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.

Perspectives & practices of doctors-in-training at the University of Santo Tomas Hospital when assessing, managing & referring patients with behavioral manifestations to psychiatry: A 2015 cross-sectional study

OBJECTIVE@#The study objective was to determine current perspectives and practices of residents- and fellows-in-training in non-psychiatric specialties when dealing with patients with behavioral and psychological problems at the University of Santo Tomas Hospital. It aimed to identify the trainees’ perceived role, and approach to diagnosis and treatment of psychiatry. Lastly, the study goals included gathering insights and suggestions on the improving psychiatric services in the hospital. @*METHODOLOGY@#This was a cross-sectional descriptive study surveying non-psychiatric residents- and fellows-in-training with clinical or patient encounters at the University of Santo Tomas Hospital in 2015. This was followed by the delivery of a lecture on psychological response to illness, an open forum, and an option for focus group discussion thereafter. Data and results underwent further statistical analysis and grouping into themes.@*RESULTS@#Among the 256 qualified subjects, a total of 178 respondents participated in the survey (69.53%). Perceptual disturbance was perceived as a behavioral problem that was most difficult to handle, followed by suicidality/self-harming behavior as well as addiction. Sleep disturbance (n=63) was cited as the behavioral manifestation that was directly managed by trainees while suicidal behavior / self-harm (n = 173), and thought disturbances (n = 164-166) were mainly cited as presentations that were referred to psychiatry. Services like Clinical Psychology and Neurology were among the specialties to whom behavioral problems were referred to. In terms of perception of psychiatric diagnosis, a pure psychological approach was deemed by 40.31% of the respondents, while only 18.85% viewed psychiatric diagnosis taking a bio-psycho-socio-spiritual approach. Psychiatric treatment approach however was deemed as a combination of biomedical, psychological, and social by 63.93%. The trainees’ view of psychiatry’s role in their practice encompassed management of psychiatric presentations of medical conditions, its complications, or treatments, psychological reactions to medical conditions or treatments, medical presentations of psychiatric conditions or treatments, and co-morbid medical and psychiatric conditions, pre & post-procedural consultation & screening, and other consultations including promotion of general mental wellness. Suggestions for improvement covered (1) the referral system/process, including a general agreement on the need for a standardized referral form (2) an intensification of education & information dissemination among colleagues, (3) psychoeducation for patients and the lay, (4) expansion and improvement access through infrastructure, (5) open collaboration, as well as (6) added services including patient support groups.@*CONCLUSION@#This study allowed for a better understanding of non-psychiatry trainees’ perspectives and approach towards patients manifesting with behavioral problems approach from non-psychiatric specialties and their understanding of psychiatry. Trainees had a good understanding of the role of psychiatry in their practice, while identifying barriers towards optimizing referral. This study was an example on how opening communication lines with the different subspecialties can bring to light, ways on how the hospital’s psychiatric services could be improved towards better patient service and care.

Psychological assessment and hierarchical management for non-psychiatric inpatients at general hospitals / 中华医院管理杂志

Early intervention contributes to improving patient experience and doctor-patient relationship in the case of non-psychiatric outpatients with psychological problems.The authors studied the psychological assessment and hierarchical management for non-psychiatric inpatients at a general hospital. Measures taken include establishing multi-disciplinary and inter-department teams, building an intra-hospital joint-action system, and implementing the psychological assessment and hierarchical management for non-psychiatric inpatients.These efforts explored ways for a general hospital in psychological counseling, offering humanistic service, and transformation of medical pattern.

Analysis of Influencing Factors for Attitude Shifting to Mental Health Work among Non-psychiatric Doctors in General Hospitals / 中国医学伦理学

Objective:To investigate the attitude towards task -shifting of mental health among non -psychiat-ric physicians of general hospitals in Guangzhou and to provide evidence for continuing education model and health policy making .Methods:A cross-sectional study was implemented among 1363 participants of 17 general hospi-tals from December 2012 to April 2013 in Guangzhou.Results:Among 1363 participants, there were 941 (69.6%) approved the concept of mental health task shift .Factors of attitude to the concept of mental health task shift include work 8-10 h/day (β=0.404, P=0.006), practice qualification (β=-1.345, P=0.016), less than 10%physical diseases combined with psychological or mental problems in clinical work (β=-0 .452 , P=0.014), demand of training cost/time(β=-0.596, P =0.021), get ready (β=1.436, P <0.001) and have little preparation (β=0 .694 ,P<0 .001 ) preparation for treating mental disorders at present work ( recognition and treatment).The possibility of participants′attitude toward task -shifting mental health is positive the highest (71.0%), followed by neutral (25.5%) and negative (3.5%).Conclusions:Strengthening non -psychiatric physicians′support for mental health task shift with respect to policy and legal levels in general hospitals , improving their recognition and preparation of mental disorders , as well as developing targeted training and courses are the highest priority .

A cross-sectional study on the mental and behaviour education among non-psychiatric medical workers of the general hospitals in Guangzhou / 中华行为医学与脑科学杂志

Objective To explore the mental education and continuing education among non-psychiatric medical workers of the general hospitals in Guangzhou city.Methods A cross-sectional study was carried out in 17 general hospitals of Guangzhou city including 2617 participants from December 2012 to April 2013.Results Among 2617 participants,41.6％ of them hadn't taken part in psychiatric course study,66.9％ hadn't received psychiatric rotation,and 66.7％ hadn't received psychiatry and related training;93.8％ of the medical staff had interest in mental specialized training courses,of which 72.0％ medical staff stood for training classes/participation,72.3％ medical staff most satisfied with 4-5 days of a training course,strengthen training every 6 months (2 days) and a psychiatrist to connect.Conclusion Non-psychiatric medical workers of the general hospitals in Guangzhou city lack the knowledge of mental health,and mental health care training are urgently needed.

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.

Development and testing of mental status scale in non-psychiatric settings / 第二军医大学学报

Objective:To develop a mental status scale in non psychiatric settings (MSSNS) and to test its reliability and validity.Methods:Based on the common negative emotions in non psychiatric settings confirmed by nursing specialists and international scales, the MSSNS was constructed with psychological testing and statistical techniques. The reliability and validity were examined with 1 010 patients in non psychiatric settings.Results: The MSSNS consisted of 38 items. The reliability coefficients were 0.932 9 for internal consistence(Cronbach ?) and 0.894 0 for split half. Using the principle component analysis with varimax rotation, we got 4 factors: anxiety, depression, anger and loneliness. The correlation between MSSNS and related factors of HAD were 0.652 and 0.533 respectively. Conclusion: With its good reliability and validity, MSSNS is an ideal rating scale for total and convenient rating of patients' mental status in non psychiatric settings.