A 25-year dynamic ecological analysis of psychiatric hospital admissions and prison committals: Penrose’s hypothesis updated

2018 ◽  
pp. 1-4 ◽  
Author(s):  
C. J. O’Neill ◽  
B. D. Kelly ◽  
H. G. Kennedy
Keyword(s):  
Psychiatric Hospital ◽  
Hospital Admissions ◽  
Psychiatric Hospitals ◽  
Causal Connection ◽  
Inverse Association ◽  
Cross Sectional ◽  
Time Dynamic ◽  
Dynamic Measures ◽  
Over Time ◽  
Static Cross

AimsThere is renewed interest in the inverse association between psychiatric hospital and prison places, with reciprocal time trends shown in more than one country. We hypothesised that the numbers of admissions to psychiatric hospitals and committals to prisons in Ireland would also correlate inversely over time (i.e. dynamic measures of admission and committal rather than static, cross-sectional numbers of places).MethodPublicly available activity statistics for psychiatric hospitals and prisons in Ireland were collated from 1986 to 2010.ResultsThere was a reciprocal association between psychiatric admissions and prison committals (Pearson r=−0.788, p<0.001), an increase of 91 prison committals for every 100 psychiatric hospital admissions foregone.ConclusionPenrose’s hypothesis applies to admissions to psychiatric hospitals and prisons in Ireland over time (dynamic measures), just as it does to the numbers of places in psychiatric hospitals and prisons in Ireland and elsewhere (static, cross-sectional measures). Although no causal connection can be definitively established yet, mentally disordered prisoners are usually known to community mental health services. Psychiatric services for prisons and the community should be linked to ensure that the needs of those currently accessing care through prisons can also be met in the community.

scholarly journals Family involvement and patient-experienced improvement and satisfaction with care: a nationwide cross-sectional study in Danish psychiatric hospitals

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie Louise Svendsen ◽  
Trine Ellegaard ◽  
Karoline Agerbo Jeppesen ◽  
Erik Riiskjær ◽  
Berit Kjærside Nielsen
Keyword(s):  
Psychiatric Hospital ◽  
Hospital Care ◽  
Psychiatric Hospitals ◽  
Cross Sectional Study ◽  
Satisfaction With Care ◽  
Sectional Study ◽  
Cross Sectional ◽  
Caregiver Relationship ◽  
Patient Reported ◽  
Caregiver Involvement

Abstract Background Randomised controlled trials suggest that family therapy has a positive effect on the course of depression, schizophrenia and anorexia nervosa. However, it is largely unknown whether a positive link also exists between caregiver involvement and patient outcome in everyday psychiatric hospital care, using information reported directly from patients, i.e. patient-reported experience measures (PREM), and their caregivers. The objective of this study is to examine whether caregiver-reported involvement is associated with PREM regarding patient improvement and overall satisfaction with care. Methods Using data from the National Survey of Psychiatric Patient Experiences 2018, we conducted a nationwide cross-sectional study in Danish psychiatric hospitals including patients and their caregivers who had been in contact with the hospital (n = 940 patients, n = 1008 caregivers). A unique patient identifier on the two distinct questionnaires for the patient and their caregiver enabled unambiguous linkage of data. In relation to PREM, five aspects of caregiver involvement were analysed using logistic regression with adjustment for patient age, sex and diagnosis. Results We consistently find that high caregiver-reported involvement is statistically significantly associated with high patient-reported improvement and overall satisfaction with care with odds ratios (OR) ranging from 1.69 (95% confidence interval (CI) 0.95–2.99) to 4.09 (95% CI 2.48–6.76). This applies to the following aspects of caregiver-reported involvement: support for the patient-caregiver relationship, caregiver information, consideration for caregiver experiences and the involvement of caregivers in decision making. No statistically significant association is observed regarding whether caregivers talk to the staff about their expectations for the hospital contact. Conclusion This nationwide study implies that caregiver involvement focusing on the patient-caregiver relationship is positively associated with patient improvement and overall satisfaction with care in everyday psychiatric hospital care.

The Sensitivity of Dynamic Time-Path Typologies

1971 ◽  
Vol 8 (4) ◽  
pp. 472-479 ◽  
Author(s):  
John G. Myers
Keyword(s):  
Cluster Analysis ◽  
Time Perspective ◽  
Data Input ◽  
Cross Sectional ◽  
Time Path ◽  
Dynamic Time ◽  
Over Time ◽  
Static Cross

This article describes a procedure for adapting cluster analysis from its usual static, cross-sectional perspective to a dynamic, over-time perspective, and tests the sensitivity of results from using the new procedure to variations in data input and partitioning conditions.

scholarly journals Gender differences in clinical and sociodemographic pattern of substance Use disorder

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M M Elhabiby ◽  
H H Elrassas ◽  
M H Morsi ◽  
F M N Ezzat
Keyword(s):  
Substance Use ◽  
Psychiatric Hospital ◽  
Substance Use Disorder ◽  
Psychiatric Hospitals ◽  
Life Time ◽  
Health Concern ◽  
Treatment Programs ◽  
Cross Sectional ◽  
Male And Female ◽  
Significant Difference

Abstract Background Substance use disorder (SUD) is a significant public health concern and is one among the most common psychiatric disorders beginning in young adulthood. The history of substance abuse is as old as mankind itself; recently it has become a global problem that is influenced by social, economic, political, and psychosocial factors, scientist have long noted an association between social relationships and health. Aim of the work to analyze and discuss similarities and difference between the genders in substance use disorder, highlighting severity of substance use disorder in both male and female focusing on comorbidity of substance use disorder in both male and female. Subjects and Methods This cross sectional descriptive study was conducted on a sample of 117 addict patient (39 f and 78 m) who seek a treatment in Egyptian psychiatric hospitals. The Sample was collected from inpatient and outpatient department of Ain Shams Psychiatric hospital, Heliopolis (Almatar) Psychiatric Hospital and Alabasseya Psychiatric hospital. Results the study revealed a statistically significant difference in various parameters as the mean age of abuse was higher among men than women with longer duration of life time and last 30 days intake compared to females. As regard marital status, married men percentage was lower in comparison to females who had a higher percentage of divorces. Regarding educational level, more females completed primary level but more males completed to tertiary diploma and higher percentage compared with females. Males abuse was more physically and emotionally but females exposed to more sexual abuse. Legal problems were higher in males as violation and drug charge compared to the females. On the other hand, job and dealing drugs as a source of money for drugs were mainly in males but females gained money mainly from the family or prostitution. Men showed higher rates of HCV infection than female. Conclusion there is a clear difference between men and women in many of the points covered in this study, which confirms that there must be different programs developed specifically for women and not as sometimes happens by the application of treatment programs addiction to men, which leads to the consequences of unsatisfactory For female patients as well as those involved in the treatment of addiction.

Reducing hospitalisation among people living with severe mental illness

2016 ◽  
Vol 40 (2) ◽  
pp. 124 ◽  
Author(s):  
Shannon McDermott ◽  
Jasmine Bruce ◽  
Kristy Muir ◽  
Ioana Ramia ◽  
Karen R. Fisher ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Psychiatric Hospital ◽  
Hospital Admissions ◽  
Small Sample ◽  
Supported Housing ◽  
Health Records ◽  
Individual Level ◽  
Over Time

Objective People with severe mental illness have high rates of hospitalisation. The present study examined the role that permanent housing and recovery-oriented support can play in reducing the number and length of psychiatric hospital admissions for people with severe mental illness. Methods The study examined de-identified, individual-level health records of 197 people involved in the New South Wales Mental Health Housing and Accommodation Support Initiative (HASI) to compare changes in hospitalisation over a continuous 4-year period. Results On average, HASI consumers experienced significant reductions in the number of psychiatric hospital admissions and length of stay after entering the HASI program, and these reductions were sustained over the first 2 years in HASI. Male consumers and consumers under 45 years of age experienced the largest reductions in the number and length of hospital admissions. Conclusions The findings of the present study add support to the hypothesis that supported housing and recovery-oriented support can be effective approaches to reducing hospital admissions for people with chronic mental illness, and that these changes can be sustained over time. What is known about this topic? People living with severe mental illness are heavy users of health and hospitalisation services. Research into the effects of partnership programs on preventing unnecessary admissions is limited because of short periods of comparison and small sample sizes. What does this paper add? The present study extends previous research by analysing de-identified individual-level health records over a continuous 4-year period and showing that reductions in hospitalisation among people with severe mental illness can be sustained over time. What are the implications for practitioners? These findings provide further evidence that community-based recovery-oriented supported housing programs can assist consumers to manage their mental health and avoid hospital admissions. Although the provision of recovery-oriented community services requires an investment in community mental health, the reduction in consumers’ use of hospital services makes this investment worthwhile.

scholarly journals Resilience of the health team in caring for people with mental disorders in a psychiatric hospital

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Débora Felippe Brolese ◽  
Greice Lessa ◽  
José Luís Guedes dos Santos ◽  
Jucimara da Silva Mendes ◽  
Kamylla Santos da Cunha ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Psychiatric Hospital ◽  
Health Professionals ◽  
Qualitative Data ◽  
Positive Impact ◽  
Psychiatric Hospitals ◽  
Cross Sectional ◽  
Health Team ◽  
Resilience Scale ◽  
Resilience Process

Abstract OBJECTIVE Evaluating and understanding the resilience process of the health team in caring for people with mental disorders in a psychiatric hospital. METHOD 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. RESULTS 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. CONCLUSION Understanding this process of resilience enables developing strategies to improve the quality of life of workers in psychiatric hospitals.

scholarly journals Self-Reported Antidepressant Drug Side Effects, Medication Adherence, and Its Associated Factors among Patients Diagnosed with Depression at the Psychiatric Hospital of Nepal

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Nirmal Raj Marasine ◽  
Sabina Sankhi ◽  
Rajendra Lamichhane ◽  
Nabin Raj Marasini ◽  
Nim Bahadur Dangi
Keyword(s):  
Medication Adherence ◽  
Side Effects ◽  
Psychiatric Hospital ◽  
Associated Factors ◽  
Antidepressant Drug ◽  
Antidepressant Drugs ◽  
Psychiatric Hospitals ◽  
Bivariate Analysis ◽  
Drug Side Effects ◽  
Cross Sectional

Objective. The present study is aimed at evaluating the side effects of antidepressant drugs, medication adherence (MA), and associated factors among patients diagnosed with depression at a psychiatric hospital in western Nepal. Methods. A prospective cross-sectional study was conducted among 174 patients visiting the outpatient clinic of a psychiatric hospital. The antidepressant side effect checklist (ASEC) was used to classify the reported antidepressant drug side effects into mild, moderate, and severe types. The Naranjo adverse drug reaction (ADR) probability scale was employed to assess the ADRs, and the Morisky Green Levine Adherence (MGLA) score was employed to determine the rate of medication adherence. Descriptive statistics and bivariate analysis were used, and a P value < 0.05 was taken as statistically significant in the multivariate analysis. Results. The patients were mostly female (55.74%), with a median (IQR) age of 32 (20) years. Approximately 74.13% of the patients experienced antidepressant side effects, where insomnia (17.05%) and anxiety (17.05%) were the most common. More than half of the patients (52.29%) had a low level of adherence. Females were 1.01 times more likely to be nonadherent to their antidepressant medications compared to males, adjusted odds ratio (AOR): 1.001 (0.31-1.63). Similarly, illiterate patients tended to be more nonadherent compared to literates, AOR: 1.342 (0. 93-2.82), and unemployed individuals were 1.5 times more likely to be nonadherent to their medications compared to employed individuals, AOR: 1.46 (1.16-4.13). Likewise, patients with severe side effects were more prone to develop nonadherence than those with moderate side effects, AOR: 1.173 (0.42-3.25). A significant association was found between the Naranjo score and medication adherence. Conclusions. This study suggests that antidepressant drug side effects were more prevalent and medication adherence was extremely poor among depressive patients in psychiatric hospitals. Factors such as gender, occupation, education, side effects, and ADRs attributed to poor medication adherence in patients.

scholarly journals Clinical outcomes and mortality associated with weekend admission to psychiatric hospital

2016 ◽  
Vol 209 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Rashmi Patel ◽  
Edward Chesney ◽  
Alexis E. Cullen ◽  
Alex D. Tulloch ◽  
Matthew Broadbent ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Clinical Outcomes ◽  
Psychiatric Hospital ◽  
Hospital Admissions ◽  
Mental Healthcare ◽  
Psychiatric Hospitals ◽  
Healthcare Services ◽  
Clinical Population ◽  
Minority Ethnic Group ◽  
Increased Risk

BackgroundStudies indicate that risk of mortality is higher for patients admitted to acute hospitals at the weekend. However, less is known about clinical outcomes among patients admitted to psychiatric hospitals.AimsTo investigate whether weekend admission to a psychiatric hospital is associated with worse clinical outcomes.MethodData were obtained from 45 264 consecutive psychiatric hospital admissions. The association of weekend admission with in-patient mortality, duration of hospital admission and risk of readmission was investigated using multivariable regression analyses. Secondary analyses were performed to investigate the distribution of admissions, discharges, in-patient mortality, episodes of seclusion and violent incidents on different days of the week.ResultsThere were 7303 weekend admissions (16.1%). Patients who were aged between 26 and 35 years, female or from a minority ethnic group were more likely to be admitted at the weekend. Patients admitted at the weekend were more likely to present via acute hospital services, other psychiatric hospitals and the criminal justice system than to be admitted directly from their own home. Weekend admission was associated with a shorter duration of admission (B coefficient –21.1 days, 95% CI –24.6 to –17.6, P<0.001) and an increased risk of readmission in the 12 months following index admission (incidence rate ratio 1.13, 95% CI 1.08 to 1.18, P<0.001), but in-patient mortality (odds ratio (OR) = 0.79, 95% CI 0.51 to 1.23, P = 0.30) was not greater than for weekday admission. Fewer episodes of seclusion occurred at the weekend but there was no significant variation in deaths during hospital admission or violent incidents on different days of the week.ConclusionsBeing admitted at the weekend was not associated with an increased risk of in-patient mortality. However, patients admitted at the weekend had shorter admissions and were more likely to be readmitted, suggesting that they may represent a different clinical population to those admitted during the week. This is an important consideration if mental healthcare services are to be implemented across a 7-day week.

Behind the screen of voluntary psychiatric hospital admissions: A qualitative exploration of treatment pressures and informal coercion in experiences of patients in Italy, Poland and the United Kingdom

2021 ◽  
pp. 002076402110039
Author(s):  
Justyna Klingemann ◽  
Piotr Świtaj ◽  
Antonio Lasalvia ◽  
Stefan Priebe
Keyword(s):  
United Kingdom ◽  
Psychiatric Hospital ◽  
Hospital Admissions ◽  
Psychiatric Inpatient ◽  
Psychiatric Hospitals ◽  
Term Treatment ◽  
Structured Interviews ◽  
Perceived Coercion ◽  
The United Kingdom ◽  
Informal Coercion

Background: Despite the extensive research and intense debate on coercion in psychiatry we have seen in recent years, little is still known about formally voluntarily admitted patients, who experience high levels of perceived coercion during their admission to a psychiatric hospital. Aims: The purpose of the present research was to explore forms of treatment pressure put on patients, not only by clinicians, but also by patients’ relatives, during admission to psychiatric hospitals in Italy, Poland and the United Kingdom. Methods: Data were obtained via in-depth, semi-structured interviews with patients ( N = 108) diagnosed with various mental disorders (ICD-10: F20–F49) hospitalised in psychiatric inpatient wards. Maximum variation sampling was applied to ensure the inclusion of patients with different socio-demographic and clinical characteristics. The study applied a common methodology to secure comparability and consistency across participating countries. The qualitative data from each country were transcribed verbatim, coded and subjected to theoretical thematic analysis. Results: The results of the analysis confirm that the legal classifications of involuntary and voluntary hospitalisation do not capture the fundamental distinctions between patients who are and are not coerced into treatment. Our findings show that the level of perceived coercion in voluntary patients ranges from ‘persuasion’ and ‘interpersonal leverage’ (categorised as treatment pressures) to ‘threat’, ‘someone else’s decisions’ and ‘violence’ (categorised as informal coercion). Conclusion: We suggest that the term ‘treatment pressures’ be applied to techniques for convincing patients to follow a suggested course of treatment by offering advice and support in getting professional help, as well as using emotional arguments based on the personal relationship with the patient. In turn, we propose to reserve the term ‘informal coercion’ to describe practices for pressuring patients into treatment by threatening them, by making them believe that they have no choice, and by taking away their power to make autonomous decisions.

scholarly journals Patterns of Prescription of Psychotropic Medications and Their Adherence among Patients with Schizophrenia in Two Psychiatric Hospitals in Accra, Ghana: A Cross-Sectional Survey

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Sharon Ashong ◽  
Irene A. Kretchy ◽  
Barima Afrane ◽  
Ama de-Graft Aikins
Keyword(s):  
Side Effects ◽  
Psychiatric Hospital ◽  
Psychiatric Hospitals ◽  
Psychotropic Medications ◽  
Therapeutic Monitoring ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Adherence To Medication ◽  
Adherence Behaviour

Background. Patients with schizophrenia are managed with antipsychotics and other psychotropic medications. Objectives. This study aimed to assess the commonly prescribed psychotropic medications for patients with schizophrenia, explore the types of therapeutic monitoring that were performed, and find out whether the side effects experienced by the patients played any role in their adherence behaviour. Methods. This hospital-based cross-sectional study enrolled 259 patients with schizophrenia from Accra Psychiatric Hospital and Pantang Psychiatric Hospital. Data were collected on mental status, side effects, types of therapeutic monitoring performed, and adherence behaviour. Results. Olanzapine was the commonly prescribed psychotropic medication. Most of respondents (73.4%) experienced mild levels of side effects. The negative effects were predominantly genitourinary (26%) and gastrointestinal (17.2%). Blood pressure and heart rate measures were the main types of monitoring performed but no measurement of drug levels was reported. About 98.1% of the participants poorly adhered to their medications and the major reasons for poor adherence were economic challenges, forgetfulness, and the feeling of wellness. Conclusion. Adherence to medication is a major health problem among patients with schizophrenia and there is a need to improve adherence and treatment outcomes.

scholarly journals Changing landscape of nutrition and dietetics research? A bibliographic analysis of top-tier published research in 1998 and 2018

2021 ◽  
pp. 1-10
Author(s):  
Sze Lin Yoong ◽  
Jacklyn Jackson ◽  
Courtney Barnes ◽  
Nicole Pearson ◽  
Taren Swindle ◽  
...  
Keyword(s):  
Research Design ◽  
Dissemination And Implementation ◽  
Cross Sectional ◽  
Bibliographic Analysis ◽  
Type Design ◽  
Study Type ◽  
Nutrition And Dietetics ◽  
Published Research ◽  
Research Type ◽  
Over Time

Abstract Objective: The current study sought to describe and compare study type, research design and translation phase of published research in nutrition and dietetic journals in 1998 and 2018. Design: This was a repeat cross-sectional bibliographic analysis of Nutrition and Dietetics research. All eligible studies in the top eight Nutrition and Dietetics indexed journals in 1998 and 2018 were included. Two independent reviewers coded each study for research design (study type and study design) and translation phase (T0-T4) of the research using seminal texts in the field. Setting: Not relevant. Participants: Not relevant. Results: The number of publications (1998, n 1030; 2018, n 1016) has not changed over time, but the research type, design and translation phases have. The proportion of intervention studies in 1998 (43·8 %) was significantly higher than 2018 (19·4 %). In 2018, more reviews (46·9 % v. 15·6 % in 1998) and less randomised trials (14·3 % v. 37·8 % in 1998) were published. In regard to translation phase, there was a higher proportion of T2–T4 research in 2018 (18·3 % v. 3·8 % in 1998); however, the proportion of T3/T4 (dissemination, implementation and population-level research) research was still low (<3 %). Our sensitivity analysis with the four journals that remained in the top eight journal across the two time periods found no differences in the research type, design and translation phases across time. Conclusions: There was a reduction in intervention and T0 publications, alongside higher publication of clinical study designs over time; however, published T3/T4 research in Nutrition and Dietetics is low. A greater focus on publishing interventions and dissemination and implementation may be needed.

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