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Psychiatry Service (psychiatry + service)
Selected AbstractsSevere eating disorder initially diagnosed in a 72-year-old manINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2008Susan G. Manejías Parke MD Abstract Objective: Eating disorders in our society mainly affect young women. Cases in males are far less common, and reported cases in elderly males are rare. Method: We report the case of 72-year- old male admitted to a geriatric psychiatry service for grave passive neglect with mild dementia thought to be due to nutritional deficiency. Results: The patient was found to have an eating disorder not otherwise specified, most closely resembling anorexia nervosa, which was believed to be the cause of the nutritional problem. Conclusion: This case highlights the need for diagnostic awareness regarding eating disorders in patients of all ages and of both genders. © 2008 by Wiley Periodicals, Inc. Int J Eat Disord 2008 [source] An audit of service utilization by graduates attending an old age psychiatry serviceINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2006Brian A. Lawlor No abstract is available for this article. [source] Needs assessment in dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2005A. M. Meaney Abstract Background Resource allocation and service development traditionally focuses on diagnostic categories and consequent perceived need. Identification of the actual level of need in the elderly with dementia, and the degree to which it is unmet is necessary to plan services both individually and as a group. The aim of this study was to characterise the needs of a sample of community dwelling elderly patients with dementia who were referred to an old age psychiatry service in Ireland between July 2002 and July 2003. Methodology Eighty-two consecutively referred community dwelling patients with ICD-10 diagnosis of dementia were assessed on The Care Needs Assessment Pack for Dementia (CareNap-D). Data on needs across seven domains (health and mobility, self-care and toileting, social interaction, thinking and memory, behaviour and mental state, housecare, community living) is presented (Reynolds T et al., 1998). Results Subjects had a mean of 33 (range: 13,56) identified needs. Approximately 1/3 of these were unmet with a mean of 13 (range: 0,37) and a mean of 20 (range: 4,39) were met. High levels of unmet need was identified in the domains of behaviour and mental state (84% of those with agitation) and of social interaction (79% of those with ,partaking in activities' need). The specific item of repetitive questioning occurred in 68 individuals and was unmet in 88% of these cases. Increasing age, lower MMSE score, and living alone were associated with greater total levels of unmet need. Conclusion This data underlines the degree of unmet need in the community dwelling elderly with dementia and the importance of developing a spectrum of services on the basis of the actual needs identified. Copyright © 2005 John Wiley & Sons, Ltd. [source] Factors disturbing treatment for cancer in patients with schizophreniaPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2006TAKUJI INAGAKI md Abstract Patients with schizophrenia who develop cancer often have a variety of complicated medical and psychiatric problems. Problems associated with receiving a diagnosis of cancer and with understanding or cooperating with medical treatment may develop. Research in managing and treating schizophrenia patients with cancer is scarce. Presented herein is the experience of the authors' consultation,liaison psychiatry service in treating patients with schizophrenia who have cancer, and discussion of the medical management of such cases. Fourteen patients were treated between April 1999 and March 2003 and included patients receiving consultation psychiatric services at Shimane University Hospital as well as patients referred from other psychiatric hospitals. These patients were divided into two groups based on whether they were amenable to cancer treatment or not. The treated group consisted of patients who accepted cancer treatment, and the untreated group consisted of patients who refused or interrupted the cancer treatment. The clinical course, clinical psychiatric symptoms, problems in understanding cancer, cancer treatment course and convalescence were retrospectively assessed. Psychiatric symptoms and state were measured using the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS). The mean of the duration of schizophrenia in these two groups was not significantly different. The mean scores on measures of psychiatric symptoms in each group (treated and untreated) were as follows: BPRS, 45.3 ± 15.4 and 64.9 ± 9.2 (P < 0.05); positive symptoms scores on PANSS, 14.4 ± 8.8 and 20.6 ± 6.0 (NS); negative symptoms scores on PANSS, 20.6 ± 4.7 and 33.6 ± 4.4 (P < 0.01); and total scores on PANSS, 31.7 ± 7.0 and 48.6 ± 7.4 (P < 0.01). Patients with severe negative symptoms had greater difficulty understanding and cooperating with the cancer treatment. Regarding cancer stage, when cancer was discovered, the disease had already advanced and was no longer amenable to first-line treatment. Regarding notification of the diagnosis, it was rarely possible to give sufficiently early notice to patients in the untreated group. The important role of consultation,liaison psychiatrist in treating cancer patients is suggested. Some steps are proposed for managing schizophrenia patients with cancer who are not able to give informed consent. [source] |