scholarly journals Prospective controlled study of psychiatric out-patient non-attendance

2000 ◽  
Vol 176 (2) ◽  
pp. 160-165 ◽  
Author(s):  
Helen Killaspy ◽  
Sube Banerjee ◽  
Michael King ◽  
Margaret Lloyd
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Social Adjustment ◽  
Drop Out ◽  
Controlled Study ◽  
Attendance Rates ◽  
Severe Mental Disorder ◽  
Psychiatric Admissions ◽  
Prospective Controlled Study

BackgroundPsychiatric clinics have high non-attendance rates and failure to attend may be a sign of deteriorating mental health.AimsTo investigate why psychiatric out-patients fail to attend, and the outcome of attenders and non-attenders.MethodProspective cohort study of randomly selected attenders and non-attenders at general adult psychiatric out-patient clinics. Subjects were interviewed at recruitment and severity of mental disorder and degree of social adjustment were measured. Six and 12 months later their engagement with the clinic and any psychiatric admissions were ascertained.ResultsOf the 365 patients included in the study, 30 were untraceable and 224 consented to participate. Follow-up patients were more psychiatrically unwell than new patients. For follow-up patients, non-attenders had lower social functioning and more severe mental disorder than those who attended. At 12-month follow-up patients who missed their appointment were more likely to have been admitted than those who attended.ConclusionsThose who miss psychiatric follow-up out-patient appointments are more unwell and more poorly socially functioning than those who attend. They have a greater chance of drop-out from clinic contact and subsequent admission.

scholarly journals Mental disorder and PTSD in Syria during wartime: a nationwide crisis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ameer Kakaje ◽  
Ragheed Al Zohbi ◽  
Osama Hosam Aldeen ◽  
Leen Makki ◽  
Ayham Alyousbashi ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Mental Disorder ◽  
Mental Distress ◽  
Poverty Line ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Severe Mental Disorder ◽  
Related Factors ◽  
Cross Sectional

Abstract Background Syria has experienced war since 2011, leaving over 80% under the poverty line and millions displaced. War and its retaliations have significantly impacted the mental health of Syrians. This study evaluates the post-traumatic stress disorder (PTSD), and the severity of the mental distress caused by war and other factors such as low social support. This study also evaluates other variables and compares the findings with those of multiple studies on Syria and refugees. Methods This is a cross-sectional study that included people who lived in Syria in different governorates. Online surveys were distributed into multiple online groups and included the Kessler 10 (K10) scale which screens for anxiety and depression, the Screen for Posttraumatic Stress Symptoms (SPTSS) tool, the Multidimensional Scale of Perceived Social Support, and questionnaires on demographic and war-related factors. Results Our study included 1951 participants, of which, 527 (27.0%) were males and 1538 (78.8%) between the age of 19 and 25. Among participants, 44% had likely severe mental disorder, 27% had both likely severe mental disorder and full PTSD symptoms, 36.9% had full PTSD symptoms, and only 10.8% had neither positive PTSD symptoms nor mental disorder on the K10 scale. Around 23% had low overall support. Half of the responders were internally displaced, and 27.6% were forced to change places of living three times or more due to war. Around 86.6% of the responders believed that the war was the main reason for their mental distress. Those with high SPTSS and K10 scores were found to take more days off from work or school due to negative feelings and having somatic symptoms. Moreover, the number of times changing places of living due to war, educational level, and being distressed by war noise were the most prominent factors for more severe PTSD and mental distress. No differences in PTSD and mental disorder prevalence were noted in participants living in different governorates or among different types of jobs. A strong significant correlation (r = 0.623) was found between SPTSS and K10 scores. Conclusion The conflict in Syria has left the population at great risk for mental distress which was higher compared to Syrian refugees elsewhere. Many measures with an emphasis on mental health are needed to help the people against a long-term avoidable suffering.

scholarly journals Involuntary out-patient commitment: 2-year follow-up

2013 ◽  
Vol 37 (2) ◽  
pp. 60-64 ◽  
Author(s):  
Laura Castells-Aulet ◽  
Miguel Hernández-Viadel ◽  
Pedro Asensio-Pascual ◽  
Carlos Cañete-Nicolás ◽  
Carmen Bellido-Rodríguez ◽  
...  
Keyword(s):  
Mental Disorder ◽  
Emergency Room ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Delusional Disorder ◽  
Emergency Room Visits ◽  
Court Order ◽  
Severe Mental Disorder ◽  
The Impact

Aims and methodTo evaluate the impact of involuntary out-patient commitment (OPC) in patients with severe mental disorder who use hospital services. This is a retrospective–observational study in a population of 91 patients under OPC. The psychiatric diagnosis, sociodemographic variables, who requested the court order and for what motive were studied. The study also looked at the use of the available health services (emergency room visits, admissions, average length of hospital stay) for the period beginning 2 years before and ending 2 years after the initiation of the OPC.ResultsThe number of emergency room visits, admissions and the length of hospitalisation diminished in the 2 years following the initiation of the OPC. In terms of diagnosis, the OPC has the most impact on individuals with schizophrenia and delusional disorder.Clinical implicationsThe OPC can be useful for certain patients with severe mental disorder, particularly individuals with schizophrenia and delusional disorder.

Home-Based Versus Hospital-Based Care for People with Serious Mental Illness

1994 ◽  
Vol 165 (2) ◽  
pp. 179-194 ◽  
Author(s):  
I. M. Marks ◽  
J. Connolly ◽  
M. Muijen ◽  
B. Audini ◽  
G. McNamee ◽  
...  
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Social Adjustment ◽  
Daily Living ◽  
Emergency Admission ◽  
Controlled Study ◽  
Patient Admissions ◽  
Home Based ◽  
Home Based Care

Background.A controlled study tested whether the superior outcome of community care for serious mental illness (SMI) in Madison and in Sydney would also be found in inner London.Method.Patients from an inner London catchment area who faced emergency admission for SMI (many were violent or suicidal) were randomised to 20 months or more of either home-based care (Daily Living Programme, DLP; n = 92), or standard in-patient and later out-patient care (controls, n = 97). Most DLP patients had brief in-patient stays at some time. Measures included number and duration of in-patient admissions, independent ratings of clinical and social function, and patients' and relatives' satisfaction.Results.Outcome was superior with home-based care. Until month 20, DLP care improved symptoms and social adjustment slightly more, and enhanced patients' and relatives' satisfaction. From 3 to 18 months DLP care greatly reduced the number of in-patient bed days as long as the DLP team was responsible for any in-patient phase its patients had. Cost was less. DLP care did not reduce the number of admissions, nor of deaths from self-harm (3 DLP, 2 control). One DLP patient killed a child. Even at 20 months many DLP and control patients still had severe symptoms, poor social adjustment, no job, and need for assertive follow-up and heavy staff input. (Beyond 20 months most gains were lost apart from satisfaction.)Conclusions.It is unclear how much the gain until 20 months from home-based care was due to its site of care, its being problem-centred, its teaching of daily living skills, its assertive follow-up, the home care team's keeping responsibility for any in-patient phase, its coordination of total care (case management), or to other care components. Home-based care is hard to organise and vulnerable to many factors, and needs careful training and clinical audit if gains are to be sustained.

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