Mental disorders and/or substance abuse related to one of every eight emergency department cases

2010 ◽  
Keyword(s):  
Emergency Department ◽  
Substance Abuse ◽  
Mental Disorders

Emergency department use at the end of life in elderly patients with gastrointestinal malignancies and mental health comorbidities.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 811-811
Author(s):  
Mehr Kashyap ◽  
Jeremy Phillip Harris ◽  
Daniel Tandel Chang ◽  
Erqi L. Pollom
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Substance Abuse ◽  
Mental Disorders ◽  
Elderly Patients ◽  
End Of Life ◽  
Health Care Expenditures ◽  
Gastrointestinal Malignancies ◽  
The Impact

811 Background: Aggressive care at the end-of-life can contradict patients’ wishes, negatively impact patient quality of life, and contribute to overall health care expenditures. Patients with mental disorders (MD) often experience disparities in medical care and have poorer clinical outcomes. We investigated the impact of mental disorders on emergency department (ED) use at the end of life among elderly patients with gastrointestinal (GI) malignancies. Methods: We conducted a retrospective cohort study using the SEER-Medicare database. We identified patients aged 66 years and older with GI malignancies (colorectal, pancreatic, gastric, hepatic, biliary, esophageal, small bowel, and anal cancer) diagnosed between 2004 and 2013 who had recorded death. We assessed the association between MD (depression, bipolar disorder, psychotic disorder, anxiety, dementia, and substance abuse) and ED use within 30 days of death using logistic regression models. Results: Of the 160,367 decedents included, 54,461 (34.1%) had at least one MD diagnosis between one year prior to cancer diagnosis and death. Those with MD were more likely to use the ED more than once in the last 30 days of life (14.7% vs. 12.4% p < 0.01). ED use was highest among decedents with anxiety disorder (15.8%) and substance abuse (16.3%). Among decedents with mental disorders, risk factors associated with ED use at end of life include being male (adjusted odds ratio [aOR] 1.16, 95% confidence interval [CI] 1.10 – 1.22), younger (aOR 1.14, 95% CI 1.06 - 1.23), and black (aOR 1.33, 95% CI 1.23 – 1.45), living in a lower income zip code (1.21, 95% CI 1.13 – 1.30), and having a higher Charlson comorbidity score (aOR 1.71, 95% CI 1.56 – 1.87). ED use was also associated with pancreatic (aOR 1.16, 95% CI 1.08 - 1.25), hepatic (aOR 1.21, 95% CI 1.11 - 1.33), biliary (aOR 1.16, 95% CI 1.03 - 1.30) and esophageal (aOR 1.16, 95% CI 1.04 - 1.29) cancer compared to colorectal cancer. Conclusions: MD is associated with increased ED use at the end of life among elderly patients with GI cancer. Palliative and supportive care including mental health services early in the disease course may improve quality of end-of-life care in this vulnerable population.

A descriptive study of the prevalence of psychological distress and mental disorders in the Canadian population: comparison between low-income and non-low-income populations

2010 ◽  
Vol 30 (3) ◽  
pp. 148-149 ◽  
Author(s):  
J. Caron ◽  
A. Liu
Keyword(s):  
Mental Health ◽  
Substance Abuse ◽  
Psychological Distress ◽  
Mental Disorders ◽  
Low Income ◽  
Well Being ◽  
Descriptive Study ◽  
Canadian Community Health Survey ◽  
Vulnerable Groups ◽  
High Psychological Distress

Objective This descriptive study compares rates of high psychological distress and mental disorders between low-income and non-low-income populations in Canada. Methods Data were collected through the Canadian Community Health Survey – Mental Health and Well-being (CCHS 1.2), which surveyed 36 984 Canadians aged 15 or over; 17.9% (n = 6620) was classified within the low-income population using the Low Income Measure. The K-10 was used to measure psychological distress and the CIDI for assessing mental disorders. Results One out of 5 Canadians reported high psychological distress, and 1 out of 10 reported at least one of the five mental disorders surveyed or substance abuse. Women, single, separated or divorced respondents, non-immigrants and Aboriginal Canadians were more likely to report suffering from psychological distress or from mental disorders and substance abuse. Rates of reported psychological distress and of mental disorders and substance abuse were much higher in low-income populations, and these differences were statistically consistent in most of the sociodemographic strata. Conclusion This study helps determine the vulnerable groups in mental health for which prevention and promotion programs could be designed.

scholarly journals Experiences of substance-using suicidal males who present frequently to the emergency department

CJEM ◽  
2008 ◽  
Vol 10 (04) ◽  
pp. 339-346 ◽  
Author(s):  
Julia M. Spence ◽  
Yvonne Bergmans ◽  
Carol Strike ◽  
Paul S. Links ◽  
Jeffrey S. Ball ◽  
...  
Keyword(s):  
Emergency Department ◽  
Substance Abuse ◽  
Suicidal Behaviour ◽  
Group Identification ◽  
High Risk Group ◽  
Staff Members ◽  
Care Workers ◽  
History Of ◽  
Seeking Help ◽  
Iterative Coding

ABSTRACTObjective:This qualitative study investigated the repeated use of the emergency department (ED) by men with a history of suicidal behaviour and substance abuse to understand the needs and barriers to care for this high-risk group. Identification of common themes from interviews with patients and health care workers can serve as a basis for improved ED-based interventions.Methods:Using semistructured interviews, patients, ED staff and family physicians were asked about needs of the aformentioned group. Twenty-five patients were interviewed and completed questionnaires regarding their substance use, aggression, parasuicidal behaviour, alexithymia and childhood trauma. In addition, 27 staff members were interviewed. Interviews were tape-recorded, transcribed and qualitatively analyzed using an iterative coding process.Results:Of the 25 patients, 23 (96%) had a mood or anxiety disorder and 18 (75%) had borderline personality disorder. One-half of the patients scored high and another quarter scored moderate on alexithymia testing. The ED was viewed as a last resort despite seeking help. Frustration was felt by both patients and staff regarding difficult communication, especially during an acute crisis.Conclusion:The ED plays an important role in the provision of care for men with recurrent suicidal behaviour and substance abuse. Some of the diagnoses and problems faced by these patients are beyond the purview of the ED; however, staff can identify mutual goals for crisis interventions, allow for frequent communication and seek to de-escalate situations through the validation of the stress patients are experiencing.

Emotion Modulation in Psychiatric Patients Through Music

2012 ◽  
Vol 31 (5) ◽  
pp. 485-493 ◽  
Author(s):  
Stefan Gebhardt ◽  
Markus Kunkel ◽  
Richard von Georgi
Keyword(s):  
Substance Abuse ◽  
Problem Solving ◽  
Mental Disorders ◽  
Personality Disorders ◽  
Reference Group ◽  
Psychiatric Patients ◽  
Applied Music ◽  
Cognitive Problem ◽  
Psychiatric Population ◽  
Degree Of Severity

This study explores differences in the use of music in everyday life among diagnostic groups of a psychiatric population (n = 180) in reference to a group of healthy subjects (n = 430). The results indicate that patients with mental disorders use music more for emotion modulation than healthy controls. In particular, patients with substance abuse and those with personality disorders used music mainly for cognitive problem solving and the reduction of negative activation, whereas patients with substance abuse in addition used music not often to stimulate themselves positively. Patients suffering from schizophrenia and personality disorders more often applied music for relaxation than the subjects of the reference group. Furthermore, the degree of severity of the psychiatric disorder correlated with the increased use of music for emotion modulation, i.e., for relaxation and cognitive problem solving. Thus, the results demonstrate an increased use of music for emotion modulation in patients with mental disorders in association with the severity of the disorder.

scholarly journals The Role of Acetyl Cysteine in Cocaethylene (Non-Acetaminophen) Acute Liver Failure

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Getaw Worku Hassen ◽  
Amaninder Dhaliwal ◽  
Catherine Ann Jenninigs ◽  
Hossein Kalantari
Keyword(s):  
Emergency Department ◽  
Substance Abuse ◽  
Liver Failure ◽  
Liver Transplant ◽  
Acute Liver Failure ◽  
Active Substance ◽  
Vital Signs ◽  
Normal Limits ◽  
History Of ◽  
Acetyl Cysteine

Background.Acute liver failure can result from acetaminophen overdose, viral infection, toxins, and other disease conditions. Liver transplant is available in limited fashion and the criteria are strict as to who should get an available liver. N- Acetyl Cysteine (NAC) has been used in non-acetaminophen induced liver failure with success. Here we report a case of acute liver failure from cocaethylene that was reversed with NAC along with other medical therapy.Case Presentation.A 50-year-old female patient presented to the Emergency Department (ED) with a two-day history of coffee ground vomiting and hematemesis. She reported occasional substance abuse and heavy alcoholism. She reported shortness of breath and chest pain from the recurrent forceful vomiting. The rest of the review of systems was unremarkable except a fall from intoxication. Physical examination revealed anicteric conjunctiva and nontender abdomen and her vital signs were within normal limits. Initial blood work revealed acute liver and renal failure. The patient was started with general medical management and liver transplant service rejected the case due to active substance abuse. She underwent brief hemodialysis and was started on NAC. Over the course of her hospital stay her liver function and kidney function improved significantly and patient was discharged to home.Conclusion.In cases where liver transplant is not an option for various reasons including active substance abuse, a trial of N-Acetyl Cysteine may be beneficial and should be considered in the Emergency Department.

scholarly journals Características sociodemográficas de las personas admitidas en un centro hospitalario psiquiátrico alemán: un estudio retrospectivo.

2020 ◽  
pp. 4-10
Author(s):  
Blanca Patricia Silva-Barrera ◽  
Rocio Juliá-Sanchis ◽  
Andrés Montoyo-Guijarro ◽  
Rosa Requena-Morales
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Substance Abuse ◽  
Retrospective Study ◽  
Mental Disorders ◽  
Psychiatric Hospital ◽  
Psychiatric Symptoms ◽  
Clinical History ◽  
Severe Mental Disorders ◽  
Salud Mental

Resumen En los últimos años se han suscitado cambios en la salud mental de las personas, debido a las diversas problemáticas sociodemográficas actuales. Se requiere de la exploración de los acontecimientos que causan síntomas psiquiátricos en las personas con necesidad de ingreso y hospitalización. Es por eso que se realizó este estudio retrospectivo sobre 1.593 historias clínicas del hospital psiquiátrico Main-Kinzig-Kreis Schlüchtern en Alemania durante el período 2000-2014 en pacientes de 18 a 69 años. Se identificó como motivo de ingreso a un 37.16% de personas como pacientes con síntomas agudos, una relación con consumos de sustancias provocadas por adicciones en un 41.62% y el trastorno depresivo en un 28.75%. Se detecta la descompensación de trastornos mentales graves en 27.05%, en donde el 34.71% de los pacientes fueron derivadas desde otros dispositivos asistenciales y el 32.89% decidió ingresar por sí mismo. El perfil del paciente ingresado es de ser hombre entre 41-50 años, casado o con pareja, derivado por recurso asistencial relacionado con la descompensación de un trastorno mental grave. Abstract In recent years, changes have occurred in people&#39;s mental health due to various current socio- demographic issues. The exploration of the events that cause psychiatric symptoms in people who need admission and hospitalization is required. That is why this retrospective study was conducted on 1.593 clinical history from the Main-Kinzig-Kreis Schlüchtern psychiatric hospital in Germany during the period 2000-2014 in patients aged 18 to 69. A total of 37.16% of the patients were identified as having acute symptoms, 41.62% as having substance abuse due to addiction and 28.75% as having a depressive disorder. Decompensation of severe mental disorders was detected in 27.05%, where 34.71% of the patients were referred from other care devices and 32.89% decided to be admitted on their own. The profile of the admitted patient is a man between 41-50 years old, married or with a partner, referred to the psychiatric hospital for health care resources due to a decompensation of some serious mental disorder.

Definitions and measurement of negative symptoms in schizophrenia

2020 ◽  
pp. 1-18
Author(s):  
István Bitter
Keyword(s):  
Substance Abuse ◽  
Mental Disorders ◽  
Negative Symptoms ◽  
Rating Scales ◽  
Social Deprivation ◽  
Unmet Need ◽  
Disease Process ◽  
Extrapyramidal Symptoms ◽  
Positive Symptoms ◽  
Need For Treatment

Negative symptoms of schizophrenia represent deficits in different domains, e.g. loss or diminution in emotions, thinking and movement. Persistent primary negative symptoms are considered to be part of the schizophrenia disease process and represent an unmet need for treatment, while secondary negative symptoms are associated with positive symptoms of schizophrenia, other mental disorders (e.g. depression, substance abuse), extrapyramidal symptoms, social deprivation, etc. Validated rating scales are helpful in the evaluation and measurement of negative symptoms. Current consensus supports the focus on the following five domains (five ‘As’): blunted affect, alogia, anhedonia, asociality, and avolition.

ICD-10/DSM-IV index

2013 ◽  
pp. 1023-1042
Keyword(s):  
Substance Abuse ◽  
Mental Disorders ◽  
Affective Disorders ◽  
Somatoform Disorders ◽  
Physical Factors ◽  
Psychoactive Substance ◽  
Adult Personality ◽  
Behavioural Syndromes ◽  
Icd 10 ◽  
Dsm Iv

F00-F09 Organic, including symptomatic mental disorders F10–F19 Mental and behavioural disorders due to psychoactive substance abuse F20–F29 Schizophrenia, schizotypal, and delusional disorders F30–F39 Mood (affective) disorders F40–F49 Neurotic, stress-related, and somatoform disorders F50–F59 Behavioural syndromes associated with physiological disturbance and physical factors F60–F69 Disorders of adult personality and behaviour...

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