Mental health status among non-psychiatric inpatients in a general hospital / 四川精神卫生

ObjectiveTo analyze the mental health status of non-psychiatric inpatients in a general hospital， and to explore the relevant influencing factors， so as to provide references for the screening of mental health problems and the construction of intervention models among non-psychiatric inpatients. MethodsA cross-sectional study was conducted among 916 non-psychiatric inpatients in a third grade class A general hospital in Guangzhou， and all the inpatients were assessed using Patient Health Questionnaire-9 item （PHQ-9）， Generalized Anxiety Disorder-7 item （GAD-7）， Athens Insomnia Scale （AIS） and Columbia-Suicide Severity Rating Scale （C-SSRS） to detect their depression， anxiety， insomnia and suicide risk status. Thereafter， univariate and multivariate Logistic regression analysis were used to screen the risk factors affecting the mental health of inpatients. ResultsA total of 339 （37.0%） inpatients with positive mental health problems were screened， and the screening results for each dimension revealed 218 cases （23.8%） of depression， 141 cases （15.4%） of anxiety， 257 cases （28.1%） of insomnia， 42 cases （4.6%） of suicidal ideation and 7 cases （0.8%） of suicidal behavior. Binary Logistic regression analysis showed that female （OR=1.379， P<0.05） was a risk factor for positive screening of mental health problems. Ordinal Logistic regression analysis denoted that age above 60 years old （OR=1.542， P<0.05） and singlehood （OR=2.055， P<0.05） were risk factors affecting the severity of depression， while senior high school to junior college education （OR=0.524， P<0.05） was a protective factor of depression， meantime， female （OR=1.472， P<0.05） was a risk factor affecting the severity of insomnia. ConclusionMental health problems are quite common among non-psychiatric inpatients in general hospitals， and are mainly affected by factors such as gender， age， marital status and educational background.

Factors affecting duration of untreated psychosis – A retrospective study done in general hospital setting

Background: Duration of the untreated psychosis has been predicted to be one of a factor which affects the outcome of disease and leading to poor prognosis in the patients. Previous studies had predicted that the longer the duration of psychosis the poor the outcome of the treatment. Aim: To assess the factors affecting the Duration of untreated psychosis among patients with first episode psychosis in General hospital setup. Materials and methods: Retrospective study was done on patients who got admitted for the duration of 6 months (1st June 2014 to 31st November 2014). Patients who were diagnosed to have first episode psychosis according to ICD-10 were taken up for the study. Duration of untreated psychosis and the socio demographic details were noted. Results: The duration of untreated psychosis was seen more in male (58%), 45% in age group of 20- 29, 54% were married, 71% in lower middle economic status, 75% of people were from semi urban background and 41% of patients had duration of untreated psychosis for duration of 2-5 weeks. Mean average age is 30.75 and duration of untreated psychosis is 40 days. Conclusion: Mean average age is 30.75 and duration of untreated psychosis is 40 days. Age, gender, marital status, socio-economic status and residence (Environment) acting as a predictor for the long DUP is consistent with previous studies but significant findings couldn’t be found, when two groups Ananthi B, Sabari Sridhar O.T., Kailash S, Shajahan M Ismail, Srinivasan B. Factors affecting duration of untreated psychosis - A retrospective study done in general hospital setting. IAIM, 2017; 4(3): 10-14. Page 11 were compared thus giving the conclusion that Sociodemographic factors alone doesn’t influence on DUP

Workplace Violence Toward Mental Healthcare Workers Employed in Psychiatric Wards

BACKGROUND: Workplace violence (WPV) against healthcare workers (HCWs) employed in psychiatric inpatient wards is a serious occupational issue that involves both staff and patients; the consequences of WPV may include increased service costs and lower standards of care. The purpose of this review was to evaluate which topics have been focused on in the literature and which are new in approaching the concern of patient violence against HCWs employed in psychiatric inpatient wards, in the past 20 years. METHODS: We searched for publications in PubMed and Web of Science using selected keywords. Each article was reviewed and categorized into one or more of the following four categories based on its subject matter: risk assessment, risk management, occurrence rates, and physical/nonphysical consequences. RESULTS: Our search resulted in a total of 64 publications that matched our inclusion criteria. The topics discussed, in order of frequency (from highest to lowest), were as follows: “risk assessment,”“risk management,”“occurrence rates,” and “physical/nonphysical consequences.” Schizophrenia, young age, alcohol use, drug misuse, a history of violence, and hostile-dominant interpersonal styles were found to be the predictors of patients’ violence. CONCLUSION: Risk assessment of violence by patients appeared the way to effectively minimize the occurrence of WPV and, consequently, to better protect mental HCWs. We found paucity of data regarding psychologic sequelae of WPV. According to these findings, we suggest the need to better investigate the psychologic consequences of WPV, with the aim of checking the effective interventions to assist HCW victims of violence and to prevent psychologic illness.

A cross sectional study on prevalence and pattern of personality disorders in psychiatric inpatients of a tertiary care hospital

Background: Co-occurrence of personality disorders with other psychiatric disorders has also been well documented by many researchers in the past. Diagnosing co occurring personality disorders in psychiatric patients with is of strong clinical significance, considering their association with the duration, recurrence, and outcome of these disorders. They also can have wide range of other adverse health outcomes. However, most of the existing literature regarding the studies related to personality disorders (PDs) in India is confined to community and mental hospitals. Aim: To study the prevalence and factors affecting personality disorders in a general hospital psychiatry unit. Materials and methods: The study was a cross sectional study conducted in a psychiatric unit of a tertiary care teaching hospital in south India. ICD-10, Mini International Neuropsychiatric Interview (MINI) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental DisordersIV Personality Disorders (SCID-II) were used. Results: A total of 116 participants were included in the study. Majority of the participants were between 26 to 45 years of age. The prevalence of personality disorder was 21.55% (95%CI 14.07 to 29.03) among the study population. The most common type of personality disorder was avoidance (7.7%), followed Maanasa T J, Sivabackiya C, Srinivasan B, Shajahan Ismail, Sabari Sridhar OT, Kailash S. A cross sectional study on prevalence and pattern of personality disorders in psychiatric inpatients of a tertiary care hospital. IAIM, 2016; 3(5): 94-100. Page 95 by anti social (5.17%) and borderline (3.45%) personality disorders. Highest proportion of PD was seen in people with major depressive disorder (35.7%), followed by people with multiple psychiatric illness (31.6%) and Psychotic disorders/mood disorders with psychosis (18.9%). Conclusion: The proportion of personality disorders was highest in 26 to 35 year age group, was higher in males, compared to females. People who studied up to primary school had higher proportion of PD, compared to other educational categories. The proportion was higher in people belonging to higher socio economic strata, people who are separated and people from nuclear family.

Socio demographic, clinical and side effect profile of electroconvulsive therapy use among psychiatric inpatients: a cross sectional study from South East Asia - Kashmir.

Background: Electroconvulsive Therapy (ECT) is a neuromodulative technique, which is effective but underutilized for treatment of psychiatric disorders. The aim of the study was to investigate socio demographic, clinical and side effect profile of electroconvulsive therapy use among psychiatric inpatients. Methods: A cross sectional study was performed for a period of 1 year in postgraduate department of psychiatry (Institute of mental health and neurosciences Kashmir - center of excellence). Patients of pharmacotherapy resistant psychiatric disorders attending the hospital during this period were taken in study. The data was recorded in a specially designed proforma which documented the socio-demographic variables including age, sex, residence, occupation, socioeconomic status was recorded. Chi-square, Fisher exact, and t tests were used to note the statistically significant association. Results: The mean age of the study sample was 39.6 (±11.76) years. Maximum number of patients were in the age group 41-50 years i.e. 16 (28.6%), followed by 31-40 years i.e. 15 (26.8%). The mean number of ECT’s received was 8.22 (±2.073). About 29 (51.8%) patients reported body aches, 24 (42.9%) patients reported forgetfulness, 9 (16%) patients reported headache and only 1 (2%) patient reported agitation. Conclusion: The results indicate that electroconvulsive therapy is used in all psychiatric disorder with fewer side effects in pharmacotherapy resistant psychiatric disorders.

Alcohol use disorder among elderly non-psychiatric inpatients in a tertiary general hospital

OBJECTIVE: To determine the prevalence of alcoholic use disorder among elderly non-psychiatric inpatients in a tertiary hospital and the ability of the medical staff to identify alcoholism among this specific population.METHODOLOGY: This is a cross-sectional analytic study. Inpatients aged 65 and above were drawn from a tertiary general hospital. The Tagalog edition of the Short Michigan Alcoholism Screening Test-Geriatric version (SMAST-G) was administered to these subjects. The screened positive respondents were classified as non-hazardous, hazardous and harmful drinkers. They were also classified as either alcohol abusers or dependents based on DSM-IV-TR. The ability of the medical staff to identify alcoholism was assessed by interviewing the attending physician and reviewing the medical records of the patients.RESULTS: The overall prevalence rate of alcoholic use disorder among elderly non-psychiatric inpatients was 18.5%, with male respondents comprising 83.3%. A strong association was observed between elderly alcohol use and male gender, higher educational attainment, age less than 75, married status, smoking status, current employment and past manual occupation. The identification rate of medical staff was computed at 41.7%, with internal medicine physicians detecting the most number of cases.CONCLUSION: Approximately one-fifth of elderly inpatients has alcohol use disorder and has been neglected substantially by the medical staff.

Emotional Reaction of Psychiatric Nurses and Resident Physicians toward Suicidal Behavior in Psychiatric Inpatients / 정신간호학회지

PURPOSE: In this study, emotional reaction of psychiatric nurses and resident physicians toward suicidal behavior of psychiatric inpatients was examined. METHODS: Subjects were 396 working in general hospitals or mental hospitals. Demographic factors, exposure to suicidal behaviors, mood states, and impact of event scores were collected between April and July 2008. Mood state was measured with Korean Edition of Profile of Mood States (K-POMS). Impact of event was measured with Impact of Event Scale-revised (IES-R). RESULTS: Of the respondents, 90.9% experienced at least one inpatient suicidal behavior. Emotional responses of respondents after their patients' suicidal behavior were shock, anxiety, self-doubt and disbelief. Mood states were negative for those who had worked over 10 years, had experienced colleagues quitting and were significantly different according to patient's diagnosis, period of maintaining emotions, and level of stress. Impact of event was high among those who were nurses, had worked in mental hospitals, had worked over 10 years, had experienced colleagues quitting and were significantly differenced according to job status, patient's diagnosis, period of maintaining emotion, and level of stress. CONCLUSION: This study confirms that suicidal behaviors of inpatients are commonly encountered and significantly stressful events for psychiatric nurses and physicians.

Prevalence of metabolic syndrome in psychiatric inpatients in a tertiary care centre in north India.

Background & objectives: Metabolic syndrome (MS) is associated with major mental illnesses. It is a major predictor of mortality and morbidity. This research was undertaken to study the prevalence and correlates of MS in psychiatric inpatients in a tertiary care hospital in north India. Methods: Consecutive adult patients with a primary psychiatric disorder admitted to the psychiatric ward during the study period (July-December 2007) were evaluated for prevalence of MS as per the criteria of the International Diabetes Federation (IDF). Results: Among the 90 patients included in the study, the prevalence of MS as per IDF was 37.8 per cent and it was significantly associated with the body mass index (BMI). Interpretation & conclusions: The present findings showed a higher prevalence of MS in psychiatric inpatients than that in the general population. further studies on a larger sample need to be done before advising evaluation for the presence of MS in all psychiatric patients.

Effects of Weight Control Program on Body Weight and the Sense of Efficacy for Control of Dietary Behavior of Psychiatric Inpatients / 간호학회지

PURPOSE: This study was designed to examine the effects of a weight control program on body weight and the sense of efficacy for control of dietary behavior in psychiatric inpatients. METHODS: A quasi-experimental design was used. Data were collected from March 1 to September 30, 2007. Female mentally ill patients in closing psychiatry ward of H University Hospital participated in the study (16 persons in the experimental group and 13 in the control group). RESULTS: The weight control program including diet therapy, exercise, education and behavior modification therapy decreased the rate of weight gain in female mentally ill patients taking atypical antipsychotics, and effectively increased a sense of efficacy for control of dietary behavior. CONCLUSION: Weight control program had a positive effect as a nursing intervention to decrease obesity and to increase the sense of efficacy for control of dietary behavior of psychiatric inpatients in psychiatric inpatients.

Utilization of Antipsychotics in Psychiatric Inpatients in Our Hospital / 中国药房

OBJECTIVE:To investigate the utilization of antipsychotic drugs in hospitalized patients of our hospital to provide reference for rational use of drug. METHODS: The utilization of antipsychotic drugs in psychiatric inpatients in our hospital in Jul. 21th of 2008 was surveyed and analyzed. RESULTS: 734 patients were treated with antipsychotic drugs, involving 30 drug therapy schemes. 676 patients were only treated with one kind of drug (87.8%),among which the top 3 drugs in the list of utilization rate were risperidone (n=190, 24.7%), quetiapine (n=144, 18.7%) and olanzapine (n=123, 16.0%). Antipsychotic drugs were mostly combined with following drugs for mental disorder, such as antidepressant, mood stabilizers, benzodiazepine, sedative-hypnotic drugs, hypoglycemics and lipid regulators. CONCLUSION:The new atypical antipsychotic drugs have replaced traditional antipsychotic drugs and took up dominant position in the clinical treatment with single category.

Violence Predictors in Psychiatric Inpatients / 신경정신의학

OBJECTIVES: The goal of this study was to predict the factors related to psychiatric inpatients' violence in a mental hospital. This was a follow-up study to assess the psychopathology of patients and the quality of the initial therapeutic alliance between the patient and the therapist, as a predictor of the risk of violent behavior. METHODS: The subjects were 105 psychiatric inpatients admitted to St. Andrews' Neuropsychiatric Hospital from January 1998 to November 1998, but alcohol dependent patients and conduct disorder patients were excluded. Within the first five hospital days, we rated past history of violence, patients' psychopathology using Brief Psychiatric Rating Scale and quality of initial therapeutic alliance. We also evaluated violent behaviors using Overt Aggression Scales during the two weeks before admission and during the two weeks of hospital stay and compared the 67 non-violent ingatients with 38 violent ingatients on the utility of socio-demographics variables, past history of violence, utility of the initial therapeutic alliance and psychopathology in evaluating the risk of violent behaviors. Multiple logistic analysis was conducted to analyze risk factors for violent behaviors. RESULTS: 1) The violent inpatients significantly were more closely related with the previous history of violent behavior. 2) The weaker the initial therapeutic alliance were, the significantly higher violent behavior exhibited. 3) Violent behavior was related significantly with higher BPRS-agitation-excitement factor score and higher BPRS-hostile-suspicious factor score. Violent behavior also was related with lower BPRS-withdrawal-retardation factor score. 4) According to the multiple logistic analysis, the predictors of violent behavior were past history of violence and initial therapeutic alliance and BPRS-agitation-excitement factor. CONCLUSION: The results suggest that initial therapeutic alliance and the specific psychopathology ane useful in evaluating patients' risk for violence.

Characteristics of Violent Behavior in Psychiatric Inpatients / 신경정신의학

To evaluate the characteristics of violent behavior of psychiatric inpatients, the authors reviewed clinical records of psychiatric patients who had admitted at UiJong Bu St. Mary's Hospital from January 1994 to lune 1995. We divided the 287 subjects into violent and nonviolent group according to the presence of violent behaviors in psychiatric ward. We assessed demographic variables, clinical characteristics and violent behaviors using Overt Aggression Scale and compared these variables of violent group with nonviolent group. The results were as follows: 1) The number of violent patients was 72(25.1% of the total). 2) In terms of demographic variables, the differences between two groups in education and occupation were significant(p<.05). 3) In psychiatric diagnoses, violent group were more likely to have mania, schizophrenia and organic rental disorder in sequence but there were no differences between violent and nonviolent group. 4) The history of violent behavior was greater in violent group(p<.001) and the mode of admission was significantly different between two groups(p<.005). 5) In cluster of psychopathology on admission, more frequently found clusters of psychopathology in violent group were agitation-excitement and hostile- suspiciousness and there were significant differences between two groups(p<.001). 6) The length of stay in violent group(59.3 days)was significantly longer than nonviolent group(38.4 days)(p<.001). 7) The types of violent behavior were verbal aggression, physical aggression against objects and physical aggression against other people in frequency sequence. 8) The most frequent type of behavioral clue before violent behavior was hyperactive, loud, verbally abusive, angry, hostile(68.1%). 9) Most of violent behaviors were presented between midday and 6 pm. in resting time. 10) 62.3% of total violent behaviors were occurred within first week following admission. 11) The variables which showed significant effects on total aggression score were religion, educational status, occupation, mode of admission, psychiatric diagnosis, psychopathology on admission and history of violent behavior before admission. In summary, these results showed similar trends compared to previous studies on characteristics of psychiatric inpatients. And we fecund that more important predictors of violent behavior in practice were likely to be history of violent behavior, psychopathology on admission and behavioral cue before violent behavior.