ABSTRACT
The long-term effect of outpatient commitment on service use was evaluated in 81 patients with serious and persistent mental illness. An increased number of outpatient visits and a decreased number of hospital admissions, total hospital days, and lengths of stay were observed during commitment periods of greater than 1 year relative to levels of use in the same patients over the 12-month period preceding commitment. This study provides support that outpatient commitment improves compliance with outpatient treatment and reduces hospital use in patients who are on outpatient commitment to a single treatment agency for periods up to 5 years.
Subject(s)
Commitment of Mentally Ill/legislation & jurisprudence , Mental Disorders/epidemiology , Outpatient Clinics, Hospital/statistics & numerical data , Patient Compliance , Psychiatric Department, Hospital/statistics & numerical data , Adolescent , Adult , Aged , Appointments and Schedules , Bipolar Disorder/drug therapy , Bipolar Disorder/epidemiology , Depressive Disorder/drug therapy , Depressive Disorder/epidemiology , Female , Humans , Iowa/epidemiology , Male , Mental Disorders/drug therapy , Middle Aged , Psychotic Disorders/drug therapy , Psychotic Disorders/epidemiology , Reminder Systems , Schizophrenia/drug therapy , Schizophrenia/epidemiologyABSTRACT
The contributions of genetic and both positive and negative environmental factors were tested in the prediction of alcohol abuse/dependence among 300 adult adoptees. No direct effects for either genetic or environmental factors were significant in the prediction of adoptee alcohol abuse/dependence. However, among women, early-life family conflict and psychopathology in the adoptive family interacted with a biological background of alcoholism. Among women with at least one alcoholic biological parent, conflict or psychopathology in the adoptive family increased the probability of alcohol abuse and/or dependence. Among men, no significant interactions were found between a biological background of alcoholism and environmental variables. Results suggest a pattern of gene-environment interaction among women.
