Audit of anticholinergic treatment in a psychiatric patient population

Justin H. G. Williams

doi:10.1192/pb.23.1.22

Audit of anticholinergic treatment in a psychiatric patient population

Psychiatric Bulletin ◽

10.1192/pb.23.1.22 ◽

1999 ◽

Vol 23 (1) ◽

pp. 22-24 ◽

Cited By ~ 1

Author(s):

Justin H. G. Williams

Keyword(s):

Psychiatric Patient ◽

Patient Population ◽

Psychiatric Patients ◽

Anticholinergic Medication ◽

Clinical Implications ◽

Treatment Needs ◽

Regular Monitoring ◽

The Mean ◽

Depot Medication

Aims and methodAn audit was performed to look at how carefully anticholinergic medication was prescribed and monitored in a population of psychiatric patients on depot medication.ResultsThe mean duration of prescription was 47 months and 44% of patients' prescriptions went unaltered for over three years. Evidence was lacking for rational initial anticholinergic prescription.Clinical implicationsAnticholinergic treatment needs to be prescribed more rationally with regular monitoring of extra-pyramidal symptoms.

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Towards the development of a reciprocal liaison service

Psychiatric Bulletin ◽

10.1192/pb.24.10.379 ◽

2000 ◽

Vol 24 (10) ◽

pp. 379-381 ◽

Cited By ~ 2

Author(s):

Mark Davies

Keyword(s):

Response Rate ◽

Psychiatric Patients ◽

Surgical Patients ◽

Clinical Implications ◽

Total Response ◽

District Health ◽

Total Response Rate ◽

The Mean ◽

Equity Of Access

Aims and MethodThe aim of this survey was to determine attitudes among consultants in different specialities towards the development of a reciprocal liaison service providing access for psychiatric patients to medical and surgical liaison services equal to the access of medical and surgical patients to psychiatric liaison services. All medical, surgical and psychiatric consultants in a district health service were surveyed, with a total response rate of 48%.ResultsThe mean number of medical and surgical patients requiring a psychiatric liaison service was 6%. The mean number of psychiatric patients requiring medical and surgical liaison services was 11%. Ratings overall for various components of the two types of liaison service were generally similar, with acute assessments and follow-up being given a high priority for both types.Clinical ImplicationsAs liaison services are developed, the notion of equity of access for all patients is paramount. Commissioning of such services should thereby specify the reciprocal nature of development. This survey shows that generally there is a positive attitude to the development of such a service.

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PERIODONTAL DISEASE STATUS, KNOWLEDGE, ATTITUDE, PRACTICE AND TREATMENT NEEDS OF PREGNANT WOMEN

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.6.18 ◽

2018 ◽

Vol 8 (6) ◽

pp. 138-144

Author(s):

Thien Nguyen Duc ◽

Tai Tran Tan

Keyword(s):

Periodontal Disease ◽

Pregnant Women ◽

Oral Hygiene ◽

Disease Status ◽

Incidence Rates ◽

Gestation Period ◽

Treatment Needs ◽

Cross Sectional ◽

Mean Values ◽

The Mean

Background: Periodontal disease is a prominent and important issue of public health, especially in pregnant women. The objective of this study is to describe the clinical characteristics; learn knowledge, attitudes, practice oral hygiene and assess the need for treatment of periodontal disease in pregnant women. Subjects and Methods: A cross-sectional study of 210 pregnant women who visited the Department of Obstetrics and Gynecology at the Hue University of Medicine and Pharmacy Hospital. Clinical examination and interview questions on knowledge, attitudes and practice of oral care for all subjects. Results: The incidence of gingivitis was 100%, with mild gingivitis of 4,3% and moderate gingivitis of 95.7%. There was a difference in incidence rates of gingivitis in the gestational period (p<0.001). The incidence of periodontitis is 17.6% and there is no difference in gestational age (p>0.05). The mean values of GI and BOP indices differed by gestation period (p<0.05) and PD, OHI-S, PlI have statistically significant relationship with gestation period (p>0.05). The incidence of periodontal disease is 80.5%; The percentage of pregnant women who abstain from brushing their teeth after birth is 61.4%. Prevalence of brushing once a day: 7.1%; Twice a day: 70.5% and 3 times daily: 22.4%; The mean values of GI, PD, BOP, OHI-S and PlI were inversely proportional to the number of brushing (p<0.001). The rate of dental hygiene is just 3.3%; The rate of oral hygiene, dental plaque and plaque removal was 94,3%; The proportion of subjects required for intensive treatment is 2.4%. Conclusion: Periodontal disease, especially for pregnant women, is high. It is necessary to educate the knowledge, attitudes and practice of proper oral hygiene and to better meet the demand for periodontal disease treatment for pregnant women. Key words: Periodontal disease, pregnant women, knowledge, attitude, practice for oral hygiene, treatment needs

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Validity and Clinical Scale Comparisons between the MMPI and MMPI-2 with Psychiatric Inpatients

Psychological Reports ◽

10.2466/pr0.1992.70.1.323 ◽

1992 ◽

Vol 70 (1) ◽

pp. 323-332 ◽

Cited By ~ 5

Author(s):

Dudley David Blake ◽

Phillip M. Kleespies ◽

Walter E. Penk ◽

Suellen S. Walsh ◽

DeAnna L. Mori ◽

...

Keyword(s):

Discriminant Function ◽

Relative Stability ◽

Patient Population ◽

Psychiatric Patients ◽

Special Populations ◽

Clinical Scale ◽

Acute Psychiatry ◽

Highly Correlated ◽

Discriminant Function Analyses

This study was designed to investigate the comparability of the original MMPI (1950) and the MMPI-2 (1989) with a psychiatric patient population. 34 male and 3 female patients, shortly after admission to one of two acute psychiatry units, completed the old and revised versions of the MMPI. Paired t tests indicated but scant differences for raw scores, while many more differences were found among T scores for validity, clinical, and supplemental scales. Analyses, however, showed all scales on the two forms to be highly correlated. Analysis of the high-point and two-point codes across the two administrations also showed relative stability, although the proportion of Scales 2 (Depression) and 8 (Schizophrenia) decreased, while those for Scales 6 (Paranoia) and 7 (Psychasthenia) increased markedly in the MMPI-2 protocols. Examination of each version's discriminability among mood- and thought-disordered subsamples suggested that the MMPI provides slightly better delineation between diagnostic classes. Discriminant function analyses showed that there were essentially no differences between the two forms in the accurate classification of clinical and nonclinical groups. The findings reported here provide support for the MMPI-2; despite modification, the newer form retains the advantages of the original MMPI. Differences found here may be unique to psychiatric patients and their patterns of MMPI/MMPI-2 equivalence and may not generalize to other special populations.

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Machine learning for psychiatric patient triaging: an investigation of cascading classifiers

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocy109 ◽

2018 ◽

Vol 25 (11) ◽

pp. 1481-1487 ◽

Cited By ~ 1

Author(s):

Vivek Kumar Singh ◽

Utkarsh Shrivastava ◽

Lina Bouayad ◽

Balaji Padmanabhan ◽

Anna Ialynytchev ◽

...

Keyword(s):

Machine Learning ◽

Psychiatric Patient ◽

Classification Accuracy ◽

Psychiatric Patients ◽

Patient Records ◽

Classification Technique ◽

Machine Learning Approach ◽

The One ◽

Unique Dataset

Abstract Objective Develop an approach, One-class-at-a-time, for triaging psychiatric patients using machine learning on textual patient records. Our approach aims to automate the triaging process and reduce expert effort while providing high classification reliability. Materials and Methods The One-class-at-a-time approach is a multistage cascading classification technique that achieves higher triage classification accuracy compared to traditional multiclass classifiers through 1) classifying one class at a time (or stage), and 2) identification and application of the highest accuracy classifier at each stage. The approach was evaluated using a unique dataset of 433 psychiatric patient records with a triage class label provided by “I2B2 challenge,” a recent competition in the medical informatics community. Results The One-class-at-a-time cascading classifier outperformed state-of-the-art classification techniques with overall classification accuracy of 77% among 4 classes, exceeding accuracies of existing multiclass classifiers. The approach also enabled highly accurate classification of individual classes—the severe and mild with 85% accuracy, moderate with 64% accuracy, and absent with 60% accuracy. Discussion The triaging of psychiatric cases is a challenging problem due to the lack of clear guidelines and protocols. Our work presents a machine learning approach using psychiatric records for triaging patients based on their severity condition. Conclusion The One-class-at-a-time cascading classifier can be used as a decision aid to reduce triaging effort of physicians and nurses, while providing a unique opportunity to involve experts at each stage to reduce false positive and further improve the system’s accuracy.

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Retirement intentions of older consultant psychiatrists

Psychiatric Bulletin ◽

10.1192/pb.28.4.130 ◽

2004 ◽

Vol 28 (4) ◽

pp. 130-132 ◽

Cited By ~ 10

Author(s):

Alex Mears ◽

Tim Kendall ◽

Cornelius Katona ◽

Carole Pashley ◽

Sarah Pajak

Keyword(s):

Early Retirement ◽

Response Rate ◽

Important Determinant ◽

Clinical Implications ◽

Consultant Psychiatrist ◽

Health Officer ◽

Decisions To Leave ◽

The Mean ◽

The Uk ◽

Retirement Intentions

Aims and MethodThis survey gathered data on the retirement intentions of consultant psychiatrists over the age of 50 years, in order to address retention issues. A questionnaire was sent to all 1438 consultants over this age in the UK.ResultsA total of 848 questionnaires were returned, an adjusted response rate of 59%. The mean age at which consultants intended to retire in this sample was 60 years (s.d. 4.16), suggesting a potential loss of 5725 consultant years. Reasons for early retirement are complex: factors encouraging retirement include too much bureaucracy, lack of free time and heavy case-loads; those discouraging retirement include enjoyment of work, having a good team and money. Mental Health Officer status is an important determinant in the decision to retire early.Clinical ImplicationsWith numerous vacancies in consultant psychiatrist posts throughout the UK, premature retirement is a cause for concern, possibly contributing to an overall reduction in consultant numbers of 5%. Addressing factors that influence consultants' decisions to leave the health service early should form an important part of an overall strategy to increase consultant numbers.

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Validity of the Revised Beta Examination and a Short-Form Beta for Hospitalized Alcoholics

Psychological Reports ◽

10.2466/pr0.1983.53.3.751 ◽

1983 ◽

Vol 53 (3) ◽

pp. 751-756 ◽

Cited By ~ 2

Author(s):

Daniel R. Panitz ◽

Alan Feingold

Keyword(s):

Educational Attainment ◽

Short Form ◽

Psychiatric Patients ◽

Occupational Status ◽

General Intelligence ◽

Digit Symbol ◽

State Hospitals ◽

Picture Completion ◽

Rehabilitation Agency ◽

The Mean

Although the Revised Beta Examination, a nonverbal measure of general intelligence, is one of the few group tests extensively validated for psychiatric patients in state hospitals, it has not been determined whether the instrument is useful for discriminating among alcoholic inpatients in state facilities. The Beta was administered to 494 detoxified alcoholics (471 men, 23 women), aged 20 to 60 yr. ( M = 3.99, SD = 10.1) and hospitalized in a state rehabilitation agency. They were grouped by prior occupational status and educational attainment. Means of the Beta Weighted Scores differed significantly among the groups on both criteria whereas the mean IQs differed only for the educational classification. Also reported was the development of a two-subtest short-form Beta based on the Digit Symbol and Picture Completion subtests. The short-form scores differentiated the groups about as well as the Weighted Scores.

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The TAPS Project. 9: The Reliability of the Patient Attitude Questionnaire

The British Journal of Psychiatry ◽

10.1192/s0007125000292210 ◽

1993 ◽

Vol 162 (S19) ◽

pp. 25-29 ◽

Cited By ~ 13

Author(s):

Graham Thornicroft ◽

Christopher Gooch ◽

Catherine O'Driscoll ◽

Sawsan Reda

Keyword(s):

Living Arrangements ◽

Psychiatric Patients ◽

Kappa Coefficient ◽

Attitudinal Change ◽

Attitude Questionnaire ◽

Retest Reliability ◽

Patient Attitude ◽

The Mean ◽

Test Retest Reliability

The development of the hospital and community versions of the Patient Attitude Questionnaire is described. The instrument rates the attitudes of psychiatric patients towards their treatment settings and staff, and is framed specifically to assess attitudinal change during the transfer of patients from hospital. For the items rated using the kappa coefficient of agreement, the mean test-retest reliability value was 0.51, and the average inter-rater value was 0.82. This study shows that long-term psychiatric patients are able to give clear and consistent views about their living arrangements - views that should be sought and respected by staff.

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Intestinal Obstruction following Ingestion of Metallic Instruments in a Psychiatric Patient

Case Reports in Surgery ◽

10.1155/2018/2469462 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Oscar Kivike ◽

Israel Soko ◽

David Mgaya ◽

Frank Sandi

Keyword(s):

Physical Examination ◽

Intestinal Obstruction ◽

Female Patient ◽

Psychiatric Patient ◽

Psychiatric Patients ◽

Abdominal Distension ◽

History Taking ◽

Proximal Intestine ◽

Psychotic Features

Pica among psychiatric patients has been well documented. We report a 25-year-old female patient who presented with abdominal distension for one week. She is a known psychiatric patient for 5 years. Through history taking, physical examination, and investigations, the patient was found to have psychotic features and features of intestinal obstruction. Surgery was done by opening the abdomen and then the stomach. The stomach, together with the proximal intestine, was found to be filled with metallic instruments weighing 780 mg. The diagnosis of a metalophagia type of pica was reached. All instruments were removed and the patient did well postoperatively.

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Tobacco Smoking and Motivation to Quit in Psychiatric Patients

European Psychiatry ◽

10.1016/s0924-9338(09)70653-4 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1

Author(s):

I. Ganhão ◽

E. Gonçalves ◽

A. Paixão ◽

M. Trigo

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Patient Population ◽

Psychiatric Patients ◽

Major Health ◽

Smoking Restrictions ◽

Motivation To Quit ◽

Smoking Quantity ◽

Heavy Smokers

Introduction:Smoking is a major health risk in the population in general with significantly increased morbility/mortality with severe consequences on the quality of life and tremendous economic burden on society. It is well known that psychiatric patients have an even higher prevalence of smoking, of heavy smokers and of other risk factors that contribute to the same illnesses.Non-smoking campaigns/smoking restrictions have flourished and it appears that more people are quitting or seriously contemplating the idea. When once, many non-smokers tolerated smokers, today the stigma associated with smoking is undeniable. Psychiatric patients, already greatly stigmatized, risk even becoming more so. Furthermore, smoking cessation programs and interventions frequently are not available, exclude many psychiatric patients and/or are ill-adapted to the special needs in this patient population.Aim:To establish the prevalence of smoking, quantity of tobacco smoked, other factors of dependence by psychiatric diagnosis in a portuguese psychiatric hospital.Establish the motivation of these patients to seek help by professionals and motivation to quit.Methods:Application of questionnaires including Fagerstrom's Modified Questionnaire to patients under care by one team of a Psychaitric hospital in Lisbon, Portugal (CHPL - Sector A).Discussion and conclusions:The study is under way therefore, there are no valid conclusions yet.Certainly it will be possible to confirm high levels of smoking tobacco in this patient population. Hopefully, we may also conclude that there is the desire to change smoking habits making cessation programs a needed and welcomed intervention in psychiatric settings.

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