ABSTRACT
Opiate misuse is extremely prevalent in the UK. A high proportion of these individuals experience withdrawal symptoms. This article describes the clinical features and discusses the current literature on the pharmacological management of opiate withdrawal.
Subject(s)
Narcotics/adverse effects , Substance Withdrawal Syndrome/drug therapy , Ambulatory Care , Hospitalization , Humans , Treatment OutcomeABSTRACT
Individuals with a diagnosis of excessive alcohol intake are commonly encountered in police custody. These individuals have a high incidence of co-morbid psychiatric disorders. The Epidemiological Catchment Area (ECA) Study reported that 37% of alcoholics have a co-morbid mental disorder.(1)It is, therefore, important that individuals in custody who have a history of excessive alcohol intake are adequately assessed, in order to identify such co-morbid disorders so that appropriate management is implemented. Assessment of all individuals in police custody should include: To date, little has been written on how such assessments should be carried out in police custody. This paper discusses the presentation of psychiatric disorders in individuals with a history of excessive alcohol intake and suggests how they should be assessed in custody. A subsequent issue of the journal will include an article discussing the management of such individuals.
ABSTRACT
Psychiatric disorders and alcohol misuse often coexist. This article outlines the clinical management of these comorbid disorders. It discusses and suggests therapeutic recommendations.
Subject(s)
Alcoholism/complications , Anti-Anxiety Agents/administration & dosage , Psychotic Disorders/therapy , Alcoholism/therapy , Anti-Anxiety Agents/therapeutic use , Benzodiazepines , Diagnosis, Dual (Psychiatry) , Humans , Psychoses, Alcoholic/drug therapy , Psychoses, Alcoholic/etiology , Psychotic Disorders/etiology , Substance Withdrawal Syndrome/rehabilitation , Wernicke Encephalopathy/diagnosis , Wernicke Encephalopathy/drug therapyABSTRACT
BACKGROUND: Little is known about the long-term mortality and causes of death after first psychiatric admission. METHOD: A consecutive series of 87 patients admitted for the first time from a strictly defined catchment area to Saxondale Hospital, Nottinghamshire, who were discharged in 1974 and 1975, were traced in 1992 to either their general practitioner or death. The causes of their deaths were ascertained and the observed mortality was compared with expected mortality. RESULTS: Twelve subjects had died. None had committed suicide, and there were no open verdicts or accidental deaths. Although the observed mortality was higher than expected, there was no significant excess. CONCLUSIONS: There may be little scope for reducing suicide rates by targeting patients for careful follow-up after discharge from their first psychiatric admission. More research is required before large investments are made in potentially fruitless interventions to achieve the objectives of The Health of the Nation.
Subject(s)
Mental Disorders/mortality , Adolescent , Adult , Age Distribution , Aged , Cause of Death , England/epidemiology , Female , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Sex Distribution , Suicide/statistics & numerical dataSubject(s)
Alcohol Drinking , Medical History Taking , Aged , Female , Humans , Male , Patient Admission , Sex FactorsSubject(s)
Communication , Family Practice , Psychiatry , Humans , Interprofessional Relations , Referral and ConsultationSubject(s)
Muscular Diseases/pathology , Neoplasms, Muscle Tissue/pathology , Adult , Humans , Male , ThighABSTRACT
Ryle's tube drainage of the afferent loop effectively prevented duodenal blow-out or anastomotic leakage in 40 patients undergoing partial gastrectomy for recurrent peptic ulcer. Similarly the same procedure was adopted in 20 cases of cholecystojejunostomy. The tube prevented anastomotic leakage and decompressed the biliary tree by effective bile drainage from the very 1st day thus favouring the prognosis. There was no complication observed directly related to either procedure in the present series.
