Diagnostic profile of inpatients as a determinant of length of stay in a general hospital psychiatric unit

The aim of this study was to determine if the diagnostic profile of inpatients of a psychiatric unit in a general hospital influences the length of stay. The results of a retrospective survey comprising the first 16 years of operation of the Psychiatric Unit of the Ribeiräo Preto General Hospital (PURP) showed that the progressive increase observed in the length of stay correlated with the increase in percentage of schizophrenia diagnosis, after the 8th year of hospital operation, and of affective disorders, after the 12th year. The length of hospitalization kept increasing until the 16th year, even though there was no change in the diagnostic profile of the patients admitted to the unit. In a prospective study encompassing the next six months, 61 inpatients were evaluated with the Structured Clinical Interview for DSM-III-R and the Brief Psychiatric Rating Scale (BPRS). The results showed that 82 percent of the inpatients fulfilled the diagnostic criteria for the schizophrenic or affective disorder spectrum at admission, with a discharge rate slower than for other diagnoses, although the length of hospitalization did not significantly differ among diagnostic categories. The results further demonstrated that in every diagnostic category more than 50 percent of the patients stayed in hospital for more than one week after reaching a BPRS score equal to 6, indicative of discharge. Overall, these data suggest that the increase in length of hospitalization may be due to a higher percentage of patients with a diagnosis of schizophrenia and affective disorder admitted to the PURP. In addition, patients with low symptomatic levels remained in hospital longer than they should have

Distribuicao da mortalidade por suicidio em areas geograficas do municipio de Ribeirao Preto. / Distribution of mortality by suicide in geographical areas of the municipality of Ribeirao Preto

Estudou-se a distribuicao dos obitos por suicidio em areas geograficas do Municipio de Ribeirao Preto, durante o periodo de 1953 a 1976. Os dados oficiais de obitos por essa causa foram coletados nos mapas demografos-sanitarios fornecidos pela Divisao Regional de Saude de Ribeirao Preto (D.R.S. 6), nos atestados de obitos compilados pelo Departamento de Medicina Social da Faculdade de Medicina e nos livros de obitos dos Cartorios de Paz e Registro Civil dessa cidade. Os dados populacionais foram obtidos do censo de 1970. Verificouse que a mortalidade por essa causa nao apresentou uma distribuicao uniforme pelas areas do municipio

Aspectos psicopatologicos do comportamento suicida. / Psychopathological aspects of suicidal behavior

Estudaram-se 17 casos de suicidios atraves de entrevistas domiciliares, utilizando-se de um questionario aplicado aos familiares ou pessoas mais ligadas ao suicida, apos o seu comportamento autodestrutivo. Neste trabalho, usando parte dos dados coletados atraves da metodologia descrita, o autor analisa o estado mental dessas pessoas, proximo ao comportamento suicida, bem como as alteracoes detectadas em seus relacionamentos interpessoais.Entre outros aspectos, os resultados sugerem que o comportamento autodestrutivo nao ocorreu como consequencia de um comportamento psicotico mesmo entre os suicidas que haviam exibido, previamente, um padrao psicotico