ABSTRACT
OBJECTIVE: Antipsychotics are the standard treatment for psychosis. However, when combined with other lifestyle factors they are partially responsible for an excessive mortality rate. A clinical and paraclinical monitoring of patients is therefore necessary. In 2011, this element led doctors and pharmacists to improve monitoring and formalize a follow-up adapted to inmate patients. The aim of this study was to assess the impact of medical-pharmaceutical collaboration on monitoring quality of patients treated by antipsychotics. METHODS: This is a retrospective study including all patients treated by antipsychotics for at least 6 months in 2011 and again in 2015. Data were collected from medical files. The indicator assessing the monitoring quality was the compliance percentage, of registred parameters for each patient on the basis of specific guidelines. RESULTS: In 2015 compared to 2011, the monitoring quality increased for 9 out of 10 parameters. This improvement was statisticaly significant for 7 of them : Body Mass Index, lipid test, complete blood count, transaminase, ionogram, glycemia, glomerular filtration rate. CONCLUSION: The actions of improvement collectivelly implemented in 2011 had a concrete impact on patients in the follow-up in 2015.
Subject(s)
Antipsychotic Agents/therapeutic use , Monitoring, Physiologic/standards , Patient Safety/standards , Prisons/statistics & numerical data , Psychotic Disorders/drug therapy , Quality of Health Care , Adult , Antipsychotic Agents/adverse effects , Cohort Studies , Delirium/drug therapy , Delirium/epidemiology , Drug-Related Side Effects and Adverse Reactions/epidemiology , Drug-Related Side Effects and Adverse Reactions/prevention & control , Female , Guideline Adherence/statistics & numerical data , Humans , Male , Medical Records/standards , Monitoring, Physiologic/methods , Pharmacists/organization & administration , Pharmacists/standards , Prisons/organization & administration , Prisons/standards , Psychotic Disorders/epidemiology , Quality Indicators, Health Care , Quality of Health Care/standards , Retrospective Studies , Schizophrenia/drug therapy , Schizophrenia/epidemiologySubject(s)
Homicide , Adolescent , Child , Child Behavior Disorders/psychology , Humans , Male , Psychotic Disorders/psychologyABSTRACT
The referrals for urgent psychiatric treatment were studied systematically to improve our understanding of the acute forms of psychological distress in children and adolescents and the crisis situations which disrupt the usual relationships between the child and his family. During the last 12 months, 212 requests for urgent psychiatric opinion in children under 18 years of age were received. The following points were analyzed: --general: age, sex, geographical distribution of the patients and their families, present family conditions, socio-economic class, origin of the urgent referral; --psychological or psychopathological: presenting symptoms, organisation of the personality of the child or adolescent, previous psychological or psychiatric history; --practical: the emergency management, ulterior orientation. The authors conclude with some remarks on the possible lines of action in the emergency situations.
Subject(s)
Crisis Intervention , Mental Disorders/therapy , Acute Disease , Adolescent , Age Factors , Child , Child, Preschool , Female , Humans , Male , Mental Disorders/epidemiology , Parent-Child Relations , Sex Factors , Socioeconomic FactorsABSTRACT
From our experience in the pedopsychiatric emergency unit at the Salpêtrière Hospital, we discuss the concept of psychiatric emergency in children and adolescents. In 90% of cases, patients are adolescents aged 14 to 18 years. The acting out and the ensuing emergency consultation seem to be a propitious time for establishing a relationship with the adolescent, meeting his difficulties from a psychological rather than affective standpoint and instituting an exchange with the family.
