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Psychiatric Hospitalization (psychiatric + hospitalization)

Distribution by Scientific Domains

Medical Sciences	92%

Selected Abstracts

Brief Integrated Outpatient Dual-diagnosis Treatment Reduces Psychiatric Hospitalizations

THE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2003
Eric Granholm Ph.D.
A retrospective pilot study was conducted to determine whether a relatively brief integrated outpatient treatment for patients with dual disorders reduced inpatient hospital service utilization. Outpatients (n = 44) with substance dependence and either comorbid schizophrenia, major depressive disorder, or bipolar disorder were studied. A multidisciplinary team provided relatively brief (up to 24 weeks), integrated, dual-diagnosis outpatient treatment. A significant 60% reduction in the number of psychiatric hospitalization days was found for the year after treatment as compared to the year before. Patients with schizophrenia showed the greatest reduction (74%) in hospitalization days. Thus, even brief integrated outpatient dual-diagnosis treatment can reduce inpatient psychiatric hospitalizations. [source]

Mental health outcomes of adjudicated males and females: the aftermath of juvenile delinquency and problem behaviour

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2004
Mélanie Corneau
Background Empirical evidence indicates that the rates of mental health problems and disorders are relatively high among adjudicated youths, especially females, yet few longitudinal studies have focused on gender differences regarding their mental health outcomes as adults. Aims The present study was designed to assess the prevalence rates of self-reported suicide attempts and psychological help-seeking in young adults adjudicated for antisocial behaviours in adolescence. This study also assessed gender differences in the prevalence rates of mental health problems and disorders reported by participants. Methods Structured interviews assessing personal and social adaptation were conducted on three occasions with 292 adjudicated male and 113 female youths (mean age 15 years on the first occasion). Data from the third testing wave (mean age 23.51 at T3) provide information on their mental health outcomes in adulthood. Results Results indicate that in individuals with a history of juvenile delinquency and/or problem behaviour over 10% of the males and 20% of the females reported suicide attempts, and one-fifth and one-third respectively reported psychological consultation. Similar and lower proportions reported psychiatric hospitalization and/or drug addiction programme/therapy at the beginning of adulthood. Implications for practice The present study suggests that these youths may need more mental health directed interventions in their assessment rehabilitation programmes. Copyright © 2004 Whurr Publishers Ltd. [source]

Preterm birth or foetal growth impairment and psychiatric hospitalization in adolescence and early adulthood in a Swedish population-based birth cohort

ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2009
W. Monfils Gustafsson
Objective:, Preterm birth and restricted foetal growth are related to symptoms of psychiatric disorder. Our aim was therefore to investigate possible relations between being born preterm and/or small for gestational age (SGA) and later psychiatric hospitalization. Method:, A population-based registry study of psychiatric hospitalization of in total 155 994 boys and 148 281 girls born in Sweden in 1973,1975. Results:, The risk of hospitalization for all mental disorders was increased for preterm SGA boys (OR 2.19, 95% CI 1.49,3.21); at-term SGA boys (OR 1.55, 95% CI 1.34,1.79); at-term SGA girls (OR 1.31, 95% CI 1.15,1.50). At-term SGA boys and girls suffered increased risk of anxiety and adjustment disorders (OR 1.70, 95% CI 1.18,2.45 and OR 1.49, 95% CI 1.14,1.94). Preterm SGA boys were at risk of personality disorders (OR 3.30, 95% CI 1.16,9.41) and psychotic disorders (OR 4.36, 95% CI 1.85,10.30). Conclusion:, The results show a relationship between being born SGA and later psychiatric hospitalization, where preterm birth and male gender seem to increase the risk. [source]

Suicide after hospitalization in the elderly: a population based study of suicides in Northern Finland between 1988,2003

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2008
Kaisa Karvonen
Abstract Objective Elderly people commit suicide more often than people under the age of 65. An elevated risk is also attached to depression and other axis I psychiatric disorders. However, little is known about the preferred suicide method, effect of primary psychiatric diagnosis, and length of time between discharge from psychiatric hospitalization and suicide. The lack of information is most apparent in the oldest old (individuals over 75 years). Methods On the basis of forensic examinations, data on suicide rates were separately examined for the 50,64, 65,74 and over 75 year-olds (Total n,=,564) with regard to suicide method, history of psychiatric hospitalization and primary diagnoses gathered from the Finnish Hospital Discharge Register. Study population consisted of all suicides committed between 1988 and 2003 in the province of Oulu in Northern Finland. Results Of the oldest old, females had more frequent hospitalizations than males in connection with psychiatric disorders (61% vs 23%), of which depression was the most common (39% vs 14%). In this age group, 42% committed suicide within 3 months after being discharged from hospital and 83% used a violent method. Both elderly males and females were less often under the influence of alcohol, but used more often violent methods than middle-aged persons. Conclusions Suicide rates within the first 3 months following discharge from hospital in the 65,74 and the over 75 year olds were substantial and should influence post-hospitalization treatment strategies. To reduce the risk of suicides in elderly patients discharged from hospital, close post-hospitalization supervision combined with proper psychoactive medication and psychotherapy, are possible interventions. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Validity and reliability of an inpatient severity of psychiatric illness measure

INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 2 2005
Bentson H. McFarland
Abstract Inpatient psychiatric severity measures are often used but few psychometric data are available. This study evaluated the psychometric properties (reliability and validity) of a measure used to assess severity of psychiatric illness among inpatients. Using the severity measure, minimally trained raters conducted retrospective patient record reviews to assess medical necessity for psychiatric hospitalization. The data analysis compared 135 civilly committed psychiatric inpatients with a heterogeneous group of 248 psychiatric inpatients at a general hospital. The severity measure showed acceptable inter-rater reliability in both populations. Two-way analysis of variance showed that the intra-class correlation coefficient for the total score was 0.65 for general hospital subjects and 0.63 for civilly committed subjects. Differences in mean scores were substantial (15 out of a possible 75 points for general hospital subjects versus 42 for civilly committed subjects, Mann-Whitney U = 562, p < 0.001). As expected, all civilly committed subjects were well above admission cut-off score of 12, versus only 64% of the general hospital patients. The measure is appropriate for retrospective severity assessment and may also be useful for pre-admission screening. Copyright © 2005 Whurr Publishers Ltd. [source]

Anesthesiologists at work: an increase in pro-inflammatory and Th2 cytokine production, and alterations in proliferative immune responses

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 10 2006
B. Beilin
Background:, Anesthesiologists are a population at high risk of alcohol and drug abuse, depression, suicide, and psychiatric hospitalization. The impact of their working milieu on specific immune indices has scarcely been studied, and it is assumed that immune perturbations may contribute to some of the above risks. This study took advantage of an unplanned, 3-month long strike of anesthesiologists, and explored its relations to specific immune measures. Methods:, We assessed induced cytokine production and lymphocytes proliferative responses in blood samples taken from 10 anesthesiologists just before the strike and at its end, after a long period of markedly reduced workload. Results:, The results indicated that the proliferative responses to phytohemagglutinin (PHA) and concanavalin A (Con A) were significantly lower at the end of the strike. At this time point, we observed a significant decrease in the production of interleukin-6 (IL-6), IL-10 and IL1ra levels, and a significant increase in IL-2 production. A strong trend towards a decline in tumor necrosis factor-, (TNF-,) levels was evident, while levels of IL-1, were unchanged. Conclusion:, These findings suggest that the working conditions of anesthesiologists are associated with specific immune alterations, including a shift towards a Th2 cytokines' dominance, and an elevated pro-inflammatory cytokine response. A reduced Th1 profile has been related to increased susceptibility to infections, and high pro-inflammatory cytokine levels were recently proposed as etiological factors in cardiovascular diseases and in depression. [source]

Predictors of Residential Placement Following a Psychiatric Crisis Episode Among Children and Youth in State Custody

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2009
Jung Min Park PhD
This study examined the extent and correlates of entry into residential care among 603 children and youth in state custody who were referred to psychiatric crisis services. Overall, 27% of the sample was placed in residential care within 12 months after their 1st psychiatric crisis screening. Among the children and youth placed in residential care, 51% were so placed within 3 months of their 1st crisis screening, with an additional 22% placed between 3 and 6 months after screening. Risk behavior and functioning, psychiatric hospitalization following screening, older age, placement type, and caregiver's capacity for supervision were associated with increased residential placement. The findings highlight the importance of early identification and treatment of behavior and functioning problems following a crisis episode among children and youth in state custody to reduce the need for subsequent residential placement. Having an inpatient psychiatric episode following a crisis episode places children at greater risk for residential placement, suggesting that the hospital is an important point for diversion programs. Children and youth in psychiatric crisis may also benefit from efforts to include their families in the treatment process. [source]

Risk of developing schizophrenia among Japanese high-risk offspring of affected parent: outcome of a twenty-four-year follow up

PSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 1 2009
Atsushi Nishida phd
Aims:, Prospective follow-up studies of high-risk children may help clarify the etiological factors in schizophrenia. While studies from North America, Europe and Israel have estimated the risk of schizophrenia at 7,16% in the offspring of an affected parent, no data have been reported for Asian populations. Method:, We started a follow up of the offspring of Japanese schizophrenia patients in 1978. We investigated the estimated risk of schizophrenia in 51 high-risk offspring at the 24-year follow up. The effects of the parents' status, including history of psychiatric hospitalization and social functioning, on the risk in the offspring were also investigated. Results:, The cumulative incidence of schizophrenia was 13.7 % and the lifetime prevalence was estimated to be 13.5 ± 4.8%. The association between the psychiatric hospitalization in the probands and the risk of schizophrenia in the offspring was not significant, and the Global Assessment of Functioning score was significantly lower in the probands with a history of psychiatric hospitalization than in those without such a history. Conclusions:, The risk of developing schizophrenia in Japanese high-risk offspring might be comparable with the Western results. The present study suggests that the severity of the disease or the level of social functioning may not significantly affect the risk in Japanese offspring. [source]

Ethnic differences in symptom presentation of youths with bipolar disorder

BIPOLAR DISORDERS, Issue 1 2006
Nick C Patel
Objective:, To compare symptom profiles of African-American and white adolescents with a diagnosis of bipolar disorder. Method:, Adolescents, aged 12,18 years at their first psychiatric hospitalization, with a DSM-IV diagnosis of bipolar disorder, manic or mixed, were evaluated on measures of manic, depressive, and positive symptoms of psychosis. Ethnic differences in symptom profiles were examined using multivariate analysis of covariance, and specific symptoms contributing to the difference were analyzed. Results:, Ethnic differences existed in manic and positive symptom profiles, but not depressive symptoms. Compared with the white cohort, African-American youths were diagnosed more frequently as having psychotic features, and had higher ratings for auditory hallucinations. Conclusions:, Similar to adults, symptom expression in adolescent bipolar disorder may differ between ethnic groups. Future studies are needed to replicate these findings and explore possible explanations. [source]

Comparison of the metabolic and economic consequences of long-term treatment of schizophrenia using ziprasidone, olanzapine, quetiapine and risperidone in Canada: a cost-effectiveness analysis

JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2010
Roger S. McIntyre MD FRCPC
Abstract Rationale, aims and objectives, Second-generation antipsychotic agents have varying propensities to cause weight gain, elevated lipid levels and associated long-term complications. This study evaluates the cost-effectiveness of four second-generation antipsychotic agents used in Canada for the treatment of schizophrenia (ziprasidone, olanzapine, quetiapine, risperidone) with a focus on their long-term metabolic consequences. Method, Using data from the Clinical Antipsychotic Trials of Intervention Effectiveness Study, a semi-Markov model was developed to predict the incidence and associated costs of type 2 diabetes, cardiovascular complications (e.g. angina, myocardial infarction, stroke, cardiovascular disease death), and acute psychiatric hospitalizations in patients with chronic schizophrenia treated over 5 years. Incremental costs per quality-adjusted life year (QALY) gained were calculated from the perspective of the Canadian provincial ministries of health. Scenario and probabilistic sensitivity analyses were performed. Results, The total average cost of treatment with ziprasidone was $25 301 versus $28 563 with olanzapine, $26 233 with quetiapine and $21 831 with risperidone. Ziprasidone had the lowest predicted number of type 2 diabetes cases and cardiovascular disease events, and the highest QALY gains. Patients receiving quetiapine had the highest predicted number of hospitalizations. Ziprasidone was less costly and resulted in more QALYs compared with olanzapine and quetiapine. Compared with risperidone, ziprasidone was more costly and had higher QALYs, with an incremental cost per QALY gained of $218 060. Conclusion, Compared with olanzapine and quetiapine, ziprasidone produced savings to the health care system. Although ziprasidone generated incremental expenditures versus risperidone, it resulted in more QALYs. Based on this analysis, ziprasidone treatment possesses cost and therapeutic advantages compared with olanzapine and quetiapine. [source]

Brief Integrated Outpatient Dual-diagnosis Treatment Reduces Psychiatric Hospitalizations

Substance abuse in bipolar disorder

BIPOLAR DISORDERS, Issue 4 2001
Frederick Cassidy
Background: High rates of substance abuse have been reported in the general population, with males more often affected than females. Although high rates of substance abuse have also been reported in bipolar patients, the relationship between substance abuse and bipolar disorder has not been well characterized. Methods: Substance abuse histories were obtained in 392 patients hospitalized for manic or mixed episodes of bipolar disorder and rates of current and lifetime abuse calculated. Analyses comparing sex, subtype (manic vs. mixed) and clinical history variables were conducted. Results: Rates of lifetime substance abuse were high for both alcohol (48.5%) and drugs (43.9%). Nearly 60% of the cohort had a history of some lifetime substance abuse. Males had higher rates of abuse than females, but no differences in substance abuse were observed between subjects in manic and mixed bipolar states. Rates of active substance abuse were lower in older age cohorts. Subjects with a comorbid diagnosis of lifetime substance abuse had more psychiatric hospitalizations. Conclusions: Substance abuse is a major comorbidity in bipolar patients. Although rates decrease in older age groups, substance abuse is still present at clinically important rates in the elderly. Bipolar patients with comorbid substance abuse may have a more severe course. These data underscore the significance of recognition and treatment of substance abuse in bipolar disorder patients. [source]