clinic of Psychiatric Ward, Golestan Hospital, Ahvaz, Southwest Iran, 98 children were selected by convenience sampling in 2014. Disorders were diagnosed by clinical interview based on the fourth edition of the Diagnostic and Statistical Manual for Psychiatric Disorders (DSM-IV) and the Child Symptom Inventory-4 (CSI-4). We also used a questionnaire, containing demographic information about the patient and their family and also other data. Data was analyzed using descriptive statistics and chi-square test with SPSS software version 16. Of the children who participated in this study (most of whom were boys), 31.6% suffered from masturbation. The phobias (p=0.002), separation anxiety disorder (p=0.044), generalized anxiety disorder (p=0.037), motor tics (p=0.033), stress disorder (p=0.005), oppositional defiant disorder (p=0.044), thumb sucking (p=0.000) and conduct disorder (p=0.001) were associated with masturbation. Masturbation was common in children referred to psychiatric clinic, and may be more associated with oppositional defiant disorder, or conduct disorder, some anxiety disorders, motor tics and other stereotypical behavior. Authors recommended more probing for psychiatric disorders in children with unusual sexual behavior.

  7. [Introducing computer units into the reception office as part of the Vrapce Psychiatric Hospital Information System]. (United States)

    Majdancić, Zeljko; Jukić, Vlado; Bojić, Miroslav


    Computerized medical record has become a necessity today, because of both the amount of present-day medical data and the need of better handling and processing them. In more than 120 years of the Vrapce Psychiatric Hospital existence, the most important changes in the working concept of the reception office took place when computer technology was introduced into the routine use. The reception office of the Hospital is the vital place where administrative activities intersect with medical care for a patient presenting to the Hospital. The importance of this segment of the Hospital is emphasized by the fact that the reception office is in function and at patients' disposition round-the-clock, for 365 days a year, with great frequency of patients. The shift from the established way of registering medical data on patient admission in handwriting or, later, typescript, to computer recording was a challenging and demanding task (from the aspects of hardware, software, network, education) for the development team as well as for the physicians because it has changed the concept (logic of the working process) of previous way of collecting the data from the patient (history, status, diagnostic procedures, therapy, etc.). The success in the development and implementation of this project and the confirmation of its usefulness during the four-year practice at Vrapce Psychiatric Hospital are best illustrated by the fact that other psychiatric hospitals in Croatia have already introduced or are introducing it in their daily practice.

  8. Pathway for inpatients with depressive episode in Flemish psychiatric hospitals: a qualitative study

    Directory of Open Access Journals (Sweden)

    Simoens Steven R


    Full Text Available Abstract Background Within the context of a biopsychosocial model of the treatment of depressive episodes, a multidisciplinary approach is needed. Clinical pathways have been developed and implemented in hospitals to support multidisciplinary teamwork. The aim of this study is to explore current practice for the treatment of depressive episodes in Flemish psychiatric hospitals. Current practice in different hospitals is studied to get an idea of the similarities (outlined as a pathway and the differences in the treatment of depressive episodes. Methods A convenience sample of 11 Flemish psychiatric hospitals participated in this qualitative study. Semi-structured interviews were conducted with different types of health care professionals (n = 43. The websites of the hospitals were searched for information on their approach to treating depressive episodes. Results A flow chart was made including the identified stages of the pathway: pre-admission, admission (observation and treatment, discharge and follow-up care. The characteristics of each stage are described. Although the stages are identified in all hospitals, differences between hospitals on various levels of the pathway exist. Hospitals emphasized the individual approach of each patient. The results point to a biopsychosocial approach to treating depressive episodes. Conclusion This study outlined current practice as a pathway for Flemish inpatients with depressive episodes. Within the context of surveillance of quality and quantity of care, this study may encourage hospitals to consider developing clinical pathways.

  9. Potentially inappropriate prescriptions in patients admitted to a psychiatric hospital

    DEFF Research Database (Denmark)

    Soerensen, Ann Lykkegaard; Nielsen, Lars Peter; Poulsen, Birgitte Klindt


    university hospital during a 3-month period (September 2013–November 2013). Patients medication lists (n = 207) were reviewed at the time of admission and all identified PIPs were assessed for potential consequences by clinical pharmacologists. Results There were 349 PIP identified in 1291 prescriptions...... with the probability of PIP. Improving the quality of prescribing might benefit from an interprofessional approach and thus better training of physicians and nurses is needed in order to minimize PIP....

  10. Intriguing model significantly reduces boarding of psychiatric patients, need for inpatient hospitalization. (United States)


    As new approaches to the care of psychiatric emergencies emerge, one solution is gaining particular traction. Under the Alameda model, which has been put into practice in Alameda County, CA, patients who are brought to regional EDs with emergency psychiatric issues are quickly transferred to a designated emergency psychiatric facility as soon as they are medically stabilized. This alleviates boarding problems in area EDs while also quickly connecting patients with specialized care. With data in hand on the model's effectiveness, developers believe the approach could alleviate boarding problems in other communities as well. The model is funded by through a billing code established by California's Medicaid program for crisis stabilization services. Currently, only 22% of the patients brought to the emergency psychiatric facility ultimately need to be hospitalized; the other 78% are able to go home or to an alternative situation. In a 30-day study of the model, involving five community hospitals in Alameda County, CA, researchers found that ED boarding times were as much as 80% lower than comparable ED averages, and that patients were stabilized at least 75% of the time, significantly reducing the need for inpatient hospitalization.

  11. Review of two years of experiences with SPECT among psychiatric patients in a rural hospital setting. (United States)

    Sheehan, William; Thurber, Steven


    We summarize single proton emission computed tomography (SPECT) findings from 63 psychiatric patients in a small rural hospital in western Minnesota. SPECT scans were ordered only for patients in whom documentation of hypoperfusion and functional deficits might be helpful in clarifying diagnoses and treatment planning. The patients referred for SPECT scans had histories of traumatic brain injuries, atypical psychiatric symptom presentations, or conditions that were refractory to standard treatments. In the context of strict referral guidelines and close psychiatrist-radiologist collaboration, a much higher yield of significant findings was obtained compared with those noted in other reports in the literature.

  12. Nurse-directed care model in a psychiatric hospital: a model for clinical accountability. (United States)

    E-Morris, Marlene; Caldwell, Barbara; Mencher, Kathleen J; Grogan, Kimberly; Judge-Gorny, Margaret; Patterson, Zelda; Christopher, Terrian; Smith, Russell C; McQuaide, Teresa


    The focus on recovery for persons with severe and persistent mental illness is leading state psychiatric hospitals to transform their method of care delivery. This article describes a quality improvement project involving a hospital's administration and multidisciplinary state-university affiliation that collaborated in the development and implementation of a nursing care delivery model in a state psychiatric hospital. The quality improvement project team instituted a new model to promote the hospital's vision of wellness and recovery through utilization of the therapeutic relationship and greater clinical accountability. Implementation of the model was accomplished in 2 phases: first, the establishment of a structure to lay the groundwork for accountability and, second, the development of a mechanism to provide a clinical supervision process for staff in their work with clients. Effectiveness of the model was assessed by surveys conducted at baseline and after implementation. Results indicated improvement in clinical practices and client living environment. As a secondary outcome, these improvements appeared to be associated with increased safety on the units evidenced by reduction in incidents of seclusion and restraint. Restructuring of the service delivery system of care so that clients are the center of clinical focus improves safety and can enhance the staff's attention to work with clients on their recovery. The role of the advanced practice nurse can influence the recovery of clients in state psychiatric hospitals. Future research should consider the impact on clients and their perceptions of the new service models.

  13. [Comparison of sexual murderers in forensic psychiatric hospitals and in prison]. (United States)

    Ujeyl, M; Habermann, N; Briken, P; Berner, W; Hill, A


    Empirical data are lacking that answer the question of how sexual murderers detained in forensic mental hospitals can be differentiated from those sentenced to prison. Psychiatric court reports and national criminal records on sexual murderers detained in a forensic mental hospital (n=45) were compared with those of prisoners (n=89) regarding diagnostic, criminologic, and prognostic characteristics and criminal recidivism rates after detention. Sexual murderers detained in forensic mental hospitals were characterized by higher psychiatric morbidity and slightly higher risk of future sexual and nonsexual violence. They were released from incarceration less often than the prison inmates but did not show higher sexual or nonsexual violence recidivism rates than those from the prison group.

  14. Stress and psychiatric disorder in healthcare professionals and hospital staff. (United States)

    Weinberg, A; Creed, F


    Previous studies of stress in healthcare staff have indicated a probable high prevalence of distress. Whether this distress can be attributed to the stressful nature of the work situation is not clear. No previous study has used a detailed interview method to ascertain the link between stress in and outside of work and anxiety and depressive disorders. Doctors, nurses, and administrative and ancillary staff were screened using the general health questionnaire (GHQ). High scorers (GHQ>4) and matched individuals with low GHQ scores were interviewed by means of the clinical interview schedule to ascertain definite anxiety and depressive disorders (cases). Cases and controls, matched for age, sex, and occupational group were interviewed with the life events and difficulties schedule classification and an objective measure of work stress to find out the amount of stress at work and outside of work. Sociodemographic and stress variables were entered into a logistic-regression analysis to find out the variables associated with anxiety and depressive disorders. 64 cases and 64 controls were matched. Cases and controls did not differ on demographic variables but cases were less likely to have a confidant (odds ratio 0.09 [95% CI 0.01-0.79]) and more likely to have had a previous episode of psychiatric disorder (3.07 [1.10-8.57]). Cases and controls worked similar hours and had similar responsibility but cases had a greater number of objective stressful situations both in and out of work (severe event or substantial difficulty in and out of work-45 cases vs 18 controls 6.05 [2.81-13.00], pcontrols (median 6 vs 4, z=3.81, pstress outside of work had been taken into account, stressful situations at work contributed to anxiety and depressive disorders. Both stress at work and outside of work contribute to the anxiety and depressive disorders experienced by healthcare staff. Our findings suggest that the best way to decrease the prevalence of these disorders is individual

  15. The Relationship between Job Satisfaction and Burnout among Rehabilitation Personnel of Razi Psychiatric Hospital in Tehran

    Directory of Open Access Journals (Sweden)

    MH Haghighizadeh


    Full Text Available Background and purpose: The study about effective management dimensions in hospital staff performance is important. This study was done to survey the relationship between job satisfaction and burnout in the rehabilitation personnel of Razi Psychiatric Hospital in Tehran. Materials & Methods: In this cross-sectional study, 77 subjects including psychometrics, general practitioners, specialists, nurses, social workers, occupational therapists and psychologists were selected randomly among rehabilitation staff in Razi Psychiatric Hospital in 2011. The data were collected using Maslach Burnout Inventory (MBI and Minnesota Job Satisfaction Questionnaire (MSQ.The data were analyzed using Pearson’s correlation method. Results: Job satisfaction had an inverse relationship with "emotional exhaustion" and "depersonalization"(p<0.001, but there was not a significant relationship between "personal accomplishment" and "job satisfaction". The mean of emotional exhaustion was 68.18, depersonalization 68.4 and personal accomplishment 29.36. In addition, the results of this study showed that 36.6 percent of rehabilitation team employees in Razi Psychiatric Hospital were satisfied with their jobs. Conclusion: As the results show, it is necessary to perform further research to find the main reasons of intensifying job burnout and then reduce these critical factors leading to personnel dissatisfaction from their jobs and any probable consequence of this dissatisfaction.

  16. Simulating policy options for psychiatric care in general hospitals under Medicare's PPS. (United States)

    Freiman, M P; Mitchell, J B; Rosenbach, M L


    Psychiatric hospitals and certain distinct part psychiatric units of general hospitals are currently exempt from diagnosis related group (DRG)-based payment under Medicare's prospective payment system (PPS), in large part due to concern about the degree to which such payment would match historical costs for these facilities. This communication simulates DRG-based payments for psychiatric admissions to general hospitals under the PPS and also under a modified version of the PPS. Two major types of modifications are made: (1) an increase in the role of outlier payments and (2) a restructuring of the DRG classification to allow for a difference in the basic payment rate, depending on whether or not care is provided in a facility that is currently exempt. When compared with cost data from just before the start of the PPS, the simulation results show the degree to which these hypothetical modifications will decrease the systematic risk of general hospitals with exempt units from receiving payments that fall short of costs.

  17. [Cost-effectiveness of two hospital care schemes for psychiatric disorders]. (United States)

    Nevárez-Sida, Armando; Valencia-Huarte, Enrique; Escobedo-Islas, Octavio; Constantino-Casas, Patricia; Verduzco-Fragoso, Wázcar; León-González, Guillermo


    In Mexico, six of every twenty Mexicans suffer psychiatric disorders at some time in their lives. This disease ranks fifth in the country. The objective was to determine and compare the cost-effectiveness of two models for hospital care (partial and traditional) at a psychiatric hospital of Instituto Mexicano del Seguro Social (IMSS). a multicenter study with a prospective cohort of 374 patients was performed. We made a cost-effectiveness analysis from an institutional viewpoint with a six-month follow-up. Direct medical costs were analyzed, with quality of life gains as outcome measurement. A decision tree and a probabilistic sensitivity analysis were used. patient care in the partial model had a cost 50 % lower than the traditional one, with similar results in quality of life. The cost per successful unit in partial hospitalization was 3359 Mexican pesos while in the traditional it increased to 5470 Mexican pesos. treating patients in the partial hospitalization model is a cost-effective alternative compared with the traditional model. Therefore, the IMSS should promote the infrastructure that delivers the psychiatric services to the patient attending to who requires it.

  18. Occupational stressors, burnout and coping strategies between hospital and community psychiatric nurses in a Dublin region. (United States)

    McTiernan, K; McDonald, N


    Burnout negatively impacts the delivery of mental health services. Psychiatric nurses face stressors that are distinct from other nursing specialities. The research was conducted in Ireland and captured a relatively large sample of respondents. The results compared the stressors, coping strategies and burnout levels between hospital and community-based psychiatric nurses. Occupational stress can negatively impact on the well-being of psychiatric nurses, which in turn can lead to poor client care. There is a dearth of published research conducted in Ireland that examines stress within the discipline. A between-groups study, undertaken in February 2011, investigated stressors, burnout and coping strategies between hospital and community-based psychiatric nurses in a Dublin region. Sixty-nine participants (8 males and 61 females), aged between 18 to 60 years voluntarily completed the Mental Health Professional Stress Scale, the Maslach Burnout Inventory and the PsychNurse Methods of Coping Scale. The findings revealed that nurses were operating in a moderately stressful environment. Stressors focused on organizational issues as opposed to client issues. The main stressors identified were lack of resources, workload and organizational structures/processes. Both groups reported average levels of emotional exhaustion, low levels of depersonalization and average levels of personal accomplishment. A Mann-Whitney U-test and Independent Samples t-test found significant differences between hospital and community-based nurses regarding depersonalization and personal accomplishment, respectively. Hospital nurses reported higher depersonalization scores, and community nurses had a greater sense of personal accomplishment. The personal accomplishment scores of hospital nurses were below mental health professional norms. No significant differences emerged regarding coping strategies. Avoidant coping strategies were favoured by both groups. It is recommended that interventions

  19. Attitudes towards patient gender among psychiatric hospital staff: results of a case study with focus groups. (United States)

    Krumm, Silvia; Kilian, Reinhold; Becker, Thomas


    There is an increasing awareness of gender-related issues in psychiatry. However, empirical findings on attitudes of psychiatric staff towards patient gender are limited. Gender-related issues are particularly relevant in the debate about mixed versus segregated sex wards, yet while the appropriateness of mixed-sex wards is questioned in Great Britain this is not the case in Germany. To investigate attitudes of psychiatric staff towards both patient gender and mixed versus segregated sex wards, we conducted a case study using focus groups with members of professional teams. We evaluated the transition process from two single-sex wards to two mixed-sex wards in a 330-bed psychiatric hospital in a rural area in south Germany. Staff described female patients as more externally oriented, motivating of others, demanding, and even sexually aggressive. Male patients, on the other hand, were described as more quiet, modest, or lazy. Furthermore, participants described the mixing process as a positive development whereas they did not see a need for gender-separated wards in order to protect vulnerable female patients. Some gender descriptions by professionals are "reversed" in comparison with gender stereotypes supposed to be present in wider society. The perception of crossed gender norms may affect staff attitudes towards the vulnerability of female patients in psychiatric settings and the provision of single-sex wards in in-patient psychiatric care. Practical implications are discussed against the background of a high rate of female patients with sexual abuse histories.

  20. Can personality traits predict the future development of heart disease in hospitalized psychiatric veterans? (United States)

    Williams, Wright; Kunik, Mark E; Springer, Justin; Graham, David P


    To examine which personality traits are associated with the new onset of chronic coronary heart disease (CHD) in psychiatric inpatients within 16 years after their initial evaluation. We theorized that personality measures of depression, anxiety, hostility, social isolation, and substance abuse would predict CHD development in psychiatric inpatients. We used a longitudinal database of psychological test data from 349 Veterans first admitted to a psychiatric unit between October 1, 1983, and September 30, 1987. Veterans Affairs and national databases were assessed to determine the development of new-onset chronic CHD over the intervening 16-year period. New-onset CHD developed in 154 of the 349 (44.1%) subjects. Thirty-one psychometric variables from five personality tests significantly predicted the development of CHD. We performed a factor analysis of these variables because they overlapped and four factors emerged, with positive adaptive functioning the only significant factor (OR=0.798, p=0.038). These results support previous research linking personality traits to the development of CHD, extending this association to a population of psychiatric inpatients. Compilation of these personality measures showed that 31 overlapping psychometric variables predicted those Veterans who developed a diagnosis of heart disease within 16 years after their initial psychiatric hospitalization. Our results suggest that personality variables measuring positive adaptive functioning are associated with a reduced risk of developing chronic CHD.

  1. Psychiatric Disorder or Impairing Psychology in Children Who Have Been Excluded from School: A Systematic Review (United States)

    Whear, Rebecca; Marlow, Ruth; Boddy, Kate; Ukoumunne, Obioha C.; Parker, Claire; Ford, Tamsin; Thompson-Coon, Jo; Stein, Ken


    When children with special educational needs are excluded from school, it should raise the concern that these children are not receiving adequate help and support. This systematic review aims to identify the prevalence of psychiatric disorder or impairing psychopathology among children who are excluded from school compared to children who are not…

  2. Demographic and clinical characteristics of patients referred to psychiatric unit in a tertiary care hospital

    International Nuclear Information System (INIS)

    Yousafzai, A.W.; Kazim, M.; Jehangiri, A.U.R.


    Very few studies from Pakistan have examined the profile of patients seen by psychiatrists in general hospital. The aim of this research is to describe the clinical and demographic characteristics of patients referred to the psychiatric unit of a general hospital over a one year period. Methods: This cross-sectional study was conducted at the Ayub Teaching Hospital, Abbottabad, from January 1st to December 31st 2012. All patients being referred to psychiatry were included in the study over one year period. The information was recorded on a structured questionnaire and analysed the data using SPSS-19.0. Results: Out of the 105 patients referred to the psychiatric unit, 74 (72.3%) were females. A total of 69 (68.5%) patients were married. More than half were uneducated and only number 4 (3%) patients had university qualification. Housewives made up 64.4% of the patient population followed by students (11%). Majority 55 (53%) had less than Rs. 5000/ monthly income. About 30% patients were shifted to psychiatry ward while, nearly one tenth were discharged. In 35% cases the psychiatrist was asked to help in the management, while in 50% cases only opinion was sought. Aggressive and threatening behaviour was source of concern in majority of patients for the primary team while 34% exhibited suicidal behaviour. Depression was most frequent diagnosis in 45 43% patients, followed by conversion disorder 19 (17%) and delirium 16 (14%). Conclusion: The rate of psychiatric referrals is dismal with only one third of the patients being transferred to the psychiatric ward. The major psychiatric diagnosis was depression. Patients with aggressive and threatening behaviour were more frequently referred. (author)

  3. [40 years of toxicomania at the psychiatric hospital in Liège]. (United States)

    Husquinet, H


    Drug abuse was observed during 40 years (1939-1979) in a psychiatric hospital for women (sanatorium Sainte-Agathe, Liège, Belgium). Seventy patients were labelled with that diagnosis, -i.e. 2,9% of 2386 admissions. The frequency of drug addiction grew with years and between 1975 and 1979, outnumbered 10% of all admissions. 3/4 of those patients were previously inmates of other psychiatric clinics and well known in medical urgency services. Morphinomaniacs were the only patients between 1939 and 1949 (11 women). As a rule, they survived and did not come back. No haschich, L.S.D. or heroin addicts were seen: their psychiatric confinement was never required. Beginning in december 1959, barbituromaniacs (58 patients) invaded the wards. Other hypnotics were used as well (e.g. metaqualone). Forty-five per cent of the patients died and the survivors came back and back again, -en masse. The illness is very serious if it starts before 30 years: the risk of death goes to 75%. Barmaids and prostitutes were definitely doing hazardous jobs (5 deaths among 6 cases). Other psychiatric illnesses interfere with toxicomania, especially depression. Four patients committed suicide without hypnotics. To conclude: barbiturates are dangerous drugs and they ought not to be used for insomnia. Benzodiazepine abuse did not occur in the hospital and did not induce fatal issues. Combined with phenothiazines, benzodiazepines can solve nearly all sleep disturbances.

  4. Digestive system complications among hospitalized children with ...

    African Journals Online (AJOL)


    least common complication, occurring in one (3.3%) of the cases studied. Conclusion: Acute ... Keywords: Acute abdominal crisis, children, haemoglobin, hospitalization, multi-systemic ... improvement of the management of such children.

  5. [Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization]. (United States)

    Domingos, Thiago da Silva; Braga, Eliana Mara


    To investigate the effectiveness of aromatherapy massage using the essential oils (0.5%) of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate) were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State) was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. There was a statistically significant decrease (p Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

  6. Significance of clay art therapy for psychiatric patients admitted in a day hospital

    Directory of Open Access Journals (Sweden)

    Aquiléia Helena de Morais


    Full Text Available Objective. To understand the significance of clay art therapy for psychiatric patients admitted in a day hospital. Methodology. Qualitative, descriptive and exploratory research, undertaken with 16 patients in a day hospital in Londrina, in the state of Parana, Brazil, who participated in seven clay therapy sessions. Data collection took place from January to July 2012 through interviews guided by a semi structured questionnaire and the data were submitted to content analysis. Results. Three themes emerged: Becoming familiar with clay art therapy; Feeling clay therapy; and Realizing the effect of clay therapy. Conclusion. The use of clay as a therapeutic method by psychiatric patients promoted creativity, self-consciousness, and benefited those who sought anxiety relief.

  7. Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Thiago da Silva Domingos

    Full Text Available OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5% of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. RESULTS There was a statistically significant decrease (p < 0.001 of the heart and respiratory mean rates after each intervention session, as well as in the inventory score. CONCLUSION Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

  8. Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Thiago da Silva Domingos


    Full Text Available OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5% of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate were collected before and after each session and an anxiety scale (Trait Anxiety Inventory-State was applied at the beginning and end of the intervention. The results were statistically analyzed with the chi square test and paired t test. RESULTS There was a statistically significant decrease (p < 0.001 of the heart and respiratory mean rates after each intervention session, as well as in the inventory score. CONCLUSION Aromatherapy has demonstrated effectiveness in anxiety relief, considering the decrease of heart and respiratory rates in patients diagnosed with personality disorders during psychiatric hospitalization.

  9. Massage with aromatherapy: effectiveness on anxiety of users with personality disorders in psychiatric hospitalization


    Domingos, Thiago da Silva; Braga, Eliana Mara


    OBJECTIVE To investigate the effectiveness of aromatherapy massage using the essential oils (0.5%) of Lavandula angustifolia and Pelargonium graveolens for anxiety reduction in patients with personality disorders during psychiatric hospitalization. METHOD Uncontrolled clinical trial with 50 subjects submitted to six massages with aromatherapy, performed on alternate days, on the cervical and the posterior thoracic regions. Vital data (heart and respiratory rate) were collected before and afte...

  10. Consumption of psychiatric drugs by patients of medical and surgical clinics in a general hospital


    Shirama,Flavio Hiroshi; Miasso,Adriana Inocenti


    PURPOSES: to identify the prevalence of the use of psychiatric drugs among patients admitted to medical and surgical clinics of a general hospital, and also the factors related to the consumption of this type of medication. METHOD: this is a transversal, descriptive, correlational study with quantitative analysis. For the collection of data, there was use of structured interviews and also reference to medical files. RESULTS: there was confirmation of a high prevalence of users of psy...

  11. Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

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    Amilton dos Santos Jr.


    Full Text Available Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02. Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5% reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients.

  12. A Review of Child Psychiatric Epidemiology With Special Reference to American Indian and Alaska Native Children. (United States)

    Green, Ben Ezra; And Others


    Places the limited knowledge of the psychological problems of American Indian and Alaska Native children in context of general child psychiatric epidemiology, using the taxonomy of the American Psychiatric Association's third "Diagnostic and Statistical Manual." Available from: White Cloud Center, Gaines Hall UOHSC, 840 Southwest Gaines…

  13. Psychiatric disorders in individuals diagnosed with infantile autism as children: A case control study

    DEFF Research Database (Denmark)

    Mouridsen, S.E.; Rich, B.; Isager, T.


    The objective of this study was to compare the prevalence and types of psychiatric disorders in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with psychiatric disorders in 336 matched controls from the general population using data from the nationwide Danish...

  14. Psychiatric disorders in adults diagnosed as children with atypical autism. A case control study

    DEFF Research Database (Denmark)

    Mouridsen, S.E.; Rich, B.; Isager, T.


    The prevalence and types of psychiatric disorders were studied in a clinical sample of 89 individuals with atypical autism (AA) first seen as children, and 258 matched controls from the general population using data from the nationwide Danish Psychiatric Central Register. The average observation...

  15. Emergency presentations to an inner-city psychiatric service for children and adolescents.

    NARCIS (Netherlands)

    Dil, L.M.; Vuijk, P.J.


    Psychiatric emergency services for children and adolescents vary in process, structure and outcome. There are few systematic studies on the type and prevalence of psychiatric problems encountered, related circumstances or resulting interventions. Evidence in these areas is important in evaluation of

  16. Metabolic syndrome and associated factors among psychiatric patients in Jimma University Specialized Hospital, South West Ethiopia. (United States)

    Asaye, Sintayehu; Bekele, Shiferaw; Tolessa, Daniel; Cheneke, Waqtola


    Metabolic syndrome is a multisystem disorder which coined to describe the recognized clustering of metabolic and cardiovascular abnormalities including obesity, hypertension, dyslipidemia, and abnormalities of glucose homeostasis. To assess the prevalence and associated factors of metabolic syndrome among psychiatric patients in Jimma University Specialized Hospital. This study was conducted at Jimma University Specialized hospital psychiatric ward from May 15 to July 16, 2015. A cross-sectional study design and consecutive sampling technique were used. A single population proportion formula was used to include a total of 360 psychiatric patients. An interview administered structured questionnaire was used to collect socio-demographic and some clinical data. Anthropometric data were collected based on standard guild line for anthropometric measurement. Five milliliter of venous blood was collected from ante-cubital fossa after overnight fasting for 8 h. Semi-automated clinical chemistry analyzer (Temis Linear) was used for biochemical laboratory analysis. Data analysis was performed by using SPSS version-20 software. Binary and multiple logistic regressions were used to identify the association between dependent and independent variables. P value less than 0.05 was taken as statistically significant association. The prevalence of metabolic syndrome among psychiatric patients was 28.9%. Age greater than 30 years old (AOR: 5.2, CI: 2.3, 11.8, P. value metabolic syndrome among diabetic patients in the study area. The other independent variables such as family history of hypertension, chewing chat, Psychotropic drugs, duration of treatment, regularly eating fruits and vegetables had no statistically significant association with metabolic syndrome (P. value > 0.05). There was high prevalence of metabolic syndrome among the psychiatric patients. Therefore; close assessment, management and treatment of metabolic syndrome among patients with psychiatry problem is

  17. Underestimation of substance abuse in psychiatric patients by conventional hospital screening. (United States)

    Reidy, Lisa J; Junquera, Patricia; Van Dijck, Karolien; Steele, Bernard W; Nemeroff, Charles B


    Psychiatric diagnosis mainly relies on behavioral signs and symptoms. Substance abuse can mimic the clinical presentation of primary psychiatric disorders and can also complicate the management of psychiatric patients. The reliability and accuracy of urine toxicology is a vital tool in the optimal treatment of these patients. Current demographics of substance abuse suggest that in addition to the most conventional drugs of abuse (e.g. cocaine, cannabis) that are of concern to treating physicians, prescription medications and new designer drugs also should be when evaluating patients who present with symptoms of psychosis/drug addiction or altered mental status. Urine samples from 220 psychiatric inpatients admitted to either an acute drug and alcohol unit or acute psychiatric unit were analyzed for drugs by the standard hospital assay (KIMS) and by a more sensitive ELISA and GC-MS basic drug screening protocol. The standard hospital toxicology (KIMS) was inferior to the ELISA and GC-MS methods in terms of both assay sensitivity and in detecting a broader number of drugs. The KIMS tests failed to identify opiates and amphetamine/methamphetamine in 50% of the patients. The KIMS screen did not identify zolpidem, buprenorphine and a number of synthetic drugs of abuse including cathinone and tryptamines. In order to reliably identify substance abuse in patients with altered mental status in inpatient settings, analytical methodologies with adequate assay sensitivity and range to detect the vast majority of commonly abused illicit drugs and prescription medications are required for optimal clinical assessment and treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Clinical features and therapeutic management of patients admitted to Italian acute hospital psychiatric units: the PERSEO (psychiatric emergency study and epidemiology survey

    Directory of Open Access Journals (Sweden)

    Russo Federico


    Full Text Available Abstract Background The PERSEO study (psychiatric emergency study and epidemiology is a naturalistic, observational clinical survey in Italian acute hospital psychiatric units, called SPDCs (Servizio Psichiatrico Diagnosi e Cura; in English, the psychiatric service for diagnosis and management. The aims of this paper are: (i to describe the epidemiological and clinical characteristics of patients, including sociodemographic features, risk factors, life habits and psychiatric diagnoses; and (ii to assess the clinical management, subjective wellbeing and attitudes toward medications. Methods A total of 62 SPDCs distributed throughout Italy participated in the study and 2521 patients were enrolled over the 5-month study period. Results Almost half of patients (46% showed an aggressive behaviour at admission to ward, but they engaged more commonly in verbal aggression (38%, than in aggression toward other people (20%. A total of 78% of patients had a psychiatric diagnosis at admission, most frequently schizophrenia (36%, followed by depression (16% and personality disorders (14%, and no relevant changes in the diagnoses pattern were observed during hospital stay. Benzodiazepines were the most commonly prescribed drugs, regardless of diagnosis, at all time points. Overall, up to 83% of patients were treated with neuroleptic drugs and up to 27% received more than one neuroleptic either during hospital stay or at discharge. Atypical and conventional antipsychotics were equally prescribed for schizophrenia (59 vs 65% during stay and 59 vs 60% at discharge, while atypical drugs were preferred in schizoaffective psychoses (72 vs 49% during stay and 70 vs 46% at discharge and depression (41 vs 32% during stay and 44 vs 25% at discharge. Atypical neuroleptics were slightly preferred to conventional ones at hospital discharge (52 vs 44%. Polypharmacy was in general widely used. Patient attitudes toward medications were on average positive and self

  19. Suicide ideation and attempts in children with psychiatric disorders and typical development. (United States)

    Dickerson Mayes, Susan; Calhoun, Susan L; Baweja, Raman; Mahr, Fauzia


    Children and adolescents with psychiatric disorders are at increased risk for suicide behavior. This is the first study to compare frequencies of suicide ideation and attempts in children and adolescents with specific psychiatric disorders and typical children while controlling for comorbidity and demographics. Mothers rated the frequency of suicide ideation and attempts in 1,706 children and adolescents with psychiatric disorders and typical development, 6-18 years of age. For the typical group, 0.5% had suicide behavior (ideation or attempts), versus 24% across the psychiatric groups (bulimia 48%, depression or anxiety disorder 34%, oppositional defiant disorder 33%, ADHD-combined type 22%, anorexia 22%, autism 18%, intellectual disability 17%, and ADHD-inattentive type 8%). Most alarming, 29% of adolescents with bulimia often or very often had suicide attempts, compared with 0-4% of patients in the other psychiatric groups. It is important for professionals to routinely screen all children and adolescents who have psychiatric disorders for suicide ideation and attempts and to treat the underlying psychiatric disorders that increase suicide risk.

  20. Deliberate Self-harm seen in a Government Licensed Private Psychiatric Hospital and Institute. (United States)

    Krishnaram, Vaithiyam Devendran; Aravind, Vaithiyam Krishnaram; Vimala, A Rupavathy


    Majority of the published studies on suicide deal with identifying the sociodemographic and psychosocial aspects of suicide attempters and those who have completed suicide or to identify the characteristic differences between the two groups. There are very few studies focusing mainly or only on deliberate self harm. Most of these are hospital based studies or in a setting of general hospital psychiatry units. The present study is from Ram Psychiatry Hospital and Institute, a government licensed private psychiatric institute at Madurai, Tamil Nadu. It is a prospective study of individuals with self harm behavior mostly without the intention to kill, attending the psychiatry outpatient department of the hospital for the period of one year (January to December 2014) a total number of 140 cases are registered. Sociodemographic, clinical profiles with Axis I or Axis II diagnosis or otherwise, and the initiating or precipitating cause or mode of self-injury or self-harm are studied. The results are presented and discussed.

  1. [Closing forensic psychiatric hospitals in Italy: a new deal for mental health care?]. (United States)

    Casacchia, Massimo; Malavolta, Maurizio; Bianchini, Valeria; Giusti, Laura; Di Michele, Vittorio; Giosuè, Patricia; Ruggeri, Mirella; Biondi, Massimo; Roncone, Rita


    The date of March 31, 2015, following the Law 81/2014, has marked a historical transition with the final closure of the six forensic psychiatric hospitals in Italy. This law identifies a new pathway of care that involves small-scale high therapeutic profile facilities (Residenze per la Esecuzione della Misura di Sicurezza, REMS) instead of the old forensic psychiatric hospitals. The Law promotes a new recovery-oriented rehabilitation approach for the persons with mental disorders who committed a criminal offence, but lack criminal responsibility and deemed as socially dangerous. After a brief description of what happens abroad, this article highlights the positive aspects of the law that, as a whole, has to be considered innovative and unavoidable. The main debated problems are also reviewed, including the lack of changes to the Criminal Code; the improper equation between insanity and mental illness and social dangerousness; the evaluation of "socially dangerousness", based solely on "subjective qualities" of the person, assessed out of his/her context, without paying attention to family and social conditions suitable for discharge; the expensive implementation of the REMS, mainly based on security policies and less on care and rehabilitation, the delay in their construction, and the search for residential alternatives structures; the uncertain boundaries of professional responsibility. Finally, several actions are suggested that can support the implementation of the law: information programs addressed to the general population; training activities for mental health professionals; systematic monitoring and evaluation of the outcomes of the care provided to the forensic psychiatric population; implementation of Agreement Protocols and a better cooperation with the judiciary. Scientific societies dealing with psychosocial rehabilitation need to be involved in such issues relating to the identification of the best care and rehabilitation pathways, which should be

  2. Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals

    Directory of Open Access Journals (Sweden)

    Judith McLenan


    Full Text Available Objective: The aim of this study was to evaluate the type, severity and progression of psychiatric pathologies in a sample of 372 outpatients (age range 18–65 years referred by their primary general practitioners (GPs to an Urgent Referral Team (URT based in a psychiatric hospital in Aberdeen, Scotland. This team offers immediate appointments (1- to 7-day delays for rapid assessments and early interventions to the outpatients referred by their primary family doctors.Method: One-sample t-test and z statistic were used for data analysis. From the total population, a convenience sample of 40 people was selected and assessed to evaluate whether follow-up appointments after the first visit could reduce the severity of suicidal ideation, depression and anxiety in the outpatients seen by the URT. A two-sample t-test and a Wilcoxon signed-rank test were used to assess the variations in the scores during the follow-up visits.Results: We found a statistically significant prevalence of depressive disorders, comorbid with anxiety at first presentation in people who were females, white, never married, living with a partner, not studying and not in paid employment. The common presentation of borderline personality disorder and dysthymia in this population underscores its vulnerability to major socioeconomic challenges.Conclusion: The data confirmed the impact that primary care cooperation with psychiatric hospitals can have on the psychiatric system, and as a reflection, on the population’s mental health and well-being. In fact, active cooperation and early diagnosis and intervention will help detect cases at risk in the general population and reduce admissions into hospitals.

  3. Impact on the psychotic vulnerability of the therapeutic approachin the Prison Psychiatric Hospital in Seville (Spain). (United States)

    Massé-García, P; Lamas-Bosque, F J; Massé-Palomo, A


    to analyze changes in psychotic vulnerability following the implementation of a program of prison psychiatric treatment, recidivism after the release and various descriptive variables of criminological interest. review of a sample consisting of 50 patients diagnosed with schizophrenia admitted to the Prison Psychiatric Hospital of Seville. there was a statistically significant reduction of psychotic vulnerability according to an assessment using the Frankfurt psychopathological inventory (FBF-3), after conducting a complete psychiatric, psychological, social and rehabilitation approach in the prison environment. The core symptoms relating to complex perception and language also decreased significantly. The reduction is particularly noticeable in the number of patients categorized as medium-high and high severity. Recidivism in the follow-up of release of patients in the study sample is low (6%) and there were no cases of serious felony or grievous bodily harm. Recidivism, when it occurs, is not immediate. Although there is some criminal versatility, it is limited. The most frequent victims are parents with a previous relationship with the patient. Most of the patients in the sample, and all recidivists, have comorbid substance abuse (dual diagnosis). we need more comprehensive studies to establish causal relationships between the decrease in psychotic vulnerability and an integrated psychiatric, psychological, social and rehabilitation approach in prisons; or to attribute the low rate of recidivism to the decline of psychotic vulnerability.

  4. Impact on the psychotic vulnerability of the therapeutic approachin the Prison Psychiatric Hospital in Seville (Spain

    Directory of Open Access Journals (Sweden)

    P. Massé-García

    Full Text Available Objectives: to analyze changes in psychotic vulnerability following the implementation of a program of prison psychiatric treatment, recidivism after the release and various descriptive variables of criminological interest. Materials and methods: review of a sample consisting of 50 patients diagnosed with schizophrenia admitted to the Prison Psychiatric Hospital of Seville. Results: there was a statistically significant reduction of psychotic vulnerability according to an assessment using the Frankfurt psychopathological inventory (FBF-3, after conducting a complete psychiatric, psychological, social and rehabilitation approach in the prison environment. The core symptoms relating to complex perception and language also decreased significantly. The reduction is particularly noticeable in the number of patients categorized as medium-high and high severity. Recidivism in the follow-up of release of patients in the study sample is low (6% and there were no cases of serious felony or grievous bodily harm. Recidivism, when it occurs, is not immediate. Although there is some criminal versatility, it is limited. The most frequent victims are parents with a previous relationship with the patient. Most of the patients in the sample, and all recidivists, have comorbid substance abuse (dual diagnosis. Discussion: we need more comprehensive studies to establish causal relationships between the decrease in psychotic vulnerability and an integrated psychiatric, psychological, social and rehabilitation approach in prisons; or to attribute the low rate of recidivism to the decline of psychotic vulnerability.

  5. Incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients


    Ruengorn, Chidchanok; Sanichwankul, Kittipong; Niwatananun, Wirat; Mahatnirunkul, Suwat; Pumpaisalchai, Wanida; Patumanond, Jayanton


    Chidchanok Ruengorn1, Kittipong Sanichwankul2, Wirat Niwatananun3, Suwat Mahatnirunkul2, Wanida Pumpaisalchai2, Jayanton Patumanond11Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University; 2Suanprung Psychiatric Hospital; 3Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, ThailandBackground: The incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients remain uninvestig...

  6. Are Ataques de Nerviosa in Puerto Rican Children Associated with Psychiatric Disorder? (United States)

    Guarnaccia, Peter J.; Martinez, Igda; Ramirez, Rafael; Canino, Glorisa


    Objective: To provide the first empirical analysis of a cultural syndrome in children by examining the prevalence and psychiatric correlates of ataques de nervios in an epidemiological study of the mental health of children in Puerto Rico. Method: Probability samples of caretakers of children 4-17 years old in the community (N = 1,892; response…

  7. [Reality of treatment in psychotherapy: Results of a survey of German psychiatric hospitals]. (United States)

    Laux, G; Sander, K; Artmann, S; Dreher, J; Lenz, J; Hauth, I


    Since the introduction of the qualification as specialist for psychiatry and psychotherapy, in addition to psychopharmacotherapy psychotherapy is an integral component of the treatment of mentally ill people. A survey was carried out to evaluate the reality of clinical routine use of psychotherapy in German psychiatric hospitals. Between October 2011 and March 2012 German hospitals of psychiatry and psychotherapy were contacted by the head organization, the conference of national directors (Bundesdirektorenkonferenz), to participate in a survey regarding the application of psychotherapy in the real clinical world of daily treatment. With an anonymous questionnaire, data were requested as either a printed form or online version. Data from 25 psychiatric hospitals in the year 2010 could be analysed (average number of beds 300 of which 53 were for psychosomatic/psychotherapeutic patients) and a total of 87,000 inpatients were treated whereby 34 % were diagnosed as F1 addictive disorders and 24 % as F3 affective disorders. More than 80 % of the hospitals applied group therapies of relaxation, cognitive behavior therapy, social competence training and specific techniques, such as dialectic-behavior therapy. As individual treatment methods, patients with depressive disorders were treated with cognitive behavior therapy, interpersonal psychotherapy or psychodynamic therapy in more than 50 % of the cases. Relaxation techniques were offered in most cases by the nursing staff, behavior therapy by psychologists and physicians and psychodynamic therapy mainly by psychiatrists.

  8. Discontinuing the Use of PRN Intramuscular Medication for Agitation in an Acute Psychiatric Hospital. (United States)

    Hayes, Ariel; Russ, Mark J


    This study examined the impact of eliminating intramuscular PRN medication for agitation on patient and staff safety in an acute psychiatric inpatient setting. The current retrospective chart review investigated the use of PRN medications (oral and intramuscular) to treat acute agitation, including aggression, and related outcomes before and after a mandated change in PRN practice that required real time physician input before administration of intramuscular medications. The use of both oral and intramuscular PRN medications dramatically decreased following implementation of the mandated change in practice. In particular, the use of intramuscular PRNs for agitation decreased by about half. Despite this decrease, the assault rate in the hospital was unchanged, and the utilization of restraint and seclusion continued to decrease. It is possible to reduce the utilization of PRN medications for agitation without broadly compromising safety on acute care psychiatric inpatient units.

  9. Incipient offending among schizophrenia patients after first contact to the psychiatric hospital system

    DEFF Research Database (Denmark)

    Munkner, Runa; Haastrup, Soeren; Joergensen, Torben


    The study examines how age, sex and substance use disorder are associated with the risk of committing a criminal offence. The study explicitly examines the risk after the first contact to the psychiatric hospital system and after the diagnosis of schizophrenia for those with no previous criminal...... record; the association between previous non-violent criminality and later violent criminality is also analysed. The study sample comprised 4619 individuals ever diagnosed with schizophrenia. All solved offences were accessible. Data were analysed using Cox's regression. Schizophrenic men had twice....... Previous non-violent criminality increased the risk for later violent criminality 2.5- to 2.7-fold, depending on the starting point for the analyses. The results suggest that the psychiatric treatment system can play an active role in preventing criminality among individuals with schizophrenia...

  10. Psychiatric comorbidity distribution and diversities in children and adolescents with attention deficit/hyperactivity disorder: a study from Turkey

    Directory of Open Access Journals (Sweden)

    Yüce M


    Full Text Available Murat Yüce,1 Süleyman Salih Zoroglu,2 Mehmet Fatih Ceylan,3 Hasan Kandemir,4 Koray Karabekiroglu5 1Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey; 2Department of Child and Adolescent Psychiatry, Medical Faculty of Istanbul, Istanbul University, Istanbul, Turkey; 3Department of Child and Adolescent Psychiatry, Dr Sami Ulus Children's Hospital, Ankara, Turkey; 4Department of Child and Adolescent Psychiatry, Faculty of Medicine, Harran University, Sanliurfa, Turkey; 5Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey Objective: We aimed to determine distribution and diversities of psychiatric comorbidities in children and adolescents with attention deficit/hyperactivity disorder (ADHD in terms of age groups, sex, and ADHD subtype. Materials and methods: The sample included 6–18 year old children and adolescents from Turkey (N=108; 83 boys, 25 girls diagnosed with ADHD. All comorbid diagnoses were determined based on the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version assessment. Results: 96.3% of the cases were found to have at least one psychiatric comorbid diagnosis. The most frequent psychiatric comorbid disorder was oppositional defiant disorder (69.4% followed by anxiety disorders (49% and elimination disorders (27.8%. Disruptive behavior disorders were more common in ADHD-combined type. Depression and anxiety disorders were more common in girls. Separation anxiety disorder and elimination disorder were more common in children, whereas depression, bipolar disorder, obsessive–compulsive disorder, and social phobia were more common in the adolescents. Conclusion: According to our results, when a diagnostic tool was used to assess the presence of comorbid psychiatric disorders in children and adolescents diagnosed with ADHD, almost all cases had at least one

  11. Understanding readmission to psychiatric hospital in Australia from the service users' perspective: a qualitative study. (United States)

    Duhig, Michael; Gunasekara, Imani; Patterson, Sue


    Inpatient care is integral to balanced mental health systems, contributing to containment of risk associated with psychiatric crises and affording opportunities for treatment. However, psychiatric wards are not always safe and service users are often dissatisfied with the experience. Hence, and because inpatient care is the most costly component of mental health systems, minimising duration of admission and reducing risk of readmission are clinical and strategic priorities internationally. With (primarily quantitative) research to date focused on explaining readmission in terms of characteristics of individuals and services, understanding of the 'revolving door phenomenon' remains limited. Considering verstehen critical to addressing this messy problem, we examined readmission from the service users' perspective. Using grounded theory techniques, we inductively analysed data from interviews with 13 people readmitted to inpatient care within 28 days of discharge. Participants, including eight men, were recruited in 2013 from three psychiatric wards at a metropolitan hospital in Australia. Analysis supported description of readmission as a process, fundamentally related to insufficiency of internal, interpersonal and/or environmental resources to maintain community tenure. For the people in this study, admission to hospital was either the default coping mechanism or the culmination of counter-productive attempts to manage stressful circumstances. Readmission can appropriately be understood as one representation of a fundamental social malaise and the struggle of some people to survive in an apparently inhospitable world. The findings indicate that neither locating the 'problem of readmission' within an individual and promoting self-governance/self-control/self-regulation, nor identifying failures of specific services or sectors are likely to support the economic and ethical imperative of reducing psychiatric admissions. The findings of the study and limitations

  12. Hospitalization of abused and neglected children. (United States)

    Marshall, W N


    To describe the use of inpatient hospitalization for abused and neglected children living in a metropolitan area. Retrospective record review of abused and neglected children admitted in 1992 and 1993 to hospitals with 87% of metropolitan area pediatric admissions; comparison of these data with population, crisis nursery, and child protective services data. Thirty-four abused and neglected children were admitted to hospital, representing 0.3% (34/11,066; 95% confidence interval, 0%-1.2%) of pediatric admissions and 0.2% (34/19,950; 95% confidence interval, 0%-0.6%) of child protective services reports. This represents a rate of hospitalization for child abuse of 10 children (95% confidence interval, 0-46) per 100,000 child population per year. Seven hundred fifteen children were admitted to the crisis nursery by child protective services. Of those admitted to the hospital, 12 needed intensive care, 5 of whom died. Only 3 of 34 hospital-admitted children had private health insurance; 19 of 34 were younger than 1 year. Inpatient hospitalization for abuse represented a small fraction of total pediatric admissions and of child protective services reports. Comprehensive medical care for most abused children and medical education about child abuse must occur in outpatient settings.

  13. An anatomy of countertransference: staff reactions to difficult psychiatric hospital patients. (United States)

    Colson, D B; Allen, J G; Coyne, L; Dexter, N; Jehl, N; Mayer, C A; Spohn, H


    Countertransference among hospital staff was investigated as part of ongoing research on difficult-to-treat psychiatric hospital patients. Staff's ratings of their emotional reactions to 127 patients on long-term units were analyzed by factor analysis, and the resulting factors were correlated by discipline with patient problem behaviors. Among the conclusions were that different forms of psychopathology elicit characteristic patterns of emotional reaction from staff; that some dimensions of psychopathology, particularly suicidal-depressed behavior and violence-agitation, elicit different emotional reactions among different disciplines, thus laying the groundwork for division among staff; and that the more difficult the process of hospital treatment, the more likely staff will experience a variety of emotions.

  14. Children Hospitalized With Varicella in Denmark

    DEFF Research Database (Denmark)

    Glode Helmuth, Ida; Broccia, Marcella Ditte; Glenthøj, Jonathan Peter


    is not part of the national immunization program and there is no national surveillance of varicella. The primary aim of the study was to describe the epidemiology and clinical characteristics of children hospitalized with varicella in Denmark. The secondary aim was to validate the sensitivity and completeness...... of the Danish National Patient Register. METHODS: Active surveillance of children hospitalized with varicella was carried out at 4 pediatric departments. In the Danish National Patient Register, we identified all children discharged with an International Classification of Diseases, 10th revision code...... of varicella from the 4 departments. We used a capture-recapture analysis to estimate the "true" number of hospitalized children with varicella. RESULTS: By active surveillance, we identified 86 children eligible for clinical description. In 87% of cases, the children were 0-4 years of age. Complications were...

  15. Psychiatric comorbidity in children and youth with epilepsy: An association with executive dysfunction? (United States)

    Alfstad, Kristin Å; Torgersen, Halvor; Van Roy, Betty; Hessen, Erik; Hansen, Berit Hjelde; Henning, Oliver; Clench-Aas, Jocelyne; Mowinckel, Petter; Gjerstad, Leif; Lossius, Morten I


    Psychopathology in children and youth with epilepsy has previously been related to executive dysfunction, but the nature of the association is uncertain. We sought to explore risk factors for psychiatric disorders in children and youth with epilepsy, with emphasis on executive dysfunction, along with seizure-related and psychosocial factors. The cohort consisted of one hundred and one consecutive patients aged 10-19 years with focal (n=52) or genetic generalized (n=49) epilepsy. All were screened for psychiatric symptoms, using part of an extensive questionnaire, the Strengths and Difficulties Questionnaire (SDQ) for both patients and their parents. Participants scoring in the borderline or abnormal range on the SDQ received a psychiatric interview (Kiddie-SADS-PL). All participants underwent a neuropsychological examination, and those with general cognitive abilities (IQ)epilepsy-related or psychosocial factors were not significantly associated with psychiatric disorders. Multiple factors are associated with psychiatric problems in children and youth with epilepsy. In this study, executive dysfunction, male gender, and early epilepsy onset were independent risk factors for having a psychiatric disorder. An evaluation of psychiatric and cognitive problems is important to enable a positive long-term outcome in childhood epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. The Middlesex Hospital Questionnaire: a validity study with American psychiatric patients. (United States)

    Mavissakalian, M; Michelson, L


    The Middlesex Hospital Questionnaire (MHQ) was used as a screening test for psychiatric disorder in 169 new outpatients. The profile obtained on the six subscales of the MHQ was strikingly similar in this American sample compared to four previous British reports. The MHQ significantly differentiated between diagnostic groups, most particularly between neuroses and personality disorders. Moreover, 75 per cent of the patients could be correctly classified as either neurosis or personality disorder on the basis of their MHQ total and subscale scores. The MHQ appears to be particularly useful in identifying phobic disorders, and the phobia subscale consistently discriminated between anxiety-phobic states and other diagnostic groups.

  17. Sociodemographic profile and psychiatric diagnosis of patients referred to consultation-liaison psychiatric services of general hospital psychiatric unit at a Tertiary Care Center

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    Shri Gopal Goyal


    Full Text Available Context: Previous studies have reported high psychiatric comorbidity with physical illness. However, referral rate to consultation-liaison (C-L psychiatry from other departments is very low. There is a paucity of literature from India in this subspecialty of psychiatry. Aims: This study was conducted to assess the sociodemographic profile and psychiatric diagnosis of patients referred to C-L psychiatric services at a tertiary care center. Settings and Design: This was a descriptive cross-sectional study conducted in a tertiary care multispecialty teaching institution. Patients and Methods: The study population comprised all the patients who were referred for psychiatric consultation from other departments to C-L services of psychiatry department for 2 months. Information was collected using semi-structured pro forma, and diagnosis was made based on the International Classification of Diseases-10 criteria. Results: A total of 160 patients were referred for C-L psychiatric services. Majority of the patients were in the age group of 31–45 years, married, educated matriculation or beyond, belonged to Hindu religion, nuclear family, and residing in urban area. The maximum referrals were from internal medicine department (17.5 followed by nephrology (15.0% and neurology (10.6%. The most common psychiatric diagnosis was depression (12% followed by delirium (8%. The most common reason for seeking psychiatric consultation was psychiatric clearance of prospective kidney donor and bone marrow transplant/stem cell transplant recipient. Conclusions: Psychiatric comorbidity may present with chronic physical illness. The C-L psychiatry would play a major role in the management of psychiatric comorbidity.

  18. Manicômio em circuito: os percursos dos jovens e a internação psiquiátrica The psychiatric hospital circuit: the trajectories of yong people prior to psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Andrea Cristina Coelho Scisleski


    Full Text Available Este artigo analisa a internação psiquiátrica de jovens, tomando-a não a partir de uma perspectiva psicopatológica individual, mas de uma dimensão subjetivo-social com base nos percursos desses jovens até a internação. O estudo foi realizado no Centro Integrado de Atenção Psicossocial para crianças e adolescentes do Hospital Psiquiátrico São Pedro, na cidade de Porto Alegre, Rio Grande do Sul, Brasil, por meio de oficinas com os jovens que estavam em atendimento na internação deste serviço. Percebeu-se uma recorrência que marca o percurso desses jovens e expressa um determinado modo de funcionamento da rede de atenção até a internação, acarretando na produção de um certo perfil desses jovens: pobreza sócio-econômica, baixa escolaridade e uso de drogas. Outro aspecto importante é o papel da ordem judicial nos encaminhamentos à internação, que obedece tanto a uma lógica de punição aos jovens e aos serviços, como também, paradoxalmente, constitui-se numa estratégia de acesso aos serviços de saúde.This article analyzes psychiatric hospitalization of young patients from a contemporary social-subjective (rather than a psychopathological perspective, following the trajectory of these youth prior to their admission. The study was conducted at the Center for Comprehensive Psychosocial Care for Children and Adolescents, São Pedro Psychiatric Hospital, in the city of Porto Alegre, Rio Grande do Sul State, Brazil. Recurrent traits in the trajectory of these youth expressed how the health care network functioned with them prior to their hospitalization, with a consistent pattern of socioeconomic deprivation, low schooling, and drug use. Another key aspect was the role of the court system in referring them for hospitalization, adhering to a kind of logic that punished both the youth and the services and paradoxically formed a strategy for access to health services.

  19. Psychiatric comorbidities in a sample of Iranian children and adolescents with epilepsy

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    Shahrokh Amiri


    Full Text Available Introduction: Epilepsy is a common disorder worldwide, commonly starting during childhood. Despite the high impact of psychiatric comorbidities in these patients, little is known about Iranian children with epilepsy. Methods: This cross sectional study was carried out in the tertiary clinics of the Tabriz University of Medical Sciences, Tabriz, Iran. All of the children (aged between 6 and 18 with a diagnosis of epilepsy were enrolled in this study. A semi-structured psychiatric interview was carried out using the Farsi (Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL. Results: From a total of 298 participants, 270 (90.6% completed the process, including 120 (44.4% girls and 150 (55.6% boys. At least one psychiatric diagnosis was made in 222 (82.2% patients. The most prevalent psychiatric disorders in children and adolescents with epilepsy were attention deficit/hyperactivity disorder (34.4%, major depressive disorder (MDD (29.6%, social phobia (14.8% and oppositional defiant disorder (ODD (14.8%. Agoraphobia and anorexia nervosa were significantly more prevalent among girls. The following disorders were more prevalent in children aged between 13 and 18: MDD (47.5%, psychotic disorder (2.5%, social phobia (23.7%, generalized anxiety disorder (GAD (15.3%, conduct disorder (13.6%, chronic motor tic disorder (13.6% and substance related disorders (4.8%. Separation anxiety (15.1% and enuresis (1.5%, on the other hand, were more prevalent among younger children. A logistic regression model showed that psychiatric disorders in parents or siblings could independently predict at least one psychiatric comorbidity in children with epilepsy.Conclusion: Iranian children with epilepsy face a high burden of psychiatric and behavioral comorbidities compared to same aged general population that should be considered for comprehensive care.

  20. Psychiatric disorders and symptoms severity in pre-school children with cow's milk allergy. (United States)

    Topal, E; Catal, F; Soylu, N; Ozcan, O O; Celiksoy, M H; Babayiğit, A; Erge, D; Karakoç, H T E; Sancak, R


    Psychiatric disorders are seen frequently in atopic diseases. The present study aims to evaluate the frequency of psychiatric disorders and the severity of psychiatric symptoms in pre-school children with cow's milk allergy. The parents of the pre-school children with cow's milk allergy were interviewed in person and asked to fill out the Early Childhood Inventory-4 form. The cow's milk allergy group included 40 children (27 male, 13 female) with mean age, 44.5±14.7 months, and the control group included 41 children (25 male, 16 female) with mean age, 47.6±15.2 months. It was established that 65% of the group with cow's milk allergy received at least one psychiatric diagnosis, while 36.6% of the control group received at least one psychiatric diagnosis, with a statistically significant difference (p=0.02). Within the psychiatric disorders, attention deficit hyperactivity disorders (odds ratio: 4.9, 95% CI: 1.472-16.856, p=0.006), oppositional defiant disorder (odds ratio: 5.6, 95% CI: 1.139-28.128, p=0.026), and attachment disorder (odds ratio: 4.8, 95% CI: 1.747-13.506, p=0.004) were found significantly higher compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores, calculated by using the Early Childhood Inventory-4 form, attention deficit hyperactivity disorders severity (p=0.006) and oppositional defiant disorder severity (p=0.037) were found to be higher in the cow's milk allergy group. Psychiatric disorders are frequent and severe in pre-school children with cow's milk allergy. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  1. Sleep problems in children and adolescents with epilepsy: Associations with psychiatric comorbidity. (United States)

    Hansen, Berit Hjelde; Alfstad, Kristin Å; van Roy, Betty; Henning, Oliver; Lossius, Morten I


    Sleep problems are common in pediatric epilepsy and may influence seizure control, daytime functioning, and overall quality of life. Knowledge of factors contributing to sleep problems is likely to improve treatment. The aim of this study was to investigate associations between psychiatric comorbidity and parent-reported and self-reported sleep problems in a sample of children and adolescents with epilepsy. Participants were children and adolescents (N=94), aged 10-19years, with generalized or focal epilepsy who had been referred to a tertiary epilepsy treatment center in Norway. Participants underwent a thorough clinical assessment and 24h of EEG registration. Information on sleep problems was obtained from parents using the Children's Sleep Habit Questionnaire (CSHQ) and from self-reporting using the Sleep Self-Report (SSR) questionnaire. Psychiatric diagnoses were established using the semistructured psychiatric interview Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (Kiddie-SADS-PL). Both the total and subdomain CSHQ and SSR scores were high in comparison with scores from population-based samples. Having one or more psychiatric disorder(s) was significantly associated with elevated scores on both the CSHQ and the SSR. With the exception of parent-reported parasomnias, associations between sleep problems and psychiatric disorders remained significant after adjusting for relevant epilepsy variables. Psychiatric comorbidity explained about one-third of the variance of the reported sleep problems in children and adolescents with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Clinical Profile and Sex Differences in Brazilian Children and Adolescents Receiving Psychiatric Services in the Emergency Department. (United States)

    Tonezer, Jordana; Muller, Thomaz; Rocha, Gibsi Possapp; Recondo, Rogéria; Nogueira, Eduardo Lopes; Spanemberg, Lucas


    We present a survey of sex differences and socio-demographic and clinical variables in children and adolescents receiving a psychiatric consultation service in an emergency department (ED). This observational, retrospective, and cross-sectional study included all records of patients (age, services in an ED in a 4-year period (January 2010 to December 2013). Two hundred fifty-nine records of children and adolescents were located. The mean age of the participants was 14.19 years, and most subjects were female (59.5%) and had private health insurance (83.7%). Most participants (87.4%) were accompanied by their parents. The main complaints were suicide attempts (21.8%) and psychomotor agitation/aggressiveness (21.8%). Unipolar depression (37.8%) and adjustment, reactive, and anxiety disorders (13.7%) were the most prevalent diagnoses. Most patients received an indication of psychiatric hospitalization (51.7%). Females had more suicide attempts than males (28.3% vs 12.4%) and less psychomotor agitation/aggressiveness than males (15.5% vs 31.4%). Females also exhibited more unipolar depression (47.6% vs 23.5%), fewer psychotic disorders (4.2% vs 16.3%), and substance use/misuse (1.4% vs 13.3%) than males. Males needed more psychiatric medication during evaluation (37.9% vs 19.2%). This survey of the profile of pediatric patients evaluated by a psychiatric service in an ED in Brazil was the first of its kind. The large percentage of patients referred for hospitalization highlights the importance of specialized psychiatry care for this age group in this facility, which is a common entry point for mental health care.

  3. Psychiatric effects of military deployment on children and families: the use of play therapy for assessment and treatment. (United States)

    James, Trenton; Countryman, Jacqueline


    Deployments in the United States military have increased greatly in the past 10 years. Families and children are psychiatrically affected by these deployments, and recent studies are clarifying these effects. This article focuses on the psychiatric effects of deployment on children and uses a composite case example to review the use of play therapy to treat children who are having psychiatric issues related to the deployment of one or both parents.

  4. A case study: Inclusion for children with psychiatric diagnosis in physical education (PE) at primary school

    DEFF Research Database (Denmark)

    Bentholm, Anette Lisbeth

    A case study: Inclusion for children with psychiatric diagnosis in physical education (PE) at primary school.Research bagground and aim:A large majority in the Danish parliament decided in 2012 that more children with special needs for example children with psychiatric diagnosis as autism spectrum...... activities at least 45 minutes each school day (Bekendtgørelse af lov om folkeskolen, 2014). ASD and ADHD are disabling conditions that emerge in childhood and affects social communication and interaction, and often also their motor skill performance and cognition fx. academic skills (Harvey & Reid, 2003...... framework:My overall research design is a Case study, because the research question requires an “in-depth” description and valuable insights to the complexities of the social phenomenon of inclusion and exclusions processes (Flyvbjerg, 2006; Yin, 2014). The research focus on 11 children with psychiatric...

  5. Psychiatric Disorders among Children with Cerebral Palsy at School Starting Age (United States)

    Bjorgaas, H. M.; Hysing, M.; Elgen, I.


    The aim of the present population study was to estimate the prevalence of psychiatric disorders in children with cerebral palsy (CP), as well as the impact of comorbid conditions. A cohort of children with CP born 2001-2003, and living in the Western Health Region of Norway were evaluated at school starting age. Parents were interviewed with the…

  6. Evaluation of treatment effects in obese children with co-morbid medical or psychiatric conditions (United States)

    The need for effective treatments for pediatric overweight is well known. We evaluated the applicability of an evidence-based treatment in an applied clinic setting that includes children with severe obesity and comorbid medical or psychiatric conditions. Forty-eight overweight children and their fa...

  7. Gross Motor Performance and Physical Fitness in Children with Psychiatric Disorders (United States)

    Emck, Claudia; Bosscher, Ruud J.; van Wieringen, Piet C. W.; Doreleijers, Theo; Beek, Peter J.


    Aim: Gross motor performance appears to be impaired in children with psychiatric disorders but little is known about which skill domains are affected in each disorder, nor about possible accompanying deficits in physical fitness. The present study has sought to provide information about these issues in children with emotional, behavioural, and…

  8. Nurses' perceptions of and participation in continuing nursing education: results from a study of psychiatric hospital nurses in Bahrain. (United States)

    Al-Majid, Sadeeka; Al-Majed, Hashmiya; Rakovski, Cyril S; Otten, Rebecca A


    Although many psychiatric hospital nurses in Bahrain attend at least one continuing nursing education (CNE) activity per year, many others do not. This study explored these nurses' perceptions of CNE and factors that promote or hinder participation in CNE activities. A descriptive design was used to gather data from a convenience sample of 200 nurses working at the psychiatric hospital in Bahrain. Nurses believed that CNE improved the quality of patient care and patient outcomes, increased nurses' knowledge and skills, and kept them current with advances in nursing. Participation in CNE was hindered by unavailability of CNE activities related to psychiatric nursing. The majority of nurses had positive perceptions of CNE. Their participation was hindered by unavailability of CNE activities related to psychiatric nursing. Those responsible for planning continuing education in Bahrain should consider these findings when planning future CNE activities. Copyright 2012, SLACK Incorporated.

  9. Substance abuse and the risk of readmission of people with schizophrenia at Amanuel Psychiatric Hospital, Ethiopia

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    M.S. Bimerew


    Full Text Available Frequent readmissions of people with schizophrenia pose considerable pressure on the psychiatric service provision of Amanuel Psychiatric Hospital. The purpose of the study was to ascertain factors mainly contributing to the rate of readmissions of people with schizophrenia. Descriptive survey methods and qualitative focus group interviews were employed to conduct the study. Random sampling techniques were used to select 43 respondents of people with schizophrenia from 231 people with schizophrenia who were readmitted for two or more times in the last two years and who gained access during the time of the study. Structured interviews were used for respondents of people with schizophrenia. Fourteen (N = 14 family members/caregivers were selected using purposive sampling methods for focus group discussions. Quantitative data was analyzed using the SPSS Version 11.00 program and the qualitative data was analyzed by generating themes and categories. The results suggest that alcohol and that abuse were contributing factors for the rate of readmissions of people with schizophrenia into the Amanuel Psychiatric Hospital. It was found that communities contribute to the problems of substance abuse by providing and/or selling it to those mentally ill people. The study also revealed that patients use alcohol and that in order to tolerate the severe side effects of the anti-psychotic drugs, to suppress hunger due to shortage of food and to avoid drowsiness. Raising community awareness, psycho-education, strengthening the capacities of caretakers and laws to prevent substance abuse, as well as campaigning to prevent people from abusing mentally ill sufferers, should be established.

  10. Suicide Risk Among Holocaust Survivors Following Psychiatric Hospitalizations: A Historic Cohort Study. (United States)

    Lurie, Ido; Gur, Adi; Haklai, Ziona; Goldberger, Nehama


    The association between Holocaust experience, suicide, and psychiatric hospitalization has not been unequivocally established. The aim of this study was to determine the risk of suicide among 3 Jewish groups with past or current psychiatric hospitalizations: Holocaust survivors (HS), survivors of pre-Holocaust persecution (early HS), and a comparison group of similar European background who did not experience Holocaust persecution. In a retrospective cohort study based on the Israel National Psychiatric Case Register (NPCR) and the database of causes of death, all suicides in the years 1981-2009 were found for HS (n = 16,406), early HS (n = 1,212) and a comparison group (n = 4,286). Age adjusted suicide rates were calculated for the 3 groups and a logistic regression model was built to assess the suicide risk, controlling for demographic and clinical variables. The number of completed suicides in the study period was: HS-233 (1.4%), early HS-34 (2.8%), and the comparison group-64 (1.5%). Age adjusted rates were 106.7 (95% CI 93.0-120.5) per 100,000 person-years for HS, 231.0 (95% CI 157.0-327.9) for early HS and 150.7 (95% CI 113.2-196.6) for comparisons. The regression models showed significantly higher risk for the early HS versus comparisons (multivariate model adjusted OR = 1.68, 95% CI 1.09-2.60), but not for the HS versus comparisons. These results may indicate higher resilience among the survivors of maximal adversity compared to others who experienced lesser persecution.

  11. The hoarding habit, countertransference, and consultation anthropology in a Peruvian psychiatric hospital. (United States)

    Stein, W W


    The 'hoarding habit' is the practice of collecting a large number of mostly useless objects by psychiatric patients. Countertransference consists of distorted perceptions by psychotherapists in their study of individuals, or social scientists in their study of human groups, which interfere with the pursuit of their therapeutic or research goals. A case is here presented from observations made by the author in one pavilion of the Hospital Victor Larco Herrera in Lima, Peru, of a 'bag man' who persisted in carrying his 'hoard' with him in large market bags. The practice of hoarding is related to the culture and social structure of the hospital, patients' use of physical space, the existence of trade networks, the smuggling of alcohol, and patients' needs to retain a feeling of selfness and personal autonomy as well as to maintain ties with the external world. In all these senses the hoarding habit is overdetermined: it is both a symptom of pathology and a sign of healthy functioning. However, its clinical construction may be expanded by an observer who can function as a 'culture broker' and who may be able to apply the dialectic of pathology and health to the operation of psychiatric services for more therapeutic ends. However, the observer, in a consultation capacity, is advised to go beyond the study of transference and countertransference in his or her subjects to focus on his/her own countertransference in order to consult more effectively.

  12. Sociodemographic and clinical profile of patients in voluntary and involuntary psychiatric hospitalizations

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    Carlos Robson Bezerra de Medeiros


    Full Text Available Objective: To assess the sociodemographic and clinical profile of patients in psychiatric hospitalizations of voluntary inpatients (IPV and involuntary (IPI, in psychiatric hospitals of Fortaleza-CE, Brazil, under contract with the Unified Health System (SUS. Methods: A quantitative study, descriptive, cross-sectional and analytical. The sample comprised 393 patients, distributed among 253 IPV and 140 IPI, submitted to Psychiatry specialtytreatment, in the year 2007. Results: For both patients, IPV and IPI, most were male: 185 (73.1% and 82 (58.6%; single: 181 (46.7% and 103 (26.5%; living in Fortaleza: 181 (71.5% and 95 (67.9%, respectively, and aged 20 to 60 years (mean age of 37 years. Weobserved significant difference between the type of hospital and patient gender (p = 0.003, which did not occur with marital status (p = 0.688 and origin (p = 0.95. The main symptom profiles which justified the clinical admission of these patients were the use of alcohol or drugs 70 (27.6%, changes in critical judgments 40 (28.6% and psychological distress 68 (26.9%. Family members were the main responsible for conducting these patients to the hospital. Conclusion: The results showed that patients on IPV and IPI, which joined in the study, had a socio-demographic and clinical profile characterized by: prevalence of male patients, from the capital Fortaleza, single, mean age of 37 years, having been brought tohospital by a relative, mainly due to alcohol use or drugs.

  13. [Prescription of olanzapine in children and adolescent psychiatric patients]. (United States)

    Frémaux, T; Reymann, J-M; Chevreuil, C; Bentué-Ferrer, D


    A review of the literature from 1996-2004 on the indications and adverse reactions concerning the use of olanzapine, a second generation antipsychotic agent, in children and adolescents with psychiatric illness is made in this article. Studies lasted for 2 to 3 months and a few had a follow up period up to a year. Olanzapine, dosed from 2.5 to 20 mg/day, is shown to be a useful drug in the treatment of child and adolescent onset schizophrenia, bipolar disorder, anorexia nervosa with delusions, pervasive developmental disorder, tic disorders, and aggression. OPEN AND DOUBLE-BLIND STUDIES: In 4 open labeled studies (26, 34, 39, 43) and 2 case reports (25), 53 patients, aged from 6-18 years old, afflicted by child onset schizophrenia, were treated with olanzapine for 1 1/2 weeks to one year; 19 had treatment resistant childhood schizophrenia and 34 a first episode. In the first group 13/19 showed improvement whereas, in the second group 27/34 were considered responders. Four patients in the first group who had responded to clozapine (stopped because of adverse events) did less well on olanzapine. In 5 studies, 4 open labeled (15, 20, 44) and 1 double blind (27), 59 adolescent onset schizophrenic patients were treated by olanzapine from 8 to 26 weeks; 50/59 patients were considered responders. In the open label study (20) comparing 43 adolescents treated by olanzapine (19 patients), risperidone (17 patients), or haloperidol (7 patients), improvement was significant in the three groups after 4 weeks of treatment and continued after 8 weeks. It is most interesting to mention that 2 months after the end of the study 71% (12/17) of the olanzapine group that had completed the study, 10/15 (67%) of the risperidone group, and 43% (3/7) of the haloperidol group had continued their treatment. Dropouts were for inefficacy and non-compliance in the olanzapine and risperidone groups whereas they were also for adverse events in the haloperidol group (2/4). A final double blind

  14. Psychiatric disorders and symptoms severity in preschool children with atopic eczema. (United States)

    Catal, F; Topal, E; Soylu, N; Ozel Ozcan, O; Celiksoy, M H; Babayiğit, A; Karakoç, H T E; Erge, D; Sancak, R


    To compare with a control group the frequency of psychiatric disorders and severity of psychiatric symptoms in preschool children with atopic eczema. The study included children between the ages of 3-5 who were diagnosed to have atopic eczema. The parents of the children with atopic eczema were interviewed in person and were asked to fill in "The Early Childhood Inventory-4" form. This form assesses the psychiatric disorders and symptoms severity in children between the ages of 3-5. The atopic eczema group included 80 patients (38 male, 42 female) with a mean age of 48.4 ± 15.7 months and the control group included 74 patients (41 male, 33 female) with a mean age of 49.9 ± 15.19 months. It was established that 68.8% of the group with atopic eczema received at least one psychiatric diagnosis. Between the psychiatric disorders, ADHD (Odds ratio: 2.57, 95% CI: 1.049-6.298, p=0.035), enuresis and encopresis (Odds ratio: 2.39, 95% CI: 1.121-5.097, p=0.022) and attachment disorder (Odds ratio: 2.03, 95% CI: 1.046-3.953, p=0.035) were found to be significantly higher when compared with the healthy control group. When the groups were compared in terms of psychiatric symptom severity scores calculated by using ECI-4, ADHD severity (p=0.043), conduct disorder severity (p=0.001), anxiety disorders severity (p<0.001), eating disorders severity (p=0.011) and tic disorder severity (p=0.01) were found to be higher in the atopic eczema group. Psychiatric illnesses are frequent in preschool children with atopic eczema. Copyright © 2015 SEICAP. Published by Elsevier Espana. All rights reserved.

  15. Medication adherence and its determinants among psychiatric patients in an Ethiopian referral hospital

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    Demoz Z


    Full Text Available Zaid Demoz,1 Befikadu Legesse,1 Gebrehiwot Teklay,1 Birhanu Demeke,1 Tewodros Eyob,2 Zewdneh Shewamene,3 Mubarek Abera4 1Department of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, 2Department of Pharmacy, College of Public Health and Medical Sciences, Jimma University, Jimma, 3Department of Pharmacology, School of Pharmacy, University of Gondar, Gondar, 4Department of Psychiatry, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia Background: The degree to which an individual follows medical advice is a major concern in every medical specialty. Non-adherence to psychiatric treatment regimens has a pro­found impact on the disease course, relapse, future recovery, cost of health care, and the outcome for the patient. The aim of this study was to assess medication adherence and its correlates among psychiatric patients at Ayder Referral Hospital, Northern Ethiopia.Methods: A cross-sectional study was conducted from June to September 2013 at Ayder Referral Hospital, where 423 patients were selected by a systematic random sampling technique from all patients attending the psychiatric clinic at the hospital. Data were collected by trained data collectors through interview of the patients using a structured questionnaire. The collected data were entered into Epi Info version 7 and analyzed by Statistical Package for the Social Sciences version 16 software. Logistic regression was used to assess independent predictors of adherence. Results: A total of 387 patients completed the interview. Two hundred and sixteen (55.8% and 113 (29.2% were patients with a diagnosis of schizophrenia and mood disorder, respectively, while 35 (9% and 23 (5.9% had a diagnosis of drug addiction and autistic disorder. Two hundred and seven (71.6% patients were found to be adherent to their medication. When adherence rates were observed according to type of disorder, 60 (53.1%, 24 (68.6%, 149 (69%, and 18 (78.3% of patients

  16. The Attitude of Psychiatric and Non-psychiatric Health-care Workers Toward Suicide in Malaysian Hospitals and Its Implications for Training. (United States)

    Siau, Ching Sin; Wee, Lei-Hum; Yacob, Sapini; Yeoh, Seen Heng; Binti Adnan, Tassha Hilda; Haniff, Jamaiyah; Perialathan, Komathi; Mahdi, Aziman; Rahman, Abu Bakar; Eu, Choon Leng; Binti Wahab, Suzaily


    This research is aimed to examine the attitude of health-care workers toward suicidal patients in Malaysian hospitals, comparing responses from psychiatric and non-psychiatric workers, and to identify specific needs in suicide prevention and management training. This is a multi-site cross-sectional study. The authors conducted a survey based on a translated self-administered questionnaire to participants from seven core hospital departments. While most health-care workers regardless of department and specialty took their duty to prevent suicide seriously, a large majority of them expressed negative attitudes such as finding suicidal behavior irritating, and more than half believed suicidal attempts were a way of making others sorry. However, psychiatric workers were less likely to have judgmental attitudes that included believing suicide attempters as being selfish or trying to get sympathy from others. As there were more similarities than differences in health-care workers' attitudes toward suicide, recommendations on basic and continuous suicide prevention and management training among hospital workers were made. The interventions focused on improving knowledge, affective, and skill-based areas that were aimed to correct the wrongful understanding of and to minimize the negative attitudes toward suicidal individuals indicated by the study results.

  17. Incidence of psychiatric disorders among accompanied and unaccompanied asylum-seeking children in Denmark

    DEFF Research Database (Denmark)

    Norredam, Marie; Nellums, Laura; Nielsen, Runa Schmidt


    linked a cohort of refugee children who obtained right of residency in Denmark between 01 January 1993 and 31 December 2010 to the Danish Psychiatric Central Register, and calculated incidence rates per 100,000 person years and incidence rate ratios of overall psychiatric disorder, psychotic disorders...... psychiatric disorder (aIRR: 1.38, 95% CI 1.14-1.68) and neurotic disorders (aIRR: 1.67, 95% CI 1.32-2.13) than accompanied minors. Among children from Afghanistan, unaccompanied minors had significantly higher rates of any psychiatric disorder (aIRR: 2.23, 95% CI 1.26-3.93) and neurotic disorders (aIRR: 3.......50, 95% CI 1.72-7.11). Among children from Iraq, unaccompanied minors had higher rates of any psychiatric disorder (aIRR: 2.02, 95% CI 1.18-3.45), affective disorders (aIRR: 6.04, 95% CI 2.17-16.8), and neurotic disorders (aIRR: 3.04, 95% CI 1.62-5.70). Unaccompanied children were found to experience...

  18. Applying Toyota Production System principles to a psychiatric hospital: making transfers safer and more timely. (United States)

    Young, John Q; Wachter, Robert M


    Health care organizations have increasingly embraced industrial methods, such as the Toyota Production System (TPS), to improve quality, safety, timeliness, and efficiency. However, the use of such methods in psychiatric hospitals has been limited. A psychiatric hospital applied TPS principles to patient transfers to the outpatient medication management clinics (MMCs) from all other inpatient and outpatient services within the hospital's system. Sources of error and delay were identified, and a new process was designed to improve timely access (measured by elapsed time from request for transfer to scheduling of an appointment and to the actual visit) and patient safety by decreasing communication errors (measured by number of failed transfers). Complexity was substantially reduced, with one streamlined pathway replacing five distinct and more complicated pathways. To assess sustainability, the postintervention period was divided into Period 1 (first 12 months) and Period 2 (next 24 months). Time required to process the transfer and schedule the first appointment was reduced by 74.1% in Period 1 (p < .001) and by an additional 52.7% in Period 2 (p < .0001) for an overall reduction of 87% (p < .0001). Similarly, time to the actual appointment was reduced 31.2% in Period 1 (p < .0001), but was stable in Period 2 (p = .48). The number of transfers per month successfully processed and scheduled increased 95% in the postintervention period compared with the pre-implementation period (p = .015). Finally, data for failed transfers were only available for the postintervention period, and the rate decreased 89% in Period 2 compared with Period 1 (p = .017). The application of TPS principles enhanced access and safety through marked and sustained improvements in the transfer process's timeliness and reliability. Almost all transfer processes have now been standardized.

  19. Factors related to job burnout among nurses in the Razi Psychiatric Hospital, Iran. (United States)

    Rezaei, Omid; Habibi, Kamelia; Arab Ghahestany, Davood; Sayadnasiri, Mohammad; Armoon, Bahram; Khan, Vida; Fattah Moghadam, Ladan


    Background One of the most prevalent problems in work places that is considered as an important risk factor for the health of the employee is job burnout (JB). JB could be harmful to employees, their families and society. Therefore, decreasing JB among individuals and determining factors associated with it is important to improve the working environment and prevent its negative outcomes. This study aims to elicit the conditions and factors that cause job burnout among nurses of the Razi Psychiatric Hospital, Iran. Methods This study was a descriptive correlational and cross-sectional survey which the demographic and occupational burnout variables of nurses were measured. The study was conducted from January to April 2016. Accordingly, with a type I error probability of 0.05 and a power of 0.80, the sample size was determined to be 100 nurses for each group (men and women). Then, 200 were selected in the Razi Psychiatric Hospital (of whom approx. 60% worked in a rotating shift schedule). The data were collected in two phases: the first step was created by the authors, including gathering demographic data with questionnaire such as gender, age, marital status, education level, years of professional experience, hours of overtime working per month, shift schedules, and their working hospitals and wards. The second step was the Maslach burnout inventory (MBI), human services survey (HSS) version, developed by Maslach and Jackson to assess the three dimensions of burnout. Descriptive statistics (frequency distribution) were used for integrating the demographic variables. Additionally, logistical regression was applied to realize the association between demographic characteristics with the job burnout in SPSS software V.19. Results Our findings indicated that age, hours of work per week, nursing skills, management experience and work experiences accounted for 30% of the variance of depersonalization. Formal employment was significantly associated with emotional exhaustion

  20. Are ataques de nervios in Puerto Rican children associated with psychiatric disorder? (United States)

    Guarnaccia, Peter J; Martinez, Igda; Ramirez, Rafael; Canino, Glorisa


    To provide the first empirical analysis of a cultural syndrome in children by examining the prevalence and psychiatric correlates of ataques de nervios in an epidemiological study of the mental health of children in Puerto Rico. Probability samples of caretakers of children 4-17 years old in the community (N = 1,892; response rate: 90%) and in clinical services (N = 761; response rate 72%) were administered structured interviews to assess the presence and correlates of ataques de nervios. Nine percent of children in the community sample and 26% of children in the clinical sample had a reported history of an ataque de nervios. In contrast to the overall community and clinical samples, which had more boys in them, the ataque de nervios groups in both samples had more girls in them. Family history of ataques de nervios was associated with ataques de nervios in children in both samples. Across a wide range of depression, anxiety, and disruptive disorders, children who reported an ataque de nervios were more likely to meet research criteria for psychiatric disorder in both samples. Ataques de nervios are a frequently reported cultural syndrome among children in Puerto Rico. Adolescent girls are more likely to report this experience. Ataques de nervios have a significant relationship with psychiatric disorder and impairment in Puerto Rican children.

  1. [Nutritional status and risk in hospitalized children]. (United States)

    Hankard, R; Bloch, J; Martin, P; Randrianasolo, H; Bannier, M F; Machinot, S; Cézard, J P


    A few studies report malnutrition in hospitalized patients. This one-day cross-sectional survey performed in January 1999 assessed nutritional status and protein-energy intake in a pediatric population hospitalized in medicine or surgery units. Every child older than six months, hospitalized for more than 48 h and free of nutritional support (parenteral, enteral, or special regimens for metabolic diseases) was included. Fifty-eight children among the 183 present the day of the study met the inclusion criteria and were included in the statistical analysis. They were hospitalized in medicine (48%), psychiatry (31%) and surgery (21%). The body mass index (BMI) was below -2 standard deviations (DS) in 21% of them. Excluding patients with anorexia nervosa, BMI was +2 SD, or in between these limits in respectively 12, 14 and 74%. Energy intake measured at the hospital was below 75% of the recommended dietary allowances in two-thirds of the children whether malnourished or not. Fifty percent of the malnourished children had been referred to a dietician the day of the study. Malnutrition is frequent in a population of hospitalized children. Energy intake and referral to a dietician are insufficient.

  2. [Psychiatric Disorders in Pediatric Patients With Systemic Lupus Erythematosus in a Reference Hospital]. (United States)

    Zuñiga Zambrano, Yenny Carolina; Vásquez, Rafael


    To describe the psychiatric manifestations in pediatric patients with systemic erythematous lupus seen in the Fundación Hospital de la Misericordia. Observational descriptive study. Medical charts and test results of inpatients and outpatients between 2007 and2013 were reviewed; 39 patients were selected. SPSS 19 was used for statistical analysis. Statistical significance was considered with P=.05. Mean age was 13.7 (2.33), with 78.9% female. The most frequent psychiatric manifestation was anxiety (52.6%), followed by adjustment disorder and depression (36.8% each one), psychosis (10%), conversion disorder (7.9%), and obsessive compulsive disorder (5.3%). The mean SLICC score was 2.76 (2.8), and the mean SLEDAI score was 20.81 (20.82). Antinuclear antibodies were positive in 81.25%. Neuropsychiatric lupus was diagnosed in 65.8% of patients; seizures were observed in 23.7%, headache in 36.8%, stroke in 13.2%, vasculitis, chorea 5.3%, and meningitis 5.3% of patients. The mean time from lupus diagnosis was 20.47 (22.2) months, with the shortest period for adjustment disorder and the longest period in patients with conversion disorder (pseudo-seizures) being 15 months and 31 months, respectively. The highest SLEDAI score was in patients with psychosis (35.5 [16.21] vs 19.08 [13.72]; P=.032), and also the highest disease damage (SLICC, 4.25 [4.03] vs 2.58 [2.67]; P=.27) in comparison with the other manifestations. The most frequent psychiatric manifestations were anxiety, depression, and adjustment disorder, with a higher frequency than other studies, and with lupus activity principally in patients with psychosis. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  3. The experience of admission to psychiatric hospital among Chinese adult patients in Hong Kong

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    Lam Linda


    Full Text Available Abstract Background The paper reports on a study to evaluate the psychometric properties and cultural appropriateness of the Chinese translation of the Admission Experience Survey (AES. Methods The AES was translated into Chinese and back-translated. Content validity was established by focus groups and expert panel review. The Chinese version of the Admission Experience Survey (C-AES was administered to 135 consecutively recruited adult psychiatric patients in the Castle Peak Hospital (Hong Kong SAR, China within 48 hours of admission. Construct validity was assessed by comparing the scores from patients admitted voluntarily versus patients committed involuntarily, and those received physical or chemical restraint versus those who did not. The relationship between admission experience and psychopathology was examined by correlating C-AES scores with the Brief Psychiatric Rating Scale (BPRS scores. Results Spearman's item-to-total correlations of the C-AES ranged from 0.50 to 0.74. Three factors from the C-AES were extracted using factor analysis. Item 12 was omitted because of poor internal consistency and factor loading. The factor structure of the Process Exclusion Scale (C-PES corresponded to the English version, while some discrepancies were noted in the Perceived Coercion Scale (C-PCS and the Negative Pressure Scale (C-NPS. All subscales had good internal consistencies. Scores were significantly higher for patients either committed involuntarily or subjected to chemical or physical restrain, independent on severity of psychotic symptoms. Conclusion The Chinese AES is a psychometrically sound instrument assessing the three different aspects of the experience of admission, namely "negative pressure, "process exclusion" and "perceived coercion". The potential of C-AES in exploring subjective experience of psychiatric admission and effects on treatment adherence should be further explored.

  4. Psychiatric disorders in ASEAN-migrants in Malaysia--a university hospital experience. (United States)

    Krahl, W; Hashim, A


    Malaysia's workforce presently includes 13% foreigners most coming from the neighboring ASEAN-countries. No data of the prevalence of psychiatric disorders amongst this population is currently available. All patients from ASEAN-countries admitted to the University Hospital, Kuala Lumpur between January 1994 and June 1996 were included in a prospective study. During the study period 39 patients were admitted. Five patients were male (12.8%) and 34 female (87.2%). Most came from Indonesia (51.3%) and the Philippines (41.0%), while one each was from Brunei, Singapore and Thailand. Thirty (76.9%) were working in Malaysia as unskilled workers, 23 (59.0%) as maids. Six of the patients (15.4%) were married to Malaysians and only three (7.2%) held white-collar jobs. Three patients (7.2%) received the diagnosis schizophrenia and ten (25.6%) acute and transient psychotic disorder. Two (5.1%) were diagnosed as bipolar affective disorder--manic and two (5.1%) as depression without psychotic features. Five patients (12.8%) were depressed and had as well presence of psychotic features. Adjustment disorders mostly with depressed mood was diagnosed in fourteen (35.9%), three (7.2%) received another diagnosis. The study showed high rates of acute and transient psychosis as well as adjustment disorders indicating high stress level in this population. In particular maids from Indonesia and the Philippines with their dependent and isolated situation seem vulnerable to develop psychiatric disorders. However, overall the rates of psychiatric admissions (only 1.3%) in the ASEAN-nationals is relatively low and tends to support the view that migrants do not suffer from an excess of mental disorders.

  5. [Asylum: the Huge Psychiatric Hospital in the 19th century U.S]. (United States)

    Kazano, Haruki


    The large-scale state psychiatric hospitals, referred to as "asylums," were built in the USA in the 19th century and generally have a bad reputation in Japan as institutions with an unpleasant environment for the patients. Asylums were not built for institutionalizing mental patients. The original meaning of the word asylum is a "retreat" or "sanctuary," and these institutions were originally built to act as sanctuaries for the protection of mental patients. The field of psychiatric medicine in western countries in the 19th century began to embrace the concept of "moral treatment" for mental patients, including no restraint of the patients and treating them in a more open environment. With this background, asylums were built according to the efforts of social activist Dorothea Dix with financial assistance from the Quakers. The psychiatrist Dr. Thomas Kirkbride had a large influence on asylum architecture, and believed that the hospital building and environment as well as location have healing effects on the patients, which he called the "therapeutic landscape". Kirkbridelater proposed an architectural plan that became the basis for subsequent mental hospital architecture, and many asylums were built according to this plan. As the architecture was considered part of the treatment, many leading architects and landscape architects at the time became involved in building asylums. In the later half of the 19th century, over 150 asylums were built across the USA. However, moral treatment fell out of favor toward the end of the 19th century, and the concept of therapeutic landscape was also neglected. The hospitals had many uncured patients, and caregivers became pessimistic about the efficacy of the treatments. Abuse and neglect of the patients were also common. The environment at the asylums deteriorated, which created the image of asylums that, we hold today. Many asylums have been demolished or abandoned. These early attempts at asylum failed due to insufficient

  6. Study of coercive measures in prisons and secure psychiatric hospitals: the views of inmates and caregivers

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    A. Runte-Geidel


    Full Text Available Aim: The aim of the study was to ascertain the opinions of both inmates and staff of prison establishments about the use of coercive measures justified for clinical reasons for people with mental health problems and about the need to create protocols to regulate the application of these measures. Method: These opinions were gathered in a Qualitative Study with Focus Groups (prison inmates and prison staff from the Granada Penitentiary Centre and the Alicante Penitentiary Psychiatric Hospital, both in Spain. Results: The results showed that forced medication is the most commonly used coercive measure in these institutions. The inmates did not understand and rejected the use of this measure, above all because they were poorly informed about their illness and the medication required to treat it. The staff however defended the benefits of psychiatric medicine, even when administered without the patient's consent. Conclusions: Both inmates and staff agreed that it would be useful to have a protocol regulating the use of coercive measures. The study has also identified a number of important factors that could help to reduce the need for coercive measures or make their use unnecessary.

  7. Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece

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    Papamichael Georgios


    Full Text Available Abstract Background There is a dearth of studies regarding chemical restraint in routine clinical psychiatric practice. There may be wide variations between different settings and countries. Methods A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010 were examined. Results Chemical restraint was applied in 33 cases (10.5% of total admissions. From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases, usually in combination with a benzodiazepine (61.7% of cases. In 36.4% of cases the patient was further subjected to restraint or seclusion. Conclusions In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.

  8. Factors influencing adherence to standard precautions among nursing professionals in psychiatric hospitals

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    Thaís Helena Piai-Morais


    Full Text Available OBJECTIVE Evaluate and correlate individual, work-related and organizational factors that influence adherence to standard precautions among nursing professionals of psychiatric hospitals in São Paulo. METHOD An exploratory cross-sectional study conducted with 35 nursing professionals, using the assessment tool for adherence to standard precautions through the Likert scale, ranging from 1 to 5. RESULTS Knowledge of the precautions received a high score (4.69; adherence received (3.86 and obstacles (3.78, while intermediaries and the scales of organizational factors received low scores (2.61. There was a strong correlation between the magnitude adherence scale and the personal protective equipment availability (r = 0.643; p = 0.000. The training scale for prevention of HIV exposure (p = 0.007 was statistically different between the nurses and nursing assistants. CONCLUSION The organizational factors negatively contributed to adherence to standard precautions, indicating that psychiatric institutions lack safe working conditions, ongoing training and management actions to control infections.

  9. Suicide ideation and attempts and bullying in children and adolescents: psychiatric and general population samples. (United States)

    Mayes, Susan Dickerson; Baweja, Raman; Calhoun, Susan L; Syed, Ehsan; Mahr, Fauzia; Siddiqui, Farhat


    Studies of the relationship between bullying and suicide behavior yield mixed results. This is the first study comparing frequencies of suicide behavior in four bullying groups (bully, victim, bully/victim, and neither) in two large psychiatric and community samples of young children and adolescents. Maternal ratings of bullying and suicide ideation and attempts were analyzed for 1,291 children with psychiatric disorders and 658 children in the general population 6-18 years old. For both the psychiatric and community samples, suicide ideation and attempt scores for bully/victims were significantly higher than for victims only and for neither bullies nor victims. Differences between victims only and neither victims nor bullies were nonsignificant. Controlling for sadness and conduct problems, suicide behavior did not differ between the four bullying groups. All children with suicide attempts had a comorbid psychiatric disorder, as did all but two children with suicide ideation. Although the contribution of bullying per se to suicide behavior independent of sadness and conduct problems is small, bullying has obvious negative psychological consequences that make intervention imperative. Interventions need to focus on the psychopathology associated with being a victim and/or perpetrator of bullying in order to reduce suicide behavior.

  10. Psychiatric disorders and family functioning in children and adolescents with functional abdominal pain syndrome. (United States)

    Ghanizadeh, Ahmad; Moaiedy, Farah; Imanieh, Mohammad Hadi; Askani, Hamid; Haghighat, Mahmood; Dehbozorgi, Gholamreza; Dehghani, Seyed Mohsen


    Functional abdominal pain syndrome (FAPS) is a functional gastrointestinal disorder. There is a heightened risk when conducting potentially dangerous and unnecessary medical investigations and procedures in children with FAPS. The aim of this study was to survey the rate of the psychiatric disorders and family functioning in children and adolescents with FAPS. The subjects were a consecutive new sample of 45 children and adolescents with FAPS, 45 with an organic abdominal pain, and 45 pain-free comparison subjects aged 5-18 years that were interviewed using the Farsi version of K-SADS. Family functioning and the severity of pain were also studied. About 51.1% of patients with FAPS suffered from at least one psychiatric disorder. Psychiatric disorders in the FAPS patients studied included general anxiety disorder (8.9%), obsessive-compulsive disorder (11.1%), attention deficit hyperactivity disorder (15.6%), separation anxiety disorder (24.4%), and major depressive disorder (15.6%). Except for generalized anxiety disorder and tic disorder, the other disorders were significantly more common in the FAPS group than in the two other control groups. Family functioning scores were not significantly different between groups. There is a high rate of psychiatric disorders in children and adolescents with FAPS in Iran, but our study found fewer incidences of disorders than previous reports have indicated. Family dysfunction difficulties in FAPS children are not more common than those in the control groups.

  11. Development of a Questionnaire to Assess Nursing Competencies for the Care of People with Psychiatric Disabilities in a Hospital Environment. (United States)

    Feng, Danjun; Li, Hongyao; Meng, Lu; Zhong, Gengkun


    The recovery of people with psychiatric disabilities requires high-quality nursing care. However, the existing research on the nursing competencies needed for caring for people with psychiatric disabilities have been based on a narrow competency framework. By adopting a broader competency framework, this study aimed to find the competencies needed for the nursing care of people with psychiatric disabilities in a hospital environment. Accordingly, a questionnaire will be developed to measure these competences. First, a literature review and interviews with psychiatrists, psychiatric nurses, and people with psychiatric disabilities were conducted to develop the pool of competency items. Second, a pilot study was conducted to review the initial pool of items. Finally, a survey of 581 psychiatric nurses was used to conduct a series of principal component analyses to explore the structure of the questionnaire. The 17-item questionnaire included 5 factors, which accounted for 68.60% of the total variance: sense of responsibility, vocational identification, agreeableness, cooperation capacity, and carefulness; the Cronbach's alpha coefficients were 0.85, 0.85, 0.74, 0.80, and 0.77, respectively. Most of the competencies belonged to attitudes, values, and traits, which were overlooked in previous studies. The questionnaire has satisfactory internal reliability and structural validity, and could contribute some to the selection of the psychiatric workforce.

  12. Psychiatric Morbidity, Violent Crime, and Suicide among Children and Adolescents Exposed to Parental Death (United States)

    Wilcox, Holly C.; Kuramoto, Satoko J.; Lichtenstein, Paul; Langstrom, Niklas; Brent, David A.; Runeson, Bo


    Objective: This retrospective cohort study examined the risk for suicide, psychiatric hospitalization, and violent criminal convictions among offspring of parents who died from suicide, accidents, and other causes. Method: Population-based data from multiple Swedish national registers were linked from 1969 to 2004. Participants were 44,397…

  13. Prevalence and determinants of workplace violence of health care workers in a psychiatric hospital in Taiwan. (United States)

    Chen, Wen-Ching; Hwu, Hai-Gwo; Kung, Shou-Mei; Chiu, Hsien-Jane; Wang, Jung-Der


    Workplace violence, a possible cause of job stress, has recently become an important concern in occupational health. This study determined the prevalence of workplace violence and its risk factors for employees at a psychiatric hospital in Taiwan. A questionnaire developed by ILO/ICN/WHO/PSI was first translated and validated. It was then used to survey the prevalence of workplace violence in the last 12 months experienced by all nursing aides, nurses, and clerks at the hospital. Multiple logistic regression models were constructed to discover the determinants of violence. A total of 222 out of 231 surveyed workers completed a valid questionnaire. The one-year prevalence rates of physical violence (PV), verbal abuse, bullying/mobbing, sexual harassment, and racial harassment were 35.1, 50.9, 15.8, 9.5, and 4.5%, respectively. The prevalence of PV at this hospital was higher than that reported by other countries for the health sector. A high anxiety level was associated with the occurrence of PV. These results need to be corroborated by future investigation. A training program may be required for high risk groups to reduce workplace violence.

  14. Organizational culture of a psychiatric hospital and resilience of nursing workers. (United States)

    Rocha, Fernanda Ludmilla Rossi; Gaioli, Cheila Cristina Leonardo de Oliveira; Camelo, Silvia Helena Henriques; Mininel, Vivian Aline; Vegro, Thamiris Cavazzani


    to analyze the organizational culture of a psychiatric hospital and identify the capacity of resilience of nursing workers. quantitative research. For data collection, were used the Brazilian Instrument for Evaluation of Organizational Culture (IBACO - Instrumento Brasileiro para Avaliação da Cultura Organizacional) and the Resilience Scale (RS). participants reported the existence of centralization of power and devaluation of workers, despite recognizing the existence of collaboration at work and practices for improving interpersonal relations. In relation to the capacity of resilience, 50% of workers showed high level, and 42.9% a medium level of resilience. The correlation tests revealed negative values between the IBACO and RS domains, indicating that the lower the appreciation of individuals in the institution, the greater their capacity of resilience. the organizational values reflect the work organization model in the institution that devalues the workers' needs and requires greater capacity of resilience.

  15. Communication of nursing students in listening to patients in a psychiatric hospital

    Directory of Open Access Journals (Sweden)

    Albert Lengruber de Azevedo


    Full Text Available Abstract Qualitative exploratory and descriptive study with the aim of analyzing the communication of nursing students in the listening to patients in mental suffering admitted in a psychiatric hospital. The study was carried out from April to May 2013, with 23 nursing students regularly enrolled in a public higher education institution in the Southeast of Brazil. The data were collected based on artistic production and interviews, analyzed and categorized according to their thematic content. Proxemic nonverbal communication was unanimously indicated by the students based on personal-body position of face, neck, and, shoulders adopted in the listening to patients in mental suffering. The conscious use of proxemics favored clinical reasoning, improving interaction and listening in speech and thought disorders. Attentive, effective, and affective listening demands availability, control of fear, tension, anxiety, and insecurity.

  16. Psychiatric morbidity of overseas patients in inner London: A hospital based study

    Directory of Open Access Journals (Sweden)

    Parshall Alice M


    Full Text Available Abstract Background Evaluation of the referral, admission, treatment, and outcome of overseas patients admitted to a psychiatric hospital in central London. Ethical, legal and economic implications, and the involvement of consulates in the admission process, are discussed. Method Assessment and review of overseas patients admitted between 1 January 1999 and 31 December 1999. Non-parametric statistical tests were used, and relevant outcomes described. Results 19% of admissions were overseas patients. Mean age was 38 years. 90% were unattached; 84% were white, 71% from European countries. 45% spoke fluent English. Differences in socio-economic status between home country and England were found. 74% were unwell on arrival; 65% travelled to England as tourists. 65% of admissions came via the police. 32% had been ill for more than one year before admission; 68% had psychiatric history. 77% were admitted and 48% discharged under section of the Mental Health Act. 74% had psychotic disorders, all of them with positive symptoms. 55% showed little to moderate improvement in mental state; 10% were on Enhanced Care Programme Approach. Relatives of 48% of patients were contacted. The Hospital repatriated 52% of patients; the Mental Health Team followed up 13% of those discharged. The average length of admission was 43.4 days (range 1–365. Total cost of admissions was GBP350, 600 ($577, 490; average individual cost was GBP11, 116 (range GBP200-81, 000. Conclusions Mentally ill overseas individuals are a vulnerable group that need recognition by health organisations to adapt current practice to better serve their needs. The involvement of consulates needs further evaluation.

  17. Psychotropic Drug Prescription in Adolescents: A Retrospective Study in a Swiss Psychiatric University Hospital. (United States)

    Ansermot, Nicolas; Jordanov, Véronique; Smogur, Michal; Holzer, Laurent; Eap, Chin B


    This retrospective study aims to evaluate off-label prescriptions and administrations of psychotropic medications in adolescents in a university psychiatric hospital in Switzerland. Data were collected during the entire stays from the electronic database for 76 inpatients in 2008 and 76 inpatients in 2014. Data collected included gender, age, psychiatric diagnosis, duration of hospitalization, and psychotropic drug prescriptions and administrations. A total of 224 psychotropic drugs (mean 2.9 drugs/patient) were prescribed in 2008 and 268 (mean 3.5 drugs/patient) in 2014. Due to the prescriptions of some drugs as required, only 76% of the prescriptions were actually administered in 2008 (mean 2.3 drugs/patient) and 55% in 2014 (mean 1.9 drugs/patient). Antipsychotics were the most frequently prescribed drugs in 2008 (74% of patients) and 2014 (86% of patients). Anxiolytics were also highly prescribed in 2008 (54% of patients) and 2014 (66% of patients), as well as antidepressants in 2008 (30% of patients), but less in 2014 (13% of patients). Overall, 69% of prescriptions were found to be off label in 2008 and 68% in 2014, according to age, diagnosis, dose, or formulation as approved by Swissmedic. The medication classes with the highest rate of off-label prescriptions were antidepressants (100% for both years), antipsychotics (94% in 2008 and 92% in 2014), and hypnotics (67% in 2008 and 100% in 2014). For both study periods, at least one off-label psychotropic drug prescription and administration was recorded in 96% and 79% of the patients, respectively. The high rate of off-label psychotropic drug use strengthens the need for clinical trials to better evaluate the efficacy and safety of these treatments in adolescents.

  18. AKI in Children Hospitalized with Nephrotic Syndrome. (United States)

    Rheault, Michelle N; Zhang, Lei; Selewski, David T; Kallash, Mahmoud; Tran, Cheryl L; Seamon, Meredith; Katsoufis, Chryso; Ashoor, Isa; Hernandez, Joel; Supe-Markovina, Katarina; D'Alessandri-Silva, Cynthia; DeJesus-Gonzalez, Nilka; Vasylyeva, Tetyana L; Formeck, Cassandra; Woll, Christopher; Gbadegesin, Rasheed; Geier, Pavel; Devarajan, Prasad; Carpenter, Shannon L; Kerlin, Bryce A; Smoyer, William E


    Children with nephrotic syndrome can develop life-threatening complications, including infection and thrombosis. While AKI is associated with adverse outcomes in hospitalized children, little is known about the epidemiology of AKI in children with nephrotic syndrome. The main objectives of this study were to determine the incidence, epidemiology, and hospital outcomes associated with AKI in a modern cohort of children hospitalized with nephrotic syndrome. Records of children with nephrotic syndrome admitted to 17 pediatric nephrology centers across North America from 2010 to 2012 were reviewed. AKI was classified using the pediatric RIFLE definition. AKI occurred in 58.6% of 336 children and 50.9% of 615 hospitalizations (27.3% in stage R, 17.2% in stage I, and 6.3% in stage F). After adjustment for race, sex, age at admission, and clinical diagnosis, infection (odds ratio, 2.24; 95% confidence interval, 1.37 to 3.65; P=0.001), nephrotoxic medication exposure (odds ratio, 1.35; 95% confidence interval, 1.11 to 1.64; P=0.002), days of nephrotoxic medication exposure (odds ratio, 1.10; 95% confidence interval, 1.05 to 1.15; Pchildren with nephrotic syndrome. Nephrotoxic medication exposure was common in this population, and each additional nephrotoxic medication received during a hospitalization was associated with 38% higher risk of AKI. AKI was associated with longer hospital stay after adjustment for race, sex, age at admission, clinical diagnosis, and infection (difference, 0.45 [log]days; 95% confidence interval, 0.36 to 0.53 [log]days; Pchildren hospitalized with nephrotic syndrome and should be deemed the third major complication of nephrotic syndrome in children in addition to infection and venous thromboembolism. Risk factors for AKI include steroid-resistant nephrotic syndrome, infection, and nephrotoxic medication exposure. Children with AKI have longer hospital lengths of stay and increased need for intensive care unit admission. Copyright © 2015 by the

  19. Casemix reimbursement: a Singapore Children's Hospital perspective. (United States)

    Yoong, S L


    Casemix reimbursement was introduced to Singapore in October 1999 using the Australian National Diagnosis Related Groups Version 3.1 (AN-DRGs 3.1). The possible impact of this classification system on a Singapore Children's Hospital is discussed. Data on paediatric patients in KK Women's and Children's Hospital (KKH) were drawn from the inhouse Datamart warehouse system, and reviewed with regards to volume of patients, length of stay and charges. Several high cost categories were selected for a more in-depth review and discussed. The classification system and reimbursement method did not take into account the higher cost of treating children, thus penalising the Children's Hospital. The wide variety of cases treated also gave rise to difficulty in obtaining appropriate reimbursement. The lack of severity of illness measures was a drawback in the Diagnosis Related Group (DRG) for ventilated patients. The lack of outcome measures gave rise to potentially inequitable reimbursement in some high cost neonatal DRGs. While Casemix is an improvement over previous methods of providing Government funding in Singapore, particular aspects need to be reviewed, and reimbursement criteria refined to ensure equitable funding to Children's Hospital.

  20. [Incidence and risk factors for mental abnormalities in children of psychiatric inpatients]. (United States)

    Stelzig-Schöler, Renate; Hasselbring, Laura; Yazdi, Kurosch; Thun-Hohenstein, Leonhard; Stuppäck, Christoph; Aichhorn, Wolfgang


    Children of mentally ill parents are exposed to a variety of stress- and harmful life events. To which extent the mental illness of one or both parents affects their children's mental development is barely studied. Therefore, over a period of 6 months 142 patients with children below the age of 18 (n=237 children), who were admitted to the Dept. for Psychiatry and Psychotherapy 1 of the Paracelsus Medical University Salzburg, were questioned for abnormalities in their children's mental development. Additionally all these patients were assessed for their family situation, demographic data and psychiatric disorder. 38.4% (n=91) of the children showed mental abnormalities. The most common one were emotional (n=41), social (n=41) and learning (n=34) disabilities. Parental duration of the illness (p=0.001), age of the children (p=0.044), illness of both parents (p=0.008), longlasting family conflicts (p=0.003) and living with only one parent (p=0.012) were correlated significantly with mental abnormalities in children. The results confirm an increase risk for mental abnormalities in children of psychiatric patients. This risk varies with existing risk and protective factors, which can be partially influenced. Therefore children of mentally ill parents with problems in their mental development should be detected early. Even if genetic risk factors cannot be changed reducing known psychosocial risk factors and promotion protective factors can significantly influence a healthy development of these vulnerable children.

  1. School Exclusion in Children with Psychiatric Disorder or Impairing Psychopathology: A Systematic Review (United States)

    Parker, Claire; Whear, Rebecca; Ukoumunne, Obioha C.; Bethel, Alison; Thompson-Coon, Jo; Stein, Ken; Ford, Tamsin


    Childhood psychiatric disorders are associated with a wide range of adverse outcomes including poor academic attainment. For some children these difficulties are recognised through school Special Educational Need procedures (SEN) but many others may remain unidentified and/or unsupported. In Britain, government data suggests disproportionate…

  2. ADHD severity as it relates to comorbid psychiatric symptomatology in children with Autism Spectrum Disorders (ASD). (United States)

    Mansour, Rosleen; Dovi, Allison T; Lane, David M; Loveland, Katherine A; Pearson, Deborah A


    Comorbid diagnoses identified in pediatric samples have been correlated with a range of outcomes, including greater levels of emotional, behavioral, and educational impairment and the need for more intensive treatment. Given that previous research has documented high levels of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) in children with Autism Spectrum Disorders (ASD), this study closely examines the relationship between parent-reported ADHD symptoms (i.e., Conners' Parent Rating Scale, Revised [CPRS-R]) and the prevalence of additional comorbid psychiatric diagnoses in a pediatric ASD sample (n=99). Regression analyses revealed that greater severity of ADHD symptomatology was significantly related to a greater number of comorbid psychiatric diagnoses, as identified using the Diagnostic Interview for Children and adolescents, 4th Edition (DICA-IV). Additionally, more severe ADHD symptoms were also associated with higher levels of symptom severity on Child Behavior Checklist (CBCL) syndrome subscales. Interestingly, increasing severity of ASD symptomatology, as measured by the Autism Diagnostic Interview, Revised (ADI-R), was not associated with a higher prevalence of comorbid psychiatric diagnoses or CBCL syndrome severity. Our study concluded that higher levels of ADHD severity-not ASD severity-were associated with a higher prevalence of comorbid psychiatric symptomatology in school-age children with ASD. These findings may encourage clinicians to thoroughly assess ADHD symptomatology in ASD children to better inform treatment planning. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Predicting discharge in forensic psychiatry: the legal and psychosocial factors associated with long and short stays in forensic psychiatric hospitals. (United States)

    Ross, Thomas; Querengässer, Jan; Fontao, María Isabel; Hoffmann, Klaus


    In Germany, both the number of patients treated in forensic psychiatric hospitals and the average inpatient treatment period have been increasing for over thirty years. Biographical and clinical factors, e.g., the number of prior offences, type of offence, and psychiatric diagnosis, count among the factors that influence the treatment duration and the likelihood of discharge. The aims of the current study were threefold: (1) to provide an estimate of the German forensic psychiatric patient population with a low likelihood of discharge, (2) to replicate a set of personal variables that predict a relatively high, as opposed to a low, likelihood of discharge from forensic psychiatric hospitals, and (3) to describe a group of other factors that are likely to add to the existing body of knowledge. Based on a sample of 899 patients, we applied a battery of primarily biographical and other personal variables to two subgroups of patients. The first subgroup of patients had been treated in a forensic psychiatric hospital according to section 63 of the German legal code for at least ten years (long-stay patients, n=137), whereas the second subgroup had been released after a maximum treatment period of four years (short-stay patients, n=67). The resulting logistic regression model had a high goodness of fit, with more than 85% of the patients correctly classified into the groups. In accordance with earlier studies, we found a series of personal variables, including age at first admission and type of offence, to be predictive of a short or long-stay. Other findings, such as the high number of immigrants among the short-stay patients and the significance of a patient's work time before admission to a forensic psychiatric hospital, are more clearly represented than has been observed in previous research. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Research Survey on the Therapeutic Use of Horticulture in Welfare Institutions and Psychiatric Hospitals in Fukuoka Prefecture, Japan


    松尾, 英輔; 藤木, 雄二; 藤原, 勝紀; Matsuo, Eisuke; Fujiki, Yuji; Fujiwara, Katsunori


    A survey was conducted using a mailed questionnaire to investigate the use of horticulture in welfare institutions and psychiatric hospitals in Fukuoka Prefecture. Approximately 70% of the 230 surveyed institutions and hospitals responded. Sixty-two% of the responding institutions had the clients engaged in horticulture. All of them reported having sites for horticultural activities, including container gardening. It was found that farms and flower gardens were the most commonly used sites. H...

  5. Nurse practice environment, workload, burnout, job outcomes, and quality of care in psychiatric hospitals: a structural equation model approach. (United States)

    Van Bogaert, Peter; Clarke, Sean; Willems, Riet; Mondelaers, Mieke


    To study the relationships between nurse practice environment, workload, burnout, job outcomes and nurse-reported quality of care in psychiatric hospital staff. Nurses' practice environments in general hospitals have been extensively investigated. Potential variations across practice settings, for instance in psychiatric hospitals, have been much less studied. A cross-sectional design with a survey. A structural equation model previously tested in acute hospitals was evaluated using survey data from a sample of 357 registered nurses, licensed practical nurses, and non-registered caregivers from two psychiatric hospitals in Belgium between December 2010-April 2011. The model included paths between practice environment dimensions and outcome variables, with burnout in a mediating position. A workload measure was also tested as a potential mediator between the practice environment and outcome variables. An improved model, slightly modified from the one validated earlier in samples of acute care nurses, was confirmed. This model explained 50% and 38% of the variance in job outcomes and nurse-reported quality of care respectively. In addition, workload was found to play a mediating role in accounting for job outcomes and significantly improved a model that ultimately explained 60% of the variance in these variables. In psychiatric hospitals as in general hospitals, nurse-physician relationship and other organizational dimensions such as nursing and hospital management were closely associated with perceptions of workload and with burnout and job satisfaction, turnover intentions, and nurse-reported quality of care. Mechanisms linking key variables and differences across settings in these relationships merit attention by managers and researchers. © 2012 Blackwell Publishing Ltd.

  6. Predicting hospitalization in children with acute asthma. (United States)

    Buyuktiryaki, A Betul; Civelek, Ersoy; Can, Demet; Orhan, Fazıl; Aydogan, Metin; Reisli, Ismail; Keskin, Ozlem; Akcay, Ahmet; Yazicioglu, Mehtap; Cokugras, Haluk; Yuksel, Hasan; Zeyrek, Dost; Kocak, A Kadir; Sekerel, Bulent E


    Acute asthma is one of the most common medical emergencies in children. Appropriate assessment/treatment and early identification of factors that predict hospitalization are critical for the effective utilization of emergency services. To identify risk factors that predict hospitalization and to compare the concordance of the Modified Pulmonary Index Score (MPIS) with the Global Initiative for Asthma (GINA) guideline criteria in terms of attack severity. The study population was composed of children aged 5-18 years who presented to the Emergency Departments (ED) of the tertiary reference centers of the country within a period of 3 months. Patients were evaluated at the initial presentation and the 1(st) and 4(th) hours. Of the 304 patients (median age: 8.0 years [interquartile range: 6.5-9.7]), 51.3% and 19.4% required oral corticosteroids (OCS) and hospitalization, respectively. Attack severity and MPIS were found as predicting factors for hospitalization, but none of the demographic characteristics collected predicted OCS use or hospitalization. Hospitalization status at the 1(st) hour with moderate/severe attack severity showed a sensitivity of 44.1%, specificity of 82.9%, positive predictive value of 38.2%, and negative predictive value of 86.0%; for MPIS ≥ 5, these values were 42.4%, 85.3%, 41.0%, and 86.0%, respectively. Concordance in prediction of hospitalization between the MPIS and the GINA guideline was found to be moderate at the 1(st) hour (κ = 0.577). Attack severity is a predictive factor for hospitalization in children with acute asthma. Determining attack severity with MPIS and a cut-off value ≥ 5 at the 1(st) hour may help physicians in EDs. Having fewer variables and the ability to calculate a numeric value with MPIS makes it an easy and useful tool in clinical practice. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Psychiatric symptoms and disorders among Yazidi children and adolescents immediately after forced migration following ISIS attacks. (United States)

    Ceri, Veysi; Özlü-Erkilic, Zeliha; Özer, Ürün; Yalcin, Murat; Popow, Christian; Akkaya-Kalayci, Türkan


    The aim of the present study was to evaluate psychiatric problems and disorders among Yazidi Kurd refugee children and adolescents, who were assessed immediately after their forced migration following life-threatening attacks by ISIS terrorists. We retrospectively analyzed the psychiatric assessments of 38 Yazidi children and adolescents (age 2-18, mean 12 years, m:f = 16:22), which were performed upon their arrival at the refugee camp. All children and adolescents exhibited psychiatric problems and disorders, 50 % had one, and 50 % had more than one. The most relevant problems were disturbed sleeping (71 % of children), followed by depression (36.8 %), conversion disorders (28.9 %), adjustment (21.8 %), acute (18.4 %) and posttraumatic stress (PTSD, 10.5 %) disorders, and non-organic enuresis (18.4 %). Our study confirms the results of previous studies, asserting that refugee children and adolescents do not just suffer from PTSD but from various other problems that are already present in the first days of resettlement. Children and adolescents living in refugee camps urgently need psychosocial support.

  8. Resilience of the health team in caring for people with mental disorders in a psychiatric hospital. (United States)

    Brolese, Débora Felippe; Lessa, Greice; Santos, José Luís Guedes Dos; Mendes, Jucimara da Silva; Cunha, Kamylla Santos da; Rodrigues, Jeferson


    Evaluating and understanding the resilience process of the health team in caring for people with mental disorders in a psychiatric hospital. A mixed-method study with concomitant triangulation of data from a cross-sectional study, with health professionals, and Grounded Theory in the data. Quantitative data were collected using the Resilience Scale and analyzed using descriptive and inferential statistics. Qualitative data were obtained from interviews and analyzed using initial and focused coding. 40 health professionals participated in the study. Mean responses of the participants in the resilience scale were 99.80 ± 12.86 points, with a minimum of 35 and a maximum of 114 points. From the qualitative data, we can highlight the professionals' commitment in developing competencies in caring for people with mental disorders; valorization of teamwork and positive impact on work for the re-signification of the meaning of life. Understanding this process of resilience enables developing strategies to improve the quality of life of workers in psychiatric hospitals. Avaliar e compreender o processo de resiliência da equipe de saúde no cuidado a pessoas com transtornos mentais em um hospital psiquiátrico. Estudo de método misto com triangulação concomitante de dados de um estudo transversal, com profissionais de saúde, e uma Teoria Fundamentada nos Dados. Os dados quantitativos foram coletados a partir da Escala de Resiliência e analisados por meio de estatística descritiva e inferencial. Os dados qualitativos foram obtidos a partir de entrevistas e analisados mediante codificação inicial e focalizada. Participaram da pesquisa 40 profissionais de saúde. Na escala de resiliência, a média das respostas dos participantes foi 99,80±12,86 pontos, o mínimo foi de 35 e o máximo de 114 pontos. Nos dados qualitativos, destacaram-se o empenho dos profissionais para o desenvolvimento de competências para o cuidado de pessoas com transtornos mentais, a valoriza

  9. Integrated Specialized Early-Course Psychosis Treatment Services - University Psychiatric Hospital Vrapce Model. (United States)

    Ostojić, DraŽenka; Čulo, Ilaria; Silić, Ante; Kos, Suzana; Savić, Aleksandar


    First episode of psychosis presents a critical period in terms of numerous associated risks, but also possibilities for effective therapeutic interventions. There is a continued focus on early interventions in prodromal states and early course of frank psychosis, aimed at ensuring faster remission, reducing relapses, achieving better long-term functioning, and preventing adverse outcomes linked to untreated psychosis and chronic psychotic disorders. A number of different specialized treatment models and services exist trying to close knowledge gaps and provide clinical interventions to first-episode psychosis (FEP) patients, but there is still no generally accepted standard of care informing our every-day practice. FEP and early-course psychosis specialized treatment model developed in 2004 in University Psychiatric Hospital Vrapce rests on integration of care across different organization units and clinical presentation acuity levels and patient needs (intensive care, FEP inpatient unit, FEP outpatient services including day hospital). Such integration of FEP services allows for flexible entry point on multiple levels, earlier structuring of therapeutic alliance for those requiring inpatient care, reduction of risks associated with FEP, quicker formation of long-term treatment plans, reduction of delay in accessing specialized services, and a more coordinated diagnostic process and recruitment of FEP patient population. Detailed evaluations of outcomes and comparisons with different treatment models are necessary in order to assess strengths and weaknesses of each specific model and inform modifications to current practice models.

  10. Exposure to violence in children referred for psychiatric evaluation

    African Journals Online (AJOL)

    One hundred consecutive patients referred to the Child. Mental Health Section of Oranje Hospital in Bloemfontein ... clinics by general practitioners. In this study .... Lewis M. Child and Adolescent Psychiatry: A Comprehensive Textbook. 1st ed.

  11. Rota virus Diarrhea in Hospitalized Children

    International Nuclear Information System (INIS)

    Habib, M. I.; Khan, K. M. A.; Zia, N.; Kazi, S. G.


    Objective: To determine the frequency and clinical features of Rota virus diarrhea in children presenting in a tertiary care hospital. Study Design: A cross-sectional, observational study. Place and Duration of Study: National Institute of Child Health, Karachi, from January to June 2007. Methodology: A total of three hundred children of either gender aged 1 month to 5 years, who presented with diarrhea of < 7 days as a primary illness were enrolled. Children with bloody diarrhea or nosocomial gastroenteritis acquired during hospitalization for other disease were not included. Detection of Rota virus in stool was done by enzyme linked immunoassay. Results: Out of 300 children, 188 (63%) tested positive and 112 (37%) tested negative for Rota virus. Positive Rota virus cases in 7 - 12 months of age was (n = 34, 18.08%). Overall, 151 (80.3%) children with Rota virus were less than 3 years old. 182 (60.7%) had fever, 118 (39.3%) had vomiting and 156 (82.9%) children had both fever and vomiting. Conclusion: This study shows that Rota virus is a common organism causing diarrhea in children less than 3 years of age. There is a need to incorporate Rota virus vaccine in the national EPI program to decrease the disease burden as highlighted in this study. (author)

  12. Care of "new" long-stay patients in a district general hospital psychiatric unit. The first two years of a hospital-hostel. (United States)

    Gibbons, J S


    The paper describes the need for long-term inpatient care in an English health district whose psychiatric services were based on a unit in a District General Hospital. Patients who became long-stay were placed in a new hospital-hostel in a city centre. Three quarters of those eligible could be managed in the hostel, with those rejected posing more control problems. Patients in the hostel became less withdrawn and increased their activity and use of community facilities.

  13. Neurological, Metabolic, and Psychiatric Adverse Events in Children and Adolescents Treated With Aripiprazole

    DEFF Research Database (Denmark)

    Jakobsen, Klaus Damgaard; Bruhn, Christina Hedegaard; Pagsberg, Anne-Katrine


    Aripiprazole is a partial dopamine agonist with only minor neurological and psychiatric adverse effects, making it a potential first-line drug for the treatment of psychiatric disorders. However, the evidence of its use in children and adolescents is rather sparse. The aim of this case study...... with schizophrenia and psychoses, not otherwise specified; and the non-PS group consisted of fourteen cases including autism spectrum disorders, attention deficit and hyperactivity disorder, obsessive-compulsive disorder, and Tourette syndrome. The main reported adverse effects in the non-PS group were chronic...

  14. A Brazilian version of the "Children's Interview for Psychiatric Syndromes" (ChIPS A versão brasileira do "Children's Interview for Psychiatric Syndromes" (ChIPS

    Directory of Open Access Journals (Sweden)

    Isabella G. S. de Souza


    Full Text Available OBJETIVE: The advance of research in child and adolescent psychiatry in Brazil heavily depends on the existence of instruments for the investigation of psychiatric syndromes adapted to Brazilian Portuguese. METHODS: This article describes a careful process of translation of the Children's Interview for Psychiatric Syndromes for the purpose of use in research in Brazil. The Children's Interview for Psychiatric Syndromes has a version for parents (P-ChIPs and a version for children (ChIPS. In this article, the sections of P-ChIPS referring to attention-deficit hyperactivity disorder, oppositional-defiant disorder, conduct disorder, mania/hypomania, anorexia nervosa, bulimia nervosa and psychotic disorders were translated to Brazilian Portuguese. The sections of the ChIPS referring to substance use disorders, social anxiety disorder, specific phobias, obsessive-compulsive disorder, generalized anxiety disoder, separation anxiety disorder, post-traumatic disorders and depression/dysthimia were also adapted. Each section was translated by two independent translators and later discussed in a committee composed of experts in the field of Psychiatry and a professional of the field of linguistics. RESULT: A final version containing an interview for the main psychiatric syndromes was defined. CONCLUSION: The translated P-ChIPS is a helpful instrument in children and adolescent clinical evaluation.OBJETIVO: O avanço em pesquisa em psiquiatria da infância e adolescência no Brasil depende da existência de instrumentos para a investigação de síndromes psiquiátricas adaptadas à Língua Portuguesa. Este artigo descreve um cuidadoso processo de tradução do Children´s Interview for Psychiatric Syndromes para o uso em pesquisa no Brasil. MÉTODOS: O Children´s Interview for Psychiatric Syndromes tem uma versão para pais (P-ChIPs e uma versão para as crianças (ChIPs. Nesse artigo, as seções do P-ChIPs referentes ao transtorno do déficit de aten

  15. Trends in suicide risk associated with hospitalized psychiatric illness: a case-control study based on danish longitudinal registers

    DEFF Research Database (Denmark)

    Qin, Ping; Nordentoft, Merete; Hansen Høyer, Eyd


    longitudinal registers. Data were analyzed using conditional logistic regression. RESULTS: This study shows that the reduction in suicide rate is generally faster among individuals with a history of psychiatric admission than among individuals without such a history. However, this substantial reduction...... at the time of suicide or the index date, the reduction in suicide rate is relatively slower. Such trends hold for all diagnostic groups. Further analyses stratified by age indicate that the faster reduction in suicide rate associated with history of hospitalized psychiatric illness is more pronounced among...

  16. Ataques de Nervios and their psychiatric correlates in Puerto Rican children from two different contexts. (United States)

    López, Irene; Rivera, Fernando; Ramirez, Rafael; Guarnaccia, Peter J; Canino, Glorisa; Bird, Héctor R


    Among Latino adults and children, ataques de nervios has been associated with an array of psychiatric disorders. Using data from a probability sample of Puerto Rican children, aged 5 to 13 years (N = 2491), we assessed the lifetime prevalence and psychiatric correlates of ataques in youth residing in the South Bronx, New York and San Juan, Puerto Rico. Baseline site comparisons indicated that between 4% and 5% of children had a lifetime prevalence of ataques (either by child or parent report) and that ataques were associated with greater global impairment and a host of childhood disorders within the previous twelve months. Ataques were also correlated with greater exposure to violence, as well as more stressful life events for the South Bronx sample. After controlling for several covariates, ataques continued to be significantly associated with psychopathology. Ataques are, therefore, a significant correlate of global impairment and childhood psychopathology among Puerto Rican youth.

  17. Psychiatric and family functioning in children with leukemia and their parents

    Directory of Open Access Journals (Sweden)

    Goodarzi A


    Full Text Available The present study reports data from a cross-sectional investigation of the psychiatric and psychosocial functioning of 55 children diagnosed with acute lymphocytic leukemia and their families at three points in time: diagnosis (newly diagnosed, 1 year postdiagnosis, and 1 year after the completion of chemotherapy (offtherapy. Results reveal minimal psychopathology in these children and their parents based on self-and informantreports and structured diagnostic interviews. These families appear to be functioning adequately and report more family cohesiveness and marital satisfaction after chemotherapy was completed. Coping strategies commonly used by children and their parents include problem solving, a positive outlook, and good communication. Implications for psychiatric consultation are presented.

  18. A critical black feminist ethnography of treatment for women with co-occurring disorders in the psychiatric hospital. (United States)

    Creswell, Laryssa M


    The purpose of this study was to explore the perspectives of women diagnosed with co-occurring disorders on the treatments provided by a state psychiatric hospital so that appropriate recommendations for changes in treatment may be made. Critical ethnography was used and the data was viewed through the lens of intersectionality from the black feminist perspective. Seven women hospitalized in one psychiatric hospital in the Mid-Atlantic region participated in the study. Data was collected via semistructured interviews, Consumer Perceptions of Care survey, researcher's observations, and archival data. Three major findings emerged: (1) Dialectical Behavioral Therapy (DBT) was identified as a beneficial treatment, (2) a lack of trust in the system and people in the system, and (3) housing or homelessness was perceived as a barrier. Based on the results of this study, it is recommended clinicians, administrators, and policy makers listen closely to individuals receiving treatment to make decisions regarding treatment accordingly.

  19. Outcomes of a Character Strengths-Based Intervention on Self-Esteem and Self-Efficacy of Psychiatrically Hospitalized Youths. (United States)

    Toback, Rebecca L; Graham-Bermann, Sandra A; Patel, Paresh D


    Mental health treatment approaches based on character strengths can be used to complement the traditional focus on functional impairment. The study tested use of a character strengths-based intervention to enhance the self-esteem and self-efficacy of psychiatrically hospitalized youths. Eighty-one hospitalized adolescents were randomly assigned to intervention or comparison groups. The intervention used the Values in Action Inventory of Strengths for Youth to discover character strengths and incorporate them into coping skills. Self-efficacy and self-esteem were measured at baseline, postintervention, two weeks, and three months. Self-esteem and self-efficacy initially increased in both groups, but only the intervention group showed sustained improvement. The intervention was associated with increased self-efficacy at two weeks and increased self-efficacy and self-esteem at three months. A brief, easily administered character strengths-based intervention may be an adjunctive tool in the treatment of psychiatrically hospitalized youths.

  20. Psychiatric consultations and the management of associated comorbid medical conditions in a regional referral hospital

    Directory of Open Access Journals (Sweden)

    Nkokone S Z Tema


    Full Text Available Background. Psychiatrists are often called upon to evaluate patients with a medical condition and psychiatric symptoms, either as a complication thereof or initial presenting symptoms. There are often grey areas with regard to neuropsychiatric disorders in which psychiatrists and specialists from other clinical disciplines would need to co-manage or share ideas on the comprehensive treatment of a presenting patient. Objectives. This study was undertaken to provide a demographic and clinical profile of all patients consulted by the consultation-liaison psychiatry (CLP service at the Helen Joseph Hospital (HJH in Johannesburg, and to describe the clinical management of patients admitted with a diagnosis of a mental disorder associated with a comorbid medical condition, including delirium, dementia and a mood or psychotic disorder due to a general medical condition. Methods. A retrospective record review of all patients referred to the HJH CLP team over a 6-month period. Results. A total of 884 routine and emergency consultations were done for 662 patients (males n=305; females n=357 between the ages of 13 and 90 years who were referred from various other clinical departments. The most common documented reason for referral was a request for assessment (n=182; 27.5%, which consisted of mental state assessment, reconsultation and assessing capacity. A total of 63 patients (10.0% of cases consulted were admitted to either the medical or psychiatric wards with a confirmed diagnosis of delirium, dementia and/or a mood or psychotic disorder due to a general medical condition (although admission wards were identified in 55 files only. The medical wards admitted the majority (n=37; 67.3% mostly for delirium (n=28; 50.9%. HIV was identified as the most common systemic aetiological factor (n=23; 67.7%. Conclusion. In this study, a female patient between 31 and 45 years of age was slightly more likely to be referred to the HJH CLP service for assessment, and

  1. Hospital care for mental health and substance abuse in children with epilepsy. (United States)

    Thibault, Dylan P; Mendizabal, Adys; Abend, Nicholas S; Davis, Kathryn A; Crispo, James; Willis, Allison W


    Reducing the burden of pediatric mental illness requires greater knowledge of mental health and substance abuse (MHSA) outcomes in children who are at an increased risk of primary psychiatric illness. National data on hospital care for psychiatric illness in children with epilepsy are limited. We used the Kids' Inpatient Database (KID), the Healthcare Cost and Utilization Project (HCUP), and the Agency for Healthcare Research and Quality from 2003 to 2009 to examine MHSA hospitalization patterns in children with comorbid epilepsy. Nonparametric and regression analyses determined the association of comorbid epilepsy with specific MHSA diagnoses and examined the impact of epilepsy on length of stay (LOS) for such MHSA diagnoses while controlling for demographic, payer, and hospital characteristics. We observed 353,319 weighted MHSA hospitalizations of children ages 6-20; 3280 of these involved a child with epilepsy. Depression was the most common MHSA diagnosis in the general population (39.5%) whereas bipolar disorder was the most common MHSA diagnosis among children with epilepsy (36.2%). Multivariate logistic regression models revealed that children with comorbid epilepsy had greater adjusted odds of bipolar disorder (AOR: 1.17, 1.04-1.30), psychosis (AOR: 1.78, 1.51-2.09), sleep disorder (AOR: 5.90, 1.90-18.34), and suicide attempt/ideation (AOR: 3.20, 1.46-6.99) compared to the general MHSA inpatient population. Epilepsy was associated with a greater LOS and a higher adjusted incidence rate ratio (IRR) for prolonged LOS (IRR: 1.12, 1.09-1.17), particularly for suicide attempt/ideation (IRR: 3.74, 1.68-8.34). Children with epilepsy have distinct patterns of hospital care for mental illness and substance abuse and experience prolonged hospitalization for MHSA conditions. Strategies to reduce psychiatric hospitalizations in this population may require disease-specific approaches and should measure disease-relevant outcomes. Hospitals caring for large numbers of

  2. Excess mortality in general hospital patients with delirium: A 5-year follow-up of 519 patients seen in psychiatric consultation

    NARCIS (Netherlands)

    A.M. van Hemert (Bert); R.C. van der Mast (Roos); M.W. Hengeveld (Michiel); M. Vorstenbosch (Marielle)


    textabstractMortality was determined in 519 patients with delirium who were seen in psychiatric consultation in two general hospitals. Among 419 patients with simple delirium (DSM-III: 293.00) in-hospital mortality was 26%. As compared to average hospital patients the age adjusted in-hospital excess

  3. Factors related to positive and negative outcomes in psychiatric inpatients in a General Hospital Psychiatric Unit: a proposal for an outcomes index

    Directory of Open Access Journals (Sweden)



    Full Text Available Background General Hospital Psychiatric Units have a fundamental importance in the mental health care systems. However, there is a lack of studies regarding the level of improvement of patients in this type of facility. Objective To assess factors related to good and poor outcomes in psychiatric inpatients using an index composed by clinical parameters easily measured. Methods Length of stay (LOS, Global Assessment of Functioning (variation and at discharge and Clinical Global Impression (severity and improvement were used to build a ten-point improvement index (I-Index. Records of psychiatric inpatients of a general hospital during an 18-month period were analyzed. Three groups (poor, intermediate and good outcomes were compared by univariate and multivariate models according to clinical and sociodemographic variables. Results Two hundred and fifty patients were included, with a percentage in the groups with poor, regular and good outcomes of 16.4%, 59,6% and 24.0% respectively. Poor outcome at the discharge was associated mainly with lower education, transient disability, antipsychotics use, chief complaint “behavioral change/aggressiveness” and psychotic features. Multivariate analysis found a higher OR for diagnoses of “psychotic disorders” and “personality disorders” and others variables in relation to protective categories in the poor outcome group compared to the good outcome group. Discussion Our I-Index proved to be an indicator of that allows an easy and more comprehensive evaluation to assess outcomes of inpatients than just LOS. Different interventions addressed to conditions such as psychotic disorders and disruptive chief complaints are necessary.

  4. Association of positive responses to suicide screening questions with hospital admission and repeated emergency department visits in children and adolescents. (United States)

    Ballard, Elizabeth D; Horowitz, Lisa M; Jobes, David A; Wagner, Barry M; Pao, Maryland; Teach, Stephen J


    Although validated suicide screening tools exist for use among children and adolescents presenting to emergency departments (EDs), the associations between screening positive for suicide risk and immediate psychiatric hospital admission or subsequent ED use, stratified by age, have not been examined. This is a retrospective cohort study of a consecutive case series of patients aged 8 to 18 years presenting with psychiatric chief complaints during a 9-month period to a single urban tertiary care pediatric ED. Eligible patients were administered a subset of questions from the Risk of Suicide Questionnaire. Outcomes included the odds of psychiatric hospitalization at the index visit and repeated ED visits for psychiatric complaints within the following year, stratified by age. Of the 568 patients presenting during the study period, responses to suicide screening questions were available for 442 patients (78%). A total of 159 (36%) of 442 were hospitalized and 130 (29%) of 442 had 1 or more ED visits within the following year. The proportion of patients providing positive responses to 1 or more suicide screening questions did not differ between patients aged 8 to 12 years and those aged 13 to 18 years (77/154 [50%] vs 137/288 [48%], P = 0.63). A positive response to 1 or more of the questions was significantly associated with increased odds of psychiatric hospitalization in the older age group [adjusted odds ratio, 3.82; 95% confidence interval, 2.24-6.54) and with repeated visits to the ED in the younger age group (adjusted odds ratio, 3.55 95% confidence interval, 1.68-7.50). Positive responses to suicide screening questions were associated with acute psychiatric hospitalization and repeated ED visits. Suicide screening in a pediatric ED may identify children and adolescents with increased need of psychiatric resources.

  5. Prevalence of psychiatric disorders among children of different ethnic origin.

    NARCIS (Netherlands)

    Zwirs, B.W.; Burger, H.; Schulpen, T.W.J.; Wiznitzer, M.; Fedder, H.; Buitelaar, J.K.


    The present study assesses the population prevalence of DSM-IV disorders among native and immigrant children living in low socio-economic status (SES) inner-city neighborhoods in the Netherlands. In the first phase of a two-phase epidemiological design, teachers screened an ethnically diverse sample

  6. Prevalence of psychiatric disorders among children of different ethnic origin

    NARCIS (Netherlands)

    Zwirs, Barbara W. C.; Burger, Huibert; Schulpen, Tom W. J.; Wiznitzer, Martin; Fedder, Hans; Buitelaar, Jan K.

    The present study assesses the population prevalence of DSM-IV disorders among native and immigrant children living in low socio-economic status (SES) inner-city neighborhoods in the Netherlands. In the first phase of a two-phase epidemiological design, teachers screened an ethnically diverse sample

  7. Infection prevention and control practices in children's hospitals. (United States)

    Bender, Jeffrey M; Virgallito, Mary; Newland, Jason G; Sammons, Julia S; Thorell, Emily A; Coffin, Susan E; Pavia, Andrew T; Sandora, Thomas J; Hersh, Adam L


    We surveyed hospital epidemiologists at 28 Children's Hospital Association member hospitals regarding their infection prevention and control programs. We found substantial variability between children's hospitals in both the structure and the practice of these programs. Research and the development of evidence-based guidelines addressing infection prevention in pediatrics are needed.

  8. Experiences of frontline nursing staff on workplace safety and occupational health hazards in two psychiatric hospitals in Ghana. (United States)

    Alhassan, Robert Kaba; Poku, Kwabena Adu


    Psychiatric hospitals need safe working environments to promote productivity at the workplace. Even though occupational health and safety is not completely new to the corporate society, its scope is largely limited to the manufacturing/processing industries which are perceived to pose greater dangers to workers than the health sector. This paper sought to explore the experiences of frontline nursing personnel on the occupational health and safety conditions in two psychiatric hospitals in Ghana. This is an exploratory cross-sectional study among 296 nurses and nurse-assistants in Accra (n = 164) and Pantang (n = 132) psychiatric hospitals using the proportional stratified random sampling technique. Multivariate Ordinary Least Squares (OLS) regression test was conducted to ascertain the determinants of staff exposure to occupational health hazards and the frequency of exposure to these occupational health hazards on daily basis. Knowledge levels on occupational health hazards was high in Accra and Pantang psychiatric hospitals (i.e. 92 and 81% respectively), but barely 44% of the 296 interviewed staff in the two hospitals said they reported their most recent exposure to an occupational health hazard to hospital management. It was found that staff who worked for more years on the ward had higher likelihood of exposure to occupational health hazards than those who worked for lesser years (p = 0.002). The category of occupational health hazards reported most were the physical health hazards. Psychosocial hazards were the least reported health hazards. Frequency of exposure to occupational health hazards on daily basis was positively associated with work schedules of staff particularly, staff on routine day schedule (Coef = 4.49, p = 0.011) and those who alternated between day and night schedules (Coef = 4.48, p = 0.010). Occupational health and safety conditions in the two hospitals were found to be generally poor. Even though majority of

  9. Raising adults as children? A report on milieu therapy in a psychiatric ward in Norway. (United States)

    Oeye, Christine; Bjelland, Anne Karen; Skorpen, Aina; Anderssen, Norman


    Milieu therapy is widely used as a therapeutic approach in psychiatric wards in the Nordic countries, but few studies exist that report on what practices a milieu therapy approach implies as seen from an ethnographic perspective. Therefore, there is a need to obtain insight into how milieu therapy unfolds in a psychiatric ward setting. The present ethnographic study aims to explore this in a locked-up psychiatric ward that was tied to a psychodynamic-oriented milieu therapy approach. Metaphors from traditional nuclear family life were widely used. Patients were often understood as harmed children and were taught self-management skills; the staff aimed at providing a caring atmosphere; and the patients seemed to behave, sometimes, in a childlike manner. In a Foucaultian framework, milieu therapy can be seen as a therapeutic normalization technique used to produce self-governing individuals. Milieu therapy "raises" patients in order to transform patients' odd behaviour and nonconforming lifestyles. We see this "raising children" approach as a type of intervention that nicely connects to the national policy of normalization and integration politics towards persons with psychiatric diagnoses.

  10. Acceptance of Medical Resume Completion at Dr. Radjiman Wediodiningrat Lawang Psychiatric Hospital

    Directory of Open Access Journals (Sweden)

    Silvia Shinta Devi


    Sistem kesehatan di Indonesia mengalami perubahan besar dengan diberlakukannya program Asuransi Kesehatan Nasional. Resume medis memiliki peran penting dalam klaim asuransi kesehatan, sehingga resume medis yang terlambat dan tidak lengkap akan mengganggu proses klaim asuransi. Penelitian ini bertujuan untuk mengetahui pengaruh persepsi kemudahan penggunaan, persepsi manfaat, dan sikap pada penerimaan dokter dalam menyelesaikan resume medis. di Dr Radjiman Wedyodiningrat Psychiatric Hospital Lawang berdasarkan Technology Acceptance Model. Technology Acceptance Model digunakan sebagai model dalam penelitian ini karena resume medis merupakan salah satu bentuk teknologi informasi yang masih dilakukan secara manual. Pengumpulan data untuk penelitian ini dilakukan pada bulan Maret 2016 dengan menggunakan kuesioner yang diberikan kepada 32 dokter di Rumah Sakit Jiwa Dr Radjiman Wediodiningrat Lawang. Skala Likert lima tingkat digunakan untuk mengukur setiap item variabel. Data dianalisis dengan menggunakan Partial Least Square. Hasil penelitian menunjukan bahwa secara umum, acceptance dokter di RSJ Dr. Radjiman Wediodiningrat Lawang terhadap pengisian resume medis masuk dalam kategori ringgi dan memiliki perceived usefulness and attitude yang dalam kategori baik, sedangkan perceived ease of use dalam kategori sedang.

  11. What helps or undermines adolescents' anticipated capacity to cope with mental illness stigma following psychiatric hospitalization. (United States)

    Moses, Tally


    Better understanding of the individual and environmental factors that promote adolescents' use of more or less adaptive coping strategies with mental illness stigma would inform interventions designed to bolster youth resilience. This cross-sectional study draws on data from research on adolescents' well-being after discharge from a first psychiatric hospitalization to explore the relationships between anticipated coping in reaction to a hypothetical social stigma scenario, and various factors conceptualized as 'coping resource' and 'coping vulnerability' factors. Focusing on coping strategies also identified in the companion article, we hypothesize that primary and secondary control engagement coping would relate to more coping resource and less coping vulnerability factors, and the opposite would be true for disengagement, aggression/confrontation and efforts to disconfirm stereotypes. Data were elicited from interviews with 102 adolescents within 7 days of discharge. Hypothesized coping resource factors included social resources, optimistic illness perceptions, better hospital experiences and higher self-esteem. Vulnerability factors included more previous stigma experiences, desire for concealment of treatment, more contingent self-worth, higher symptom levels and higher anticipated stress. Multivariate ordinary least squares (OLS) regression was used to analyze associations between coping strategy endorsement and correlates. Although some coping correlates 'behaved' contrary to expectations, for the most part, our hypotheses were confirmed. As expected, youth anticipating reacting to the stigmatizing situation with greater disengagement, aggression/confrontation or efforts to disconfirm stenotypes rated significantly lower on 'coping resources' such as self-esteem and higher on vulnerability factors such as symptom severity. The opposite was true for youth who anticipated exercising more primary and secondary control engagement coping. This study begins to

  12. Social desirability response tendencies in psychiatric inpatient children. (United States)

    Mabe, P A; Treiber, F A


    This study examined the substantive features of children's social desirability (SD) tendencies that could influence the nature and severity of psychopathology. Examinations of substantive features of SD responding in an inpatient child psychiatry unit (N = 76) suggested that higher scores on the Children's Social Desirability questionnaire were associated strongly with (1) lower mental age; (2) higher scores on self-reported social competence; (3) lower scores on self-reported anger; and (4) lower scores on parent-reported externalization behavioral disturbance. Results were interpreted as suggesting that SD responding for child inpatients may reflect a mixed picture of negative features of cognitive and social immaturity that could affect adversely their ability to judge their own and others' social behavior and of positive features of less external behavioral disturbance and more prosocial attitudes and behaviors.

  13. Sudden Cardiac Death in Young Adults With Previous Hospital-Based Psychiatric Inpatient and Outpatient Treatment

    DEFF Research Database (Denmark)

    Risgaard, Bjarke; Waagstein, Kristine; Winkel, Bo Gregers


    Introduction: Psychiatric patients have premature mortality compared to the general population. The incidence of sudden cardiac death (SCD) in psychiatric patients is unknown in a nationwide setting. The aim of this study was to compare nationwide SCD incidence rates in young individuals with and......Introduction: Psychiatric patients have premature mortality compared to the general population. The incidence of sudden cardiac death (SCD) in psychiatric patients is unknown in a nationwide setting. The aim of this study was to compare nationwide SCD incidence rates in young individuals...

  14. Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

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    Mohan Roy Gopalan


    Full Text Available Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above, having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7% had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6% of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients.

  15. Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey (United States)

    Gopalan, Mohan Roy; Karunakaran, Vidhukumar; Prabhakaran, Anil; Jayakumar, Krishnannair Lalithamma


    Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above), having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7%) had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6%) of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients. PMID:28066004

  16. Psychiatric comorbidity may not predict suicide during and after hospitalization. A nested case-control study with blinded raters. (United States)

    Walby, Fredrik A; Odegaard, Erik; Mehlum, Lars


    To investigate the differential impact of DSM-IV axis-I and axis-II disorders on completed suicide and to study if psychiatric comorbidity increases the risk of suicide in currently and previously hospitalized psychiatric patients. A nested case-control design based on case notes from 136 suicides and 166 matched controls. All cases and controls were rediagnosed using the SCID-CV for axis-I and the DSM-IV criteria for axis-II disorders and the inter-rater reliability was satisfactory. Raters were blind to the case and control status and the original hospital diagnoses. Depressive disorders and bipolar disorders were associated with an increased risk of suicide. No such effect was found for comorbidity between axis-I disorders and for comorbidity between axis-I and axis-II disorders. Psychiatric diagnoses, although made using a structured and criteria-based approach, was based on information recorded in case notes. Axis-II comorbidity could only be investigated at an aggregated level. Psychiatric comorbidity did not predict suicide in this sample. Mood disorders did, however, increase the risk significantly independent of history of previous suicide attempts. Both findings can inform identification and treatment of patients at high risk for completed suicide.

  17. Psychiatric disorders and behavioral problems in children with Prader-Willi syndrome and the effects of growth hormone treatment

    NARCIS (Netherlands)

    S.T. Lo (Sinddie)


    markdownabstract__Abstract__ This thesis includes studies about developmental, behavioral and psychiatric characteristics in children with Prader-Willi syndrome (PWS). Endocrinologists Prader, Labhart, and Willi were the first describing the combination of neonatal hypotonia, short

  18. [Issues in psychiatric evaluation of children and adolescents with visual impairment]. (United States)

    Saisky, Yaniv; Hasid, Soli; Ebert, Tanya; Kosov, Irene


    Approximately 8% from those who are defined as blind in Israel are children and adolescents. Visual impairment is correlated with a high rate of psychopathology. However, some of these children and adolescents do not receive appropriate diagnosis and treatment. Often, the clinicians and those who treat the children/adolescents lack the proper professional knowledge related to the unique diagnosis and treatment of children/ adolescents who are visually impaired. Visual impairment might influence different aspects of the psychiatric diagnosis. These aspects include the influence of the impairment on different developmental axes; the reciprocal relationship between the child and his/her environment; the clinical presentation of different psychopathologies; and the different treatment modalities. In this review we discuss these issues. Moreover, we raise the question as to whether there is a need to adapt the psychiatric evaluation and the treatment specifically to the visually impaired child. The review is based on the existing literature in addition to our clinical experience, which stems from our work with children and adolescents who are at the "Jewish Institute for the Blind", an institute for children and adolescents with visual impairment in Israel.

  19. Interviews with psychiatric inpatients about professional intervention with regard to their children

    DEFF Research Database (Denmark)

    Wang, A R; Goldschmidt, V V


    A description of mentally ill parents' experience and points of view concerning professional intervention in relation to their young children is presented in this paper. The results are from an interview survey designed with the purpose of improving the basis for cooperation between mentally ill......% of the children. In most cases their views were in accordance with those of the mentally ill parents. Clinical implications concerning planning of intervention in regard to children of mentally ill parents are discussed....... patients and professionals, when intervention in relation to these patients' children is needed. Fifty consecutively admitted psychiatric inpatients with children 0-10 years old were interviewed by child psychiatrists and their information constitutes the study material. Data concerning the family...

  20. Prevalence and factors associated with minor psychiatric disorders in hospital housekeeping workers. (United States)

    Marconato, Cintia da Silva; Magnago, Ana Carolina de Souza; Magnago, Tânia Solange Bosi de Souza; Dalmolin, Graziele de Lima; Andolhe, Rafaela; Tavares, Juliana Petri


    Investigating the prevalence and factors associated with minor psychiatric disorders (MPDs) in Hospital housekeeping workers. A cross-sectional study carried out in 2013 with workers from the cleaning service of a public university hospital in Rio Grande do Sul, Brazil. Data were collected through a form containing sociodemographic, occupational, habits and health variables. The Self-Reporting Questionnaire-20 was used in order to evaluate MPDs. The study population consisted of 161 workers. The overall prevalence of suspected MPD was 29.3%. The chances of suspected MPDs were higher in workers with Effort-Reward Imbalance, those who did not have time or who occasionally had time for leisure activities, and those taking medications. The prevalence of MPDs was similar to that found in the literature for health workers. Therefore, we consider it important to include these workers in institutional programs for continuing health education. Investigar a prevalência e os fatores associados aos Distúrbios Psíquicos Menores (DPMs) em trabalhadores do Serviço Hospitalar de Limpeza. Estudo transversal, realizado em 2013, com trabalhadores do serviço de limpeza de um hospital universitário público do Rio Grande do Sul, Brasil. Os dados foram coletados por meio de um formulário contendo variáveis sociodemográficas, laborais, hábitos e saúde. Para avaliação dos DPMs utilizou-se do Self-Reporting Questionnaire-20. A população do estudo foi composta pelos 161 trabalhadores. A prevalência global para suspeição de DPM foi de 29,3%. As chances de suspeição de DPMs foram maiores nos trabalhadores em Desequilíbrio Esforço-Recompensa, nos que não tinham ou às vezes tinham tempo para o lazer e naqueles que faziam uso de medicação. A prevalência de DPMs assemelhou-se à encontrada na literatura em trabalhadores da área saúde. Portanto, considera-se importante a inclusão desses trabalhadores em programas institucionais de educação permanente em saúde.

  1. Regional supply of outreach service and length of stay in psychiatric hospital among patients with schizophrenia: National case mix data analysis in Japan. (United States)

    Niimura, Junko; Nakanishi, Miharu; Yamasaki, Syudo; Nishida, Atsushi


    Several clinical trials have demonstrated that linkage to an outreach service can prevent prolonged length of stay of patients at psychiatric hospitals. However, there has been no investigation of the association between length of stay in psychiatric hospital and regional supply of outreach services using national case mix data. The aim of this study was to clarify the relationship between length of stay in psychiatric hospital and regional supply of outreach services. We used data from the National Patient Survey in Japan, a nationally representative cross-sectional survey of inpatient care conducted every three years from 1996 to 2014. Data from 42,268 patients with schizophrenia who had been admitted to psychiatric hospitals were analyzed. After controlling for patient and regional characteristics, patients in regions with fewer number of visits for psychiatric nursing care at home had significantly longer length of stay in psychiatric hospitals. This finding implies that enhancement of the regional supply of outreach services would prevent prolonged length of stay in psychiatric hospitals. Copyright © 2017 Elsevier B.V. All rights reserved.



    Dr. Syed Qalb-I-Hyder Naqvi*, Dr. Aysha Nighat, Dr. Nisar Ahmed Shah, Summaiya Shahid, Dr. Moin Ahmed Ansari, Syeda Maryam Hyder Naqvi, Dr.Zulfiqar Siddiqui


    Background: According to the World Health Organization (WHO), now a day’s mental health disorders are the leading causes of disability worldwide. Most of the psychiatric disorders start in child hood and adolescent. In general population 9.3% of the children had mental health problem and presence of comorbidity complicate the diagnosis and treatment. Objective: This study was aimed to determine the frequency of psychiatric co-morbidity in children and to identify the common Socio demographic ...

  3. [Integration of district psychiatric hospitals into the development of regional community psychiatry networks--the actual state. Results of a survey among medical directors of Bavarian district hospitals]. (United States)

    Welschehold, Michael; Kraus, Eva


    In this study, the medical directors of all Bavarian district psychiatric hospitals evaluated certain aspects of the integration of their hospitals into the development of regional community psychiatry networks ("Gemeindepsychiatrische Verbunde" - GPVs). They were asked to rate the actual quantity of cooperation between their hospitals and diverse community based services and to express their requests concerning the quality of cooperation. An estimation of possible advantages of the hospitals' integration in GPVs and expectations to future perspectives of GPV development were also investigated. The data were collected by a written questionnaire. The results of the survey indicate that a high relevance is attached to GPV: inspite of current heterogenous developments and inspite of existing skepticism concerning the feasibility of a complete GPV structure, medical directors strongly approve of seeing their hospitals actively engaged in the further development of community psychiatry networks.

  4. Spirometry use in children hospitalized with asthma. (United States)

    Tan, Chee Chun; McDowell, Karen M; Fenchel, Matthew; Szczesniak, Rhonda; Kercsmar, Carolyn M


    Asthma is the most common chronic disorder of childhood and continues to be a leading cause of pediatric hospital admission. The National Asthma Education and Prevention Program (NAEPP) recommends that spirometry be obtained for asthma patients upon hospital admission, after bronchodilation during the acute phase of asthma symptoms, and at least one additional time before discharge from the hospital. The objectives of this study were to describe the use of spirometry in children hospitalized with asthma and to determine association of pulmonary function with future exacerbations. A retrospective cohort study design was utilized involving review of medical records of children ≥5 years old admitted with asthma to Cincinnati Children's Hospital Medical Center from September 1, 2009 to March 31, 2011. Hospitalization or emergency department (ED) visits were identified by the ICD-9-CM codes of having either a primary diagnosis of asthma (493) or a respiratory illness (460-496) plus a secondary diagnosis of asthma. Asthma re-exacerbation was defined as either having an ED visit or hospitalization for asthma that occurred within 3 months after the index hospitalization. All spirometries were performed in a pediatric pulmonary function laboratory. Among 1,037 admissions included in this study, 89 (8.6%) had spirometry that was recommended by a consulting asthma specialist and usually performed on the day of discharge. Spirometries for forty-five of these patients (54.9%) met all acceptability and repeatability criteria of the American Thoracic Society. Patients who performed acceptable spirometry were significantly older (12.4 ± 3.8 vs. 10.7 ± 3.0 years; P = 0.041). The average forced expiratory volume in the first second (FEV1 ) was 84.4 ± 19.7% predicted; forced vital capacity (FVC) was 98.1 ± 16.0% predicted; FEV1 /FVC was 74.6 ± 9.6%; forced expiratory flow at 25-75% (FEF25-75 ) was 61.2 ± 30.1% predicted. Ten patients (22%) who

  5. Associations and Costs of Parental Symptoms of Psychiatric Distress in a Multi-Diagnosis Group of Children with Special Needs (United States)

    Thurston, S.; Paul, L.; Loney, P.; Ye, C.; Wong, M.; Browne, G.


    Background: Families supporting children with complex needs are significantly more distressed and economically disadvantaged than families of children without disability and delay. What is not known is the associations and costs of parental psychiatric distress within a multi-diagnosis group of special needs children. Methods: In this…

  6. [Establishment of an electronic medical record in a psychiatric hospital: evolution of professionals' perceptions]. (United States)

    Boyer, L; Renaud, M-H; Baumstarck-Barrau, K; Fieschi, M; Samuelian, J-C


    The potential benefits of the application of an electronic medical record (EMR) in medical care are well recognized. However, if these benefits are to be accomplished, professionals must adopt and utilize EMR as a part of their practice. The aim of this study was to assess the evolution of the health care professionals' opinions of EMR and their use on a period of 1 year in a French Public Psychiatric Hospital. Our institution is a 204-bed psychiatric hospital, employing 328 professionals and comprising three sectors: six units of complete hospitalisation (102 beds), one unit of week hospitalisation (15 beds), one unit of emergency (seven beds) and one unit of night hospitalisation (15 beds). Three extrahospital structures include the day hospitalisation (65 places), the medicopsychological centres (CMP) and the part-time therapeutic reception centres (CATTP) of the three sectors. We conducted face-to-face, semi-structured interviews with health care professionals of a public psychiatric hospital on two occasions: 1 month after the establishment of the EMR (t0) and one year later (t1). All the solicited people agreed to participate in the investigation. The interviews were conducted until no new ideas emerged in the content analysis performed in real time, comprising 60 care professionals at t0 (10 psychiatrists, 42 nurses and eight paramedical professionals) and 55 at t1 (six psychiatrists, 42 nurses and seven paramedical professionals). Content analysis was performed by two members of the steering committee who were skilled in textual analysis. A descriptive analysis was also performed. The variables were described by proportions and means. The proportions were compared using the Chi-squared test or Fisher exact test where appropriate. A two-tailed p-value of greater than 0.05 was considered to indicate statistical significance. Statistical analyses were carried out using SPSS version. The proportion of EMR use remained stable and high (respectively 97% in 2007

  7. Coping with information style and family burden: Possible roles of self-stigma and hope among parents of children in a psychiatric inpatient unit. (United States)

    Hasson-Ohayon, I; Pijnenborg, G H M; Ben-Pazi, A; Taitel, S; Goldzweig, G


    Parents of children who are hospitalized in inpatient psychiatric units must cope with significant challenges. One of these challenges relates to the way in which they cope with illness-related information. The current study examined the relationship between two such coping styles - monitoring and blunting - and family burden among parents of children in a psychiatric inpatient unit. Moreover, the possible moderating roles played by hope and self-stigma in these associations were also examined. Questionnaires regarding coping with information style, self-stigma, hope and family burden were administered to 70 parents. A main positive effect of hope and a main negative effect of self-stigma were uncovered. An interaction between self-stigma and monitoring was also revealed, suggesting that for parents with high self-stigma, compared to those with low self-stigma, more monitoring was related to more burden. Tailoring family interventions according to coping style and self-stigma is highly recommended as a mean to reduce the family burden of parents whose child is hospitalized in a psychiatric inpatient unit. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  8. Psychiatric features in perpetrators of homicide-unsuccessful-suicide at Weskoppies Hospital in a 5-year period

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    Paul Sussman


    Full Text Available Background. In the absence of medical literature reporting on homicide-unsuccessful-suicide (HUS cases in which the perpetrator is referred for forensic psychiatric observation present an opportunity to explore psychiatric features pertaining to the event. Objective. To identify possible contributing psychiatric features in HUS cases. Method. A retrospective, single-centre, descriptive study was conducted, in which were reviewed clinical records of HUS subjects referred for observation to Weskoppies Hospital from December 2005 to January 2011. Socio-demographic and psychiatric information was obtained. Results. Nine cases were reviewed. The median age of the subjects was 29 years and 7 subjects were male. Five cases involved family members. Cases involving couples demonstrated male subjects and cases involving filicide demonstrated female subjects. Only 1 case involved the use of a firearm. At the time of the incident, 4 of the cases had no psychiatric diagnosis but notable interpersonal difficulties. Psychotic disorders were diagnosed in 3 subjects, a depressive disorder in 1 subject and a depressive and anxiety disorder in 1 subject. Conclusion. Subjects commonly used less lethal methods than shooting. The high rate of psychiatric disorders diagnosed is in keeping with court referrals occurring when a mental illness is suspected. Some cases may require specialised probing before psychosis becomes apparent. Identification of psychosocial stressors and failure of coping mechanisms during periods of strife within an intimate relationship may be a focus of future research in homicide-suicide cases. Separation should possibly be investigated as an independent factor which promotes the interpersonal difficulty associated with homicide-suicide.

  9. Brief report: Correlates of inpatient psychiatric admission in children and adolescents with eating disorders. (United States)

    Hamilton, Matthew J; Watson, Hunna J; Egan, Sarah J; Hoiles, Kimberley J; Harper, Emily; McCormack, Julie; Shu, Chloe; Forbes, David A


    To examine the prevalence and importance of psychological, behavioural, and situational correlates of impending psychiatric inpatient admissions in children and adolescents with eating disorders. The sample consisted of 285 patients (8-17 years, M = 14.4, SD = 1.49) with DSM-5 eating disorders assessed between 2006 and 2013 from the Helping to Outline Pediatric Eating Disorders (HOPE) Project. The sample was split into two groups, those with (n = 38) and without (n = 247) impending psychiatric admission; Discriminant function analysis was used to examine correlates. The prevalence of impending psychiatric admission was 13.3%. Suicidal ideation provided the greatest discriminating power, followed by eating pathology, depressive symptoms, anxiety, multiple methods of weight control, binge eating, and family functioning. Earlier recognition of comorbid symptoms in eating disorders in the community may reduce the number of young people with eating disorders who present needing critical psychiatric care. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  10. Psychiatric Disorders, Sociodemographic Features and Risk Factors in Children Driving to Committing Crime (Turkish

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    Murat Eyüboğlu


    Full Text Available Object: The aim of this study was to examine children driving to committing crime who were brought to psychiatry clinic for forensic evaluation because of the crimes they committed to. Additionally, evaluation of these children's psychiaytric disorders, crime characteristics, sociodemographic data, factors driving to committing crime and forensic reports arranged by the physician were other aims. Methods: In this study 204 children, who were brought to the clinic in order to be evaluated whether they perceive the legal meaning and consequences of that action or possess sufficient ability to channel their behaviors, were included. In order to diagnose any psychiatric disorder, a structured interrogation schedule for affective disorders and schizophrenia for present and lifetime was applied all children and families and sociodemographic data form was completed. Results: At least one psychiatric disorder was present in 47% (n =96 of children driving to committing crime. The most common disorders were Attention Deficit and Hyperactivity Disorder and Conduct Disorder. Almost none of them have been treated before. 45% of them dropped out their school, and 40% were smoking. Additionally, most of their parents who had low socioeconomical level also had very low education level. Discussion: It was determined that being male, living in a low socioeconomic family environment, living in large families, using drugs, smoking, not attending school and having parents with low education level were significant related factors for juvenile delinquency.

  11. Intimate partner relationship stress and suicidality in a psychiatrically hospitalized military sample. (United States)

    LaCroix, Jessica M; Colborn, Victoria A; Hassen, Helena O; Perera, Kanchana U; Weaver, Jennifer; Soumoff, Alyssa; Novak, Laura A; Ghahramanlou-Holloway, Marjan


    Suicide among United States service members is a significant public health concern. Intimate partner relationship stress may contribute to suicide risk, as a failed or failing relationship is the most commonly documented stressor preceding military suicide attempts and deaths. However, little is known about the manner by which relationship stressors are associated with the experience of military suicidality. A sample of 190 psychiatrically hospitalized military personnel and adult dependents enrolled in an ongoing randomized controlled trial evaluating the efficacy of an inpatient cognitive behavioral treatment for suicidality were included in this study. Analyses examined depression, hopelessness, and suicidality among participants with (n = 105) and without (n = 85) self-reported romantic relationship stress. Over half (55%) of the sample reported current romantic relationship stress. Compared to participants without current romantic relationship stress, results indicated that individuals reporting current romantic relationship stress were more hopeless (AOR = 1.07 (95% CI: 1.01-1.12), p = 0.020), more likely to endorse multiple suicide attempts (AOR = 1.96 (95% CI: 1.01-3.79), p = 0.046), had higher overall suicide risk (AOR = 2.49, (95% CI: 1.03-6.06), p = 0.044), and were more likely to report that the reason for their suicidality was at least in part to get a reaction from others. Findings suggest romantic relationship stress is associated with greater suicide risk, and have clinical implications for suicide prevention and intervention. Future research may examine mechanisms and pathways between romantic relationship stress, suicidality, and prevention and intervention strategies. Published by Elsevier Inc.

  12. [Motivation in brief psychotherapy: a 30 patients study, valued in a psychiatric day-hospital]. (United States)

    Spanò, Leonardo; Rusconi, Anna Carlotta; Piccione, Michele; Coccanari de' Fornari, Maria Antonietta


    The most important predictive factor for a successful outcome in Brief Psychotherapy is the motivation of patients to the treatment itself. Against the scarcity of literature on the subject, so far limited to offer standardized tools to assess motivation, applied mainly to education and work's areas, in spite of a possible application in psychotherapy, it was considered necessary to develop a questionnaire ad hoc. It was therefore created a pattern of motivational diagnosis of the problem based on a sequence of questions and answers, which would make possible the classification of each case and then that could lead to the use of a specific method. It is the result of the attempt to create an orderly pattern and that it would be easy to use and then be analyzed. The questionnaire consists of twenty one questions and requires that the patient answers with a "yes" or a "no" to each applicant. It was administered to thirty patients who came from the psychiatric day hospital. The questionnaire was used as a "not standardized thread" in which, through groups of questions, are addressed some central cores: the spontaneous activity, motivation controlled from the outside, motivation directed to an activity that leads to results, motivation to and activity for a purpose, expectations of self-efficacy, the presence/absence of resistance and finally the area of the will. The purpose of this work is to show, bringing a contribution in agreement with the few studies on the subject, how motivation is a key parameter for predicting the effectiveness of a psychotherapy, in this case, Brief Psychotherapy. The study clearly shows how the motivation is the most important positive predictor in the preliminary assessment of a Brief Psychotherapy: results in treatment are most likely to be rapid and favorable if patients are motivated to change andif they are engaged with the therapist.

  13. Incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients

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    Ruengorn C


    Full Text Available Chidchanok Ruengorn1, Kittipong Sanichwankul2, Wirat Niwatananun3, Suwat Mahatnirunkul2, Wanida Pumpaisalchai2, Jayanton Patumanond11Clinical Epidemiology Unit, Faculty of Medicine, Chiang Mai University; 2Suanprung Psychiatric Hospital; 3Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, ThailandBackground: The incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients remain uninvestigated in Thailand.Objective: To determine incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients.Methods: A retrospective cohort study was conducted by reviewing medical charts at Suanprung Psychiatric Hospital, Chiang Mai, Thailand. Mood disorder patients, diagnosed with the International Statistical Classification of Diseases and Related Health Problems 10th Revision codes F31.x, F32.x, and F33.x, who were admitted owing to suicide attempts between October 2006 and May 2009 were eligible. The influence of sociodemographic and clinical risk factors on suicide reattempts was investigated using Cox's proportional-hazards regression analysis.Results: Of 235 eligible mood disorder patients, 36 (15.3% reattempted suicide (median 109.5 days, range 1–322, seven (3.0% completed suicide (median 90 days, range 5–185, and 192 (84.2% neither reattempted nor completed suicide during follow-up. Of all nonfatal suicide reattempts, 14 patients (38.9% did so within 90 days. Among suicide completers, one (14.3% did so 5 days after discharge, and four (57.1% did so within 90 days. The following three risk factors explained 73.3% of the probability of suicide reattempts: over two previous suicide attempts before the index admission (adjusted hazard ratio [HR] 2.48; 95% confidence interval [CI] 1.07–5.76, being concomitantly prescribed typical and atypical antipsychotics (adjusted HR 4.79; 95% CI 1.39

  14. Considerations on occupational therapy in a custody and psychiatric treatment hospital: The psychosocial field versus the forensic psychiatry field

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    Ana Carolina Santos de Souza


    Full Text Available The Custody and Psychiatric Treatment Hospital (CPTH is ambivalent and ambiguous in its essence, because it gathers not only the characteristics of a mental institution, but also those of a prison – epitomized by the security system. By analyzing this context, one can perceive the importance of implementing some knowhow able to attend the real needs of the individuals hospitalized in this type of institution. This interpretation of their needs must be done in association with a work in mental health based on the principles of the Brazilian Psychiatric Reform and Psychosocial Field Practice. The objective of this study is to reflect on the real possibilities of implementing mental health work based on the Brazilian Psychiatric Reform, inserted in the Psychosocial Field, in institutions such as CPTHs. This reflection occurs from the conflicts arisen in the beginning of Occupational Therapy service in a CPTH located in the state of Sao Paulo, Brazil, as well as through the analysis of the reality in which this Custody Hospital is inserted. When studying the Psychiatric Reform Law, ordinance 28.195/1988, which deliberates on the functions of Occupational Therapy in the CPTHs of the state of Sao Paulo, and the Penal Execution Law, the reality was analyzed from its dimensions, to conclude that the institutional forces ruled the work process of occupational therapists. Therefore, the structural, particular, singular dimensions that rule the CPTH were understood and, after that, the “nodes” that hinder the implementation of mental health work in the Psychosocial Field in this type of institution were revealed.

  15. Hospitalizations of Children with Autism Increased from 1999 to 2009 (United States)

    Nayfack, Aaron M.; Huffman, Lynne C.; Feldman, Heidi M.; Chan, Jia; Saynina, Olga; Wise, Paul H.


    We performed a retrospective analysis of hospital discharges for children with autism, in comparison to children with cerebral palsy, Down syndrome, mental retardation/intellectual disability, and the general population. Hospitalizations for autism increased nearly threefold over 10 years, especially at the oldest ages, while hospitalizations for…

  16. Prevalence and Predictors of Domestic-Violence towards Wives by their Psychiatric Hospitalized Husbands (United States)

    Sahraian, Ali; Ghanizadeh, Ahmad; Hashemi, Seyed Hamzeh; Mohammadi, Mohammad Reza; Ahmadzadeh, Laaya


    Objective: Violence imposed on wives by their inpatient psychiatric husbands has not been studied yet. The current study surveyed the rates and predictors of violence committed by inpatient psychiatric husbands towards their wives. Methods: A convenient sample of wives of 209 married male psychiatric inpatients completed a self-reported questionnaire. They were asked about physical, emotional, social and economic abuse. Results: More than 80% of the husbands socially abused their wives; 73.0% of the wives had been regularly beaten by their husbands; the rate for humiliation was 77.2%; and only 14.1% of the wives reported that their sexual relationship with their husbands is with desire. Conclusion There is a dramatic high rate of different types of abuse toward wives by their inpatient psychiatric husbands. They are commonly victimized by their husbands. Moreover, different types of violence always co-occur. Future studies should consider this important issue which is unfortunately an ignored research area. PMID:27006668

  17. Characterizing psychiatric comorbidity in children with autism spectrum disorder receiving publicly funded mental health services. (United States)

    Brookman-Frazee, Lauren; Stadnick, Nicole; Chlebowski, Colby; Baker-Ericzén, Mary; Ganger, William


    Publicly funded mental health programs play a significant role in serving children with autism spectrum disorder. Understanding patterns of psychiatric comorbidity for this population within mental health settings is important to implement appropriately tailored interventions. This study (1) describes patterns of psychiatric comorbidity in children with autism spectrum disorder who present to mental health services with challenging behaviors and (2) identifies child characteristics associated with comorbid conditions. Data are drawn from baseline assessments from 201 children with autism spectrum disorder who participated in a community effectiveness trial across 29 publicly funded mental health programs. Non-autism spectrum disorder diagnoses were assessed using an adapted Mini-International Neuropsychiatric Interview, parent version. Approximately 92% of children met criteria for at least one non-autism spectrum disorder diagnosis (78% attention deficit hyperactivity disorder, 58% oppositional defiant disorder, 56% anxiety, 30% mood). Logistic regression indicated that child gender and clinical characteristics were differentially associated with meeting criteria for attention deficit hyperactivity disorder, oppositional defiant disorder, an anxiety, or a mood disorder. Exploratory analyses supported a link between challenging behaviors and mood disorder symptoms and revealed high prevalence of these symptoms in this autism spectrum disorder population. Findings provide direction for tailoring intervention to address a broad range of clinical issues for youth with autism spectrum disorder served in mental health settings.

  18. A theoretical approach to medication adherence for children and youth with psychiatric disorders. (United States)

    Charach, Alice; Volpe, Tiziana; Boydell, Katherine M; Gearing, Robin E


    This article provides a theoretical review of treatment adherence for children and youth with psychiatric disorders where pharmacological agents are first-line interventions. Four empirically based models of health behavior are reviewed and applied to the sparse literature about medication adherence for children with attention-deficit/hyperactivity disorder and young people with first-episode psychosis. Three qualitative studies of medication use are summarized, and details from the first-person narratives are used to illustrate the theoretical models. These studies indicate, when taken together, that the clinical approach to addressing poor medication adherence in children and youth with psychiatric disorders should be guided by more than one theoretical model. Mental health experts should clarify beliefs, address misconceptions, and support exploration of alternative treatment options unless contraindicated. Recognizing the larger context of the family, allowing time for parents and children to change their attitudes, and offering opportunities for easy access to medication in the future are important ways of respecting patient preferences, while steering them toward best-evidence interventions. Future research using qualitative methods of inquiry to investigate parent, child, and youth experiences of mental health interventions should identify effective ways to improve treatment adherence.

  19. Role of maternal childhood trauma on parenting among depressed mothers of psychiatrically ill children. (United States)

    Zalewski, Maureen; Cyranowski, Jill M; Cheng, Yu; Swartz, Holly A


    Independently, maternal depression and maternal history of childhood abuse confer risk for impaired parenting. These associations may be compounded when depressed mothers with histories of childhood abuse are faced with the challenge of parenting offspring who themselves struggle with mental health problems. This study examined the relationships among maternal history of childhood abuse, maternal depression, and parenting style in the context of parenting a psychiatrically ill child, with an emphasis on examining maternal emotional abuse and neglect. We hypothesized that maternal childhood emotional abuse would be associated with maladaptive parenting strategies (lower levels of maternal acceptance and higher levels of psychological control), independent of maternal depression severity and other psychosocial risk factors. Ninety-five mother-child dyads (children ages 7-18) were recruited from child mental health centers where children were receiving treatment for at least one internalizing disorder. Participating mothers met DSM-IV criteria for major depressive disorder. Mothers reported on their own childhood abuse histories and children reported on their mothers' parenting. Regression analyses demonstrated that maternal childhood emotional abuse was associated with child reports of lower maternal acceptance and greater psychological control, controlling for maternal depression severity, and other psychosocial risk factors. When treating psychiatrically ill children, it is important for a child's clinician to consider mothers' childhood abuse histories in addition to their history of depression. These mothers appear to have additional barriers to effective parenting. © 2013 Wiley Periodicals, Inc.

  20. [Prevalence of Hypothyroidism in Major Psychiatric Disorders in Hospitalised Patients in Montserrat Hospital During the period March to October 2010]. (United States)

    Vargas Navarro, Pedro; Ibañez Pinilla, Edgar Antonio; Galeano España, Alejandra; Noguera Bravo, Ana María; Milena Pantoja, Sandra; Suárez Acosta, Ana María

    Hypothyroidism results from inadequate production of thyroid hormone. It is known that there is a relationship between the major psychiatric disorders and hypothyroidism. To determine the prevalence of hypothyroidism in patients admitted due to major psychiatric disorders in Montserrat Hospital during the period from March to October 2010. A descriptive cross-sectional study was conducted on 105 patients admitted to Montserrat Hospital with a primary diagnosis of major psychiatric disorder (major depression, bipolar affective disorder, generalised panic disorder, panic disorder, mixed anxiety-depressive disorder, and schizophrenia) in the aforementioned period. Thyroid Stimulating Hormone (TSH) was performed to assess the evidence of hypothyroidism. The overall prevalence of hypothyroidism was found to be 10.5% (95% CI; 5%-16%). It was 12.5% in anxiety disorder, 11.1% in depressive disorder, with a lower prevalence of 10.3% for bipolar disorder, and 9.9% for schizophrenia. The overall prevalence of hypothyroidism was found to be less than in the general population, which is between 4.64% and 18.5%, and hypothyroidism was found in disorders other than depression. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  1. Prevalence of Cannabis Residues in Psychiatric Patients: A Case Study of Two Mental Health Referral Hospitals in Uganda

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    Epaenetus A. Awuzu


    Full Text Available Various studies have reported that abuse of cannabis is a risk factor for psychosis. The aims of this study were to determine the prevalence of delta 9-tetrahydrocanabinol (Δ 9 -THC, a major metabolite of cannabis, in psychiatric patients in Uganda, and to assess the diagnostic capacity of two referral mental health hospitals to screen patients for exposure to cannabis in Uganda. Socio-demographic characteristics of the patients were collected through questionnaires and review of medical records. Urine samples were collected from 100 patients and analyzed using Δ 9 -THC immunochromatographic kit (Standard Diagnostics®, South Korea. Seventeen percent of the patients tested positive for Δ 9 -THC residues in their urine. There was strong association ( p < 0.05 between history of previous abuse of cannabis and presence of Δ 9 -THC residues in the urine. Alcohol, cocaine, heroin, pethidine, tobacco, khat and kuber were the other substances abused in various combinations. Both referral hospitals lacked laboratory diagnostic kits for detection of cannabis in psychiatric patients. In conclusion, previous abuse of cannabis is associated with occurrence of the residues in psychiatric patients, yet referral mental health facilities in Uganda do not have the appropriate diagnostic kits for detection of cannabis residues as a basis for evidence-based psychotherapy.

  2. A Cross-sectional study of common psychiatric morbidity in children aged 5 to 14 years in an Urban Slum

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    Rakesh N Patil


    Full Text Available Aim: Study of the prevalence of common psychiatric disorders in children aged 5 to 14 years in a health post area of an urban slum. Objectives: (1 To study frequency of specific psychiatric disorders in the study population, (2 To study the relationship between sociodemographic variables and psychiatric morbidity. Settings and Design: The present study was conducted in one of the five health posts of an urban slum, which is a field practice area of the teaching medical institute. It was a cross-sectional study. Materials and Methods: Sample size was estimated by using 20% as a prevalence of psychiatric morbidity which was obtained from previous studies done in developing countries. Household was used as a sampling unit and systematic random sampling method was used for selecting household. Total 257 children aged 5 to 14 years were included in the study. A pre-designed, semi-structured diagnostic interview schedule based on DSM-IV criteria was used for data collection. Statistical Analysis Used: The tests of significance used were Chi-square and Logistic regression analysis. Results: The prevalence of psychiatric morbidity in this study was 14.8%. Non-organic enuresis, Attention deficit hyperactivity disorder, Conduct disorder, and Mental retardation were identified as the common mental health problems. Conclusions: Factors like nuclear family, parents not living together, large family size, and positive family history of psychiatric disorder were associated with psychiatric morbidity in children.

  3. Phenomenology, psychiatric comorbidity and family history in referred preschool children with obsessive-compulsive disorder

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    Coskun Murat


    Full Text Available Abstract Objective The study aimed to investigate phenomenology, psychiatric comorbidity, and family history of obsessive-compulsive disorder (OCD in a clinical sample of normally developing preschool children with OCD. Method Subjects in this study were recruited from a clinical sample of preschool children (under 72 months of age who were referred to a university clinic. Subjects with a normal developmental history and significant impairment related to OCD symptoms were included in the study. Children’s Yale-Brown Obsessive-Compulsive Scale was used to assess OCD symptoms. Each subject was assessed for comorbid DSM-IV psychiatric disorders using a semi-structured interview. Parents were evaluated for lifetime history of OCD in individual sessions. Results Fifteen boys and ten girls (age range: 28 to 69 months; 54.12±9.08 months were included. Mean age of onset of OCD was 35.64±13.42 months. All subjects received at least one comorbid diagnosis. The most frequent comorbid disorders were non-OCD anxiety disorders (n=17; 68.0%, attention-deficit hyperactivity disorder (ADHD (n=15; 60.0%, oppositional defiant disorder (ODD (n=12; 48.0%, and tic disorders (n=6; 24.0%. Mean number of comorbid disorders was 3.65 and 2.35 for boys and girls, respectively. At least one parent received lifetime OCD diagnosis in 68 percent of the subjects. Conclusions The results indicated that OCD in referred preschool children is more common in males, highly comorbid with other psychiatric disorders, and associated with high rates of family history of OCD. Given the high rates of comorbidity and family history, OCD should be considered in referred preschool children with disruptive behavior disorders and/or with family history of OCD.

  4. [Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966)]. (United States)

    Afschar-Hamdi, Sima; Schepker, Klaus


    Coercive Measures in Child and Adolescent Psychiatry in Post-war Germany, Using the Example of the "Pflege- und Beobachtungsstation" in the State Psychiatric Hospital Weissenau (1951-1966) The patient admissions at the children's ward of the State Psychiatric Hospital Weissenau in the years 1951, 1956, 1961 and 1966 were analyzed regarding documented coercive measures. Shortage of staff, mainly inadequately skilled personnel, a mixing of age groups in the patient cohort, neurological and psychiatric disorders and of patients who were in need of nursing and of those who needed treatment constituted the general work environment. Coercive measures against patients, mostly disproportionate isolations, were a constant part of daily life on the ward. This affected in particular patients who had to stay longer at the hospital and whose stay was financed by public authority. The uselessness of such measures was known, which can be seen e. g. in the Caretaker's Handbook of that time and the comments in the patient files. The situation still escalated in some cases (for example by transfer to an adult ward). For a long time, coercive measures against patients were part of everyday life at the children's ward of the Weissenau; the actual figures are suspected to be much higher.

  5. Factors associated with recidivism at a South African forensic psychiatric hospital

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    Nirvana Morgan


    Full Text Available Aims: This study examines common factors associated with recidivism among state patients at a South African forensic psychiatric hospital. More specifically, demographic, clinical and criminological factors of a recidivist group are compared to a non-recidivist group with the intention of understanding to what extent these factors might determine the likelihood of re-offending. Method: A retrospective case file review of 293 inpatients and a random selection of 120 outpatients was conducted. For the purpose of the study, a patient was classified as a recidivist if an additional charge or act of violence was added to the file while the patient was on leave of absence in the community. Of the inpatients, only those who met the criteria for recidivism were included in the study. All 120 randomly selected outpatients were included. Demographic, clinical and criminological data were captured for all patients. Results: Eighty recidivists were compared with 100 non-recidivists. Using the × 2 and Fischer’s exact test, substance-use disorder, antisocial personality disorder, an index offence of assault and in-ward adverse events were found to be associated with recidivism (p < 0.05. Using logistic regression analysis, the odds of recidivism in a patient with an index offence of assault was 8.4 times of those who did not commit assault as an index offence (95.0% CI 1.6–43.1. The odds of recidivism for patients with cannabis use was 2.8 (95.0% CI 1.3–6.0 and for patients with in-ward adverse sexual behaviour was 17.2 (95.0% CI 2.0–150. Conclusion: Substance-use disorder and antisocial personality disorder are associated with higher risk for recidivism. This study also highlights that a less serious offence such as assault had a higher association with recidivism. Patients noted to display adverse sexual behaviour in the ward pose a potentially high risk for re-offence. Important criminal history factors and certain clinical factors could not

  6. Sex-typed play in gender-disturbed children: a comparison to sibling and psychiatric controls. (United States)

    Zucker, K J; Doering, R W; Bradley, S J; Finegan, J K


    Gender-disturbed children (n = 14) were compared to their preadolescent siblings (n = 16) and psychiatric controls (n = 13) on a sex-typed free-play task previously shown to differentiate gender-disturbed boys from normal boys. On three separate trials totaling 20 minutes, the gender-disturbed children played for a significantly longer period of time with cross-sex toys and for a significantly shorter period of time with same-sex toys than did the two control groups. The gender-disturbed children also showed greater trial-to-trial consistency in their play preferences than the other two groups. The utility of this task in the assessment of childhood gender disturbance is discussed. In addition, the results are discussed in relation to a number of perspectives regarding both typical and atypical gender identity development in childhood.

  7. Atopic dermatitis is associated with anxiety, depression, and suicidal ideation, but not with psychiatric hospitalization or suicide

    DEFF Research Database (Denmark)

    Thyssen, J P; Hamann, Carsten R; Linneberg, A


    of hospitalization and suicide. METHODS: We utilized questionnaire data from a large general population study with data on social habits and psychiatric symptoms to compare prevalences of depression, anxiety, suicidal ideation, and anxiety attacks, in adults with and without a history of AD. Additionally, we used...... nationwide hospital/clinic registry and prescription data to examine the risk of anxiety and depression in Danish adults with mild and moderate-severe AD, as well as the risk of hospitalization and suicide. RESULTS: In the general population study, those with AD reported clinician-diagnosed depression...... and anxiety more often than non-AD subjects, and had an increased prevalence of suicidal ideation and depressive symptoms. In the health registry study, moderate-severe AD patients had increased risk of antidepressant and anxiolytic medication use, while patients with mild AD only had increased risk...

  8. Intussusception in children seen at Muhimbili National Hospital, Dar ...

    African Journals Online (AJOL)

    Intussusception in children seen at Muhimbili National Hospital, Dar es salaam. ... its magnitude of concern and any seasonal variation in our environment. ... majority of the children present late, >48 hours from the onset of symptoms and ...

  9. The effects of a non-smoking policy on nursing staff smoking behaviour and attitudes in a psychiatric hospital. (United States)

    Bloor, R N; Meeson, L; Crome, I B


    The UK Department of Health required that by April 2001, all NHS bodies would have implemented a smoking policy. It has been suggested that the best demonstration a hospital can make of its commitment to health is to ban smoking on its premises. This paper reports on an evaluation of the effectiveness of a non-smoking policy in a newly opened NHS psychiatric hospital. Questionnaires were sent to all 156 nursing staff in a psychiatric hospital to assess the effectiveness of the policy in terms of staff smoking behaviour, attitudes to the restriction and compliance with the policy. Of the 156 questionnaires distributed, 92 (58%) were returned; smokers, former smokers and those who have never smoked were quite evenly represented at 34.78%, 34.78% and 30.43%, respectively. Of eight critical success factors for the policy, only one, staff not smoking in Trust public areas, had been achieved. A non-smoking policy was generally accepted as necessary by nursing staff working in a mental health setting. Staff felt that the policy was not effective in motivating smoking nurses to stop and that insufficient support was given to these nurses. The study highlights the importance of introducing staff support systems as an integral part of smoking policies and the role of counterintuitive behaviour in the effectiveness of smoking policy introduction in healthcare settings.

  10. 'Therapeutic landscapes' and the importance of nostalgia, solastalgia, salvage and abandonment for psychiatric hospital design. (United States)

    Wood, Victoria J; Gesler, Wil; Curtis, Sarah E; Spencer, Ian H; Close, Helen J; Mason, James; Reilly, Joe G


    We examine emotional reactions to changes to medical spaces of care, linked with past experiences. In this paper we draw on findings from a qualitative study of the transfer of psychiatric inpatient care from an old to a newly built facility. We show how the meanings attributed to 'therapeutic landscapes' from one׳s past can evoke emotions and memories, manifesting in ideas about nostalgia, solastalgia, salvage and abandonment, which can impinge on one׳s present therapeutic experience. We reflect on how consideration of these ideas might contribute to better future design of psychiatric inpatient facilities and the wellbeing of those using them. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Risk factors for suicide within a year of discharge from psychiatric hospital: a systematic meta-analysis. (United States)

    Large, Matthew; Sharma, Swapnil; Cannon, Elisabeth; Ryan, Christopher; Nielssen, Olav


    The increased risk of suicide in the period after discharge from a psychiatric hospital is a well-recognized and serious problem. The aim of this study was to establish the risk factors for suicide in the year after discharge from psychiatric hospitals and their usefulness in categorizing patients as high or low risk for suicide in the year following discharge. A systematic meta-analysis of controlled studies of suicide within a year of discharge from psychiatric hospitals. There was a moderately strong association between both a history of self-harm (OR = 3.15) and depressive symptoms (OR = 2.70) and post-discharge suicide. Factors weakly associated with post-discharge suicide were reports of suicidal ideas (OR = 2.47), an unplanned discharge (OR = 2.44), recent social difficulty (OR = 2.23), a diagnosis of major depression (OR = 1.91) and male sex (OR = 1.58). Patients who had less contact with services after discharge were significantly less likely to commit suicide (OR = 0.69). High risk patients were more likely to commit suicide than other discharged patients, but the strength of this association was not much greater than the association with some individual risk factors (OR = 3.94, sensitivity = 0.40, specificity = 0.87). No factor, or combination of factors, was strongly associated with suicide in the year after discharge. About 3% of patients categorized as being at high risk can be expected to commit suicide in the year after discharge. However, about 60% of the patients who commit suicide are likely to be categorized as low risk. Risk categorization is of no value in attempts to decrease the numbers of patients who will commit suicide after discharge.

  12. Diagnosis and outcome of psychiatric referrals to the Field Mental Health Team, 202 Field Hospital, Op Telic I. (United States)

    Scott, J N


    To assess referrals to a Field Hospital Mental Health Team (FMHT), assign a diagnosis, provide appropriate treatment, and decide whether suitable for safe return to unit in theatre (RTU), or evacuation home on psychiatric grounds (evac). All documented referrals to the FMHT of 202 Field Hospital during the Op Telic 1 study period of 17 March (day 1) to 23 July 2003 (day 129) were included. Data were collected on rank, gender, diagnosis, outcome (whether RTU or evac), and whether TA before mobilisation. Diagnosis was assigned by ICD-10 criteria. The FMHT documented 170 cases, 12 of whom were seen twice and one on three occasions, resulting in 184 referrals, all of whom were British. The commonest diagnosis was adjustment reaction (F43), accounting for 68% of all cases (n = 116). These were divided between chiefly theatre-related (n = 77) or chiefly home-related (n = 39) reactions. The majority (94%) of these cases were RTU. Referrals where the diagnosis was a Depressive disorder (F32, n = 23) or Intentional self-harm (by sharp object, X78, n = 7) were evacuated. Outcome was similar for Regular and TA personnel, with on average 72% of cases RTU. The majority of cases seen were ORs, reflecting their numbers in theatre. Only 14 NCOs and 14 officers were referred. Thirteen of the latter were TA before mobilisation. Gender was not associated with outcome, or TA status, but was associated with rank, in that significantly more female officers were referred. The FMHT role tasks emerged as (a) psychiatric triage and treatment, (b) psychological support of hospital staff, and (c) welfare and pastoral care liaison. The utility of the psychiatric management model employed, built upon previous military medical doctrines, was tested in a modern theatre of conflict, and seemed to prove its worth.

  13. Adversity and sex differences in social and emotional sensitivity in children; a possible mechanism for sex differences in psychiatric disorders


    Jonathan Hill; Helen Sharp; Lynne Murray


    Females are superior to males on a range of tasks indexing social sensitivity, the capacity to infer others' mental states and respond with appropriate behaviours and emotions(1-3). There are also sex differences in psychiatric disorders in children and adolescents. Boys have higher rates of psychiatric disorders before puberty, but disorders increase markedly in girls after puberty (4). The causes of the commonest forms of disorder, antisocial behaviour problems in boys, and depression ...

  14. Psychiatric medication use before and after the onset of type 1 diabetes in children and adolescents: A population-based cohort study.

    NARCIS (Netherlands)

    Abdullah, H; Fazeli Farsani, Sulmaz; Souverein, P.C.; de Boer, A.; Mantel-Teeuwisse, Aukje K.


    BACKGROUND: Several studies showed a bidirectional association between type 2 diabetes and psychiatric disorders in adults. Because there is limited information on the association between type 1 diabetes (T1D) and psychiatric disorders (including psychiatric medication use) in children and

  15. Incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients. (United States)

    Ruengorn, Chidchanok; Sanichwankul, Kittipong; Niwatananun, Wirat; Mahatnirunkul, Suwat; Pumpaisalchai, Wanida; Patumanond, Jayanton


    The incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients remain uninvestigated in Thailand. To determine incidence and risk factors of suicide reattempts within 1 year after psychiatric hospital discharge in mood disorder patients. A retrospective cohort study was conducted by reviewing medical charts at Suanprung Psychiatric Hospital, Chiang Mai, Thailand. Mood disorder patients, diagnosed with the International Statistical Classification of Diseases and Related Health Problems 10th Revision codes F31.x, F32.x, and F33.x, who were admitted owing to suicide attempts between October 2006 and May 2009 were eligible. The influence of sociodemographic and clinical risk factors on suicide reattempts was investigated using Cox's proportional-hazards regression analysis. Of 235 eligible mood disorder patients, 36 (15.3%) reattempted suicide (median 109.5 days, range 1-322), seven (3.0%) completed suicide (median 90 days, range 5-185), and 192 (84.2%) neither reattempted nor completed suicide during follow-up. Of all nonfatal suicide reattempts, 14 patients (38.9%) did so within 90 days. Among suicide completers, one (14.3%) did so 5 days after discharge, and four (57.1%) did so within 90 days. The following three risk factors explained 73.3% of the probability of suicide reattempts: over two previous suicide attempts before the index admission (adjusted hazard ratio [HR] 2.48; 95% confidence interval [CI] 1.07-5.76), being concomitantly prescribed typical and atypical antipsychotics (adjusted HR 4.79; 95% CI 1.39-16.52) and antidepressants, and taking a selective serotonin reuptake inhibitor alone (adjusted HR 5.08; 95% CI 1.14-22.75) or concomitantly with norepinephrine and/or serotonin reuptake inhibitors (adjusted HR 6.18; 95% CI 1.13-33.65). Approximately 40% of suicide reattempts in mood disorder patients occurred within 90 days after psychiatric hospital discharge. For mood disorders and when

  16. [New medical approach to out-of-hospital treatment of psychomotor agitation in psychiatric patients: a report of 14 cases]. (United States)

    Cester-Martínez, Armando; Cortés-Ramas, José Antonio; Borraz-Clares, Diego; Pellicer-Gayarre, Marta


    This case series explored the usefulness of an inhaled dose of 9.1 mg of loxapine administered outside the hospital to treat psychomotor agitation related to schizophrenia, bipolar disorder, or schizoaffective disorder. The Clinical Global Impression Scale and the Positive and Negative Syndrome Scale (excitement component) were used to assess the effects of treatment in 14 patients. The treatment was useful in 12 patients, who showed significant improvement (Pagitation related to a psychiatric disorder. Mechanical restraint and parenteral medication can be avoided after use of this drug. Loxapine treatment shortens the agitation episode and attenuates the impact on the patient, facilitating ambulance transfer.

  17. [Psychiatric comorbidity related to children with attention deficit hyperactivity disorder at schools in Sfax, Tunisia]. (United States)

    Khemakhem, K; Ayedi, H; Moalla, Y; Yaich, S; Hadjkacem, I; Walha, A; Damak, J; Ghribi, F


    Attention deficit hyperactivity disorder (ADHD) is a prevalent behavioral disorder particularly noticed among school children. It is often associated with other psychological troubles at the origin of an additional difficulty that has to be overcome. Our research's aim was to study the comorbidity of school-aged children diagnosed with ADHD in Sfax, Tunisia. A cross-sectional descriptive study was carried out from 1st April 2008 to 1st October 2008. Five hundred and thirteen pupils aged between 6 and 12, from primary arbitrarily chosen schools from Sfax were subjected to this study. Measurements were carried out in two steps: parents and teachers of each child filled in separately Conners questionnaire, then children with a score in subscales inattention, hyperactivity impulsivity higher than 70 were selected for psychiatric interview that was intended to confirm or to invalidate the ADHD diagnosis and the possible comorbid diagnosis. The diagnoses were made according to DSM-IV-TR. We have noticed that 109 pupils exhibited at least one pathological score on the Conners questionnaire. After interviewing these 109 pupils, the results have shown that 51 among them fulfilled criteria of ADHD. Prevalence of ADHD was found to be 9.94 %. About 72.54 % of children with ADHD had one or more comorbid disorder: learning disabilities (23.52 % of cases), anxiety disorder (31.37 % of cases), oppositional defiant disorder in (15.68 % of cases), mood disorder (3.92 % of cases), enuresis (13.72 % of cases) and slight mental retardation (1.95 % of cases). We can say that this study has shown that ADHD school children's psychiatric comorbidity is similar to any other previous study. Copyright © 2013 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  18. Sociodemographic and clinical profile of patients in voluntary and involuntary psychiatric hospitalizations - doi:10.5020/18061230.2011.p361

    Directory of Open Access Journals (Sweden)

    Maria Selma Nogueira Oliveira


    Full Text Available Objective: To assess the sociodemographic and clinical profile of patients in psychiatric hospitalizations of voluntary inpatients (IPV and involuntary (IPI, in psychiatric hospitals of Fortaleza-CE, Brazil, under contract with the Unified Health System (SUS. Methods: A quantitative study, descriptive, cross-sectional and analytical. The sample comprised 393 patients, distributed among 253 IPV and 140 IPI, submitted to Psychiatry specialty treatment, in the year 2007. Results: For both patients, IPV and IPI, most were male: 185 (73.1% and 82 (58.6%; single: 181 (46.7% and 103 (26.5%; living in Fortaleza: 181 (71.5% and 95 (67.9%, respectively, and aged 20 to 60 years (mean age of 37 years. We observed significant difference between the type of hospital and patient gender (p = 0.003, which did not occur with marital status (p = 0.688 and origin (p = 0.95. The main symptom profiles which justified the clinical admission of these patients were the use of alcohol or drugs 70 (27.6%, changes in critical judgments 40 (28.6% and psychological distress 68 (26.9%. Family members were the main responsible for conducting these patients to the hospital. Conclusion: The results showed that patients on IPV and IPI, which joined in the study, had a socio-demographic and clinical profile characterized by: prevalence of male patients, from the capital Fortaleza, single, mean age of 37 years, having been brought to hospital by a relative, mainly due to alcohol use or drugs.

  19. Neuropsychological screening as a standard of care during discharge from psychiatric hospitalization: the preliminary psychometrics of the CNS Screen. (United States)

    Levy, Boaz; Celen-Demirtas, Selda; Surguladze, Tinatin; Eranio, Sara; Ellison, James


    Cost-prohibitive factors currently prevent a warranted integration of neuropsychological screenings into routine psychiatric evaluations, as a standard of care. To overcome this challenge, the current study examined the psychometric properties of a new computerized measure-the CNS Screen. One hundred and twenty six psychiatric inpatients completed the CNS Screen, the Montreal Cognitive Assessment (MoCA), and the Quick Inventory of Depressive Symptomatology-Self Rated (QIDS-SR₁₆) on the day of hospital discharge. Statistical analysis established convergent validity with a moderate correlation between the self-administered CNS Screen and the clinician-administered MoCA (r=0.64). Discriminant validity was implicated by a non-significant correlation with the QIDS-SR₁₆. Concurrent validity was supported by a moderate, negative correlation with patients' age (r=-0.62). In addition, consistent with previous findings, patients with psychotic disorders exhibited significantly poorer performance on the CNS Screen than patients with a mood disorder. Similarly, patients with a formal disability status scored significantly lower than other patients. The CNS Screen was well tolerated by all patients. With further development, this type of measure may provide a cost-effective approach to expanding neuropsychological screenings on inpatient psychiatric units. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Leisure Activity and Hospital Readmission of Short-Term Psychiatric Patients. (United States)

    McMinn, Sheri B.; Lay, C. Marvin

    William Menninger (1948) reported research results indicating a significant relationship in a former patient's ability to stay well and his participation in recreation. J. Bates (1963) indicated one reason patients return to psychiatric facilities was the lack of skills that center around recreation. This study was conducted to investigate the…

  1. Ten-year mortality review in a pioneer psychiatric hospital in West ...

    African Journals Online (AJOL)

    Conclusion: It is concluded that the major psychotic disorders, schizophrenia and depression continue to constitute the highest psychopathologies diagnosed psychiatric mortality study. Finally, infections/infestations still continue to play leading role as major causes of death in the West African sub-region. East African ...

  2. Prevalence and Predictors of Domestic-Violence towards Wives by their Psychiatric Hospitalized Husbands

    Directory of Open Access Journals (Sweden)

    Ali Sahraian


    Full Text Available Objective: Violence imposed on wives by their inpatient psychiatric husbands has not been studied yet. The current study surveyed the rates and predictors of violence committed by inpatient psychiatric husbands towards their wives.Methods: A convenient sample of wives of 209 married male psychiatric inpatients completed a self-reported questionnaire. They were asked about physical, emotional, social and economic abuse.Results: More than 80% of the husbands socially abused their wives; 73.0% of the wives had been regularly beaten by their husbands; the rate for humiliation was 77.2%; and only 14.1% of the wives reported that their sexual relationship with their husbands is with desire.onclusion: There is a dramatic high rate of different types of abuse toward wives by their inpatient psychiatric husbands. They are commonly victimized by their husbands. Moreover, different types of violence always co-occur.  Future studies should consider this important issue which is unfortunately an ignored research area.

  3. Opinions about Treatment Modalities among Patients Involuntarily Committed to a Forensic Psychiatric Hospital in Finland (United States)

    Repo-Tiihonen, Eila; Vuorio, Osmo; Koivisto, Hanna; Paavola, Paula; Hakola, Panu


    Patient satisfaction studies concerning various treatment modalities are few among involuntary forensic psychiatric treatment. They indicate general satisfaction with medication, interactive treatment and occupational therapy but dissatisfaction with lack of privacy, insufficiently explained rules and inadequately explained reasons of seclusion.…

  4. Discharged from a mental health admission ward: is it safe to go home? A review on the negative outcomes of psychiatric hospitalization

    Directory of Open Access Journals (Sweden)

    Loch AA


    Full Text Available Alexandre Andrade LochLaboratory of Neurosciences, Department and Institute of Psychiatry, University of São Paulo, BrazilAbstract: Before psychiatry emerged as a medical discipline, hospitalizing individuals with mental disorders was more of a social stigmatizing act than a therapeutic act. After the birth of the mental health disciplines, psychiatric hospitalization was legitimized and has proven to be indispensable, preventing suicides and helping individuals in need. However, despite more than a century passing since this legitimization occurred, psychiatric hospitalization remains a controversial issue. There is the question of possible negative outcomes after a psychiatric admission ceases to take its protective effect, and even of whether the psychiatric admission itself is related to a negative setback after discharge. This review aims to summarize some of the most important negative outcomes after discharge from a psychiatric institution. These experiences were organized into two groups: those after a brief psychiatric hospitalization, and those after a long-stay admission. The author further suggests possible ways to minimize these adversities, emphasizing the need of awareness related to this important issue.Keywords: suicide, stigma, rehabilitation, relapse, rehospitalisation

  5. Psychiatric disorders in cases of completed suicide in a hospital area in Spain between 2007 and 2010. (United States)

    Gómez-Durán, Esperanza L; Forti-Buratti, M Azul; Gutiérrez-López, Beatriz; Belmonte-Ibáñez, Anna; Martin-Fumadó, Carles


    Suicide is an important Public Health problem. One of the most relevant known risk factors for suicide is suffering from a mental health disorder, identified in up to 90-95% of completed suicides, with this risk being increased if comorbidity is present. Findings from international research on the most common psychiatric disorders are dichotomous, divided into mood disorders and psychotic disorders. In Spain, data of this kind are scarce. This study describes the psychiatric and forensic characteristics of completed suicide cases (n=79) ocurred in a psychiatric hospital healthcare area (in Spain), between 2007 and 2010. The forensic data were obtained from the Institute of Legal Medicine of Catalonia and the clinical data by reviewing the clinical records. Most of the subjects in this sample were males (78.5%, 95% CI; 68.4%-87.3%). Almost half of the sample (45.4%, 95% CI; 33.8%-57.1%, 35/77) had records in the Mental Health Services Network (including substance misuse services). Two of the 79 were under 18, so we were not able to access the records. More than half (54.3%, 95% CI; 37.1%-71.4%) of those with psychiatric history suffered from a mood disorder; 37.1% (95% CI; 22.9%-51.4% from a depressive disorder; 14.3% (95% CI; 2.9%-25.7%) from a bipolar disorder, and 17.1% (95% CI; 5.7%-31.4%) suffered from a psychotic disorder. With regard to substance misuse, 42.9% (95% CI; 25.7%-60.0%) presented substance misuse, and 48.6% did not. Psychiatric and forensic characteristics of completed suicide in this Spanish sample confirm previous findings from international studies: there is a high rate of psychiatric disorders in those who complete suicide, and there is a specific pattern as regards the method used to complete it. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  6. Psychiatric and behavioral side effects of anti-epileptic drugs in adolescents and children with epilepsy. (United States)

    Chen, B; Detyniecki, K; Choi, H; Hirsch, L; Katz, A; Legge, A; Wong, R; Jiang, A; Buchsbaum, R; Farooque, P


    The objective of the study was to compare the psychiatric and behavioral side effect (PBSE) profiles of both older and newer antiepileptic drugs (AEDs) in children and adolescent patients with epilepsy. We used logistic regression analysis to test the correlation between 83 non-AED/patient related potential predictor variables and the rate of PBSE. We then compared for each AED the rate of PBSEs and the rate of PBSEs that led to intolerability (IPBSE) while controlling for non-AED predictors of PBSEs. 922 patients (≤18 years old) were included in our study. PBSEs and IPBSEs occurred in 13.8% and 11.2% of patients, respectively. Overall, a history of psychiatric condition, absence seizures, intractable epilepsy, and frontal lobe epilepsy were significantly associated with increased PBSE rates. Levetiracetam (LEV) had the greatest PBSE rate (16.2%). This was significantly higher compared to other AEDs. LEV was also significantly associated with a high rate of IPBSEs (13.4%) and dose-decrease rates due to IPBSE (6.7%). Zonisamide (ZNS) was associated with significantly higher cessation rate due to IPBSE (9.1%) compared to other AEDs. Patients with a history of psychiatric condition, absence seizures, intractable epilepsy, or frontal lobe epilepsy are more likely to develop PBSE. PBSEs appear to occur more frequently in adolescent and children patients taking LEV compared to other AEDs. LEV-attributed PBSEs are more likely to be associated with intolerability and subsequent decrease in dose. The rate of ZNS-attributed IPBSEs is more likely to be associated with complete cessation of AED. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  7. Improving stethoscope disinfection at a children's hospital. (United States)

    Zaghi, Justin; Zhou, Jing; Graham, Dionne A; Potter-Bynoe, Gail; Sandora, Thomas J


    Stethoscopes are contaminated with pathogenic bacteria and pose a risk for transmission of infections, but few clinicians disinfect their stethoscope after every use. We sought to improve stethoscope disinfection rates among pediatric healthcare providers by providing access to disinfection materials and visual reminders to disinfect stethoscopes. Prospective intervention study. Inpatient units and emergency department of a major pediatric hospital. Physicians and nurses with high anticipated stethoscope use. Baskets filled with alcohol prep pads and a sticker reminding providers to regularly disinfect stethoscopes were installed outside of patient rooms. Healthcare providers' stethoscope disinfection behaviors were directly observed before and after the intervention. Multivariable logistic regression models were created to identify independent predictors of stethoscope disinfection. Two hundred twenty-six observations were made in the preintervention period and 261 in the postintervention period (83% were of physicians). Stethoscope disinfection compliance increased significantly from a baseline of 34% to 59% postintervention (P stethoscope disinfection supplies and visible reminders outside of patient rooms significantly increased stethoscope disinfection rates among physicians and nurses at a children's hospital. This simple intervention could be replicated at other healthcare facilities. Future research should assess the impact on patient infections.

  8. Evaluation of an inpatient psychiatric hospital physician education program and adherence to American Diabetes Association practice recommendations. (United States)

    Koffarnus, Robin L; Mican, Lisa M; Lopez, Debra A; Barner, Jamie C


    This study evaluated adherence to American Diabetes Association (ADA) recommendations for diabetes monitoring following an educational intervention for physicians in an inpatient psychiatric hospital. This retrospective chart review was conducted in an inpatient psychiatric institution from July 1, 2010-January 15, 2011. A total of 120 subjects (60 subjects each in the pre- and post-intervention groups) meeting the inclusion criteria served as the study sample. Included subjects were admitted and discharged from an inpatient psychiatric institution within 90 days prior to (pre-intervention) and following (post-intervention) the physician education program. The medical staff was presented an educational program intervention, consisting of a 30 minute overview of the ADA 2010 Standards of Care recommendations and distribution of laminated treatment reminders. Electronic grouped order sets for patients with diabetes were also created and implemented. The primary outcome was change (pre-intervention to post-intervention) in frequency of hemoglobin A1c documentation on admission following the intervention. Secondary outcomes included the change in frequency of documentation of fasting plasma glucose, serum creatinine, urine creatinine/microalbumin ratio (UMA), fasting lipid profile (FLP), and change in days on sliding scale insulin. Regarding change in frequency of documentation of A1c values on admission, chi-square analysis revealed a significant increase from pre-intervention to post-intervention period of 30% (n = 18) to 61.7% (n = 37), respectively (p = 0.0005). Documentation of FLP also significantly increased [73.3% vs. 91.7% (p = 0.0082)]. There were no significant differences in the documentation of fasting plasma glucose, serum creatinine, and UMA or days treated with sliding scale insulin. The physician education program was successful in increasing the assessment of A1c values and lipid profiles for patients with diabetes mellitus in a psychiatric

  9. Sleep, anxiety and psychiatric symptoms in children with Tourette syndrome and tic disorders. (United States)

    Modafferi, Sergio; Stornelli, Maddalena; Chiarotti, Flavia; Cardona, Francesco; Bruni, Oliviero


    The current study evaluated the relationship between tic, sleep disorders and specific psychiatric symptoms (anxiety, depression, obsessive compulsive symptoms). Assessment of 36 consecutive children and adolescents with tic disorders included: the Yale Global Tic Severity Scale (YGTSS) to assess the severity of tic symptoms; the Self-administered scale for children and adolescents (SAFA) to evaluate the psychopathological profile; a specific sleep questionnaire consisting of 45 items to assess the presence of sleep disorders. An age and sex-matched control group was used for comparisons. Sleep was significantly more disturbed in patients with tic disorders than in controls. Difficulties in initiating sleep and increased motor activity during sleep were the most frequent sleep disturbances found in our sample. Patients showed also symptoms of anxiety (SAFA A), depressed mood (SAFA D) and doubt-indecision (SAFA O). Additionally, difficulties in initiating sleep resulted associated with other SAFA subscales relative to obsessive-compulsive symptoms and depression symptoms. Furthermore, anxiety symptoms (SAFA A) resulted associated with increased motor activity during sleep. Findings confirm literature studies reporting high frequency of sleep problems, anxiety and other psychopathological symptoms in patients with tic disorders, and support the hypothesis that intrusive thoughts and other emotional disturbances might disrupt the sleep onset of these patients. These results suggest the importance of a thorough assessment of sleep and psychiatric disturbances in patients with tic disorders. Copyright © 2016 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  10. Study of the outcome of suicide attempts: characteristics of hospitalization in a psychiatric ward group, critical care center group, and non-hospitalized group

    Directory of Open Access Journals (Sweden)

    Kemuyama Nobuo


    Full Text Available Abstract Background The allocation of outcome of suicide attempters is extremely important in emergency situations. Following categorization of suicidal attempters who visited the emergency room by outcome, we aimed to identify the characteristics and potential needs of each group. Methods The outcomes of 1348 individuals who attempted suicide and visited the critical care center or the psychiatry emergency department of the hospital were categorized into 3 groups, "hospitalization in the critical care center (HICCC", "hospitalization in the psychiatry ward (HIPW", or "non-hospitalization (NH", and the physical, mental, and social characteristics of these groups were compared. In addition, multiple logistic analysis was used to extract factors related to outcome. Results The male-to-female ratio was 1:2. The hospitalized groups, particularly the HICCC group, were found to have biopsychosocially serious findings with regard to disturbance of consciousness (JCS, general health performance (GAS, psychiatric symptoms (BPRS, and life events (LCU, while most subjects in the NH group were women who tended to repeat suicide-related behaviors induced by relatively light stress. The HIPW group had the highest number of cases, and their symptoms were psychologically serious but physically mild. On multiple logistic analysis, outcome was found to be closely correlated with physical severity, risk factor of suicide, assessment of emergent medical intervention, and overall care. Conclusion There are different potential needs for each group. The HICCC group needs psychiatrists on a full-time basis and also social workers and clinical psychotherapists to immediately initiate comprehensive care by a medical team composed of multiple professionals. The HIPW group needs psychological education to prevent repetition of suicide attempts, and high-quality physical treatment and management skill of the staff in the psychiatric ward. The NH group subjects need a

  11. Theory of mind and emotion-recognition functioning in autistic spectrum disorders and in psychiatric control and normal children. (United States)

    Buitelaar, J K; van der Wees, M; Swaab-Barneveld, H; van der Gaag, R J


    The hypothesis was tested that weak theory of mind (ToM) and/or emotion recognition (ER) abilities are specific to subjects with autism. Differences in ToM and ER performance were examined between autistic (n = 20), pervasive developmental disorder-not otherwise specified (PDD-NOS) (n = 20), psychiatric control (n = 20), and normal children (n = 20). The clinical groups were matched person-to-person on age and verbal IQ. We used tasks for the matching and the context recognition of emotional expressions, and a set of first- and second-order ToM tasks. Autistic and PDD-NOS children could not be significantly differentiated from each other, nor could they be differentiated from the psychiatric controls with a diagnosis of ADHD (n = 9). The psychiatric controls with conduct disorder or dysthymia performed about as well as normal children. The variance in second-order ToM performance contributed most to differences between diagnostic groups.

  12. [Associating children with contemporary visual arts in the hospital]. (United States)

    Dessuter, Brigitte


    In 2008, for 3 months, a visual artist in residence at the Margency children's hospital (Val d'Oise) made sculptures for the bandstand situated in the hospital's park. By bringing people together this experience helped to create a bond between the artists, the hospitalised children and the healthcare workers.

  13. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey (United States)

    Brand, Serge; Colledge, Flora; Beeler, Nadja; Pühse, Uwe; Kalak, Nadeem; Sadeghi Bahmani, Dena; Mikoteit, Thorsten; Holsboer-Trachsler, Edith; Gerber, Markus


    Background Physical activity and exercise programs (PAEPs) are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods All psychiatric hospitals (N=55) in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%), sports therapy (97%), activity-related psychotherapeutic interventions (95%), physiotherapy (85%), body therapies (59%), far-east techniques (57%), and hippotherapy (22%). Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not participate in PAEPs. Furthermore, those who do participate cannot continue to do so following discharge. PAEP providers need specific extended vocational trainings and believe that the potential of PA should be improved. PMID:27350748

  14. Bilingual children referred for psychiatric services: associations of language disorders, language skills, and psychopathology. (United States)

    Toppelberg, Claudio O; Medrano, Laura; Peña Morgens, Liana; Nieto-Castañon, Alfonso


    To investigate (1) the prevalence of language deficits and disorders and (2) the relationship of bilingual language skills and psychopathology, in Spanish-English bilingual children referred for child and adolescent psychiatry services. Bilingual language skills, emotional/behavioral problems, sociodemographics, immigration variables, and nonverbal IQ were studied in 50 consecutively referred children. Estimated prevalence was high for language deficits (48%) and disorders (41%), with most cases (>79%) being of the mixed receptive-expressive type. In children with clinically significant emotional/behavioral problems, bilingual language skills were strongly and inversely correlated with problem scores, particularly global problems (r = -0.67, p or = -0.54; p language disorders and delays and (2) the close tie between poor language skills and emotional/behavioral problems. The data strongly suggest the clinical importance and feasibility of language assessment and the significance of receptive problems in bilingual children referred for psychiatric services. A safe approach is to fully assess language skills, rather than misattributing these children's language delays to normal bilingual acquisition processes.

  15. Length of psychiatric hospitalization is correlated with CYP2D6 functional status in inpatients with major depressive disorder (United States)

    Ruaño, Gualberto; Szarek, Bonnie L; Villagra, David; Gorowski, Krystyna; Kocherla, Mohan; Seip, Richard L; Goethe, John W; Schwartz, Harold I


    Aim This study aimed to determine the effect of the CYP2D6 genotype on the length of hospitalization stay for patients treated for major depressive disorder. Methods A total of 149 inpatients with a diagnosis of major depressive disorder at the Institute of Living, Hartford Hospital (CT, USA), were genotyped to detect altered alleles in the CYP2D6 gene. Prospectively defined drug metabolism indices (metabolic reserve, metabolic alteration and allele alteration) were determined quantitatively and assessed for their relationship to length of hospitalization stay. Results Hospital stay was significantly longer in deficient CYP2D6 metabolizers (metabolic reserve <2) compared with functional or suprafunctional metabolizers (metabolic reserve ≥2; 7.8 vs 5.7 days, respectively; p = 0.002). Conclusion CYP2D6 enzymatic functional status significantly affected length of hospital stay, perhaps due to reduced efficacy or increased side effects of the medications metabolized by the CYP2D6 isoenzyme. Functional scoring of CYP2D6 alleles may have a substantial impact on the quality of care, patient satisfaction and the economics of psychiatric treatment. PMID:23734807

  16. Behavioral activation and inhibition system's role in predicting addictive behaviors of patients with bipolar disorder of Roozbeh Psychiatric Hospital (United States)

    Abbasi, Moslem; Sadeghi, Hasan; Pirani, Zabih; Vatandoust, Leyla


    Background: Nowadays, prevalence of addictive behaviors among bipolar patients is considered to be a serious health threat by the World Health Organization. The aim of this study is to investigate the role of behavioral activation and inhibition systems in predicting addictive behaviors of male patients with bipolar disorder at the Roozbeh Psychiatric Hospital. Materials and Methods: The research method used in this study is correlation. The study population consisted of 80 male patients with bipolar disorder referring to the psychiatrics clinics of Tehran city in 2014 who were referred to the Roozbeh Psychiatric Hospital. To collect data, the international and comprehensive inventory diagnostic interview, behavioral activation and inhibition systems scale, and addictive behaviors scale were used. Results: The results showed that there is a positive and significant relationship between behavioral activation systems and addictive behaviors (addictive eating, alcohol addiction, television addiction, cigarette addiction, mobile addiction, etc.). In addition, correlation between behavioral inhibition systems and addictive behaviors (addictive eating, alcohol addiction, TV addiction, cigarette addiction, mobile addiction) is significantly negative. Finally, regression analysis showed that behavioral activation and inhibition systems could significantly predict 47% of addictive behaviors in patients with bipolar disorder. Conclusions: It can be said that the patients with bipolar disorder use substance and addictive behaviors for enjoyment and as pleasure stimulants; they also use substances to suppress unpleasant stimulants and negative emotions. These results indicate that behavioral activation and inhibition systems have an important role in the incidence and exacerbation of addictive behaviors. Therefore, preventive interventions in this direction seem to be necessary. PMID:28194203

  17. The current state of physical activity and exercise programs in German-speaking, Swiss psychiatric hospitals: results from a brief online survey

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    Full Text Available Serge Brand,1,2 Flora Colledge,2 Nadja Beeler,2 Uwe Pühse,2 Nadeem Kalak,1 Dena Sadeghi Bahmani,1 Thorsten Mikoteit,1 Edith Holsboer-Trachsler,1 Markus Gerber2 1Psychiatric Clinics of the University of Basel, Center for Affective, Stress and Sleep Disorders, 2Department of Sport, Exercise and Health, Sport Science Section, University of Basel, Basel, Switzerland Background: Physical activity and exercise programs (PAEPs are an important factor in increasing and maintaining physical and mental health. This holds particularly true for patients with psychiatric disorders undergoing treatment in a psychiatric hospital. To understand whether the benefits reported in the literature are mirrored in current treatment modalities, the aim of the present study was to assess the current state of PAEPs in psychiatric hospitals in the German-speaking part of Switzerland. Methods: All psychiatric hospitals (N=55 in the German-speaking part of Switzerland were contacted in spring 2014. Staff responsible for PAEPs were asked to complete an online questionnaire covering questions related to PAEPs such as type, frequency, staff training, treatment rationale, importance of PAEPs within the treatment strategy, and possible avenues to increase PAEPs. Results: Staff members of 48 different psychiatric hospitals completed the survey. Hospitals provided the following therapeutic treatments: relaxation techniques (100%, sports therapy (97%, activity-related psychotherapeutic interventions (95%, physiotherapy (85%, body therapies (59%, far-east techniques (57%, and hippotherapy (22%. Frequencies ranged from once/week to five times/week. Approximately 25% of patients participated in the PAEPs. Interventions were offered irrespective of psychiatric disorders. PAEP providers wanted and needed more vocational training. Conclusion: All participating psychiatric hospitals offer a broad variety of PAEPs in their treatment curricula. However, the majority of inpatients do not

  18. Interactional aspects of care during hospitalization: perspectives of family caregivers of psychiatrically ill in a tertiary care setting in India. (United States)

    Dinakaran, P; Mehrotra, Seema; Bharath, Srikala


    There are very few studies on user-perspectives about mental health care services that explore perspectives of family caregivers in India. An exploratory study was undertaken to understand the perceived importance of various aspects of interactions with mental health service providers during hospitalization, from the perspectives of family caregivers. In addition, it also aimed at documenting their actual experience of interactional aspects of care during the hospitalization of their relatives. The study was conducted on fifty family caregivers of patients with varied psychiatric diagnoses hospitalized in a tertiary psychiatric care setting in South India. Measures of Interactional aspects of care were developed to assess perceived importance of six different interactional domains of care and the actual experience of care in these domains. Provision of informational inputs and addressing of concerns raised emerged as the domains of care given highest importance. The item pertaining to 'sharing with the caregiver about different alternatives for treatment' received negative ratings in terms of actual experience by maximum number of participants (18%). Significant differences on perceived importance of four domains of interactional aspects of care (dignity, confidentiality and fairness, addressing concerns raised, informational inputs and prompt attention and consistent care) emerged between caregiver subgroups based on educational level of the caregiver, socio-economic status, hospitalization history and broad diagnostic categories. In addition, the care givers of patients with psychoses assigned significantly more positive ratings on actual experience for all the domains of interactional aspects of care. The findings have implications for further research and practice. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Deliberate ingestion of foreign bodies by institutionalised psychiatric hospital patients and prison inmates.

    LENUS (Irish Health Repository)

    O'Sullivan, S T


    Deliberate and recurrent foreign body ingestion is a common problem among institutionalised patients. We review our experience with 36 cases of deliberate foreign body ingestion by prisoners or psychiatric patients, thirty of whom were institutionalised at the time of ingestion. Symptoms were frequently severe in the prison inmate group but, in contrast, psychiatric patients presented with few, if any, symptoms. A majority of objects pass spontaneously or remain in situ without complication. Twenty-four patients were discharged following initial evaluation and without specific treatment. Eight of these were reviewed electively and discharged within one week. Twelve patients were admitted for observation, seven of whom were discharged within 48 hrs. Upper gastrointestinal endoscopy was performed in four patients and an intragastric foreign body identified in two cases. Laparotomy was performed in two cases for unresolving mechanical intestinal obstruction. Management should be conservative when possible, with surgery indicated only for complications.

  20. Overcrowding as a possible risk factor for inpatient suicide in a South African psychiatric hospital

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    Christoffel Grobler


    Full Text Available About 4% of all suicides are estimated to occur while being an inpatient in a psychiatric facility. Staff generally assume that an inpatient suicide reflects a failure on their part to recognise the patient’s suicidal intent and whether it could have been prevented in any way. Inpatients who commit suicide do not seem to be a homogenous group, but some risk factors have been identified, including being young, single, male, unemployed, abusing substances, schizophrenia and personality- and affective disorders. Number of admissions in the previous month also appears to be a risk factor. When the numbers of inpatients are high, more violent incidents occu. Although literature presently do not suggest an association, overcrowding in psychiatric inpatient wards should be considered a risk factor for inpatient suicide.


    Koukourikos, Konstantinos; Tzeha, Laila; Pantelidou, Parthenopi; Tsaloglidou, Areti


    Introduction: Play constitutes an essential parameter of the normal psychosomatic development of children, as well as their statutory right. It is also an important means of communication in childhood. Objective: To review, detect and highlight all data cited regarding the role of play during the hospitalization of children. Methodology: Literature review was achieved by searching the databases Scopus, PubMed, Cinhal in English, using the following key words: therapeutic play, play therapy, hospitalized child, therapist. Results: During hospitalization, play either in the form of therapeutic play, or as in the form of play therapy, is proven to be of high therapeutic value for ill children, thus contributing to both their physical and emotional well-being and to their recovery. It helps to investigate issues related to the child’s experiences in the hospital and reduce the intensity of negative feelings accompanying a child’s admission to hospital and hospitalization. Play is widely used in pre-operative preparation and invasive procedures, while its use among children hospitalized for cancer is beneficial. Conclusion: The use of play in hospital may become a tool in the hands of healthcare professionals, in order to provide substantial assistance to hospitalized children, as long as they have appropriate training, patience, and will to apply it during hospitalization. PMID:26889107

  2. Effects of the Good Behavior Game on the behavioral, emotional, and social problems of children with psychiatric disorders in special education settings

    NARCIS (Netherlands)

    Breeman, L.D.; Van Lier, Pol; Wubbels, T.; Verhulst, Frank C.; van der Ende, Jan; Maras, Athanasios; Struiksma, Chris; Hopman, J.A.B.; Tick, Nouchka

    Teaching children with psychiatric disorders can be a challenging task. The purpose of this study was to examine the impact of the Good Behavior Game (GBG) in children with psychiatric disorders, and their teachers, in special education. Teachers were trained by licensed school consultants to

  3. Effects of the Good Behavior Game on the Behavioral, Emotional, and Social Problems of Children with Psychiatric Disorders in Special Education Settings (United States)

    Breeman, Linda D.; van Lier, Pol A. C.; Wubbels, Theo; Verhulst, Frank C.; van der Ende, Jan; Maras, Athanasios; Struiksma, A. J. Chris; Hopman, Juliette A. B.; Tick, Nouchka T.


    Teaching children with psychiatric disorders can be a challenging task. The purpose of this study was to examine the impact of the Good Behavior Game (GBG) in children with psychiatric disorders, and their teachers, in special education. Teachers were trained by licensed school consultants to implement positive behavior support strategies to…

  4. Private psychiatric hospitals, mental health care management, and wellness: an interface with industry. (United States)

    Baker, J W


    Hospitals doing business is good business. Hospitals that use their professional staff to enhance their interface with industry are usually pleased with the outcome. Health care professionals must reach beyond their doors and be willing to understand the needs of a large corporate bureaucracy and the aspiring entrepreneur. Using hospital professionals in a consultative model with gatekeepers of industry is an ideal way to market and enhance the hospital's image in the community. Professionals employed by private hospitals are usually quite willing to expand their roles into the community as trainers, consultants, educators, diagnosticians, and treatment resource consultants to the business world. Business people understand business problems, and health care is a business issue as well as a humanitarian issue. In the current climate of cost containment, the hospital's ability to help the business work with paying for health care, if properly presented, will be welcomed.

  5. Predominant diagnoses, gender, and admission duration in an adult psychiatric inpatient hospital in United Kingdom

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    Carlo Lazzari


    Full Text Available Introduction: The study objective was to epidemiologically analyse patients presenting at an adult and mixed-gender psychiatric inpatient unit in Essex, Kingswood Centre, UK, to report the predominant diagnoses, gender, and admission duration. Method and material: Meta-analysis and descriptive statistics analysed the year 2016 discharge data on Excel® for 162 patients. ICD-10 codes classified their mental illnesses. Results: Meta-analysis evidenced statistically significant heterogeneity in numbers admissions (I2=95%; p≤0.001, length (I2=78%; p≤0.001, and gender (I2=76%; p≤0.001. The prevailing diagnosis was borderline personality disorder (BPD (rate, 95% CI=0.46 [0.38-0.54]. The longest admission was for schizoaffective disorder (mean duration, 95% CI=53 [22.65-83.34], p=0.001. Gender presented a prevalence of male over female admissions for schizophrenia (OR, 95% CI=0.14 [0.05-0.35], p≤0.001 and BPD with prevalence of female over male admissions (OR, 95% CI=2.79 [1.35-5.76], p=0.05. Conclusion: Female patients with BPD were the most represented category in non-forensic psychiatric inpatient wards in the population studied. Male patients with schizophrenia represented the other gender highly represented. The longest admission was recorded for schizoaffective disorder due to the complexity to treat both mood and psychotic symptoms. It is likely that women with BPD will be the future recipients of psychiatric inpatient and outpatient healthcare services.

  6. Stigma and psychiatric morbidity among mothers of children with epilepsy in Zambia (United States)

    Elafros, Melissa A.; Sakubita-Simasiku, Claire; Atadzhanov, Masharip; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L.


    Background Epilepsy-associated stigma contributes substantially to the social, medical, and economic burden of disease for people with epilepsy (PWE), but little is known about its impact on caregivers of PWE. Methods To better understand stigma experienced by caregivers of PWE, factors that influence caregiver stigma, and the effect of stigma on a caregiver's psychologic well being, we interviewed 100 caregivers of children with epilepsy in Zambia. Questions assessed maternal knowledge, attitudes, and practices related to epilepsy, maternal stigma, mother's proxy report of child stigma, and maternal psychiatric morbidity. Results Of 100 mothers, 39 (39%) indicated that their child was stigmatized because of his or her epilepsy. Maternal proxy report of child stigma was highly correlated with maternal stigma (OR: 5.4, p=0.04), seizure frequency (p=0.03) and seizure severity (p=0.01). One in five of 100 mothers (20%) reported feeling stigmatized because of their child's epilepsy. Higher maternal stigma was associated with lower familial and community support (ORs: 65.2 and 34.7, respectively; both pepilepsy knowledge were associated with decreased maternal stigma (ORs: 0.8 and 0.7, respectively; both pepilepsy. As maternal stigma is associated with psychiatric morbidity, educating caregivers about epilepsy and screening for anxiety and depression are warranted. PMID:24214528

  7. Hospital Management of Severe Hypertriglyceridemia in Children. (United States)

    Valaiyapathi, Badhma; Ashraf, Ambika P


    Severe Hypertriglyceridemia (HTG), i.e., plasma triglyceride levels exceeding 1000 mg/dL, is one of the established causes of acute pancreatitis and severe abdominal pain. There are no established pediatric guidelines regarding treatment of children and adolescents with severe HTG. To review the pathophysiology and etiology of severe HTG in the pediatric age group, and to discuss management options. Severe HTG is usually due to deficient or absent Lipoprotein Lipase (LPL) activity, which can be due to primary genetic etiology or secondary causes triggering HTG in those with underlying genetic susceptibility. Hospitalization is indicated for patients with severe HTG who are symptomatic with abdominal pain or pancreatitis, in those with uncontrolled diabetes requiring insulin, or, in those with substantial elevations of plasma TG. Fasting followed by fat free diet until plasma TG declines to severe pancreatitis, shock or multi-organ failure. Medications such as fibrates and omega-3 fatty acids are not effective if LPL activity is absent or when plasma TG is >1800 mg/dL. Medications only have an adjunct role in the management. Low fat diet, lifestyle changes, weight loss, control of secondary causes, and patient education form the mainstay of management once the patient is discharged. Copyright© Bentham Science Publishers; For any queries, please email at

  8. Supporting staff in employment: the emotional wellbeing of staff in an NHS psychiatric hospital. (United States)

    Patterson, I D; Bell, J S


    The objective of this study was to assess the emotional wellbeing of a broad sample of NHS employees in a psychiatric setting; to seek their views on sources of distress; and to identify preferred ways of dealing with it. A cross-sectional postal survey, employing two questionnaires: GHQ-28, and a semi-structured questionnaire. These were sent to a nominal 50% sample (n = 599). The population was the staff of a large Scottish psychiatric service. A 47.9% response rate was achieved; 32.9% of respondents exceeded a cut-off score of four on the GHQ-28. Neither occupational, group nor gender effects were significant on this measure. The reporting of emotionally-distressing problems affecting their performance was found to be more common amongst doctors; males, overall, showed a non-significant trend towards having been affected more than females by such problems; and older staff (above 45) were affected significantly more often than younger staff. Almost a third of staff were unaware of the availability of an internal organisational resource (the Occupational Health service). NHS Trusts should ensure the culture at work is appropriate from a preventative point of view and be aware that factors outwith the workplace can affect employees emotional wellbeing and performance. Preventative and supportive measures to minimise psychological distress in the workforce should be considered; the Scottish Needs Assessment Programme: Mental Health in the Workplace offers useful guidance.

  9. Critical Cases Faced by Mental Health Nurses and Assistant Nurses in Psychiatric Hospitals in Greece

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    Evmorfia Koukia


    Full Text Available Background: Psychiatric Nurses and nurses’ assistants working in an inpatient unit experience a significant number of critical cases. A small number of studies have explored which patients’ problems nurses perceive as ‘critical case or incident’ and particularly which interventions they choose. Aim: The aim of the research was 1. To identify the clinical problems that mental health nurses and assistant nurses characterize as critical 2. To report the main nursing interventions 3. To investigate the main person involved in the critical incident. Material-Method: Critical incident technique was used as a method of data collection. Content analysis was carried out in order nurses’ information to be categorized into subcategories. The sample consisted of 35 mental health nurses and nurses’ assistants who work in psychiatric acute inpatient wards.Results: Nurses identified ten types of critical incidents. They noted violence (verbal, physical by patients and psychotic symptoms to be the most critical situations. Nurses were the main person involved in these incidents. The study also described eight nursing interventions used by nurses when faced with critical events. Conclusions: The findings indicated that mental health nurses and assistant nurses working in acute inpatient wards are called to confront a variety of critical incidents in their every day practice. Further research is necessary to identify in-depth nursing interventions and decision-making used in these situations.

  10. Anxiety symptoms in crack cocaine and inhalant users admitted to a psychiatric hospital in southern Brazil. (United States)

    Zubaran, Carlos; Foresti, Katia; Thorell, Mariana Rossi; Franceschini, Paulo Roberto


    The occurrence of psychiatric comorbidity among individuals with crack or inhalant dependence is frequently observed. The objective of this study was to investigate anxiety symptoms among crack cocaine and inhalant users in southern Brazil. The study investigated two groups of volunteers of equal size (n=50): one group consisted of crack cocaine users, and the other group consisted of inhalant users. Research volunteers completed the Portuguese versions of the State-Trait Anxiety Inventory (STAI), Hamilton Anxiety Rating Scale (HAM-A), and Self-Report Questionnaire (SRQ). Both crack and inhalant users experience significant symptoms of anxiety. Inhalant users presented significantly more anxiety symptoms than crack users according to the HAM-A questionnaire only. In contrast to the results of the HAM-A, the STAI failed to demonstrate a significant difference between the two groups of substance users. SRQ scores revealed that crack and inhalants users had significant degrees of morbidity. A significant difference regarding anxiety symptomatology, especially state anxiety, was observed among inhalant and crack users. Anxiety and overall mental psychopathology were significantly correlated in this sample. The results indicate that screening initiatives to detect anxiety and additional psychiatric comorbidities among crack and inhalant users are feasible and relevant. Copyright © 2013 Elsevier Editora Ltda. All rights reserved.

  11. Psychiatric disorders and psychiatric consultation in a general hospital: a case- control study Transtornos psiquiátricos e solicitações de interconsulta psiquiátrica em hospital geral: um estudo de caso controle

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    Sumaia Inaty Smaira


    Full Text Available INTRODUCTION: Psychiatric consultation (PC has been considered an efficient tool to develop research, to track and to give assistance benefiting patients, health professionals and the institution. However, it has not been much used in Brazil. Although 30 to 50% of general hospital (GH inpatients may present a psychiatric disorder, only 1 to 12% of them are referred to assessment. The aims of this study were: to assess mental disorders in a GH; to identify which of these patients are sent to psychiatric care; to verify alleged reasons for referral to psychiatric consultation, and to examine the relationship between PC and psychiatric learning (during medical school and residence. METHODS: A case-control patient study was conducted (47 cases and 94 controls to analyze in detail the following variables: socio-demographic; clinical; degree of information (about the disease and diagnostic/therapeutic procedures, and relationship between patient and health team. Psychiatric diagnoses were made according to the ICD-10 criteria. The Self Report Questionnaire (SRQ, the CAGE and Brief Psychiatric Rating Scale (BPRS were used as well as a specifically designed questionnaire to collect clinical and demographic data. RESULTS: Behavioral alterations, either of elation or of depression, were the main for requesting a PC ; 95.8% of the cases and 27.7% of the controls had a mental disorder. Organic mental disorders and alcohol-related disorders were the most frequent diagnoses in group I (cases, while anxiety, depressive and alcohol-related disorders were predominant in group II (controls. Control group patients were better informed and more able to establish an appropriate relationship with the health team than case patients. The logistic regression showed CAGE-positive patients having 12.85 times greater risk of being referred to PC, followed by unemployed patients (2.44 times more PC referrals. DISCUSSION: The SRQ and CAGE were quite useful in the screening

  12. Association of Healthy Food Intake with Psychiatric Distress in Children and Adolescents: the CASPIAN-IV study

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    Hoda Zahedi


    Full Text Available Background: Healthy dietary habits are known as a key factor for improving brain functions and cognitive ability in children and adolescents. The goal of this study was to evaluate the association of healthy food consumption with mental health in Iranian children and adolescents.Materials and Methods: Data were obtained from the fourth national school-based surveillance survey entitled CASPIAN-IV study. In this study, 14880 children and adolescents aged 6-18 years were selected by multistage, cluster sampling method from rural and urban areas. The students and their parents completed two sets of questionnaires. The psychiatric distress included depression, worry, insomnia, anxiety, aggression, confusion, and worthless and the violent behaviors comprised of physical fight, victim and bully. The healthy foods included fresh fruits, dried fruits, vegetables and dairy products.Results: The participants include 13,486 students from elementary, intermediate and high school degree. The prevalence of psychiatric distress was significantly higher among high school students, while violent behaviors were more prevalent in the middle school students. According to the multivariate model (model IV, the risk of psychiatric distress was significantly lower in students with daily consumption of fresh fruits, vegetables and milk. In addition, those with daily consumption of vegetables and milk had significantly lower risk for violent behaviors.Conclusion: Consumption of healthy foods may reduce the risk of psychiatric distress and violent behaviors. Therefore, in addition to its benefits, increasing healthy food consumption among children and adolescents can be useful in preventing mental health disorders.

  13. Hospital admission and mortality rates in anorexia nervosa: experience from an integrated medical-psychiatric outpatient treatment. (United States)

    De Filippo, E; Signorini, A; Bracale, R; Pasanisi, F; Contaldo, F


    To evaluate the effectiveness of an integrated medical-psychiatric treatment of major eating disorders. Historical cohort study. Outpatient Unit for Protein Energy Malnutrition of the Department of Clinical and Experimental Medicine, "Federico II" University of Naples, time of study: January 1994 to December 1997 PARTICIPANTS: 147 female patients with restrictive or bulimic anorexia nervosa (mean age 19.8 +/- 13.7, BMI 14.7 +/- 2.1 Kg/m2) consecutively attending the outpatient unit between January 1994 and December 1997. Hospitalization and mortality rates were evaluated up to Jan 1999 with a minimum follow-up of 18 months. There were 23 admissions to the Clinical Nutrition ward for 19 patients (i.e. 12.9%) mostly due to severe protein energy malnutrition, and 2 deaths, only 1 strictly related to anorexia (mortality rate 0.7%). Integrated outpatient medical-psychiatric treatment for major eating disorders is an effective and inexpensive procedure that reduces mortality and admissions due to medical complications in the medium term.

  14. Psychiatric Hospital Workers' Exposure to Disturbing Patient Behavior and Its Relation to Post-Traumatic Stress Disorder Symptoms. (United States)

    Hilton, N Zoe; Ham, Elke; Dretzkat, Alecia


    Background About 10% of health-care workers experience post-traumatic stress disorder (PTSD); the rate is higher among workers exposed to aggression. Objective We extended this research by examining PTSD and exposure to violence and other disturbing patient behaviors, among nursing and other staff on inpatient psychiatric units (forensic and nonforensic). Method Surveys were completed online or in person by 219 respondents (30% response rate). Participants indicated which disturbing behaviors they had been exposed to and ranked the worst three behaviors in each of three categories: most unpleasant to work with, most disruptive to patient care, and most upsetting. Most ( n = 192) also completed the PTSD Checklist (PCL). Results All but two participants reported exposure to at least one disturbing behavior and ranked violence, feces smearing, and screaming constantly as the worst experiences overall. On the PCL, 24% scored above the cut off for probable PTSD. Nursing staff had the highest scores, with no difference between nursing staff on forensic versus nonforensic units. PCL score showed a small positive correlation with the number of disturbing behaviors experienced. Conclusion PTSD symptoms are common among psychiatric hospital workers, not only nursing staff. Future research using clinical assessment, longitudinal designs, and measurement of nonviolent disturbing behaviors is recommended.

  15. Work engagement supports nurse workforce stability and quality of care: nursing team-level analysis in psychiatric hospitals. (United States)

    Van Bogaert, P; Wouters, K; Willems, R; Mondelaers, M; Clarke, S


    Research in healthcare settings reveals important links between work environment factors, burnout and organizational outcomes. Recently, research focuses on work engagement, the opposite (positive) pole from burnout. The current study investigated the relationship of nurse practice environment aspects and work engagement (vigour, dedication and absorption) to job outcomes and nurse-reported quality of care variables within teams using a multilevel design in psychiatric inpatient settings. Validated survey instruments were used in a cross-sectional design. Team-level analyses were performed with staff members (n = 357) from 32 clinical units in two psychiatric hospitals in Belgium. Favourable nurse practice environment aspects were associated with work engagement dimensions, and in turn work engagement was associated with job satisfaction, intention to stay in the profession and favourable nurse-reported quality of care variables. The strongest multivariate models suggested that dedication predicted positive job outcomes whereas nurse management predicted perceptions of quality of care. In addition, reports of quality of care by the interdisciplinary team were predicted by dedication, absorption, nurse-physician relations and nurse management. The study findings suggest that differences in vigour, dedication and absorption across teams associated with practice environment characteristics impact nurse job satisfaction, intention to stay and perceptions of quality of care. © 2012 John Wiley & Sons Ltd.

  16. Treatment received, satisfaction with health care services, and psychiatric symptoms 3 months after hospitalization for self-poisoning

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    Grimholt Tine K


    Full Text Available Abstract Background Patients who self-poison have high repetition and high mortality rates. Therefore, appropriate follow-up is important. The aims of the present work were to study treatment received, satisfaction with health care services, and psychiatric symptoms after hospitalization for self-poisoning. Methods A cohort of patients who self-poisoned (n = 867 over a period of 1 year received a questionnaire 3 months after discharge. The Beck Depression Inventory (BDI, Beck Hopelessness Scale (BHS, and Generalized Self-Efficacy Scale (GSE were used. The participation rate was 28% (n = 242; mean age, 41 years; 66% females. Results Although only 14% of patients were registered without follow-up referrals at discharge, 41% reported no such measures. Overall, satisfaction with treatment was fairly good, although 29% of patients waited more than 3 weeks for their first appointment. A total of 22% reported repeated self-poisoning and 17% cutting. The mean BDI and BHS scores were 23.3 and 10.1, respectively (both moderate to severe. The GSE score was 25.2. BDI score was 25.6 among patients with suicide attempts, 24.9 for appeals, and 20.1 for substance-use-related poisonings. Conclusions Despite plans for follow-up, many patients reported that they did not receive any. The reported frequency of psychiatric symptoms and self-harm behavior indicate that a more active follow-up is needed.

  17. Stigma, Social Structure, and the Biomedical Framework: Exploring the Stigma Experiences of Inpatient Service Users in Two Belgian Psychiatric Hospitals. (United States)

    Sercu, Charlotte; Bracke, Piet


    The study discusses the stigma experiences of service users in mental health care, within the debate on the role of the biomedical framework for mental health care and power relations in society. Interview data of inpatient users ( n = 42) and care providers ( n = 43) from two Belgian psychiatric hospitals were analyzed using a constructivist grounded theory approach: Findings offer insight into how stigma experiences are affected by social structure. Stigma seemed to be related to the relation between care providers and service users their social position. The concept "mental health literacy" is used to frame this finding. In paying attention to the specific cultural and normative context, which influences the relationship between mental health literacy and stigma, it is further possible to cast some light on the meaning of the biomedical model for the construction and maintenance of power relations in mental health care and broader society.

  18. Epidemiology of Serious Mental Illness in Malta - Consequences for developing a new psychiatric hospital and community psychiatry. (United States)

    Grech, Anton


    Mental Health Services in Malta are presently at crossroads, because they are in the stage of increasing and strengthening the community services and considering closing the main psychiatric inpatient facility and replacing it with a new hospital. For proper planning of such changes, and ideal approach is that of basing these plans on results of population based epidemiological findings on rate of mental illness and required care. Such studies are strongly recommended, and this approach has already been used in Malta a couple of years ago prior to establishing inpatient care for Eating Disorders. In absence of such studies, this paper proposes ways how to use findings from available research and data to use as basis for such proper service plans.

  19. Screening for nutritional risk in hospitalized children with liver disease. (United States)

    Song, Tiantian; Mu, Ying; Gong, Xue; Ma, Wenyan; Li, Li


    Malnutrition is a major contributor to morbidity and mortality from pediatric liver disease. We investigated the prevalence of both malnutrition and high nutritional risk in hospitalized children with liver disease as well as the rate of in-hospital nutritional support. A total of 2,874 hospitalized children and adolescents with liver disease aged 1 to 17 years (inclusive) were enrolled. Malnutrition was screened by anthropometric measures (height-for-age, weight-for-height, weight-for-age, and BMI- for-age z-scores). The Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) was used to evaluate nutritional risk status. Nutrition markers in blood, rate of nutritional support, length of hospital stay, and hospital fees were compared among nutritional risk groups. The overall prevalence of malnutrition was 38.6%. About 20.0% of children had high nutritional risk, and prevalence of malnutrition was markedly greater in the high nutritional risk group compared with the moderate risk group (67.9% vs 31.3%). Serum albumin and prealbumin differed significantly between high and moderate risk groups (pnutritional risk and 3.5% with moderate nutritional risk received nutrition support during hospitalization. Children with high nutritional risk had longer hospital stays and greater hospital costs (pnutritional risk is also prevalent at admission. Albumin and prealbumin are sensitive markers for distinguishing nutritional risk groups. High nutritional risk prolongs length of stay and increases hospital costs. The nutritional support rate is still low and requires standardization.

  20. The effects of daily weather variables on psychosis admissions to psychiatric hospitals.

    LENUS (Irish Health Repository)

    McWilliams, Stephen


    Several studies have noted seasonal variations in admission rates of patients with psychotic illnesses. However, the changeable daily meteorological patterns within seasons have never been examined in any great depth in the context of admission rates. A handful of small studies have posed interesting questions regarding a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (especially heat waves) and sunshine. In this study, we used simple non-parametric testing and more complex ARIMA and time-series regression analysis to examine whether daily meteorological patterns (wind speed and direction, barometric pressure, rainfall, sunshine, sunlight and temperature) exert an influence on admission rates for psychotic disorders across 12 regions in Ireland. Although there were some weak but interesting trends for temperature, barometric pressure and sunshine, the meteorological patterns ultimately did not exert a clinically significant influence over admissions for psychosis. Further analysis is needed.

  1. Neurasthenia, Generalized Anxiety Disorder, and the Medicalization of Worry in a Vietnamese Psychiatric Hospital. (United States)

    Tran, Allen L


    This article examines two forms of the medicalization of worry in an outpatient psychiatric clinic in Ho Chi Minh City, Vietnam. Biomedical psychiatrists understand patients' symptoms as manifestations of the excessive worry associated with generalized anxiety disorder (GAD). Drawing on an ethnopsychology of emotion that reflects increasingly popular models of neoliberal selfhood, these psychiatrists encourage patients to frame psychic distress in terms of private feelings to address the conditions in their lives that lead to chronic anxiety. However, most patients attribute their symptoms to neurasthenia instead of GAD. Differences between doctors' and patients' explanatory models are not just rooted in their understandings of illness but also in their respective conceptualizations of worry in terms of emotion and sentiment. Patients with neurasthenia reject doctors' attempts to psychologize distress and maintain a model of worry that supports a sense of moral selfhood based on notions of obligation and sacrifice. © 2016 by the American Anthropological Association.

  2. The effects of daily weather variables on psychosis admissions to psychiatric hospitals (United States)

    McWilliams, Stephen; Kinsella, Anthony; O'Callaghan, Eadbhard


    Several studies have noted seasonal variations in admission rates of patients with psychotic illnesses. However, the changeable daily meteorological patterns within seasons have never been examined in any great depth in the context of admission rates. A handful of small studies have posed interesting questions regarding a potential link between psychiatric admission rates and meteorological variables such as environmental temperature (especially heat waves) and sunshine. In this study, we used simple non-parametric testing and more complex ARIMA and time-series regression analysis to examine whether daily meteorological patterns (wind speed and direction, barometric pressure, rainfall, sunshine, sunlight and temperature) exert an influence on admission rates for psychotic disorders across 12 regions in Ireland. Although there were some weak but interesting trends for temperature, barometric pressure and sunshine, the meteorological patterns ultimately did not exert a clinically significant influence over admissions for psychosis. Further analysis is needed.

  3. Children's Hospitals' Solutions for Patient Safety Collaborative Impact on Hospital-Acquired Harm. (United States)

    Lyren, Anne; Brilli, Richard J; Zieker, Karen; Marino, Miguel; Muething, Stephen; Sharek, Paul J


    To determine if an improvement collaborative of 33 children's hospitals focused on reliable best practice implementation and culture of safety improvements can reduce hospital-acquired conditions (HACs) and serious safety events (SSEs). A 3-year prospective cohort study design with a 12-month historical control population was completed by the Children's Hospitals' Solutions for Patient Safety collaborative. Identification and dissemination of best practices related to 9 HACs and SSE reduction focused on key process and culture of safety improvements. Individual hospital improvement teams leveraged the resources of a large, structured children's hospital collaborative using electronic, virtual, and in-person interactions. Thirty-three children's hospitals from across the United States volunteered to be part of the Children's Hospitals' Solutions for Patient Safety collaborative. Thirty-two met all the data submission eligibility requirements for the HAC improvement objective of this study, and 21 participated in the high-reliability culture work aimed at reducing SSEs. Significant harm reduction occurred in 8 of 9 common HACs (range 9%-71%; P collaborative dedicated to implementing HAC-related best-practice prevention bundles and culture of safety interventions designed to increase the use of high-reliability organization practices resulted in significant HAC and SSE reductions. Structured collaboration and rapid sharing of evidence-based practices and tools are effective approaches to decreasing hospital-acquired harm. Copyright © 2017 by the American Academy of Pediatrics.

  4. Children in the hospital: elements of quality in drawings. (United States)

    Pelander, Tiina; Lehtonen, Kimmo; Leino-Kilpi, Helena


    Not much is known about how children perceive the quality of care that they receive in hospitals. This study set out to describe elements of quality in children's drawings of an ideal hospital. Thirty-five drawings were collected from children aged between 4 and 11 years during their stay in a university hospital in Finland. They were coded using the method of content analysis. The two main categories extracted from the analysis were the environment and the people of their ideal hospital. The emphasis was on the environment; patients, parents, and nurses appeared less frequently in the drawings. The findings showed that children are capable of offering valuable insights into the elements of quality through the medium of drawing.

  5. Patterns of referral to Red Cross War Memorial Children's Hospital ...

    African Journals Online (AJOL)

    Memorial Children's Hospital, K1ipfontein Road, Rondebosch, 7700 RSA,. Accepted 10 Apt 1990, ... of every patient referred in the study period, or recorded the folder number of ..... Council for providing a short-term grant; Mariah Jacobs of the.

  6. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, H; Schmiegelow, K


    , as it decreased the strain on the family and the ill child, maintained normality and an ordinary everyday life and fulfilled the need for safety and security. According to family members of children with cancer, hospital-based home care support enhanced their quality of life during the child's cancer trajectory......The study aims to describe the experiences of a hospital-based home care programme in the families of children with cancer. Fourteen parents, representing 10 families, were interviewed about their experiences of a hospital-based home care programme during a 4-month period in 2009 at a university...... hospital in Denmark. Five children participated in all or part of the interview. The interviews were transcribed verbatim and analysed using qualitative content analysis. The findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment...

  7. [Children of mentally ill parents: the impact of parental psychiatric diagnosis, comorbidity, severity and chronicity on the well-being of children]. (United States)

    Wiegand-Grefe, S; Geers, P; Petermann, F; Plass, A


    Children of mentally ill parents are known as a high-risk population for the development of psychological disturbances. In this study, the psychiatric diagnoses, the severity and chronicity and the comorbidity of a parental mental illness as well as the non-specific parameters were examined in terms of their influence on the children's mental health. n = 62 children of psychiatric inpatients were examined regarding their psychic symptomatology, assessed with the CBCL-Parent Report Form. The psychiatric ICD-10 diagnoses and comorbidities as well as the severity (CGI) of the mentally ill parents were collected from psychiatric assessment forms. Children of parents with personality disorders (PD) are evaluated as highly affected by their parents, regardless of whether the PD is the primary or the comorbid diagnosis. Children of parents suffering from addictive disorders are seen as the least affected by their parents. Overall, children of parents with multiple diagnoses tend to be rated as more affected. Severity of illness and chronicity do not have a considerable impact on the children's development of mental health problems. Strikingly, children with a high length of exposure to a parental illness are psychologically less affected than children with shorter times of exposure. Thus, children possibly acquire effective coping mechanisms with increasing time of exposure. The results reveal the necessity of preventive programmes, especially in case of personality disorders. In addition the necessity for external assessment of the children becomes clear, especially in those cases where the parents exhibit a poor acceptance of their disease. © Georg Thieme Verlag KG Stuttgart · New York.

  8. The effect of educational interventions with siblings of hospitalized children. (United States)

    Gursky, Barbara


    Research has demonstrated that siblings of chronically ill children can experience significant emotional and behavior changes; however, few studies have looked at the specific impact of pediatric hospitalization on the nonhospitalized child. Studies also indicate that children who receive age-appropriate information are better equipped to handle the stress and anxiety often associated with hospitalization.This study explored whether siblings of hospitalized children who received educational interventions had lower anxiety levels compared to siblings who did not receive interventions. A pretest-posttest experimental design was used with 50 subjects, ages 6-17 years, recruited from a children's hospital within a university medical center. Subjects were matched according to age, sex, and race, with 25 siblings each in the experimental and control groups. Siblings assigned to the experimental group received interventions from a standardized educational intervention protocol developed by the researcher. Interventions focused on teaching the sibling about hospitalization, illness or injury, and treatment for the patient, based on cognitive stages of development. All interventions were conducted by child life specialists on staff at the hospital with extensive training and experience in preparation and procedural teaching. Results shows that siblings who received educational interventions had significantly lower anxiety levels after interventions, compared to siblings who did not receive interventions. These findings have significant impact on children's health care and supporting family needs when a child is hospitalized.

  9. Cancer in Children at El Obeid Hospital, Western Sudan. | Doumi ...

    African Journals Online (AJOL)

    Conclusions: Cancers in children were seen at Western Sudan, and cases admitted to hospital only reflect the tip of the iceberg as many cases were directly referred to Oncology Hospitals. Establishment of a local radiation and isotopes centre is needed in this part of the country to provide oncology services and to integrate ...

  10. Research improves hospitals' approach to children's pain in Thailand

    International Development Research Centre (IDRC) Digital Library (Canada)

    Research that has enabled hospitals in Thailand to better treat children's pain ... requires nurses and doctors to have specialized training and more time to assess a ... having to stay longer in the hospital, or creating problems for their parents. ... pain numerically — on a scale of 1 to 10 — as is standard practice for adults.

  11. [Acute ethanol intoxication among children and adolescents. A retrospective analysis of 173 patients admitted to a university children hospital]. (United States)

    Schöberl, S; Nickel, P; Schmutzer, G; Siekmeyer, W; Kiess, W


    In the last time the alcohol consumption among children and adolescents is a big theme in all kind of media. The ethanol consumption among children and adolescents has risen during the last years, but also new hazardous drinking patterns like "binge-drinking" are increasing. These drinking episodes are responsible for many hospital presentations of children and adolescents with acute ethanol intoxication. This study is a retrospective analysis of 173 patients admitted to the university children hospital of Leipzig due to acute ethanol intoxication during the period 1998-2004. Investigated parameters were: socio-demographic factors, clinical presentation and management as well as quantity and type of alcohol. During the years 1998-2004 the rate of alcohol intoxicated patients in this study increased, from 1998-2003 at about 171.4%. Totally 173 patients with an average age of 14.5 years were admitted to the university children hospital. There were significantly more boys than girls. The mean blood alcohol concentration of these patients was 1.77%. Some of the patients had severe symptoms. 62 were unconscious, 2 were in coma and at least 3 patients had to be ventilated. A difference between socioeconomic groups could be observed by comparing the different school types. 44.8% of the patients went to the middle school. Furthermore 17 patients of this study had mental disorders or psychosocial problems and were therefore in psychological or psychiatric treatment. In this study a significant influence of social classes or psychosocial problems on alcohol consumption such as binge-drinking leading to acute ethanol intoxication could not be found. Alarming is the increasing number of ethanol intoxicated patients, the young age, the high measured blood ethanol concentrations and the severe symptoms of these patients. This is the reason why early and intensive prevention strategies are required.

  12. Services Use of Children and Adolescents before Admission to Psychiatric Inpatient Care. (United States)

    Zechmeister-Koss, Ingrid; Winkler, Roman; Fritz, Corinna; Thun-Hohenstein, Leonhard; Tuechler, Heinz


    Although 20% of children and adolescents in Europe suffer from overt mental health problems, their illness-related service utilisation is often unknown. If at all, existing research has only addressed the health care sector while services requirements in mental health care go far beyond the health care system, including the social, the educational and the criminal justice system. This paper aims at describing the service contact patterns of children and adolescents within and outside the health care sector before they are admitted to a child and adolescent mental health hospital. Additionally, we evaluate the private out-of-pocket payments that occur for primary carers. A cohort of consecutive admissions to a child and adolescent hospital in Austria was prospectively analysed. We collected data on service use and out-of-pocket expenses before hospital admission from primary carers through face-to-face interviews using an adapted version of the European Child and Adolescent Mental Health Service Receipt Inventory (EU-CAMHSRI). Clinical data came from validated questionnaires (CBCL, YSR) and from the anamnestic documentation. Ninety percent from a cohort of 441 patients had some contact with services or took medication before they were admitted to hospital. Most often, services in the health care outpatient setting were used. Outside of the health care system, support in school, as well as counselling services, were used most frequently, whereas the persons hardly sought support in living or employment. Roughly 32,400 per 100 patients was spent privately, yet these out-of pocket expenses were very unevenly distributed. Service use and out-of-pocket spending increased with social status and were gender-specific. The more severe external behaviour symptoms were, the more non-health care services were used. Mentally ill children and adolescents use a broad range of services across sectors before admission to hospital. Service use is associated with specific symptoms of

  13. Human rights abuses at a psychiatric hospital in KwaZulu-Natal

    African Journals Online (AJOL)

    inspection, the national Minister of Health addressed the hospital community. .... interviews supporting allegations of staff coming to work under the influence of alcohol .... maintain a balance between carrying out their duty of care and getting ... Although mental health impacts on all aspects of life in the country, mental health ...

  14. Inpatient Psychiatric Facility Follow-Up After Hospitalization for Mental Illness (FUH) Quality Measure Data – by Facility (United States)

    U.S. Department of Health & Human Services — Psychiatric facilities that are eligible for the Inpatient Psychiatric Facility Quality Reporting (IPFQR) program are required to meet all program requirements,...

  15. Inpatient Psychiatric Facility Follow-Up After Hospitalization for Mental Illness (FUH) Quality Measure Data – by State (United States)

    U.S. Department of Health & Human Services — Psychiatric facilities that are eligible for the Inpatient Psychiatric Facility Quality Reporting (IPFQR) program are required to meet all program requirements,...

  16. Inpatient Psychiatric Facility Follow-Up After Hospitalization for Mental Illness (FUH) Quality Measure Data – National (United States)

    U.S. Department of Health & Human Services — Psychiatric facilities that are eligible for the Inpatient Psychiatric Facility Quality Reporting (IPFQR) program are required to meet all program requirements,...

  17. Premature discharge of children from hospital admission at Ahmadu ...

    African Journals Online (AJOL)

    Introduction: Leaving hospital care prematurely could threaten the healthy survival of and expose children to a risk of harmful alternatives. It is also a concern and a challenge to healthcare providers and the health system. A better understanding of its characteristic could help mitigate the impact on children. Objective: To ...

  18. Hospitious Adoption: How Hospitality Empowers Children and Transforms Adoption (United States)

    Gritter, James L.


    Building on previous books by the author, "Hospitious Adoption: How Hospitality Empowers Children and Transforms Adoption" examines the next step after open adoption. Gritter takes the approach that practicing goodwill, respect, and courage within the realm of adoption makes the process move smoother and enriches children's lives. Following a…

  19. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Helena; Hallström, Inger; Kjaergaard, Hanne


    Hospital-based home care (HBHC) is widely applied in Pediatric Oncology. We reviewed the potential effect of HBHC on children's physical health and risk of adverse events, parental and child satisfaction, quality of life of children and their parents, and costs. A search of PubMed, CINAHL...

  20. [Requirements and reality of the German ordinance for staff in psychiatric hospitals: results of a multi-moment study on a psychiatric ward for acute psychosis]. (United States)

    Hoffmann, M; Rieger, W


    The regulation of personnel in psychiatry (PsychPV) stipulates time requirements for all relevant activities in inpatient psychiatric care as a function of the degree of disease severity of the patients treated. The demands made on employees in psychiatric care have risen substantially in recent years. Our aim was to examine whether the standard requirements of the PsychPV cover the actual work load. With the help of a multi-moment study on a general psychiatric ward we examined which activities are performed to which extent by doctors and nurses. Physicians must spend an inordinate amount of time on documentation and the nursing staff on non-patient-related tasks. The causes are the higher number of external requests and higher clinical documentation requirements. This time is lost to the direct patient contact. The PsychPV requirements must be urgently adapted so that more time is again available for the direct patient contact.

  1. Dysfunctional personality disorder beliefs and lifetime suicide attempts among psychiatrically hospitalized military personnel. (United States)

    Ghahramanlou-Holloway, Marjan; Lee-Tauler, Su Yeon; LaCroix, Jessica M; Kauten, Rebecca; Perera, Kanchana; Chen, Rusan; Weaver, Jennifer; Soumoff, Alyssa


    Personality disorders (PDs) are associated with an increased risk for suicide. However, the association between PDs and suicide risk has not been examined among military personnel. This study evaluated whether endorsement of different PD dysfunctional beliefs was associated with lifetime suicide attempt status. Cross-sectional data were collected during the baseline phase of a randomized controlled trial, evaluating the efficacy of an inpatient cognitive behavior therapy protocol for the prevention of suicide. Participants (N = 185) were military service members admitted for inpatient psychiatric care following a suicide-related event. MANOVA and Poisson regression evaluated the association between each type of PD dysfunctional belief and the number of suicide attempts. Service members' PBQ subscale scores for borderline (p = 0.049) and histrionic PD dysfunctional beliefs (p = 0.034) significantly differed across those with suicide ideation only, single attempt, and multiple attempts. Upon further analysis, histrionic PD dysfunctional beliefs scores were significantly higher among those with multiple suicide attempts than those with single attempts. One point increase of dependent (Incidence Risk Ratio = 1.04, p = 0.009), narcissistic (IRR = 1.07, p histrionic beliefs as part of a psychosocial intervention will be useful. Copyright © 2018. Published by Elsevier Inc.

  2. Lean Methodology Reduces Inappropriate Use of Antipsychotics for Agitation at a Psychiatric Hospital. (United States)

    Goga, Joshana K; Depaolo, Antonio; Khushalani, Sunil; Walters, J Ken; Roca, Robert; Zisselman, Marc; Borleis, Christopher


    To Evaluate the Effects of Applying Lean Methodology-Improving Quality Increasing Efficiency by Eliminating Waste and Reducing Costs-An Approach To Decrease the Prescribing Frequency of Antipsychotics for The Indication of Agitation. Historically Controlled Study. Bheppard Pratt Health System is the Largest Private Provider of Psychiatric Care in Maryland With a Total Bed Capacity of 300. There Were 4 337 Patient Days From November 1 2012 to October 31 2013 on the Dementia Unit. All Patients Admitted on the Dementia Unit Were 65 Years of Age and Older with a Primary Diagnosis of Dementia. our Multidisciplinary Team Used Lean Methodology to Identify the Root Causes and Interventions Necessary to Reduce Inappropriate Antipsychotic Use. The Primary Outcome Was Rate of Inappropriately Indicating Agitation as the Rationale When Prescribing Antipsychotic Medications. There Was a 90% (P Agitation. The Lean Methodology Interventions Led To A 90% (P Agitation and a 10% Rate Reduction in Overall Antipsychotic Prescribing. Key Words: Agitation Alzheimer's Antipsychotics Behavioral and Psychological Symptoms of Dementia Centers For Medicare & Medicaid Services Dementia Root-cause Analysis. BPSD = Behavioral and Psychological Symptoms of Dementia CATIE-AD = Clinical Antipsychotic Trials of Intervention Effectiveness in Alzheimer's Disease EMR = Electronic Medical Records GAO = Government Accountability Office GNCIS = Geriatric Neuropsychiatric Clinical Indicator Scale.

  3. Research Mentorship Program (RMP to Enhance the Research Productivity in a Psychiatric Hospital: First Report

    Directory of Open Access Journals (Sweden)

    Zhila Afshar


    Full Text Available Background: Despite rapid movement in student research in recent years, there is still little evidence that shows the impact of students' activities on research productivity. In this RMP (Research Mentorship Program, we have tried to create a link between medical students with little experience and the professors in the field of medicine. This research was led by a group of medical students who are highly experienced in research. The aim of this study has been to evaluate the impact of the RMP on research productivity.Methods: The Research Mentorship Program began in July 2009 and the program continued for 6 months. After that initial period, the results were evaluated following another 18 months. Some of the interventions included: introducing the RMP to the students; student meetings of the RMP; meetings with the professors; designing a psychiatric history and mental status examination checklist; and research workshops.Results: In eleven semi years, the research productivity scores were evaluated, including eight semi years before interventions and 3 semi years after it. The results show a significant increase in the research productivity score after the RMP in comparison to the research productivity score before it (P-value=0.047. The mean RPS before the RMP was 16.56±7.30 and the score changed to 28.16±7.94 after the RMP.Conclusions: This study shows that with suitable interventions the student researcher’s have the potential to increase research productivity.

  4. Impact of a smoke-free policy in a large psychiatric hospital on staff attitudes and patient behavior. (United States)

    Voci, Sabrina; Bondy, Susan; Zawertailo, Laurie; Walker, Louise; George, Tony P; Selby, Peter


    The objectives of this work were to examine changes over time in degree of staff support for the implementation of a smoke-free policy in Canada's largest public mental health and addiction teaching hospital and to assess the impact of the policy on patient behavior. Staff completed an anonymous survey, which assessed views toward the smoke-free policy and perceived change in patient behavior, 2-7 and 31-33 months after an indoor smoke-free policy was implemented (September 21, 2005). Objective indicators of patient behavior were also collected in the form of number of emergency code whites (aggressive behavior) and that of code reds (fire) called 1 year prior to and 2 years following policy implementation. Survey response rates were 19.0% (n=481) and 18.1% (n=500) at 2-7 and 31-33 months, respectively. The proportion of staff who supported the policy increased from pre-implementation (82.6%) to post-implementation (89.1%), and a high level of support was maintained 2 years after policy enactment (90.1%). The number of emergency codes did not significantly change after policy implementation, and staff did not perceive a change in most forms of patient behavior. A smoke-free policy can be implemented in a large psychiatric hospital with a high degree of support from staff and no substantial negative impact on patient behavior. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. Children and adolescents treated for post-traumatic stress disorder at the Free State Psychiatric Complex

    Directory of Open Access Journals (Sweden)

    F J W Calitz


    Full Text Available Background. Children and adolescents can develop post-traumatic stress disorder (PTSD after exposure to a range of traumatic events, including domestic, political or community violence, violent crime, physical and sexual abuse, hijacking, witnessing a violent crime and motor vehicle accidents. This is particularly critical given the substantial challenge that PTSD poses to the healthy physical, cognitive and emotional development of children and adolescents. Methods. The clinical records of 1 229 children (age 2 - 11 years and adolescents (age 12 - 18 years treated at the Child Mental Health Unit of the Free State Psychiatric Complex (FSPC were screened for the diagnosis of PTSD and analysed for the purpose of this study. Results. Forty-nine (4.0% of the children and adolescents treated at the unit were diagnosed with PTSD, of whom most were female (63.3%. Approximately 22% of the participants had comorbid major depressive disorder. The main traumatic event in both groups was witnessing the death of a close relative (32.7%, followed by sexual assault (25%, rape (25% and physical attack (10.2%. Associated stressors identified included problems at school (55.1%, isolation (39%, fear or anxiety (37%, problematic family relationships (29%, emotional (27% and physical (23% abuse, and lack of social support (23%. Most of the participants (59.2% received psychotherapy. Conclusions. Children and adolescents referred to the FSPC are also exposed to traumatic events which lead to the development of PTSD. The Free State is a sprawling province with remote areas where specialist services and facilities are limited. It is therefore recommended that preventive programmes, training opportunities and consultation services are implemented to identify and treat children and adolescents with PTSD. Schools with limited access to psychological services and large classrooms, impeding the diagnosis and treatment of PTSD specifically, face similar challenges

  6. Prevalence of psychiatric co-morbidity among patients attending dental OPD and the role of consultation-liaison psychiatry in dental practice in a tertiary care general hospital. (United States)

    Ray, Pradip K; Ray Bhattacharya, Sampa; Makhal, Manabendra; Majumder, Uttam; De, Shantanu; Ghosh, Subhankar


    Psychiatric co-morbidities are frequent among patients attending dental OPD, some of which go unrecognized and hence untreated. The present study has been carried out to detect the psychiatric co-morbidities among dental patients and determine the scope of consultation-liaison (C-L) psychiatry in a rural teaching hospital regarding comprehensive management of the patients. This cross-sectional, descriptive type study was conducted in a multi-speciality tertiary care teaching hospital in the northern part of West Bengal, India. One hundred patients attending the dental OPD were randomly included in the study and every patient was consecutively referred to psychiatry department for assessment, during the period from 1(st) November 2013 to 30(th) April 2014. All referred patients were clinically examined and psychiatric co-morbidity was assessed by the help of General Health Questionnaire (GHQ)-28 and Mental Status Examination. The data were subjected to statistical package for social sciences (SPSS), version 16, and statistically analyzed using Cross tab and Chi test. P psychiatric co-morbidity according to GHQ-28 total score. Sixty-eight patients were diagnosed to have mental disorder on mental status examination. Somatoform disorder (25%) was the commonest type of mental disorder, followed by mixed anxiety and depression (14%). This study has pointed the need for psychological examination of patients visiting dental specialty with unexplained physical symptoms. Such patients can be identified and treated, provided a psychiatric consultation service exists.

  7. An insight into frequency and predictors leading psychiatric patients to visit faith healers: A hospital-based cross-sectional survey, Karachi, Pakistan. (United States)

    Khoso, Aneeta; Soomro, Rafiq Ahmed; Quraishy, Ayesha Muquim; Khan, Hammad Ali; Ismail, Saba; Nazaz, Mehrunnisa; Younus, Sana; Zainab, Saima


    Psychiatric illnesses have recently escalated in numbers, with patients resorting to various forms of healthcare providers, including faith healers. This delays early psychiatric treatment, resulting in further mental health deterioration of the patient. Various factors impact the mode of treatment preferred by psychiatric patients. To determine the frequency of psychiatric patients visiting faith healers, presenting at the outpatient department of Liaquat National Hospital, Karachi, Pakistan, and to explore the predictors that direct them toward visiting faith healers. This cross-sectional survey was conducted using a semi-structured pre-tested questionnaire, employing a total of 219 male and female psychiatric patients. Patients were recruited through non-random consecutive sampling technique. SPSS 18 was used for statistical analysis. About 32% of the patients had visited a faith healer in their lifetime. Frequency of current visitors declined; the most frequent reason being stated was no relief from their treatment. Students, patients of upper middle class and those coming for initial visit to a psychiatrist were more likely to visit a faith healer. Patients who knew of someone previously visiting a faith healer were less likely to have visited a faith healer. This study highlights the importance of a multisectoral approach to dealing with psychiatric patients to help in bridging the treatment gap in mental health.

  8. The role of punishment in the in-patient treatment of psychiatrically disturbed children. (United States)

    Alderton, H R


    The role of punishment in the psychiatric in-patient treatment of nonpsychotic latency-age children with behaviourdisorders is discussed. Punishment is defined as the removal of previously existing positive reinforcers or the administration of aversive stimuli. Ways in which appropriate social behaviour may be acquired are briefly considered. These include reinforcement of desirable responses, non-reinforcement of undesirable responses, reinforcement of incompatible responses and imitative learning. The reported effects of punishment on behaviour are reviewed and the psychological functions necessary before punishment can have the intended effects considered. For seriously disturbed children punishment is ineffective as a treatment technique. It reinforces pathological perceptions of self and adults even if it successfully suppresses behaviour. The frame of reference of the seriously disturbed child contraindicates the removal of positive reinforcers and verbal as well as physical aversive stimuli. Controls and punishments must be clearly distinguished. Controls continue only as long as the behaviour towards which they are directed. They do not include the deliberate establishment of an unpleasant state by the adult as a result of particular behaviour. Control techniques such as removal from a group may be necessary but when possible should be avoided in favour of techniques less likely to be misinterpreted. Avoidance of punishment in treatment makes even more important explicit expectations and provision of realistic controls. Natural laws may result in unpleasant experiences as an unavoidable result of certain behaviour. By definition such results can never be imposed by the adult. Treatment considerations may necessitate that the child be protected from the results of his actions. Avoidance of punishment requires a higher staff/child ratio, more mature and better trained staff. Sometimes children have previously been deterred from serious community acting out

  9. Acute admissions among immigrants and asylum seekers to a psychiatric hospital in Norway. (United States)

    Iversen, Valentina Cabral; Morken, Gunnar


    The purpose of the present study was to compare admission rates, including admission by coercion, length of hospital stay and diagnosis among immigrants, asylum seekers and Norwegian-born patients. All admissions (n=3053) to Østmarka Hospital during the period 1995-2000 were examined. A sample including all immigrants (94) and asylum seekers (39) as well as a control group of 133 Norwegians was analysed. Immigrants and Norwegians had the same relative risk of admission (1.07). The relative risk of admission was higher for asylum seekers compared to Norwegians (8.84). There were differences in the diagnoses given at discharge in the three groups of patients, both among men (chi2=22.33, df=6, pimmigrants. The number of admissions by coercion was highest among immigrants, and lowest among asylum seekers (chi2=12.03, df=2, pimmigrants, asylum seekers had high admission rates and low frequency of admissions by coercion. Schizophrenia was frequent among female immigrants admitted to hospital.

  10. Outcomes for children hospitalized with abusive versus noninflicted abdominal trauma. (United States)

    Lane, Wendy Gwirtzman; Lotwin, Irwin; Dubowitz, Howard; Langenberg, Patricia; Dischinger, Patricia


    Abusive abdominal trauma (AAT) is the second leading cause of child abuse mortality. Previous outcome studies have been limited to data from trauma centers. The goals of this study were (1) to examine mortality, length of hospitalization, and hospital charges among a national sample of children hospitalized for AAT; and (2) to compare these outcomes with children with noninflicted abdominal trauma. Hospitalization data for children aged 0 to 9 years were obtained from the 2003 and 2006 Kids' Inpatient Database. Cases were identified using International Classification of Diseases, Ninth Revision, Clinical Modification and external cause of injury codes. Multivariable regression analyses were used to compare outcomes of children with AAT versus those with noninflicted injury. Children with AAT were younger, and more often insured by Medicaid. Among children surviving to discharge, those with AAT had longer hospitalizations (adjusted mean [95% confidence interval (CI)] length of stay: 7.9 (6.6-9.3) vs 6.4 (6.1-6.7) days, P assist families at risk should be supported.

  11. Awareness and perceptions of electroconvulsive therapy among psychiatric patients: a cross-sectional survey from teaching hospitals in Karachi, Pakistan

    Directory of Open Access Journals (Sweden)

    Choudhary Maria


    Full Text Available Abstract Background Electroconvulsive therapy (ECT is shown to be effective in many psychiatric illnesses, but its distorted projection by the Pakistani media and its unregulated use by many physicians across the country have adversely affected its acceptability. Given this situation we aimed to assess the awareness and perceptions regarding ECT as a treatment modality among the psychiatric patients. Methods This was a questionnaire based cross-sectional study carried out at 2 tertiary care hospitals in Karachi, Pakistan. Results We interviewed 190 patients of which 140 were aware of ECT. The study showed that the level of education had a significant impact on the awareness of ECT (p = 0.009. The most common source of awareness was electronic and print media (38%, followed by relatives (24% and doctors (23%. Physical injuries (42% and neurological (12% and cognitive disturbances (11% were the commonly feared side effects. The most popular belief about ECT was that it was a treatment of last resort (56%. Thirty-nine percent thought that ECT could lead to severe mental and physical illness and 37% considered it inhumane. Patients' willingness to receive ECT was dependant on whether or not they were convinced of its safety (p = 0.001 and efficacy (p = 0.0001. Conclusion We identified a serious lack of dissemination of information regarding ECT by the psychiatrists and the mental health care providers. This may be the result of an inadequate postgraduate training in Pakistan or just a lack of concern about the mentally ill patients. The media seemed to be the major source of information for our patients. We also saw the prevalence of a variety of myths regarding ECT in our society, which we feel may be responsible for the patients' adverse attitudes. Given the widespread applicability of ECT there is a dire need to dispel these misconceptions and improve its acceptability.

  12. Sexual orientation differences in treatment expectation, alliance, and outcome among patients at risk for suicide in a public psychiatric hospital. (United States)

    Plöderl, Martin; Kunrath, Sabine; Cramer, Robert J; Wang, Jen; Hauer, Larissa; Fartacek, Clemens


    Sexual minority (SM) individuals (gay, lesbian, bisexual, or otherwise nonheterosexual) are at increased risk for mental disorders and suicide and adequate mental healthcare may be life-saving. However, SM patients experience barriers in mental healthcare that have been attributed to the lack of SM-specific competencies and heterosexist attitudes and behaviors on the part of mental health professionals. Such barriers could have a negative impact on common treatment factors such as treatment expectancy or therapeutic alliance, culminating in poorer treatment outcomes for SM versus heterosexual patients. Actual empirical data from general psychiatric settings is lacking, however. Thus, comparing the treatment outcome of heterosexual and SM patients at risk for suicide was the primary aim of this study. The secondary aim was to compare treatment expectation and working alliance as two common factors. We report on 633 patients from a suicide prevention inpatient department within a public psychiatric hospital. Most patients were at risk for suicide due to a recent suicide attempt or warning signs for suicide, usually in the context of a severe psychiatric disorder. At least one indicator of SM status was reported by 21% of patients. We assessed the treatment outcome by calculating the quantitative change in suicide ideation, hopelessness, and depression. We also ran related treatment responder analyses. Treatment expectation and working alliance were the assessed common factors. Contrary to the primary hypothesis, SM and heterosexual patients were comparable in their improvement in suicide ideation, hopelessness, or depression, both quantitatively and in treatment responder analysis. Contrary to the secondary hypothesis, there were no significant sexual orientation differences in treatment expectation and working alliance. When adjusting for sociodemographics, diagnosis, and length of stay, some sexual orientation differences became significant, indicating that SM

  13. Problematic video game use scale: initial psychometric properties with psychiatrically hospitalized adolescents. (United States)

    Topor, David R; Swenson, Lance P; Liguori, Gina M; Spirito, Anthony; Lowenhaupt, Elizabeth A; Hunt, Jeffrey I


    Excessive video game use among youth has been a growing concern in the United States and elsewhere. The aims of this study are to establish validity of a video game measure in a large adolescent inpatient sample, identify clinical factors underlying problem video game use, and identify associations with measures of psychopathology. Three hundred eighty participants admitted to an adolescent inpatient psychiatric unit between November 2007 and March 2009 were administered a battery of self-report measures, including a questionnaire developed for this study that assessed reinforcers and consequences of past-year video game use (ie, Problematic Video Game Use Scale). Factor analysis was used to identify the underlying structure of behaviors associated with problem video game use. A factor analysis of the Problematic Video Game Use Scale indicated 2 primary factors. One was associated with engaging in problem behaviors that impaired the adolescent's functioning as a result of playing video games and one reflected the reinforcing effects of playing video games. Both factors were associated with measures of psychopathology, although associations were generally stronger for impairment in functioning than for reinforcing effects. Both factors were significantly correlated with self-reported daily video game use (P video game playing: impairment in functioning and reinforcing effects. Initial evidence of the content validity of the video game measure was established. Findings highlight the importance of assessing video game use among an adolescent population, the factors associated with video game use, and associations with symptoms of psychopathology. Limitations include a common reporter for multiple measures and cross-sectional data that do not allow for causal links to be made. © Copyright 2011 Physicians Postgraduate Press, Inc.

  14. Prevalence of the metabolic syndrome in a psychiatric hospital in Mexico. (United States)

    Díaz-Castro, Lina; Cabello-Rangel, Héctor; Cuevas-Pineda, Guillermo J; Reza-Garduño, Horacio; Castañeda-González, Carlos J


    The metabolic syndrome (MS) is formed by elevated blood pressure, hypercholesterolemia, hypertriglyceridemía, hyperglycemia and abdominal obesity. Mexico occupies the second place worldwide in prevalence of obesity. It has been reported that the use of psychopharmaceuticals increase the risk of MS. To detect prevalence of MS in patients with a psychiatric diagnosis with or without psychopharmaceutical treatment. An observational, descriptive study was designed. Informed consent was obtained, enrolling a sample of 216 patients in the six-month period, all of them over 18 years of age. The following variables were measured: blood pressure, weight, height, waist circumference, triglyceride, glucose and high-density lipoprotein serum levels, by colorimetric enzyme assay in Roche analyzer. Student's t-test, and Cochran-Mantel- Haenszel and Fisher's exact test. A total of 50% of the sample had a waist circumference >88 cm; 10% glycemia superior to 110 mg/dl, 30% triglycerides >150 mg/dl; 14% met the MS criteria. When patients with and without MS were grouped, and glucose and triglycerides were compared, a p 0.0001 was obtained. With a 93.4% confidence interval, the relationship between sedentary life and MS was accepted. Women, aged 40-59 years tended to have MS, with 98.4% CI. The only family background associated to MS was obesity (97.7% CI). There is a positive relationship between MS and the use of typical or atypical antipsychotics. SSRIs are significantly related with MS: p 0.072 and 91.5% confidence interval, benzodiazepines with p 0.073 and 92.7% confidence interval. Only 14% of the sample had MS. Psychopharmaceuticals were associated to MS, women between 40 to 59 years having a greater risk.

  15. Family function and its relationship to injury severity and psychiatric outcome in children with acquired brain injury: a systematized review. (United States)

    Lax Pericall, Maria Teresa; Taylor, Eric


    The psychological and psychiatric outcome of children with acquired brain injury is influenced by many variables. A review was undertaken to clarify the contribution of family function, how it relates to injury severity, and what particular aspects of family function influence psychological outcome in this group. A systematized review of the literature of studies published between 1970 and 2012 from OvidMedline, PsychoInfo, PsycARTICLES, and Cochrane was undertaken focusing on family function, injury severity, and psychiatric outcome. Thirty-six papers met the inclusion criteria. Injury severity was linked to the development of organic personality change. Family function before injury, measured by the Family Assessment Device or the Clinical Rating Scale, had a statistically significant effect on general psychological functioning in six out of eight studies. Family function had a significant effect for oppositional defiant disorder and secondary attention-deficit-hyperactivity disorder. The effects of family function may differ depending on the age of the child and the severity of the injury. Some styles of parenting moderated recovery. After injury, family function was related to the child's contemporaneous psychiatric symptoms. The level of evidence for these papers was 3 or 4 (Oxford Centre for Evidence-based Medicine criteria). Screening for some aspects of family functioning before injury and family function during the rehabilitation phase may identify children at risk of psychiatric disorders. © 2013 Mac Keith Press.

  16. Medical students' attitudes to mental illnesses and to psychiatry before and after the psychiatric clerkship: Training in a specialty and a general hospital. (United States)

    Economou, Marina; Kontoangelos, Kontantinos; Peppou, Lily Evangelia; Arvaniti, Aikaterini; Samakouri, Maria; Douzenis, Athanasios; Papadimitriou, George N


    Medical students' attitudes to mental illnesses and psychiatry may be reshaped during the psychiatric training, with important implications in their future practice of the profession. Therefore, the present study set out to explore the impact of the psychiatric clerkship in students' attitudes, while taking into consideration the site of their practical training. To this end, a total of 678 final-year medical students were recruited. Students completed a self-reported questionnaire entailing the Attitudes to Psychiatry scale, the Attitudes to Mental Illness scale and the Greek Social Distance scale before and after their placement. Findings indicate that the psychiatric clerkship had a positive effect in reducing stigma towards both psychiatry and mental illnesses, with the effect being more pronounced in the general hospital with respect to the former, while in the specialty hospital was more marked regarding the latter. A further exploration of the determinants of change revealed that the improvement discerned in the general hospital was only among those without professional experience of mental illnesses. Therefore, the psychiatric clerkship may exert a substantial influence on shaping favourable attitudes towards mental illnesses and psychiatry; however, other elements should also be taken into consideration, if the clerkship is to tackle stigma in healthcare. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Processes of in-hospital psychiatric care and subsequent criminal behaviour among patients with schizophrenia: a national population-based, follow-up study. (United States)

    Pedersen, Charlotte Gjørup; Olrik Wallenstein Jensen, Signe; Johnsen, Søren Paaske; Nordentoft, Merete; Mainz, Jan


    It is unknown whether evidence-based, in-hospital processes of care may influence the risk of criminal behaviour among patients with schizophrenia. Our study aimed to examine the association between guideline recommended in-hospital psychiatric care and criminal behaviour among patients with schizophrenia. Danish patients with schizophrenia (18 years or older) discharged from a psychiatric ward between January 2004 and March 2009 were identified using a national population-based schizophrenia registry (n = 10 757). Data for in-hospital care and patient characteristics were linked with data on criminal charges obtained from the Danish Crime Registry until November 2010. Twenty per cent (n = 2175) of patients were charged with a crime during follow-up (median = 428 days). Violent crimes accounted for 59% (n = 1282) of the criminal offences. The lowest risk of crime was found among patients receiving the most processes of in-hospital care (top quartile of received recommended care, compared with bottom quartiles, adjusted hazard ratio = 0.86, 95% CI 0.75 to 0.99). The individual processes of care associated with the lowest risk of criminal behaviour were antipsychotic treatment and staff contact with relatives. High-quality, in-hospital psychiatric care was associated with a lower risk of criminal behaviour after discharge among patients with schizophrenia.

  18. How hospitalized children and parents perceive nurses and hospital amenities: A qualitative descriptive study in Poland. (United States)

    Marcinowicz, Ludmiła; Abramowicz, Paweł; Zarzycka, Danuta; Abramowicz, Magdalena; Konstantynowicz, Jerzy


    A qualitative descriptive design using an interview guide approach was adopted to investigate the patient-nurse relationship and paediatric ward amenities from the perspective of parents and hospitalised children in Poland. The study included 26 parents or caregivers of hospitalised children (between 13 months and 15 years old) and 22 children (from 10 to 16 years old). Qualitative content analysis was used to analyse the recorded verbal data. Data from patients' transcripts were coded and classified in terms of topics on the patient-nurse relationship and hospital care. We identified five main topics. 1. Nurse qualities; 2. Nurse verbal behaviour; 3. Nurse tone of voice and non-verbal behaviour; 4. Hospital amenities; 5. Parents' expectations towards nurses. Our study contributes to increased understanding of parents' and children's experiences of paediatric hospital care. © The Author(s) 2014.

  19. Suicide risk in relation to psychiatric hospitalization: evidence based on longitudinal registers

    DEFF Research Database (Denmark)

    Qin, Ping; Nordentoft, Merete


    history increases suicide risk relatively more in women than in men; and suicide risk is substantial for substance disorders and for multiple admissions in women but not in men. CONCLUSIONS: Suicide risk peaks in periods immediately after admission and discharge. The risk is particularly high in persons...... with affective disorders and in persons with short hospital treatment. These findings should lead to systematic evaluation of suicide risk among inpatients before discharge and corresponding outpatient treatment, and family support should be initiated immediately after the discharge...

  20. Demandas de atendimento psiquiátrico em um hospital universitário Demandas de lo atendimiento psiquiátrico en un hospital universitario Demands of psychiatric care in a university hospital

    Directory of Open Access Journals (Sweden)

    Naiara Gajo Silva


    la necesidad de la interconsulta de enfermería psiquiátrica en este hospital.This is a cross-sectional study that aimed to describe the psychiatric demand in a university hospital in the city of Cuiabá, state of Mato Grosso, Brazil, and to know the current situation of the service to this demand. The data were collected from the inpatient medical records in a university hospital, from June to August, 2009, in a total of 551 records. Despite being considered by the literature as unprepared, nursing is the professional category that most identifies the psychiatric demand in this hospital. The treatment plan to this demand was restricted to medication, nine evaluations of psychology and thirteen consultation-liaison psychiatric service, without a significant involvement of nursing. The approach of emotional and/or mental aspects results in the improvement in the quality of nursing care, and there is a need for the nurses to qualify for that. To make it happen, we propose a reflection on the need for the consultation-liaison psychiatric service in this hospital.

  1. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, Hanne; Johansen, Christoffer


    BACKGROUND: To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer. PROCEDURE: A HBHC program was carried out with 51 children (0-18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety...... children and 43 parents in the home care group, and 47 children and 66 parents receiving standard hospital care. RESULTS: All parents in the HBHC program were satisfied and preferred home care. There were no serious adverse events associated with HBHC, and costs did not increase. When adjusting for age......, gender, diagnosis and time since diagnosis, we found significant higher HRQOL scores in parent-reported physical health (P = 0.04; 95% confidence interval (CI): -0.2-19.5) and worry (P = 0.04; 95% CI: -0.4-20.6) in the home-care group indicating better physical health and less worry for children...

  2. Prevalence and characteristics of suicide attempters and ideators among acutely admitted psychiatric hospital patients in northwest Russia and northern Norway. (United States)

    Sørlie, Tore; Sørgaard, Knut W; Bogdanov, Anatoly; Bratlid, Trond; Rezvy, Grigory


    More knowledge about suicidality and suicide risk profiles in acute psychiatric hospital patients (both first-time and chronic patients) is needed. While numerous factors are associated with suicidality in such populations, these may differ across cultures. Better understanding of factors underlying suicide risk can be informed by cross-cultural studies, and can aid development of therapeutic and preventive measures. An explorative, cross-sectional cohort study was carried out. Acutely admitted patients at one psychiatric hospital in northwest Russia and two in northern Norway were included. At admission, demographic, clinical, and service use data were collected, in addition to an assessment of suicidal ideation and attempts, comprising five dichotomic questions. Data from 358 Norwegian and 465 Russian patients were analyzed with univariate and multivariate statistics. Within each cohort, attempters and ideators were compared with patients not reporting any suicidality. The observed prevalence of suicidal ideation and attempts was significantly higher in the Norwegian cohort than in the Russian cohort (χ(2) = 168.1, p suicidal ideators and attempters had more depressed moods, more personality disorders, and greater problems with alcohol/drugs, but fewer psychotic disorders, cognitive problems or overactivity than non-suicidal patients. Russian suicidal ideators and attempters were younger, more often unemployed, had more depressed mood and adjustment disorders, but had fewer psychotic disorders and less alcohol/drug use than the non-suicidal patients. Rates of suicidal ideation and non-fatal attempts in Norwegian patients were intermediate between those previously reported for patients admitted for the first time and those typical of chronic patients. However, the significantly lower rates of suicidal ideation and non-fatal attempts in our Russian cohort as compared with the Norwegian, contrasted with what might be expected in a region with much higher suicide

  3. Processes of In-Hospital Psychiatric Care and Subsequent Criminal Behaviour Among Patients With Schizophrenia: A National Population-Based, Follow-Up Study

    DEFF Research Database (Denmark)

    Pedersen, C. G.; Jensen, S. O. W.; Johnsen, S. P.


    Objectives: It is unknown whether evidence-based, in-hospital processes of care may influence the risk of criminal behaviour among patients with schizophrenia. Our study aimed to examine the association between guideline recommended in-hospital psychiatric care and criminal behaviour among patients...... patients receiving the most processes of in hospital care (top quartile of received recommended care, compared with bottom quartiles, adjusted hazard ratio = 0.86, 95% CI 0.75 to 0.99). The individual processes of care associated with the lowest risk of criminal behaviour were antipsychotic treatment...

  4. Parental leave: comparing children's hospitals with Fortune 500 companies. (United States)

    Weiss, A H; Gordon, E J; O'Connor, M E


    To identify parental leave policies and availability of support systems for new parents employed by children's hospitals and compare these benefits with those offered by Fortune 500 companies. Telephone or facsimile survey of all (n=118) children's hospitals and pediatric medical centers in the National Association of Children's Hospitals and Related Institutions 1995 Directory of Members, and 118 geographically matched Fortune 500 companies. Policies for maternity and paternity leave, adoption benefits, and support services for new parents were compared. Ninety-four children's hospitals (80%) and 82 Fortune 500 companies (69%) responded to the survey. No difference in duration of maternity (P>.30) or paternity (P=.12) leave was found. Sixty-two companies (77%) classified maternity leave as short-term disability while 47 hospitals (50%) classified it as sick time (Pleave as short-term disability generally gives better benefits to employees with short duration of service, whereas classifying maternity leave as sick time usually favors employees with longer employment. Companies provided more financial support for adoption expenses (Ppaid or unpaid leave for adoption (P=.14). Hospitals provided more on-site day care (69% vs 42%; Pparental leave benefits than Fortune 500 companies; however, they offer better support systems for parents returning to work after the birth of a child.

  5. Malnutrition in hospitalized children: prevalence, impact, and management. (United States)

    Groleau, Veronique; Thibault, Maxime; Doyon, Myriam; Brochu, Eve-Emmanuelle; Roy, Claude C; Babakissa, Corentin


    Malnutrition in hospitalized children has been reported since the late 1970s. The prevalence of acute and chronic malnutrition was examined in hospitalized patients in a general pediatric unit, and the impact and management of malnutrition were assessed. The nutritional risk score (NRS) and nutritional status (NS) (weight, height, body mass index, and skinfold thickness) of children aged zero to 18 years were assessed upon hospital admission. Growth and energy intake were monitored every three days until discharge. A total of 173 children (median age three years, 88 girls) participated; 79.8% had a moderate to severe NRS and 13.3% were acutely and/or chronically malnourished. A high NRS was associated with a longer hospital stay in children older than three years (Pchildren aged three years or younger (Pchildren with abnormal NS received 92.5% of recommended energy intake. This study suggests that all children admitted to hospital should have an evaluation of their NRS and NS, so that they can receive appropriate nutrition interventions provided by a multidisciplinary nutrition team.

  6. A single mothers' group for mothers of children attending an outpatient psychiatric clinic: preliminary results. (United States)

    McNamee, J E; Lipman, E L; Hicks, F


    To provide a preliminary report of data from 2 support groups for single mothers, all of whom were mothers of children attending a child outpatient psychiatric clinic. The groups' 2 purposes were: 1. to assess the feasibility of adding structured evaluation to a common clinical intervention; 2. to improve single mothers' parenting skills through raised levels of self-esteem, increased capacity for family functioning and reduced levels of depression. Three structured evaluation instruments were used to measure the domains of self-esteem, family functioning and depression. These instruments were given to both groups of women on 3 occasions: 1. before the group; 2. after the group; 3. at a follow-up session 4 months after group termination. Open-ended questions were also asked at group termination. The questionnaire response rate was 100%; overall response rate for the 3 open-ended questions was 89%. Comparisons of pre-group and post-group scores showed that there was a significant increase in self-esteem (p parenting skills. Methodologic concerns and future directions are discussed.

  7. Prevalence of fall injuries and risk factors for fall among hospitalized children in a specialized childrens hospital in Saudi Arabia. (United States)

    AlSowailmi, Banan Abdullah; AlAkeely, Maha Heshaam; AlJutaily, Hayat Ibrahim; Alhasoon, Mohammad Abdulaziz; Omair, Amir; AlKhalaf, Hamad Abdullah


    Fall injuries among children during hospital stay is a major patient safety issue. Inpatient pediatric falls can lead to numerous negative consequences. In contrast to adults, there is a paucity of information on the prevalence and risk factors associated with children's falls during hospitalization. Identify the prevalence of fall injuries among hospital.ized children and describe the demographic and environmental factors that could predict a higher risk of severe outcomes of fall. Descriptive, cross-sectional prevalence study. Specialized children's hospital. Data was obtained through the electronic Safety Reporting System (SRS). All reported fall events during hospitalization in children less than or equal 14 years of age for the period from 1 April 2015 to 30 April 2016 were included. Fall events that occurred in the day care unit and the outpatient clinic were excluded. Prevalence and possible risk factors for fall events. 48. The prevalence of falls among the 4860 admitted children was 9.9 (95% CI=7.5, 13.1) per 1000 patients (48/4860). A majority of the falls were among boys (n=26, 54%), in the age group from 1-5 years old (n=22, 46%), in children at high risk of falling (n=35, 73%), with normal mobility status (n=21, 44%), and with no history of previ.ous falls (n=33, 69%). Severe injuries accounted for 25% of falls (n=12). However, falls among the moderate risk category (n=9, 69%) were more often severe than falls among the high risk category of children (n=12, 34%) (P=.03). Risk factor identification is required to prevent falls and their severe outcomes. Underreporting and single-centered study. None.

  8. Profile of children placed in residential psychiatric program: Association with delinquency, involuntary mental health commitment, and reentry into care. (United States)

    Yampolskaya, Svetlana; Mowery, Debra; Dollard, Norín


    This study examined characteristics and profiles of youth receiving services in 1 of Florida's Medicaid-funded residential mental health treatment programs--State Inpatient Psychiatric Program (SIPP)--between July 1, 2004, and June 30, 2008 (N=1,432). Latent class analysis (LCA) was used to classify youth, and 3 classes were identified: Children With Multiple Needs, Children With No Caregivers, and Abused Children With Substantial Maltreatment History. The results of LCA showed that Children With Multiple Needs experienced the greatest risk for adverse outcomes. Compared with youth in the other 2 classes, these children were more likely to get readmitted to SIPP, more likely to become involved with the juvenile justice system, and more likely to experience involuntary mental health assessments. Implications of the findings are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved

  9. Profile and pattern of crack consumption among inpatients in a Brazilian psychiatric hospital. (United States)

    da Cunha, Silvia Mendes; Araujo, Renata Brasil; Bizarro, Lisiane


    Crack cocaine use is associated with polydrug abuse, and inpatients dependent on crack exhibit profiles of serious consumption patterns. Use of alcohol and tobacco and other drugs is a risk factor for experimentation of additional drugs, including crack cocaine. The present study describes the characteristics and crack consumption patterns among inpatients in treatment during 2011 and 2012 at the Hospital Psiquiátrico São Pedro (Porto Alegre, Brazil). An additional objective was to identify the sequence of alcohol and tobacco consumption prior to crack use. The participants were 53 male inpatients addicted to crack with a mean age of 27.5±7.3 years. A sociodemographic questionnaire; the Alcohol, Smoking and Substance Involvement Screening Test and the Mini Mental State Examination were all administered to participants. Inclusion criteria were crack cocaine dependency (based on the 10th edition of the International Classification of Diseases [ICD-10]) and being abstinent for 7 days. Patients with cognitive difficulties who were unable to understand and/or respond to the questionnaires were excluded from the sample. The participants were young male adults with low educational level and low incomes and were polydrug users. The majority had made more than one attempt to quit. Use of legal drugs in early adolescence, prior to crack use, was identified. The profiles of the inpatients addicted to crack treated at this hospital indicate a serious usage pattern among those who seek specialized support. Crack use is frequent and is associated with use of other drugs and with difficulty sustaining abstinence. The pattern of progression from alcohol and tobacco use to crack cocaine dependency demands the attention of those responsible for prevention policies.

  10. Psychiatric conditions and general practitioner attendance prior to HPV vaccination and the risk of referral to a specialized hospital setting because of suspected adverse events following HPV vaccination

    DEFF Research Database (Denmark)

    Lützen, Tina Hovgaard; Bech, Bodil Hammer; Mehlsen, Jesper


    centers, and health data for cases and controls were obtained from national registries. PARTICIPANTS: Cases were defined as women referred to an HPV center between January 1, 2015 and December 31, 2015 (n=1,496). Each case was matched with five controls on age, region and time of first vaccine......AIM: No association between human papilloma virus (HPV) vaccination and numerous diseases has been found. Still, a large number of Danish women are reporting suspected adverse events. Other factors may play a role, and the aim of this study is to examine the association between psychiatric...... registration. The total study population consisted of 8,976 women. RESULTS: Overall, women above 18 years who had been referred to an HPV center were more likely to have used psychiatric medication (odds ratio [OR]: 1.88 [95% CI 1.48-2.40]) or to have been hospitalized because of a psychiatric disorder within...

  11. Failure to Thrive Hospitalizations and Risk Factors for Readmission to Children's Hospitals. (United States)

    Puls, Henry T; Hall, Matthew; Bettenhausen, Jessica; Johnson, Matthew B; Peacock, Christina; Raphael, Jean L; Newland, Jason G; Colvin, Jeffrey D


    Risk factors for failure to thrive (FTT) readmissions, including medical complexity, have not been described. We sought to characterize children hospitalized for FTT and identify risk factors associated with FTT-specific readmissions during the current era of increasing medical complexity among hospitalized children. This retrospective cohort study used the Pediatric Health Information System database of 43 freestanding children's hospitals across the United States. The cohort included children <2 years of age with index hospitalizations for FTT between 2006 and 2010. The main outcome was FTT-specific readmission within 3 years. Using Cox proportional hazards models, we assessed the association of demographic, clinical, diagnostic, and treatment characteristics with FTT-specific readmission. There were 10 499 FTT hospitalizations, with 14.1% being readmitted for FTT within 3 years and 4.8% within 30 days. Median time to readmission was 66 days (interquartile range, 19-194 days). Nearly one-half of children (40.8%) had at least 1 complex chronic condition (CCC), with 16.4% having ≥2 CCCs. After multivariable modeling, increasing age at admission, median household income in the lowest quartile (adjusted hazard ratio, 1.23 [95% confidence interval, 1.05-1.44]), and prematurity-related CCC (adjusted hazard ratio, 1.46 [95% confidence interval, 1.16-1.86]) remained significantly associated with readmission. Nearly one-half of children hospitalized for FTT had a CCC, and a majority of FTT-specific readmissions occurred after the traditional 30-day window. Children with prematurity-related conditions and low median household income represent unique populations at risk for FTT readmissions. Copyright © 2016 by the American Academy of Pediatrics.

  12. First-time first-trimester induced abortion and risk of readmission to a psychiatric hospital in women with a history of treated mental disorder. (United States)

    Munk-Olsen, Trine; Laursen, Thomas Munk; Pedersen, Carsten B; Lidegaard, Ojvind; Mortensen, Preben Bo


    Mental health problems are associated with women's reproductive decisions and predict poor mental health outcomes after abortion and childbirth. To study whether having a first-trimester induced abortion influenced the risk of psychiatric readmission and compare findings with readmission risk in women with mental disorders giving birth. Survival analyses were performed in a population-based cohort study merging data from the Danish Civil Registration System, the Danish Psychiatric Central Register, and the Danish National Hospital Register from January 1,1994, to December 31, 2007. Denmark. All women born in Denmark between 1962 and 1992 with a record of 1 or more psychiatric admissions at least 9 months before a first-time first-trimester induced abortion or childbirth. Main Outcome Measure  Readmission at a psychiatric hospital with any type of mental disorder from 9 months before to 12 months after a first-time first-trimester induced abortion or childbirth. Relative risk (RR) for readmission risk 9 to 0 months before a first-trimester induced abortion was 0.95 (95% CI, 0.73-1.23) compared with the first year after the abortion. This contrasts with a reduced risk of readmission before childbirth (RR, 0.56; 95% CI, 0.42-0.75) compared with the first year post partum. Proximity to previous psychiatric admission in particular predicted rehospitalization risks in both the abortion and the childbirth group. Risk of readmission is similar before and after first-time first-trimester abortion, contrasting with a marked increased in risk of readmission post partum. We speculate that recent psychiatric episodes may influence women's decisions to have an induced abortion; however, this decision does not appear to influence the illness course in women with a history of treated mental disorders.

  13. [Alteration of profile of treatment of the public psychiatric hospitals of Belo Horizonte, Brazil, in the context of mental health care reform]. (United States)

    Coelho, Vívian Andrade Araújo; Volpe, Fernando Madalena; Diniz, Sabrina Stephanie Lana; Silva, Eliane Mussel da; Cunha, Cristiane de Freitas


    This article seeks to describe the profile of treatment and internment in public psychiatric hospitals in Belo Horizonte, Brazil, from 2002 to 2011. The changes in the characteristics of treatment and the profiles of the patients treated are analyzed in the context of health care reform. It is a study of temporal series with trend analysis by means of linear regression. There was a reduction in the total of patients treated in the period under scrutiny. Inversely, there was an increase in internments with a reduction in length of stay, though no change in readmission rates. Patients from Belo Horizonte prevailed, however a relative increase in demand from the surrounding area was observed. There was a reversal in the prevalence of morbidity switching from psychotic disorders to disorders resulting from the use of alcohol and/or other drugs. The alteration observed in the profile of treatment in public psychiatric hospitals in Belo Horizonte was concomitant with the progressive implementation of community mental health services, which have probably met the demand that was formerly directed to these hospitals. Currently the psychiatric hospital is not the first, much less the only venue for treatment in the mental health network in Minas Gerais.

  14. Psychiatric aspects of acute withdrawal from gamma-hydroxybutyrate (GHB) and its analogue gamma-butyrolactone (GBL): implications for psychiatry services in the general hospital. (United States)

    Choudhuri, Debajeet; Cross, Sean; Dargan, Paul I; Wood, David M; Ranjith, Gopinath


    The objective of this study was to describe the psychiatric symptoms, management and outcomes in a consecutive series of patients being managed medically for symptoms of withdrawal from gamma-hydroxybutyrate (GHB) and its analogue gamma-butyrolactone (GBL) in a general hospital setting. A toxicology database was used to identify patients presenting with a history suggestive of withdrawal from GHB and analogues. Electronic and paper medical records were searched for demographic features, neuropsychiatric symptoms, psychiatric management while in hospital and overall outcome. There were 31 presentations with withdrawal from the drugs involving 20 patients. Of these 17 (54%) were referred to and seen by the liaison psychiatry team. Anxiety (61.3%) and agitation (48.4%) were the most common symptoms. Of the 17 cases seen by the liaison psychiatry team, 52.9% required close constant observation by a mental health nurse and 29.4% required to be detained in hospital under mental health legislation. The significant proportion of patients presenting with neuropsychiatric symptoms and requiring intensive input from the liaison psychiatry team during withdrawal from GHB and its analogues points to the importance of close liaison between medical and psychiatric teams in managing these patients in the general hospital.

  15. [Community residential devices associated with Psychiatric Hospital "Dr. Manuel A. Montes De Oca" in the Province of Buenos Aires, Argentina]. (United States)

    Keena, Cecilia; Rossetto, Jorge; Somoza, Matías; De Lellis, Martín


    The psychiatric hospital "Dr. Manuel A. Montes de Oca" has developed a Program for the Reform of the Model of Attention and Integral Rehabilitation that includes the implantation of community residential devices in the area of influence of the Institution. This program, which aims at the progressive replacement of asylum beds, has been the subject of an evaluative investigation that has included almost all the devices through a transversal and descriptive design, with instruments of survey created by the equipment and in agreement with the References of the Institution. The present article proposes to initiate a set of evaluative works in different dimensions concerning the institutional reform process, describing the antecedents, the objectives and the methodology and development of the study to achieve the general characterization of the devices. The main results of the study are summarized below on a set of aspects that we consider most signifcant for the characterization of the devices: a) Type of users served; B) Coverage of Care; C) Method of approach; D) Use of social and health services; E) Expenses and returns to the Institution; E) Main barriers encountered in the implementation of such devices. The work concludes with a series of proposals that are based on the survey carried out tending to promote the greatest possible sustainability in the implementation of the selected community devices.

  16. [Recruitment and selection of human resources in a psychiatric hospital at a municipality of São Paulo]. (United States)

    Mazon, L; Trevizan, M A


    This paper aims at disseminating the experience of recruiting and selecting human resources in a psychiatric hospital in the city of Ribeirão Preto, a philanthropic institution with one hundred and four beds that assists pharmaco-dependent patients with mental problems. It presently has eighty-four employees and a high staff turnover in different sectors. As trainees, we realized that the high turnover impaieds the development of activities at the organization as well as prevented a better care delivery to clients. Therefore, we were invited to integrate a team that was made responsible for the recruitment and selection of human resources for this institution. After these procedures and the respective follow-up by those in charge of different sectors, our purpose is to reduce the turnover, implement larger institutional engagement and more synchrony among employees, reduce expenses and bureaucratic activities related to hiring and laying off personnel, reduce operational work and implementing more assisting activities in terms of planning, orientation, execution and evaluation.

  17. The politics of black patients' identity: ward-rounds on the 'black side' of a South African psychiatric hospital. (United States)

    Swartz, L


    There are many macrosocial studies of the political organisation of health and mental health care in South Africa, and the maldistribution of resources by race is well known. Little attention, however, has been given to the minutiae of the negotiation of power in the clinical setting. This article, which reports on part of a larger study of aspects of culture in South African psychiatry, focuses on interactions in ward-rounds on the 'Black side' of a South African psychiatric hospital. Through analysis of cases, the complexity of interpreting what transpires in such a setting and the central role that the concept of culture has in debates amongst staff members are demonstrated. Close analysis demonstrates the inadequacy of models which seek to locate the institutional racism of apartheid psychiatry in the motives of individual clinicians. Clinicians may simultaneously reproduce and subvert aspects of apartheid practice. A consideration of the social positioning of the clinician both as a South African and as a practitioner of psychiatry is central to the development of psychiatry in a post-apartheid South Africa.

  18. The impact of the Great East Japan earthquake on mandatory psychiatric emergency hospitalizations in Tokyo: a retrospective observational study. (United States)

    Aoki, A; Aoki, Y; Harima, H


    On 11 March 2011, the eastern part of Japan was struck by a magnitude 9.0 quake. About 20 000 people were killed or were missing, and a nuclear crisis followed. In Tokyo, people were indirectly exposed to the earthquake and nuclear crisis by TV broadcast. The aim of our study was to evaluate the potential effect of the series of catastrophes on psychiatric emergency hospitalizations in Tokyo. Clinical records of patients who were mandatorily admitted to Tokyo Metropolitan Matsuzawa Hospital by law because of urgent risk to self or others were reviewed. Records regarding the 2 years of investigation, which include the 6 months after the earthquake, were reviewed. The six months after the earthquake were compared with the eighteen months before the earthquake in clinical and demographic data using independent t-tests or χ(2) tests. During the 6 months before and after the earthquake, 97 and 127 people were mandatorily admitted. χ(2) Tests demonstrated a significant increase in the number of patients after the earthquake (P = 0.045), attributable to the significant increase in the number of patients with schizophrenia after the earthquake (P = 0.011, 32 vs 56), whereas there were no significant differences in the number of patients with other diagnoses between those two periods. Independent t-tests revealed that patients admitted after the earthquake had marginally significantly shorter periods of education compared with those admitted before the earthquake (13.78 vs 12.82 years, P = 0.084). This work suggests that patients with schizophrenia were more sensitive to indirect exposure to the earthquake and that a shorter period of education was a potential risk factor.

  19. Exploratory factorial analysis of the working enviroment scale (WES among employees of a public psychiatric hospital in Bucaramanga, Colombia

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    Lucía Quintero Isaza


    Full Text Available Background. Job satisfaction is an important factor to guarantee work productivity. There are various scales to measure job satisfaction. Out of these scales, the recently validated Working Environment Scale-10 (WES-10 is the most brief. However, up to date the factor structure of the WES-10 has not been explored among any Colombian working populations. Objective. To determine the factor structure of the WES-10 among employees of a public psychiatric hospital in Bucaramanga, Colombia. Materials and methods. It was designed a validation study without a gold standard. Two-hundred seventeen workers participated, the mean age was 37.7 years (SD±9.8; 75.4% were women; 49.5% were narried; 37.0% were technical or vocacional degree; 58.7% lived in middle class neigbourhood; 51.7% were assistancial functions; and have been working in the hospital the mean of 13.0 year (SD± 8.8. The WES-10 is a 10-item device with five options of ordinal answer. It was done an exploratory factor analysis using the principal component method. Factors with eigenvalue over 1.0 were retrained. Results. The WES-10 showed internal consistency of 0.78 and bidimensional structure accounted for 48.8% of the variance. Factor one (working adjustment presented an eigenvalue of 3.49; and factor two (self-realization, 1.39. Conclusions. The WES-10 presents an acceptable internal consistency and may be used for research purposes. Its bidimentional structure explores approximately the proposed construct.

  20. Is Bipolar Disorder the Most Common Diagnostic Entity in Hospitalized Adolescents and Children? (United States)

    Isaac, George


    An evaluation of all children and adolescents (n=57) admitted to an acute psychiatric unit over a 3-month period was undertaken to determine the presence of bipolar disorder. Findings indicated that bipolar disorder was the most common diagnosis; thus, this disorder has to be ruled out in all youth admitted to acute care psychiatric units. (JPS)

  1. Medicine, madness and murderers: the context of English forensic psychiatric hospitals. (United States)

    McDonald, Ruth; Furtado, Vivek; Völlm, Birgit


    Purpose The purpose of this paper is to add to the understanding of context by shedding light on the relationship between context and organisational actors' abilities to resolve ongoing challenges. Design/methodology/approach The authors used qualitative data collection (interviews and focus groups with staff and site visits to English forensic psychiatry hospitals) and the analysis was informed by Lefebvre's writings on space. Findings Responses to ongoing challenges were both constrained and facilitated by the context, which was negotiated and co-produced by the actors involved. Various (i.e. societal and professional) dimensions of context interacted to create tensions, which resulted in changes in service configuration. These changes were reconciled, to some extent, via discourse. Despite some resolution, the co-production of context preserved contradictions which mean that ongoing challenges were modified, but not resolved entirely. Originality/value The paper highlights the importance of viewing context as co-produced in a continuous manner. This helps us to delineate and understand its dynamic nature and its relationship with the everyday actions and beliefs of the organisational actors concerned.

  2. Factors associated with hospitalization of children with acute odontogenic infections

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    Klačar Jelena


    Full Text Available The aim of this study was to compare the sociodemographic and clinical features of odontogenic infections between hospitalized and nonhospitalized children and to show what were the risk factors in children that could predict the course of odontogenic infection and indicate the need for hospital treatment. The design of our study was of the case-control type. The two study groups consisted of 70 inpatients and 35 outpatients with odontogenic infections who were treated at Department of Pediatric Dentistry and Department of Maxillofacial Surgery at Clinical Center in Kragujevac, Serbia. Clinical and sociodemographic data were collected retrospectively from patients' hospital records. The following characteristics were significantly associated with hospital treatment of children with acute odontogenic infection: living in a village (OR =7.26,[1.43-36.96], multi-spatial infection (OR =0.04, [0.00-0.91], and affection of upper face (OR = 0.01, [0.00-0.86]. Tooth extraction was important intervention in the treatment regimen and reduced frequency of hospitalization (OR=0.07, [0.01-0.70]. The differences between hospitalized and non-hospitalized children were not significant in regard to: ethnicity, employment of parents, anatomical region of infection, side of the facial infection, source of infection (posterior or anterior deciduous or permanent teeth, and treatment (drainage and incision, oral or parenteral antibiotics. In children with acute odontogenic infection it is necessary to do tooth extraction in timely manner, especially if the source of infection is tooth from upper jaw and if it is multi-spatial infection.

  3. Chromosomal abnormalities in a psychiatric population

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    Lewis, K.E.; Lubetsky, M.J.; Wenger, S.L.; Steele, M.W. [Univ. of Pittsburgh Medical Center, PA (United States)


    Over a 3.5 year period of time, 345 patients hospitalized for psychiatric problems were evaluated cytogenetically. The patient population included 76% males and 94% children with a mean age of 12 years. The criteria for testing was an undiagnosed etiology for mental retardation and/or autism. Cytogenetic studies identified 11, or 3%, with abnormal karyotypes, including 4 fragile X positive individuals (2 males, 2 females), and 8 with chromosomal aneuploidy, rearrangements, or deletions. While individuals with chromosomal abnormalities do not demonstrate specific behavioral, psychiatric, or developmental problems relative to other psychiatric patients, our results demonstrate the need for an increased awareness to order chromosomal analysis and fragile X testing in those individuals who have combinations of behavioral/psychiatric, learning, communication, or cognitive disturbance. 5 refs., 1 fig., 2 tabs.

  4. Hospitality and the mental health of children and families. (United States)

    Pohl, Christine D


    In many ancient cultures, hospitality was a significant moral and religious practice in responding to the needs of strangers. Although largely trivialized in contemporary society, the practice of hospitality continues to create contexts that contribute to individual and communal flourishing and that resist several dehumanizing social trends. A recovery of the practice can help faith communities connect their moral and theological commitments to the needs of children, families, and neighborhoods. © 2011 American Orthopsychiatric Association.

  5. Mycoplasma Pneumoniae among Children Hospitalized with Community-acquired Pneumonia. (United States)

    Kutty, Preeta K; Jain, Seema; Taylor, Thomas H; Bramley, Anna M; Diaz, Maureen H; Ampofo, Krow; Arnold, Sandra R; Williams, Derek J; Edwards, Kathryn M; McCullers, Jonathan A; Pavia, Andrew T; Winchell, Jonas M; Schrag, Stephanie J; Hicks, Lauri A


    The burden and epidemiology of Mycoplasma pneumoniae (Mp) among U.S. children (<18 years) hospitalized with community-acquired pneumonia (CAP) are poorly understood. In the Etiology of Pneumonia in the Community (EPIC) study, we prospectively enrolled 2254 children hospitalized with radiographically-confirmed pneumonia from January 2010-June 2012 and tested nasopharyngeal/oropharyngeal swabs for Mp using real-time polymerase chain reaction (PCR). Clinical and epidemiological features of Mp-PCR-positive and -negative children were compared using logistic regression. Macrolide susceptibility was assessed by genotyping isolates. In the EPIC study, 182(8%) children were Mp-PCR-positive (median age: 7 years); 12% required intensive care and 26% had pleural effusion. No in-hospital deaths occurred. Macrolide resistance was found in 6/169(4%) isolates. Of 178(98%) Mp-PCR-positive children tested for co-pathogens, 50(28%) had ≥1 co-pathogen detected. Variables significantly associated with higher odds of Mp detection included age {10-17 years [adjusted odds ratio (aOR): 7.9 (95% confidence interval (CI): 4.5-13.6)] and 5-9 years [aOR: 4.8 (CI: 2.9-7.8)] vs. 2-4 years}, outpatient antibiotics ≤5 days pre-admission [aOR: 2.3 (CI: 1.5-3.4)], and co-pathogen detection [aOR: 2.1 (CI: 1.3-3.1)]. Clinical characteristics often seen included hilar lymphadenopathy, rales, headache, sore throat, and decreased breath sounds. Usually considered as a mild respiratory infection, M. pneumoniae was the most commonly detected bacteria among children ≥5 years hospitalized with CAP; one-quarter of whom had co-detections. Although associated with clinically non-specific symptoms, there was a need for intensive care support in some cases. M. pneumoniae should be included in the differential diagnosis for school-aged children hospitalized with CAP.

  6. Nutritional status of children hospitalized for parapneumonic effusion.

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    Koen Huysentruyt

    Full Text Available BACKGROUND & AIMS: Among children hospitalized for pneumonia, those with parapneumonic effusion (PPE are at particular risk for nutritional deterioration. This study aimed to 1 investigate the evolution of the nutritional status during hospitalization and at outpatient follow-up; 2 determine clinical risk factors for weight loss during hospitalization; 3 describe the nutritional interventions for these children. METHODS: Retrospective chart review (January '07 - September '12 of 56 children with pneumonia, complicated by PPE in two Belgian hospitals for data on body weight and height at admission (t0 and discharge (t1, and two weeks (t2 and one month (t3 after discharge. Length of hospitalization (LoS, length of stay in paediatric intensive care (LoSPICU and maximal in-hospital weight loss (tmax were calculated and nutritional interventions were recorded. RESULTS: The median (range age was 3.5 (1.0-14.8 years. Weight or height was lacking in five (8.9% children at t0 and in 28 (50% at t1; 21.4% was weighed only once during hospitalization. At tmax, respectively 17/44 and 5/44 children lost ≥ 5% and ≥ 10% of their weight. Median (range LoS and LoSPICU were 18.0 (10-41 and 4.0 (0-23 days. One-fourth received a nutritional intervention. Weight for height at admission (WFH(t0 significantly predicted maximal weight loss (β (95% CI = -0.34 (-2.0--0.1; p = 0.03. At t2 and t3, 13/32 and 5/22 of the children with available follow-up data did not reach WFH(t0, whilst in 4/35 and 5/26 body weight remained ≥ 5% under the weight(t0. CONCLUSIONS: One-third of children with pneumonia complicated by PPE and monitored for weight and height, lost ≥ 5% of their body weight during hospitalization. One-fourth did not reach initial WFH one month after discharge. Those with a higher WFH at admission were at higher risk of weight loss. More attention for monitoring of weight loss and the nutritional policy during and after hospitalization is warranted.

  7. Anemia among hospitalized children at a multispecialty hospital, Bangalore (Karnataka, India

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    Firdos Saba


    Full Text Available Background: Due to the limited availability of data related to anemia in hospitalized children, this research was conducted to study the occurrence, morphological patterns, distribution in different age groups, sex, and severity of anemia among children aged 6 months-12 years. Setting: Inpatients in department of pediatrics at a multispecialty hospital, Bangalore. Study Design: Descriptive cross sectional study from Oct, 2011 to Sep, 2012. Materials and Methods: Ethical clearance was obtained from the ethical committee of the hospital as per 1964 Declaration of Helsinki. Unrestricted random sampling method was used to select the study group consisting of 882 children between the age of 6 months and 12 years. After obtaining the consent, data were obtained and statistically analyzed using statistical tools like mean, median, standard deviation, and Chi-square test. Results: Out of 882 children selected, 642 (72.79% were anemic, out of which a majority of 629 (98% children suffered from nonhemoglobinopathies and a meagre 13 (2% suffered from hemoglobinopathies. Children in the age group of 6 months-1 year were most affected with nonhemoglobinopathies (33%. Moderate degree of anemia (hemoglobin = 7-9.9 g/dL was the commonest grade of anemia (80%, while microcytic hypochromic anemia was commonest morphological type of anemia (48%. Among hemoglobinopathies, thalassemia major was the most common (69%, that is 9 out of 13 patients. Conclusion: The occurrence of anemia among children aged between 6 months and 12 years is high and nonhemoglobinopathies predominate over the hemoglobinopathies.

  8. Why Are There So Few Ethics Consults in Children's Hospitals? (United States)

    Carter, Brian; Brockman, Manuel; Garrett, Jeremy; Knackstedt, Angie; Lantos, John


    In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas. Then, as a case-study, we describe the different venues that have developed at one children's hospital to address ethical issues. At our hospital, there are nine different venues in which ethical issues are regularly and explicitly addressed. They are (1) ethics committee meetings, (2) Nursing Ethics Forum, (3) ethics Brown Bag workshops, (4) PICU ethics rounds, (5) Grand Rounds, (6) NICU Comprehensive Care Rounds, (7) Palliative Care Team (PaCT) case conferences, (8) multidisciplinary consults in Fetal Health Center, and (9) ethics consultations. In our hospital, ethics consults account for only a tiny percentage of ethics discussions. We suspect that most hospitals have multiple and varied venues for ethics discussions. We hope this case study will stimulate research in other hospitals analyzing the various ways in which ethicists and ethics committees can build an ethical environment in hospitals. Such research might suggest that ethicists need to develop a different set of "core competencies" than the ones that are needed to do ethics consultations. Instead, they should focus on their skills in creating multiple "moral spaces" in which regular and ongoing discussion of ethical issues would take place. A successful ethicist would empower everyone in the hospital to speak up about the values that they believe are central to respectful, collaborative practice and patient care. Such a role is closer to what the first hospital philosophers set


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    Marcela Pimenta Muniz


    Full Text Available O objetivo do estudo foi analisar a compreensão da equipe de enfermagem sobre os processos educativos vivenciados por ela em um hospital psiquiátrico. O percurso metodológico  foi  realizado   à luz da  Análise  Institucional, através de grupo focal com a equipe de enfermagem e observação participante. Os participantes do grupo focal mencionam  que  é  necessário  que  haja: tempo disponível  para participar  dos espaços educativos, mais investimento institucional, co-responsabilização da equipe multidisciplinar na formação dos profissionais de enfermagem. Apontam que cada aspecto temático requer um determinado dispositivo educativo. Concluímos que a organização das ações educativas  para  a  equipe  de enfermagem  no  HP  em  estudo  deve ser co-construída por trabalhadores, portadores de sofrimento psíquico, familiares e gestores para a busca de processos de mudança no cuidado e de trabalho responsáveis. Necessita-se ponderar estratégias que vençam o medo ou a resistência às mudanças, sem apresentar como resposta o recrudescimento.

  10. Stereotyping and nurses' recommendations for treating pain in hospitalized children. (United States)

    Griffin, Ruth A; Polit, Denise F; Byrne, Mary W


    The purpose of this study was to examine whether nurses' recommendations for managing children's pain were influenced by stereotypes based on children's personal attributes. Three vignettes, in which hospitalized children's sex, race, and attractiveness were experimentally manipulated, were mailed to a national random sample of 700 pediatric nurses; 334 nurses responded. Responses to vignette questions indicated little evidence of stereotyping. Nurses perceived similar levels of pain and recommended similar pain treatments, regardless of sex, race, and attractiveness. Nurses, on average, perceived children's pain at levels consistent with the children's self-reports and recommended assertive analgesic and non-pharmacologic pain management strategies. The results appear consistent with prevailing views on providing adequate pain treatment for children.

  11. Evaluation Of Methadone Poisoning in Hospitalized Children: A Short Review

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    Gholamali Maamouri


    Full Text Available Upload poisoning is one of the most dangerous and common poisoning in Iranian children. Depression of the respiratory and central nervous systems may lead to significant toxicity. Even low doses of uploads are dangerous in pediatrics under 6 years old. Methadone is the most toxic of the uploads; small doses as low as a single tablet can lead to death. According to this information we decided to evaluate methadone poisoning in Hospitalized Children

  12. Typhoid fever among hospitalized febrile children in Siem Reap, Cambodia. (United States)

    Wijedoru, Lalith P M; Kumar, Varun; Chanpheaktra, Ngoun; Chheng, Kheng; Smits, Henk L; Pastoor, Rob; Nga, Tran Vu Thieu; Baker, Stephen; Wuthiekanun, Vanaporn; Peacock, Sharon J; Putchhat, Hor; Parry, Christopher M


    Typhoid fever was confirmed by positive blood culture in 5 (3.7%) of 134 febrile children hospitalized in Cambodia. Typhoid was suspected in an additional 25 (18.7 %) blood culture-negative children based on: a positive immunoglobulin M lateral flow assay (IgMFA) (16); a positive polymerase chain reaction (PCR) for Salmonella typhi (2); or clinical assessment (7). The specificity of the IgMFA and PCR assays requires further study.

  13. The importance of pets’ visit in recovery of hospitalized children

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    Andreia Maria Heins Vaccari


    Full Text Available Objective: To understand the experience of hospitalized childrenwhen visited by animals at hospital. Methods: Descriptive andexploratory research with qualitative approach in a private pediatrichospital in the city of São Paulo, Brazil. Thirteen children aged threeto six years were enrolled. Observation of the children before,during, and after the animal’s visit, interviews, and drawings weresome of the strategies used to collect data, which were submittedto the Bardin content analysis technique. Results: Three meaningcategories were identified and showed some of the benefits of thisexperience to children “pleasant contact with the animals”; “easierinteraction with staff and with other children”; “pain and discomfortrelief”. Conclusions: Animal visits make the environment morerelaxed, improve the interaction between the child, the staff andother children thus helping sick children to be more cooperativewith hospital procedures. This is an alternative strategy for pain anddiscomfort relief. It has also been observed that this activity benefitsnot only children but also adults who care them.

  14. The prevalence of undernutrition upon hospitalization in children in a developing country: A single hospital study from Malaysia

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    Way-Seah Lee


    Conclusion: The prevalence of undernutrition among children admitted to a tertiary hospital in Malaysia was 14%. Strategies for systematic screening and provision of nutritional support in children at risk of undernutrition as well as treatment of undernutrition in children requiring hospitalization are needed.

  15. Frequency of medical errors in hospitalized children in khorramabad Madani hospital during six months in 2008

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    azam Mohsenzadeh


    Full Text Available Many hospitalized children are suffered from medical errors that may cause serious injuries. The aim of this study was to evaluate medical errors in hospitalized children in khorramabad Madani hospital in the first half of 2008. Materials and Methods: This study was a cross sectional that was performed for all medical errors in hospitalized children in khorramabad Madani hospital from 21/3/2008 to 21/9/2008. The sampling method was census. Studied variables included: age, sex, weight, kinds of errers, education of parents, job of parents. Data was collected by questionnaire and analyzed by SPSS software. Results: In this study out of 2250 records, 151 (6/3% had medical errors. 53%were girls and 47% were boys that there was a significant relation between sex and medical errors. 46/4%were related to age group lower than 2 years old. Most of the errors were occurred in weight group of 6kg. Types of medical errors included drug ordering 46/3% (involved incorrect dosage of drug (37%, frequency 28%, rout 19% and others 16%, transcribing10%, administering32/4%, dispensing11/3%. Most errors related to liquid therapy 76/2% and intravenous rout 85/4%. Most errors were occurred during night 47% and during weekend 56/6%. Conclusion: Medical errors are common in hospitalized patients, and in our study the rate of medical errors was 6/3%. So further efforts are needed to reduce them.

  16. Fear of clowns in hospitalized children: prospective experience. (United States)

    Meiri, Noam; Schnapp, Zeev; Ankri, Amichi; Nahmias, Itay; Raviv, Amnon; Sagi, Omer; Hamad Saied, Mohamad; Konopnicki, Muriel; Pillar, Giora


    Medical clowns (MC) have become an integral part of the pediatric staff of hospital wards. While several studies have demonstrated the huge benefits of MC, there are almost no data regarding fear of clowns, a known phenomenon that means an irrational fear of clowns. In the current study, we sought to examine the prevalence of fear of clowns in pediatrics wards, and to characterize the affected children. The clinical work of three certified MCs was prospectively assessed. Every child with fear of clowns was noted, data were retrieved from the medical records, and the parents/child completed a specific questionnaire with a research assistant. Fear of clowns was defined as crying, anxiety response or effort to avoid contact with the MCs in small children, while in older children, it was determined if the child either reported fear of MCs or made actions to avoid clowns' intervention. A total of 1160 children participated in the study. All were hospitalized in the department of pediatrics or the pediatric emergency medicine department at Carmel Medical Center, and were exposed to a MC intervention session. Of the 1160 children, 14 children experienced fear of clowns (1.2%). The average age of children who experienced fear of clowns was 3.5 years (range 1-15). Interestingly, most of the children demonstrating fear of clowns were girls (12 out of 14, 85.7%). We found no association between fear of clowns and specific diagnosis, fever, clinical appearance, religion, or ethnicity. The prevalence of fear of clowns in the general pediatric hospitalized population was 1.2%, with a significant predominance of girls (85.7%). Children who experienced significant fear of clowns also experienced significant fear of encountering or thinking about a MC visit. Fear of clowns can affect children at any age (range 1-15), any ethnicity, religion, or degree of illness. Further large scale studies are required to better understand this unique phenomenon of fear of clowns. What is Known

  17. [Symptoms of depression in children and adolescents in relation to psychiatric comorbidities]. (United States)

    Baji, Ildikó; Gádoros, Júlia; Kiss, Enikô; Mayer, László; Kovács, Eszter; Benák, István; Vetró, Agnes


    The lifetime prevalence of MDD before adolescence is 4-5%, while the symptoms concern 13-20% of the adolescents. In the development of suicidal behaviour the most important risk factors are the use of psychoactive drugs and smoking. Psychiatric comorbidities are aggravating significantly the major depression. The comorbidities are high among major depression, anxiety and disruptive disorders. We examined 649 children being in a depressive episode diagnosed by ISCA-D semi-structured interview, 45,9% of them were girls, and 54,1% were boys, the mean age was 11,7 years ( SD=2,00). The participants were enrolled into three groups according to their comorbidities: group with only depression without comorbidities, group with anxiety comorbidity, and group with disruptive comorbidity. We compared the three groups according to the frequency of their depressive symptoms. Anxiety comorbidities increase the incidence of depressive symptoms. Among the criteria symptoms irritability where the most frequent symptom independently from the comorbidities, the depressed mood is the most frequent within the anxiety group, while anhedonia occurred with a moderate frequency in each groups. In the anxiety group the vegetative symptoms, while in the disruptive group the psychomotor agitation and the feeling of worthlessness are the most frequent symptoms. Comorbidities are increasing the incidence of the suicide symptoms. The incidence of impaired decision making was high in each group, the comorbidities didn't influence it's frequency. Among depressed boys irritability and feelings of worthlessness (low self-esteem) increase the presence of externalisation comorbidity. Among depressed girls guilt was significantly more frequent in the anxiety comorbidity group, and concentration problems are the most typical symptoms in the clear MDD group, without comorbidities.

  18. Understanding Design Vulnerabilities in the Physical Environment Relating to Patient Fall Patterns in a Psychiatric Hospital: Seven Years of Sentinel Events. (United States)

    Bayramzadeh, Sara; Portillo, Margaret; Carmel-Gilfilen, Candy


    The influence of the physical environment on patient falls has not been fully explored in psychiatric units, despite this patient population's vulnerability and the critical role of the physical environment in patient safety. The research objective is to describe the spatial and temporal pattern of falls occurrences and their location in relation to the levels of safety continuum model. This article presents an exploratory case study design. Seven years of retrospective data on patient falls, yielding 818 sentinel events, in an 81-bed psychiatric hospital in the United States were collected and analyzed. Data focused on extrinsic factors for falls, emphasizing the physical environment. Through a content analysis of the sentinel event narratives, recorded by the hospital staff, this study explored patient falls related to location and elements of the physical environment. The analysis revealed that 15% of recorded falls were attributed to some aspect of or element within the physical environment. The most typical locations of falls were patient rooms (39%), patient bathrooms (22%), and dayrooms (20%). Also, the results identified patterns of environmental factors that appeared linked to increasing patients' susceptibility to falls. Risk factors included poor nighttime lighting, flooring surfaces that were uneven, and spaces that inadvertently limited visual access and supervision. The physical environment plays an often-unexamined role in fall events and specific locations. These results are deserving of further research on design strategies and applications to reduce patient falls in psychiatric hospital settings.

  19. Pénibilité du travail en hôpital psychiatrique Demanding work in a psychiatric hospital Dificultades del trabajo en un hospital psiquiátrico

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    Caroline Cintas


    Full Text Available L’objectif de cet article est de montrer que la pénibilité du travail des soignants en hôpital psychiatrique est moins due à la dangerosité des patients qu’à l’impossibilité perçue de faire un travail de qualité. Nous tentons donc à travers les discours des personnels interrogés par entretiens d’analyser les difficultés ressenties. Nous développons l’idée que cette pénibilité est liée à l’inquiétude que suscitent les changements organisationnels en cours. Cette explication de la pénibilité s’apparente davantage à un choc des cultures qui rend le décalage entre travail prescrit et réel plus prégnant. La discussion nous permet d’envisager le cadre théorique de la psychopathologie pour comprendre les résultats obtenus. Ainsi, c’est sous l’angle de l’organisation du travail que nous mettons en évidence les problèmes de pénibilité des soignants en psychiatrie. Nous formulons l’hypothèse que l’impact des changements étudiés à l’hôpital psychiatrique n’est pas spécifique à ce secteur ; ils ont, cependant, un retentissement plus fort dans des situations de travail déjà porteuses de violence. En effet, le contexte de l’hôpital psychiatrique met en évidence l’exacerbation des problèmes organisationnels généraux soulevés.The aim of this article is to show that the difficult work of nursing staff in psychiatric hospitals is less the result of the dangerousness of patients than the perceived impossibility of doing quality work. Through interviews with the staff, we attempt to analyze the difficulties felt. We develop the idea that this difficulty is related to the worry caused by current organizational changes. This explanation of the difficulty is more like a culture clash that emphasizes the difference between the prescribed work and the actual work. The discussion allows us to consider the theoretical framework of psychopathology in order to understand the results obtained

  20. Epidemiology Of Measles And Its Complications In Non- Hospitalized Children

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    Mangal N


    Full Text Available This study was conducted in 1985-86 amongst non-hospitalized children of jaipur city in33 investigative units having 3791 families with 6183 children in the 0-9 years age group. Measles vaccine coverage was only 21.7% Measles developed in 189 cases. Maximum incidence occurred in the 1-2 years olds and during the first half of the years (January to June. Complication developed in 50 (26.5% children. The most frequent was diarrohea (14.3% followed by respiratory infection (6.9%. No case fatality was reported.

  1. HIV Infection in hospitalized under-5 children with acute watery ...

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    Prof Ezechukwu


    Dec 31, 2011 ... HIV with acute watery diarrhea as a clinical manifesta- tion.5,6,9,10 This study therefore attempts to find out the prevalence of HIV among children admitted into the. Diarrhoea Treatment and Training Unit of the University of Calabar Teaching Hospital, Calabar, Nigeria. This study will help in identifying ...

  2. Are We Meeting The Calorie Needs Of Hospitalized Children ...

    African Journals Online (AJOL)

    For the past four decades, nutrition has assumed its pride of place on the list of advances in surgery and general patient care. We prospectively reviewed the effect of hospitalisation on the nutritional status of 28 children admitted for various surgical and medical conditions at the Lagos University Teaching Hospital.

  3. Maternal SSRI discontinuation, use, psychiatric disorder and the risk of autism in children: a meta-analysis of cohort studies. (United States)

    Kaplan, Yusuf Cem; Keskin-Arslan, Elif; Acar, Selin; Sozmen, Kaan


    We undertook an exclusive meta-analysis of cohort studies investigating the possible link between prenatal selective serotonin reuptake inhibitor (SSRI) exposure and autism spectrum disorders (ASD) in children to further investigate our previous suggestion of confounding by indication. The point estimates regarding the following cohorts were extracted and pooled: (1) pregnant women who discontinued SSRI until 3 months before pregnancy; (2) pregnant women who were exposed to SSRI during pregnancy; and (3) pregnant women with maternal psychiatric disorder but no exposure to SSRI during pregnancy. Although the pooled point estimate of the first cohort showed a trend for increase, it did not reach significance. The pooled point estimates of the latter cohorts showed a significant association with ASD which strengthens our previous suggestion of confounding by indication. Future studies should be adequately designed to differentiate whether the previously suggested association is a result of maternal psychiatric disorder or SSRI exposure or both. © 2017 The British Pharmacological Society.

  4. Depression and suicide risk of outpatients at specialized hospitals for substance use disorder: comparison with depressive disorder patients at general psychiatric clinics. (United States)

    Matsumoto, Toshihiko; Matsushita, Sachio; Okudaira, Kenichi; Naruse, Nobuya; Cho, Tetsuji; Muto, Takeo; Ashizawa, Takeshi; Konuma, Kyohei; Morita, Nobuaki; Ino, Aro


    The present study used a self-reporting questionnaire to compare suicide risk in outpatients being treated for substance use disorder at specialized hospitals to suicide risk in outpatients being treated for depressive disorder at general psychiatric clinics. Although patients in both groups exhibited an equal severity of depression, the patients with drug use disorder had a higher suicide risk than those with depressive disorder. These findings indicate that drug-abusing patients at specialized hospitals may have a severe risk of committing suicide, suggesting that carefully assessing the comorbidity of depression with drug abuse may be required for preventing suicide in drug-abusing patients.

  5. ADHD and Aggression as Correlates of Suicidal Behavior in Assaultive Prepubertal Psychiatric Inpatients (United States)

    Goodman, Geoff; Gerstadt, Cherie; Pfeffer, Cynthia R.; Stroh, Martha; Valdez, Adina


    Forty-three psychiatrically hospitalized prepubertal children were assessed regarding their assaultive and suicidal behaviors. These children were subsequently classified into two groups, assaultive/suicidal (AS) and assaultive-only (AO). AS children had higher aggression and suicidal-scale scores, but not higher depression scores, and were more…

  6. Comparison of the characteristics of suicide attempters with major depressive disorder and those with no psychiatric diagnosis in emergency departments of general hospitals in China. (United States)

    Wei, Shengnan; Li, Haiyan; Hou, Jinglin; Chen, Wei; Chen, Xu; Qin, Xiaoxia


    Major depressive disorder (MDD) is a known major risk factor for suicide due to the high suicide mortality. However, studies comparing the characteristics of suicide attempters with major depressive disorder and those with no psychiatric diagnosis in China are very limited. This study examined and compared the sociodemographic and psychological characteristics of suicide attempters with MDD and those with no psychiatric diagnosis in emergency departments of general hospitals to better understand the risk factors for suicide attempts in China. All subjects were enrolled in the study between June 2007 and January 2008. A total of 127 suicide attempters-54 with MDD and 73 with no psychiatric diagnosis-were enrolled. The sociodemographic and clinical characteristics were compared between two groups using the statistical analysis performed using frequency distribution, Student's t test, Chi-square test, and Fisher's exact test and a logistic regression model. Suicide attempters with MDD were more likely to be more depressive, older, divorced or separated, unemployed, and living alone, and more likely to write a suicide note, have suicide ideation, and be motivated by reducing pain and burden. Suicide attempters with no psychiatric diagnosis were more likely to be younger and more impulsive, have self-rescue, and be motivated by threatening or taking revenge on others. Multivariate logistic regression analysis identified the following independent predictors of suicide attempts in individuals with MDD: a lower score on the quality of life scale, more years of education, and suicide ideation. The present study found both similarities and differences in the sociodemographic and clinical characteristics of suicide attempters with MDD and those with no psychiatric diagnosis in the emergency departments of general hospitals in China. These findings will help us to recognize the characteristics of suicide attempters in both groups and develop specific interventions for the two

  7. Social Networking Family of Caregivers during Hospitalization of Children. (United States)

    Menezes, Marina; Moré, Carmen Leontina Ojeda Ocampo; Barros, Luísa


    To identify and analyze the significant networks of family, social and hospital support described by the family caregivers of hospitalized children 5-12 years during the hospital stay. Descriptive study, exploratory and qualitative study conducted with 20 caregivers of children hospitalized in a hospital in a city in southern Brazil, through semi-structured interviews and significant social networks maps, tailored to the hospital setting. Data analysis showed that the most active social network was comprised of families through emotional support, material aid and services. Relations with hospital health care team and the hospital context were cited as providing support to the caregivers of the hospitalized child. The identification of social networks in the child's hospitalization course enables equip professionals working in the institution aiming at better targeting of actions and care for the family and hospitalized children. Identificar e analisar as redes significativas de suporte familiar, social e hospitalar descritas pelos familiares acompanhantes de crianças hospitalizadas de 5 a 12 anos, durante o período de internação. Estudo descritivo, exploratório e de cunho qualitativo realizado com 20 acompanhantes de crianças hospitalizadas em uma unidade hospitalar em uma cidade do Sul do Brasil, por meio de entrevistas semiestruturadas e dos Mapas de Redes sociais significativas, adaptado para o contexto hospitalar. A análise dos dados demonstrou que a rede social mais atuante foi composta por familiares, através de apoio emocional, ajuda material e de serviços. As relações com a equipe de saúde do hospital e com o contexto hospitalar foram citadas como capazes de fornecer apoio ao acompanhante da criança internada. a identificação das redes sociais no curso da hospitalização da criança possibilita instrumentalizar os profissionais que atuam na instituição objetivando um melhor direcionamento de ações e cuidados destinados à família e a

  8. Hospitality: transformative service to children, families, and communities. (United States)

    Melton, Gary B


    Hospitality is an ancient moral practice that was deeply embedded in early Judaism, Christianity, and Islam. Hospitality requires acceptance of, service to, and respect for people who lack a place in the community. The contemporary importance of this practice reflects the social disconnection and economic disadvantage of many young parents and the high frequency of separation of young people, including many young parents, from their communities. Such social deterioration substantially increases the risk of child maltreatment. Building on the proposals of the U.S. Advisory Board on Child Abuse and Neglect, Strong Communities for Children demonstrated the effectiveness of community building in reducing such risk. It further suggested the importance of both relying on and learning from hospitable people in strengthening support for children and their parents. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  9. Association of Breakfast Intake with Psychiatric Distress and Violent Behaviors in Iranian Children and Adolescents: The CASPIAN- IV Study. (United States)

    Ahadi, Zeinab; Kelishadi, Roya; Qorbani, Mostafa; Zahedi, Hoda; Aram, Mahtab; Motlagh, Mohammad Esmaeil; Ardalan, Gelayol; Shafiee, Gita; Arzaghi, Seyed Masoud; Asayesh, Hamid; Heshmat, Ramin


    To assess the relationship of breakfast intake with psychiatric distress and violent behaviors among Iranian children and adolescents. This national survey was conducted among 14,880 students, aged 6-18 y. They were selected by stratified multistage sampling method from urban and rural areas of 30 provinces of Iran. Breakfast intake, psychiatric distress, and violent behaviors were assessed by a questionnaire prepared based on the Global school-based student health survey of the World Health Organization. The data were analyzed by the STATA package. The participation rate was 90.6 %. The percentage of psychiatric distress among breakfast skippers, semi-skippers and non-skippers was 13.4-50.4, 10.1-41.9, and 7.0-33.3 % respectively. The prevalence of psychiatric distress was significantly higher among breakfast skippers than semi-skippers and non-skippers (P value breakfast skippers to non-skippers. The prevalence of violent behaviors was significantly higher among breakfast skippers than non-skippers. Students who skipped breakfast reported to be more victimized (29.2 % vs. 26.7 %, respectively, P = 0.04), bullied (21.0 % vs. 16.2 %, respectively, P breakfast were less likely to experience mental health disorders and violent behavior. Adhering to a regular and balanced diet, besides the awareness of parents on the importance of breakfast eating, may be an appropriate approach for preventing mental health problems and violent behavior in children and adolescents.

  10. Heart rates in hospitalized children by age and body temperature. (United States)

    Daymont, Carrie; Bonafide, Christopher P; Brady, Patrick W


    Heart rate (HR) is frequently used by clinicians in the hospital to assess a patient's severity of illness and make treatment decisions. We sought to develop percentiles that characterize the relationship of expected HR by age and body temperature in hospitalized children and to compare these percentiles with published references in both primary care and emergency department (ED) settings. Vital sign data were extracted from electronic health records of inpatients temperature measurement pairs from each admission. Measurements from 60% of patients were used to derive the percentile curves, with the remainder used for validation. We compared our upper percentiles with published references in primary care and ED settings. We used 60,863 observations to derive the percentiles. Overall, an increase in body temperature of 1°C was associated with an increase of ∼ 10 beats per minute in HR, although there were variations across age and temperature ranges. For infants and young children, our upper percentiles were lower than in primary care and ED settings. For school-age children, our upper percentiles were higher. We characterized expected HR by age and body temperature in hospitalized children. These percentiles differed from references in primary care and ED settings. Additional research is needed to evaluate the performance of these percentiles for the identification of children who would benefit from further evaluation or intervention for tachycardia. Copyright © 2015 by the American Academy of Pediatrics.

  11. Coping strategies used by hospitalized children with cancer undergoing chemotherapy. (United States)

    Sposito, Amanda Mota Pacciulio; Silva-Rodrigues, Fernanda Machado; Sparapani, Valéria de Cássia; Pfeifer, Luzia Iara; de Lima, Regina Aparecida Garcia; Nascimento, Lucila Castanheira


    To analyze coping strategies used by children with cancer undergoing chemotherapy during hospitalization. This was an exploratory study to analyze qualitative data using an inductive thematic analysis. Semistructured interviews using puppets were conducted with 10 children with cancer, between 7 and 12 years old, who were hospitalized and undergoing chemotherapy. The coping strategies to deal with chemotherapy were: understanding the need for chemotherapy; finding relief for the chemotherapy's side effects and pain; seeking pleasure in nourishment; engaging in entertaining activities and having fun; keeping the hope of cure alive; and finding support in religion. Children with cancer undergoing chemotherapy need to cope with hospitalizations, pain, medication side effects, idle time, and uncertainty regarding the success of treatment. These challenges motivated children to develop their own coping strategies, which were effective while undergoing chemotherapy. By gaining knowledge and further understanding about valid coping strategies during chemotherapy treatment, health professionals can mobilize personal and material resources from the children, health teams, and institutions aiming to potentiate the use of these strategies to make treatments the least traumatic. © 2015 Sigma Theta Tau International.

  12. One-year risk of psychiatric hospitalization and associated treatment costs in bipolar disorder treated with atypical antipsychotics: a retrospective claims database analysis

    Directory of Open Access Journals (Sweden)

    Pikalov Andrei


    Full Text Available Abstract Background This study compared 1-year risk of psychiatric hospitalization and treatment costs in commercially insured patients with bipolar disorder, treated with aripiprazole, ziprasidone, olanzapine, quetiapine or risperidone. Methods This was a retrospective propensity score-matched cohort study using the Ingenix Lab/Rx integrated insurance claims dataset. Patients with bipolar disorder and 180 days of pre-index enrollment without antipsychotic exposure who received atypical antipsychotic agents were followed for up to 12 months following the initial antipsychotic prescription. The primary analysis used Cox proportional hazards regression to evaluate time-dependent risk of hospitalization, adjusting for age, sex and pre-index hospitalization. Generalized gamma regression compared post-index costs between treatment groups. Results Compared to aripiprazole, ziprasidone, olanzapine and quetiapine had higher risks for hospitalization (hazard ratio 1.96, 1.55 and 1.56, respectively; p Conclusions In commercially insured adults with bipolar disorder followed for 1 year after initiation of atypical antipsychotics, treatment with aripiprazole was associated with a lower risk of psychiatric hospitalization than ziprasidone, quetiapine, olanzapine and risperidone, although this did not reach significance with the latter. Aripiprazole was also associated with significantly lower total healthcare costs than quetiapine, but not the other comparators.

  13. Risk-adjusted hospital outcomes for children's surgery. (United States)

    Saito, Jacqueline M; Chen, Li Ern; Hall, Bruce L; Kraemer, Kari; Barnhart, Douglas C; Byrd, Claudia; Cohen, Mark E; Fei, Chunyuan; Heiss, Kurt F; Huffman, Kristopher; Ko, Clifford Y; Latus, Melissa; Meara, John G; Oldham, Keith T; Raval, Mehul V; Richards, Karen E; Shah, Rahul K; Sutton, Laura C; Vinocur, Charles D; Moss, R Lawrence


    BACKGROUND The American College of Surgeons National Surgical Quality Improvement Program-Pediatric was initiated in 2008 to drive quality improvement in children's surgery. Low mortality and morbidity in previous analyses limited differentiation of hospital performance. Participating institutions included children's units within general hospitals and free-standing children's hospitals. Cases selected by Current Procedural Terminology codes encompassed procedures within pediatric general, otolaryngologic, orthopedic, urologic, plastic, neurologic, thoracic, and gynecologic surgery. Trained personnel abstracted demographic, surgical profile, preoperative, intraoperative, and postoperative variables. Incorporating procedure-specific risk, hierarchical models for 30-day mortality and morbidities were developed with significant predictors identified by stepwise logistic regression. Reliability was estimated to assess the balance of information versus error within models. In 2011, 46 281 patients from 43 hospitals were accrued; 1467 codes were aggregated into 226 groupings. Overall mortality was 0.3%, composite morbidity 5.8%, and surgical site infection (SSI) 1.8%. Hierarchical models revealed outlier hospitals with above or below expected performance for composite morbidity in the entire cohort, pediatric abdominal subgroup, and spine subgroup; SSI in the entire cohort and pediatric abdominal subgroup; and urinary tract infection in the entire cohort. Based on reliability estimates, mortality discriminates performance poorly due to very low event rate; however, reliable model construction for composite morbidity and SSI that differentiate institutions is feasible. The National Surgical Quality Improvement Program-Pediatric expansion has yielded risk-adjusted models to differentiate hospital performance in composite and specific morbidities. However, mortality has low utility as a children's surgery performance indicator. Programmatic improvements have resulted in

  14. Telemedicine for a Children's Field Hospital in Chechnya. (United States)

    Ehrlich, A I; Kobrinsky, B A; Petlakh, V I; Rozinov, V M; Shabanov, V E


    In 2001, the Children's Field Hospital in the Gudermes area of the Chechen Republic was connected to a telemedical centre at the Scientific Institute of Pediatrics and Children's Surgery in Moscow, via the Russian SCA HeliosNet satellite system. An asymmetric satellite link, in which there was a high-speed downlink from the satellite to Gudermes and a low-speed uplink from Gudermes to the satellite was used. In total, 179 teleconsultations were carried out from October 2001 until February 2002, when the field hospital was closed. Of the 179 teleconsultations, 26 were real-time, by videoconference and the rest were asynchronous, by email. Almost half of consultations were carried out for emergency or urgent reasons, thus demonstrating the value of providing access to the necessary experts. The use of satellite communication allowed telemedical support for medical decisions in a wide range of disease and trauma in children and teenage in a conflict situation.

  15. A comprehensive psychiatric service

    DEFF Research Database (Denmark)

    Wang, A G


    A comprehensive psychiatric service was established in 1969 in the Faroe Islands. This service was created as a department of a general hospital. The spheres covered by this department, operating in the midst of the community were: acute and chronic patients, a liaison-psychiatric service...

  16. Risk of malnutrition of hospitalized children in a university public hospital. (United States)

    Muñoz-Esparza, Nelly Carolina; Vásquez-Garibay, Edgar Manuel; Romero-Velarde, Enrique; Troyo-Sanromán, Rogelio


    The study aimed to demonstrate that the duration of hospitalization has a significant effect on the nutritional status of children treated in a university hospital. A longitudinal study was conducted during 2014, with a non-random sampling site concentration in children from birth to 19 years who were admitted to the hospital in the past 24 hours and who met the inclusion criteria and had signed informed consent. Upon entering, at 7 days, and at discharge, anthropometric indices, including weight/age, height/age, weight/height, BMI/age, head circumference/age, triceps and subscapular skin folds, and fat percentage, were obtained. Student's t-test, U Mann-Whitney, ANOVA, chi square, Wilcoxon, and odds ratios were used to analyze the data. In total, 206 patients were included: 40% infants, 25% preschoolers, 15% schoolchildren, and 20% teenagers. Infants had a significant improvement from admission to discharge in the indices weight/length (p = 0.042) and BMI (p = 0.002); adolescents showed decreased BMI from admission to discharge from the hospital (p = 0.05). Patients with longer hospitalization (more than 10 days) had an increased deficit in anthropometric indices at admission (p malnutrition and require greater monitoring of nutritional status during hospitalization.

  17. Causes of recurrent pneumonia in children in a general hospital. (United States)

    Hoving, M F Paulien; Brand, Paul L P


    Because the few previous studies on underlying causes of recurrent pneumonia in children have come from tertiary care referral centres where selection bias may be important, the aim of this study was to examine underlying causes of recurrent pneumonia in children in a general hospital. We performed a retrospective chart review in a general hospital of 62 children with recurrent pneumonia over a 7.5 years period. In 19 patients (30.6%), no cause was identified, commonly because favourable natural history obviated the need for a full and invasive diagnostic work-up. Other underlying causes included recurrent aspiration in 16 patients (25.7%), lung disease (airway stenosis, bronchiectasis, middle lobe syndrome or tracheooesophageal fistula) in 10 patients (16.1%) and immune deficiency in 10 patients (16.1%). In contrast to previous studies, asthma was never diagnosed as an underlying cause, but diagnostic confusion between asthma (or recurrent upper respiratory tract infections) and recurrent pneumonia was common. The cause of recurrent pneumonia in children remains elusive in almost a third of patients, partly because the favourable natural history consistent with immune system maturation eliminates the need for further diagnostic procedures. Asthma is more likely a differential diagnostic consideration than an underlying cause of recurrent pneumonia in children. A standardised diagnostic guideline is needed to improve knowledge on causes of recurrent pneumonia in children. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  18. Magical attachment: Children in magical relations with hospital clowns

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    Lotta Linge


    Full Text Available The aim of the present study was to achieve a theoretical understanding of several different-age children's experiences of magic relations with hospital clowns in the context of medical care, and to do so using psychological theory and a child perspective. The method used was qualitative and focused on nine children. The results showed that age was important to consider in better understanding how the children experienced the relation with the hospital clowns, how they described the magical aspects of the encounter and how they viewed the importance of clown encounters to their own well-being. The present theoretical interpretation characterized the encounter with hospital clowns as a magical safe area, an intermediate area between fantasy and reality. The discussion presented a line of reasoning concerning a magical attachment between the child and the hospital clowns, stating that this attachment: a comprised a temporary relation; b gave anonymity; c entailed reversed roles; and d created an emotional experience of boundary-transcending opportunities.

  19. Co-occurrence of communication disorder and psychiatric disorders in maltreated children and adolescents: relationship with global functioning. (United States)

    Stivanin, Luciene; Oliveira, Christian C de; Santos, Fernanda P Dos; Santos, Bernardo Dos; Scivoletto, Sandra


    To study the co-occurrence of psychiatric disorders (PD) and communication disorders (CD) and their relationship with global functioning in maltreated children and adolescents. The sample comprised 143 maltreated children and adolescents (55.8% male). All underwent clinical communication and psychiatric evaluations, as well as global functioning assessment using the Children's Global Assessment Scale (C-GAS). Four groups emerged from evaluation: Group 1 (n=7, 4.9%) did not exhibit any disorders; Group 2 (n=26, 18.2%) exhibited PD; Group 3 (n=34, 23.8%) exhibited CD; and Group 4 (n=76, 53.1%) exhibited both PD and CD on evaluation. Significant differences in global functioning scores were found between G1 and G2, G1 and G4, G2 and G4, and G3 and G4, with the highest C-GAS scores found in G1 and the lowest in G4. Rates of PD and CD are high in this maltreated population. The presence of PD has a major impact on C-GAS score, and the simultaneous presence of CD increases the already impaired function of PD. Demonstration of the additive effects of PD and CD on youth functioning suggests that professionals should be alert to the presence of both disorders to better act preventively and therapeutically in a high-risk population.

  20. Use of drawings in children with pervasive developmental disorder during hospitalization: a developmental perspective. (United States)

    Stefanatou, Athena


    The level and nature of emotional upheaval and relationship to developmental stage was studied in children with pervasive developmental disorder (PDD) hospitalized for head injury. The sample consisted of 25 hospitalized children aged 5-12 years. Children were asked to make the drawing of a ;person in hospital'. The drawings were evaluated by Koppitz's emotional indicators. Punishment and persecution were the main cognitive constructs of children in order to explain hospitalization.

  1. Socioeconomic Status and Intelligence Quotient as Predictors of Psychiatric Disorders in Children and Adolescents with High-Functioning Autism Spectrum Disorder and in Their Siblings (United States)

    Rosa, Mireia; Puig, Olga; Lázaro, Luisa; Calvo, Rosa


    Previous studies have shown high rates of comorbid disorders in children and adolescents with autism spectrum disorder, but failed to compare them with general population and few of them have identified predictors of comorbidity. This study compared the rates of psychiatric disorders in 50 children and adolescents with autism spectrum disorder, 24…

  2. Knowledge of the mothers of hospitalized children in a university hospital regarding diarrhea

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    Ana Paula do Rego


    Full Text Available This qualitative research aimed at identifying the knowledge of the mothers regarding diarrhea. It was conducted with eight mothers of hospitalized children in a university hospital located in Santa Cruz, Rio Grande do Norte, Brazil, in 2012. Data were collected through open interviews and the analysis was based on Bardin. The categories emerging from the analysis were: understanding diarrhea and preventing/treating diarrhea. Regarding the understanding of diarrhea, mothers conceptualize and understand it from the symptoms, habits/eating mistakes and/or cultural beliefs. Concerning the prevention and treatment of the disease, the mothers highlight hygiene and home cleaning as preventive measures, as well the importance of home and hospital care measures. The interviewees have basic knowledge of pathology, further studies are necessary in order to define the current gap between the knowledge of mothers and recurrence of diarrhea cases, resulting in hospitalization and expenses with unnecessary treatment.

  3. Dental trauma that require fixation in a children's hospital. (United States)

    Bruns, Timothy; Perinpanayagam, Hiran


    Children and adolescents who suffer traumatic injuries often seek emergency treatment at a Children's Hospital. Complex injuries to permanent teeth and their periodontium require immediate repositioning and stabilization. Many of these emergencies are treated by pediatric dental residents at the Women and Children's Hospital of Buffalo, Buffalo, New York. The purpose of this study was to characterize these complex injuries of permanent teeth that require emergency treatment in a Children's Hospital. All of the cases of dental trauma which had involved permanent teeth and which had been treated with a splint in 2001 and 2002 were reviewed. There were 79 patients that were between 5 and 19 years of age with twice as many males (54) as females (25). The number of males increased from childhood (5-10 years) to early adolescence (11-15 years) and then decreased rapidly in late adolescence (16-19 years), whereas the number of females decreased steadily with age. Most of the incidents occurred during the summer months (72%), particularly in June and July (42%), and Fridays and Saturdays were the busiest days of the week. Most of the injuries were caused by organized and recreational sporting activities (39%) and accidental falls (33%), followed by interpersonal violence (15%) and a few motor vehicle accidents (7%). The 173 permanent tooth injuries were mostly luxations (62%) or avulsions (20%), with only a few fractures of the alveolar bone (5%) or tooth root (1%). Most of the displacements were lateral luxations (40%) or extrusions (18%) with only a few intrusions (3%). These injuries most commonly afflicted the maxillary central incisors (54%), followed by the maxillary laterals (18%) and mandibular centrals (17%). The emergency treatment that was provided at the Children's Hospital included replantation and repositioning, and the placement of a semi-rigid or flexible splint.

  4. A decentralised model of psychiatric care: Profile, length of stay and outcome of mental healthcare users admitted to a district-level public hospital in the Western Cape

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    Eileen Thomas


    Full Text Available Background. There is a lack of studies assessing the profile and outcome of psychiatric patients at entry-level public hospitals that are prescribed by the Mental Health Care Act to provide a decentralised model of psychiatric care. Objective. To assess the demographic and clinical profile as well as length of stay and outcomes of mental healthcare users admitted to a district-level public hospital in the Western Cape.  Method. Demographic data, clinical diagnosis, length of stay, referral profile and outcomes of patients (N=487 admitted to Helderberg Hospital during the period 1 January 2011 - 31 December 2011 were collected.  Results. Psychotic disorders were the most prevalent (n=287, 59% diagnoses, while 228 (47% of admission episodes had comorbid/secondary diagnoses. Substance use disorders were present in 184 (38% of admission episodes, 37 (57% of readmissions and 19 (61% of abscondments. Most admission episodes (n=372, 76% were discharged without referral to specialist/tertiary care.  Conclusion. Methamphetamine use places a significant burden on the provision of mental healthcare services at entry-level care. Recommendations for improving service delivery at this district-level public hospital are provided.

  5. Prevalence of rotavirus in children hospitalized with acute gastroenteritis in Imam Sajjad Hospital of Yasuj, 2011

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    P Khodadadi


    Full Text Available Abstract Background & Aim: Rotavirus infection is the most common cause of dehydrating and gastroenteritis among children worldwide. . The aim of this study was to determine the prevalence of rotavirus in children hospitalized with acute gastroenteritis in Imam Sajjad Hospital of Yasuj. Methods: This cross sectional – descriptive study was done on 184 stool samples of children younger than 7 years of age hospitalized at Imam Sajjad hospital of Yasuj in 2011 due to acute gastroenteritis. All samples were routinely analyzed for detection of rotavirus by Enzyme Immunoassay (EIA test. Data was analyzed by SPSS version 16, Chi-square test and Fisher's exact test. Results: Of the 184 samples analyzed, 52(28.26% were positive.The Results showed significant relationship between the seasonal distribution and virus detection (p=0/001. The highest incidence of rotavirus was seen in autumn with frequency of (48.08% and the lowest in spring (5.77%. Conclusions: According to high prevalence of rotavirus infection, continual surveillance is necessary to provide useful data for formulating effective vaccines and perform diarrhea prevention programs. Key words: Rotavirus, Gastroenteritis, Prevalence, Elisa

  6. Patient and social work factors related to successful placement of long-term psychiatric in-patients from a specialist psychiatric hospital in South Africa. (United States)

    Krüger, C; Lewis, C


    The slow discharge of long-term psychiatry patients from Weskoppies Hospital into the community has not matched the national and international drive towards deinstitutionalisation. This article investigates patient and social work factors related to successful community placement, in the context of limited community care facilities. Thirty-six long-term patients who were successfully placed outside of the hospital during a seven month period were compared to 235 unplaced long-term patients in terms of demographic and clinical variables. Social work services were analysed in terms of which patients received the most interventions, and the most common type of interventions. The most significant patient factors associated with successful placement were: female patients; medium-to-high level of functioning; having involved relatives living far away; a low frequency of behavioural problems (especially of cannabis abuse, verbal or physical aggression, uncontrolled sexual activity), and agitation or restlessness. These patient factors were mirrored in the social work services rendered to the long-term patients during the study period: The recipients were mostly female, in open wards (higher-functioning); and the social services utilised were mostly related to planning for placement and patient support. The lack of community care facilities in the Pretoria area that are able to care for the more difficult long-term psychiatry patients, limits successful placement and increases the burden of hospital based social workers. The problem cannot be resolved at a hospital level and needs to be addressed in the context of provincial and national health departments.

  7. Application of Barcoding to Reduce Error of Patient Identification and to Increase Patient's Information Confidentiality of Test Tube Labelling in a Psychiatric Teaching Hospital. (United States)

    Liu, Hsiu-Chu; Li, Hsing; Chang, Hsin-Fei; Lu, Mei-Rou; Chen, Feng-Chuan


    Learning from the experience of another medical center in Taiwan, Kaohsiung Municipal Kai-Suan Psychiatric Hospital has changed the nursing informatics system step by step in the past year and a half . We considered ethics in the original idea of implementing barcodes on the test tube labels to process the identification of the psychiatric patients. The main aims of this project are to maintain the confidential information and to transport the sample effectively. The primary nurses had been using different work sheets for this project to ensure the acceptance of the new barcode system. In the past two years the errors in the blood testing process were as high as 11,000 in 14,000 events per year, resulting in wastage of resources. The actions taken by the nurses and the new barcode system implementation can improve the clinical nursing care quality, safety of the patients, and efficiency, while decreasing the cost due to the human error.

  8. Hospital readmission after management of appendicitis at freestanding children's hospitals: contemporary trends and financial implications. (United States)

    Rice-Townsend, Samuel; Hall, Matthew; Barnes, Jeff N; Baxter, Jessica K; Rangel, Shawn J


    The purpose of this study was to characterize epidemiologic trends and cost implications of hospital readmission after treatment of pediatric appendicitis. We conducted a 5-year retrospective cohort analysis of 30-day readmission rates for 52,054 patients admitted with appendicitis at 38 children's hospitals participating in the Pediatric Health Information System database. Patients were categorized as "uncomplicated" (postoperative length of stay [LOS] ≤ 2 days) or "complicated" (LOS ≥ 3 days and ≥ 4 consecutive days of antibiotics) and analyzed for demographic data, treatment received during the index admission, readmission rates, and excess LOS and hospital-related costs attributable to readmission encounters. The aggregate 30-day readmission rate was 8.7%, and this varied significantly by disease severity and management approach (uncomplicated appendectomy, 5.6%; complicated appendectomy, 12.8%; drainage, 22.6%; antibiotics only, 24.6%; P management approach (uncomplicated appendectomy, $1946 [31% relative increase]; complicated appendectomy, $6524 [53% increase]; drainage, $6827 [48% increase]; antibiotics only, $5835 [58% increase]; P < .0001). In freestanding children's hospitals, readmission after treatment of pediatric appendicitis is a relatively common and costly occurrence. Collaborative efforts are needed to characterize patient, treatment, and hospital-related risk factors as a basis for developing preventative strategies. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Neural Reactivity to Emotional Stimuli Prospectively Predicts the Impact of a Natural Disaster on Psychiatric Symptoms in Children. (United States)

    Kujawa, Autumn; Hajcak, Greg; Danzig, Allison P; Black, Sarah R; Bromet, Evelyn J; Carlson, Gabrielle A; Kotov, Roman; Klein, Daniel N


    Natural disasters expose entire communities to stress and trauma, leading to increased risk for psychiatric symptoms. Yet, the majority of exposed individuals are resilient, highlighting the importance of identifying underlying factors that contribute to outcomes. The current study was part of a larger prospective study of children in Long Island, New York (n = 260). At age 9, children viewed unpleasant and pleasant images while the late positive potential (LPP), an event-related potential component that reflects sustained attention toward salient information, was measured. Following the event-related potential assessment, Hurricane Sandy, the second costliest hurricane in United States history, hit the region. Eight weeks after the hurricane, mothers reported on exposure to hurricane-related stress and children's internalizing and externalizing symptoms. Symptoms were reassessed 8 months after the hurricane. The LPP predicted both internalizing and externalizing symptoms after accounting for prehurricane symptomatology and interacted with stress to predict externalizing symptoms. Among children exposed to higher levels of hurricane-related stress, enhanced neural reactivity to unpleasant images predicted greater externalizing symptoms 8 weeks after the disaster, while greater neural reactivity to pleasant images predicted lower externalizing symptoms. Moreover, interactions between the LPP and stress continued to predict externalizing symptoms 8 months after the hurricane. Results indicate that heightened neural reactivity and attention toward unpleasant information, as measured by the LPP, predispose children to psychiatric symptoms when exposed to higher levels of stress related to natural disasters, while greater reactivity to and processing of pleasant information may be a protective factor. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  10. Planning an outing from hospital for ventilator-dependent children. (United States)

    Gilgoff, I S; Helgren, J


    Returning ventilator-dependent children to the home environment has become a well-accepted occurrence. The success of a home program depends on careful pre-discharge planning in order to ensure the child's medical safety, and adequate preparation to ensure the child's and family's adjustment to an active community life after discharge. To achieve this, involvement in community activities must begin while the child is still in hospital. As part of a complete rehabilitation program, nine ventilator-dependent children were taken on an inpatient outing to Disneyland. The planning and goals of the outing are described.

  11. Suicídio de internos em um hospital de custódia e tratamento Suicide among inmates hospitalized in a Forensic Psychiatric Hospital

    Directory of Open Access Journals (Sweden)

    Elizabete Rodrigues Coelho


    Full Text Available OBJETIVO: Descrever o perfil dos internos suicidas do Instituto Psiquiátrico Forense (IPF de Porto Alegre em duas décadas. MÉTODO: Foi realizado um estudo retrospectivo dos registros dos internos com óbito por suicídio. Os dados foram analisados por meio da estatística descritiva. RESULTADOS: Dos 20 casos de suicídio, 70% cumpriam medida de segurança, 70% eram réus primários, 80% dos crimes era contra a pessoa; a maioria (45% dos suicídios foi cometida durante a madrugada e 40% dos casos ocorreram com internos que estavam de 1 a 9 anos na instituição; 90% eram do sexo masculino, 55% tinham idade entre 20 e 39 anos, 70% eram solteiros, 60% não tinham filhos, 85% eram naturais do interior do RS, 25% não tinham profissão, 84,2% tinham até o Ensino Fundamental; 55% dos casos tinham diagnóstico de esquizofrenia. Em 75% dos casos a morte ocorreu por enforcamento. CONCLUSÕES: Os dados apontam para o seguinte perfil: homem, solteiro, sem filhos, do interior do Estado, com baixa qualificação profissional e pouca escolaridade. Os fatores psicossociais encontrados foram transtorno mental grave, uso de drogas e/ou álcool, baixo suporte social e familiar e tentativas anteriores de suicídio.OBJECTIVE: To describe the profile of suicides inmates at a Forensic Psychiatric Institute in Porto Alegre from two decades. METHOD: It was a retrospective study of the inmates records with a history of death by suicide. The data were analyzed through descriptive statistics. RESULTS: There was a total of 20 cases of suicide, 70% were involuntary commitment, 70% were primary defendants, 80% of crimes against persons, the majority (45% of suicides were committed in the daybreak period and 40% of the cases occurred in inmates that were from 1 to 9 years in the institution. They also had the following characteristics: 90% were male, 55% were between 20 and 39 years old, 70% single, 60% childless man, 85% of the subjects were originally from small towns

  12. Neonatal hypoglycemia: prevalence and clinical manifestations in tehran children's hospital

    International Nuclear Information System (INIS)

    Dashti, N.; Einollahi, N.; Abbasi, S.


    To measure the prevalence of hypoglycemia among newborn infants in Children Hospital using a standard laboratory glucose method and to evaluate the evidence of clinical manifestations of hypoglycemia, designing appropriate strategies for prevention and treatment. The study population consisted of 673 neonates in Tehran Children's Hospital and was conducted between June 2004 and March 2005. The incidence of neonatal hypoglycemia in the present study group was 15.15% live births. The clinical features which remained significantly associated with the hypoglycemic neonates were refusal of feeding (45%), hyporeflexia (36.2%), irritability (30%), cyanosis (28.4%), tackypnea (24.5%), seizure (16.6%), weak cry (15.8%), apneic spels (9.8%), pallor (1.9%), cardiac arrest (9.1%) and sweating (1%). Hypoglycemia does occur frequently in newborn infants and requires careful monitoring and therapy of serum glucose. (author)

  13. Hospitalized children's representations of their relationship with nurses and doctors. (United States)

    Corsano, Paola; Majorano, Marinella; Vignola, Valentina; Cardinale, Elisa; Izzi, Giancarlo; Nuzzo, Maria Josè


    This article reports an explorative study which aims to investigate hospitalized children's views of their relationships with nurses and doctors. Twenty-seven school-aged children and adolescents from 6 to 15 years old in the paediatric haematology and oncology ward of an Italian hospital participated in the study. Each participant was asked to draw him or herself with a doctor or nurse from the ward while they were doing something. The drawings were analysed using Pictorial Assessment of Interpersonal Relationships (PAIR) and a qualitative analysis. The results showed that the participants viewed their relationships with health professionals positively, in particular with the nurses. This relationship was perceived as close, intimate, cohesive and without conflict. In some cases it became an emotional bond. Finally, this relationship helped the patients to cope with painful and uncomfortable medical procedures, which gradually became familiar and accepted. The clinical implications of this study are discussed.

  14. Characteristics of Hospitalized Children With a Diagnosis of Malnutrition: United States, 2010. (United States)

    Abdelhadi, Ruba A; Bouma, Sandra; Bairdain, Sigrid; Wolff, Jodi; Legro, Amanda; Plogsted, Steve; Guenter, Peggi; Resnick, Helaine; Slaughter-Acey, Jaime C; Corkins, Mark R


    Malnutrition is common in hospitalized patients in the United States. In 2010, 80,710 of 6,280,710 hospitalized children malnutrition (CDM). This report summarizes nationally representative, person-level characteristics of hospitalized children with a CDM. Data are from the 2010 Healthcare Cost and Utilization Project, which contains patient-level data on hospital inpatient stays. When weighted appropriately, estimates from the project represent all U.S. hospitalizations. The data set contains up to 25 ICD-9-CM diagnostic codes for each patient. Children with a CDM listed during hospitalization were identified. In 2010, 1.3% of hospitalized patients malnutrition's true prevalence may be underrepresented. Length of stay among children with a CDM was almost 2.5 times longer than those without a CDM. Hospital costs for children with a CDM were >3 times higher than those without a CDM. Hospitalized children with a CDM were less likely to have routine discharge and almost 3.5 times more likely to require postdischarge home care. Children with a CDM were more likely to have multiple comorbidities. Hospitalized children with a CDM are associated with more comorbidities, longer hospital stay, and higher healthcare costs than those without this diagnosis. These undernourished children may utilize more healthcare resources in the hospital and community. Clinicians and policymakers should factor this into healthcare resource utilization planning. Recognizing and accurately coding malnutrition in hospitalized children may reveal the true prevalence of malnutrition. © 2016 American Society for Parenteral and Enteral Nutrition.

  15. Incidence and Outcome of Acute Cardiorenal Syndrome in Hospitalized Children. (United States)

    Athwani, Vivek; Bhargava, Maneesha; Chanchlani, Rahul; Mehta, Amar Jeet


    To determine the incidence, etiology and outcome of Cardiorenal syndrome (CRS) in hospitalized children. A prospective cohort study was carried out in 242 children between 6 mo to 18 y of age hospitalized with primary cardiac, renal or any systemic disorder at a tertiary care center in India. The primary outcome was the development of CRS. Univariate and multivariate logistic regression analysis were performed to determine the risk of mortality secondary to CRS. Among 242 children, 67 (27.7%) children developed CRS and the rest 175 (72.3%) did not. Among those with CRS, 40.3%, 20.9%, and 38.8% had CRS-1, 3 and 5, respectively. Cardiac diseases leading to CRS were myocarditis (40.7%) followed by congenital heart disease (25.9%), rheumatic heart disease (18.5%), and dilated cardiomyopathy (7.4%); renal disease associated with CRS was acute glomerulonephritis (100%) and major systemic disorders leading to CRS were septicemia (53.8%), malaria (23.1%), scrub typhus (7.7%), and acute gastroenteritis (3.8%). The occurrence of CRS was associated with an increased risk of mortality (OR 6.3, 95% CI: 2.8, 14.1; p 0.000). A subgroup analysis revealed that children with CRS having acute kidney injury stage 2 and 3 also had a higher risk of mortality (p 0.001). The incidence of CRS is quite high in children with cardiac, renal or systemic diseases and is associated with a significant risk of mortality. Children presenting with these illnesses should be monitored for the occurrence of CRS so that early intervention may reduce mortality.

  16. Job sharing at a children's hospital: evaluation by medical staff. (United States)

    Valentine, J P; Martin, C J


    To evaluate job sharing for registrars at Princess Margaret Hospital for Children, Perth, by seeking responses from members of the relevant medical teams. A questionnaire was sent to all 126 medical staff within the hospital (and three managers in medical administration) asking their views on job sharing for registrars. Whether job sharing should continue, who should do it, at what stage of training, and the effects on patient care. Among the 77 respondents (60%) there was broad support for the continuation of job sharing at the hospital: only 5 of 37 consultants and 2 of 19 non-job sharing registrars rejected the idea (with a further 4 consultants uncertain). 43% Of the consultants who had worked with job sharing registrars thought continuity of care was adversely affected. The committee for physician training of the Royal Australasian College of Physicians emphasises that advanced training should be flexible, with a wide range of opportunities for individuals to plan an appropriate training programme in line with their personal goals. This study has shown that job sharing for registrars at Princess Margaret Hospital for Children allows this choice. Action on concerns over any adverse effects on patient care should resolve any persisting disquiet.

  17. Prevalence and co-morbidity among anxiety disorders in a national cohort of psychiatrically referred children and adolescents

    DEFF Research Database (Denmark)

    Esbjørn, Barbara Hoff; Hoeyer, Mette; Dyrborg, Jørgen


    The paper provides prevalence estimates of anxiety disorders as well as homotypic (e.g., other anxiety disorders) and heterotypic (e.g., mood, externalizing) co-morbidity in a national sample of children and adolescents referred to the psychiatric system in Denmark. Data were gathered from a data...... as routine to increase the precision in recognizing and reporting on childhood anxiety disorders.......The paper provides prevalence estimates of anxiety disorders as well as homotypic (e.g., other anxiety disorders) and heterotypic (e.g., mood, externalizing) co-morbidity in a national sample of children and adolescents referred to the psychiatric system in Denmark. Data were gathered from...... a database containing 83% of all youth referred from 2004 to 2007 (N=13,241). A prevalence of 5.7% of anxiety disorder was found in the sample. Homotypic co-morbidity was found in only 2.8%, whereas heterotypic co-morbidity was found in 42.9% of the cohort. A total of 73.6% had a principal anxiety disorder...

  18. Use of children's artwork to evaluate the effectiveness of a hospital preparation program. (United States)

    Wilson, C J


    Approximately 1.5 million children are hospitalized on an emergency basis per year and are not able to be fully prepared for the event due to the emergency (Azarnoff & Woody, 1981). For this reason many pre-crisis hospital preparation programs are being instituted by hospitals and pediatric nurses. This pilot study investigated the use of children's artwork to evaluate the effectiveness of a hospital preparation program. The 6 to 10 year old children attending summer school at a day care center participated in a hospital preparation program. The purpose of the program was to decrease children's anxieties and fears in the event of an emergency hospitalization.

  19. Applicability of the Chinese version of the Hypomania Symptom Checklist (HCL-32 scale for outpatients of psychiatric departments in general hospitals.

    Directory of Open Access Journals (Sweden)

    Xiao Huang

    Full Text Available OBJECTIVES: This study aimed to determine the suitability of the Chinese version of the Hypomania Symptom Checklist (HCL-32 scale for psychiatric department outpatients with mood disorders in Chinese general hospitals, and provide a theoretical basis for the application of the HCL-32 scale. METHODS: Outpatients with mood disorders receiving continuous treatment in the psychiatric medicine department of three top-ranking general hospitals in three cities completed scoring the HCL-32 scale. RESULTS: A total of 1010 patients were recruited. 417 were diagnosed with bipolar disorder (236 for type I and 181 for type II and 593 were depression. Four factors with eigenvalues >1 were considered. Factor 1 with an eigenvalue of 5.5 was labeled "active/cheerful". Factor 2 with an eigenvalue of 2.7 was labeled "adventurous/irritable." The coefficient of internal consistency reliability of the HCL-32 total scale was 0.84, and the coefficients for factors 1 and 2 were 0.84 and 0.88, respectively. With the total score of HCL-32≥14 as positive standard, the sensitivity of HCL-32 was calculated at 69.30% and the specificity was 97.81%. CONCLUSIONS: Results showed that HCL-32 had a preferable reliability and validity and was suitable as auxiliary means for bipolar disorder screening in general hospitals.

  20. The importance of relationships in mental health care: A qualitative study of service users' experiences of psychiatric hospital admission in the UK

    Directory of Open Access Journals (Sweden)

    Slade Mike


    Full Text Available Abstract Background While a number of studies have looked at life on service users' experiences of life on psychiatric wards, no research exists that have approached these experiences from the user perspective since the introduction of community care. Methods This user-led study uses a participatory approach to develop an understanding of the processes and themes which define the user experience of hospitalisation. Nineteen service users who had all had inpatient stays in psychiatric hospitals in London were interviewed in the community. Results Relationships formed the core of service users' experiences. Three further codes, treatment, freedom and environment defined the role of hospital and its physical aspects. Themes of communication, safety, trust, coercion, and cultural competency contributed to the concept of relationships. Conclusion Relationships with an individual which comprised effective communication, cultural sensitivity, and the absence of coercion resulted in that person being attributed with a sense of trust. This resulted in the patient experiencing the hospital as a place of safety in terms of risk from other patients and staff. Barriers to positive relationships included ineffective and negative communication, a lack of trust, a lack of safety in terms of staff as ineffective in preventing violence, and as perpetrators themselves, and the use of coercion by staff. This unique perspective both acts as a source of triangulation with previous studies and highlights the importance of the therapeutic relationship in providing a safe and therapeutic milieu for the treatment of people with acute mental health problems.

  1. Inter-hospital transport of critically ill children.

    LENUS (Irish Health Repository)

    Aherne, E


    Most Irish paediatric tertiary care services are centralised in Dublin. Many children are transferred there each year from regional paediatric units around the country. We aimed to quantify and describe all children transferred from one regional tertiary hospital over a two year period. Seventy three out of 75 identified transfers were examined. Sixty nine transfers (94.5%) were sent to the major tertiary centre. Fifteen (20.5%) required intensive care services for transfer. Seventeen seriously ill neonates required transfer, however only 4 (23.5%) of those met both the criteria for and the availability of the National Neonatal Transfer Team (NNTT). Significant events during transfer were only documented in 3 cases. Most transfers arrived in Dublin outside normal working hours. Standards of documentation were found to be very inconsistent. In conclusion, a national transport service for all critically ill children is urgently needed in Ireland.

  2. Therapeutic Hypothermia after In-Hospital Cardiac Arrest in Children. (United States)

    Moler, Frank W; Silverstein, Faye S; Holubkov, Richard; Slomine, Beth S; Christensen, James R; Nadkarni, Vinay M; Meert, Kathleen L; Browning, Brittan; Pemberton, Victoria L; Page, Kent; Gildea, Marianne R; Scholefield, Barnaby R; Shankaran, Seetha; Hutchison, Jamie S; Berger, John T; Ofori-Amanfo, George; Newth, Christopher J L; Topjian, Alexis; Bennett, Kimberly S; Koch, Joshua D; Pham, Nga; Chanani, Nikhil K; Pineda, Jose A; Harrison, Rick; Dalton, Heidi J; Alten, Jeffrey; Schleien, Charles L; Goodman, Denise M; Zimmerman, Jerry J; Bhalala, Utpal S; Schwarz, Adam J; Porter, Melissa B; Shah, Samir; Fink, Ericka L; McQuillen, Patrick; Wu, Theodore; Skellett, Sophie; Thomas, Neal J; Nowak, Jeffrey E; Baines, Paul B; Pappachan, John; Mathur, Mudit; Lloyd, Eric; van der Jagt, Elise W; Dobyns, Emily L; Meyer, Michael T; Sanders, Ronald C; Clark, Amy E; Dean, J Michael


    Targeted temperature management is recommended for comatose adults and children after out-of-hospital cardiac arrest; however, data on temperature management after in-hospital cardiac arrest are limited. In a trial conducted at 37 children's hospitals, we compared two temperature interventions in children who had had in-hospital cardiac arrest. Within 6 hours after the return of circulation, comatose children older than 48 hours and younger than 18 years of age were randomly assigned to therapeutic hypothermia (target temperature, 33.0°C) or therapeutic normothermia (target temperature, 36.8°C). The primary efficacy outcome, survival at 12 months after cardiac arrest with a score of 70 or higher on the Vineland Adaptive Behavior Scales, second edition (VABS-II, on which scores range from 20 to 160, with higher scores indicating better function), was evaluated among patients who had had a VABS-II score of at least 70 before the cardiac arrest. The trial was terminated because of futility after 329 patients had undergone randomization. Among the 257 patients who had a VABS-II score of at least 70 before cardiac arrest and who could be evaluated, the rate of the primary efficacy outcome did not differ significantly between the hypothermia group and the normothermia group (36% [48 of 133 patients] and 39% [48 of 124 patients], respectively; relative risk, 0.92; 95% confidence interval [CI], 0.67 to 1.27; P=0.63). Among 317 patients who could be evaluated for change in neurobehavioral function, the change in VABS-II score from baseline to 12 months did not differ significantly between the groups (P=0.70). Among 327 patients who could be evaluated for 1-year survival, the rate of 1-year survival did not differ significantly between the hypothermia group and the normothermia group (49% [81 of 166 patients] and 46% [74 of 161 patients], respectively; relative risk, 1.07; 95% CI, 0.85 to 1.34; P=0.56). The incidences of blood-product use, infection, and serious adverse

  3. Hospitalization Rate and Population-Based Incidence of Hospitalization for