A comparative study on sociodemographic and clinical profile of patients undergoing admission and readmission in a mental health institute

Aims: Psychiatric patients have a high rate of readmission. So, we need to understand what kind of patients are more likely to be readmitted, to predict the clinical and social factors that place them at risk, and to identify potential limitations in existing healthcare delivery systems. Objective of the study was to find out and compare sociodemographic and clinical profiles of patients getting first admission and readmission. Methods: It was a retrospective, record-based observational study from computerised database of the institute and the case record files of patients for one year. Variables like age, sex, religion, marital status, locality, education, occupation, and diagnosis were studied. Analysis was done by chi-square test using the Statistical Package for the Social Sciences (SPSS) version 16.0. Results: The total number of admissions during this period was 876, among which 463 had been admitted previously in the institute and 60 had been admitted more than once in the time period. Among new admissions and readmissions, majority were unemployed, unmarried, Hindu males, 16-30 years of age, and had schizophrenia and related spectrum diagnosis (F20-F29). No significant difference in readmission rates were found for sex, marital status, religion, educational status, or locality. Readmission rates among housewives were seen less than expected. There were significant differences among different diagnoses in terms of readmission (p<0.001), with F30-F39 showing more than expected readmissions and F10-F19 showing more than expected first admission with less than expected readmissions. Conclusions: Current study reviews the scenario of mental healthcare utilisation. Decreased readmission rates of women and of patients with substance abuse disorders warrants further community-based research.

Homicídios e consumo de drogas: breve revisão contextualizada em uma zona urbana metropolitana / Homicide and drug abuse: a brief, contextualized review in an urban metropolitan area

O consumo de drogas é reconhecido atualmente como um dos principais fatores de risco para a morte por homicídios. No entanto, quando se trata do tipo da droga envolvido, em geral obtido a partir da realização de exames toxicológicos, é raramente conhecido no campo da saúde, embora seja uma prática nos laboratórios forenses mundiais. Foi realizada revisão da literatura sobre o tema, utilizando como banco de dados o Medline e o Lilacs, com base no PubMED e BIREME/Biblioteca Virtual de Saúde, com os seguintes descritores: ?drogas ilícitas? e ?homicídios?. Os artigos indicam queda das taxas de mortalidade por homicídios, tanto nos Estados Unidos como no Brasil, a partir de 2004, porém com alteração relevante do perfil da mortalidade, concentrando-se e aumentando nas faixas etárias mais jovens e de classes menos favorecidas. O álcool tem sido descrito como a substância mais encontrada entre as vítimas; mas as drogas ilícitas vêm se tornando igualmente importantes, com crescente participação em vários países, embora com ampla variação entre os achados da substância detectada entre as vítimas, dentro e entre países. No Brasil, destaca-se o crack, coincidente com a entrada da droga no comércio ilegal desde 2004. No Brasil, devido à falta de recursos dos Institutos Médico-Legais, as análises toxicológicas são pouco requisitadas nos casos de morte violenta. No campo do Direito, o exame toxicológico não é realizado obrigatoriamente em todas as vítimas de homicídio, por se tratar de elemento dispensável para a apuração desse tipo de crime, sendo, entretanto, de relevância para estabelecer estratégia de política pública, principalmente no âmbito da saúde pública...

Drug abuse is currently recognized as one of the major factors of risk of homicide. The type of drug involved is usually part of toxicological exams at forensic laboratories worldwide, but this practice is rarely found in the health care in general. A review of the literature was carried out using the Medline and Lilac databanks based on the PubMed and BIREME/Virtual Library of Health with the following descriptors: ?illicit drugs? and ?homicides?. The research articles indicate decreasing mortality rates related to homicides, both in the USA and in Brazil, from 2004 onwards. However, the mortality profile has changed, increasingly affecting the youngsters and unprivileged classes. Alcohol has been described as the most used substance among the victims, but illicit drugs have become equally widely used in several countries irrespective of the wide variation in the findings of the substance used by victims within and across countries. In Brazil, crack is pointed out as an issue of major concern since the drug inclusion in the illegal trade in 2004. Because of the lack of resources at the Brazilian Forensic Institutions, toxicological analyses are usually neglected in the cases of violent death. In the Law , the toxicological exam is not compulsory for most of the homicide victims, as this is regarded as dispensable to investigate this type of crime. However, such knowledge is in fact necessary to establish public health policies...

As relações interpessoais e o consumo de drogas por adolescentes / Interpersonal relations and drug consumption by teenagers / Las relaciones interpersonales y el consumo de drogas por los adolescentes

Este estudo objetivou conhecer, sob a ótica de adolescentes dependentes químicos, os motivos que os levaram a iniciar o consumo de substâncias psicoativas. Trata-se de pesquisa qualitativa, descritiva, desenvolvida em um hospital geral de pequeno porte e em um Centro de Atenção Psicossocial álcool e drogas, localizados na região noroeste do Rio Grande do Sul. Participaram do estudo sete adolescentes. Para a coleta de dados, utilizou-se a entrevista aberta, gravada e transcrita. A análise dos dados seguiu os preceitos da análise de conteúdo. Resultados apontaram as relações do adolescente com a família, amigos, escola e comunidades como fatores determinantes para o início ou não do uso de drogas.

This study aimed to understand, in chemical addicted teenagers’ perspective, the reasons that made them start taking drugs. It was a qualitative and analytical research, developed in a small hospital and a Psychosocial Care Center: alcohol and drugs. Seven teenagers participated in this research. Live, recorded and transcribed interviews were used for data collection. Data analysis followed the rules of content analysis. The results indicated that adolescent relationships with family, friends, school and communities are crucial for starting drug use or not.

Este estudio tenía como objetivo conocer, por la óptica de adolescentes dependientes químicos, los motivos por los cuales empezaron a consumir drogas. Investigación cualitativa y analítica, desarrollada en un hospital general de pequeño porte y en un Centro de Atención Psicosocial de alcohol y drogas, de la cual participaron siete adolescentes. Para la colecta de datos se utilizó la entrevista abierta, grabada y transcripta. El análisis de los datos siguió los preceptos del análisis de contenido. Los resultados demostraron que las relaciones del adolescente con la familia, amigos, escuela y comunidades son factores determinantes para el comienzo o no del uso de drogas.