Hospital violence: site, severity, and nurses' preventive training.

A sample of 663 nurses was surveyed about exposure to violence at the work site; 243 (37%) had faced violence. Hospitals with low response rates to the questionnaire reported less assault, yet the violence admitted to was described as more deadly. More nurses at public than private hospitals had obtained some training to handle potentially violent situations. Serious assault was negatively related to amount of training. At the public psychiatric hospital, violent acts were most frequent, but the rate of deadly violence (e.g., rape, use of knives or guns, etc.) was lowest. The need to train staffs at general as well as psychiatric hospitals was discussed.

Effects of doxepin on withdrawal symptoms in smoking cessation.

In a double-blind study, 15 cigarette smokers self-monitored 10 withdrawal symptoms. For the first 21 days (baseline), subjects received doxepin hydrochloride, up to 150 mg/day, or inert medication while continuing to smoke. On day 22, they were instructed to stop smoking; medication was continued. Withdrawal symptoms on the first 28 days of treatment (baseline and 7 days of attempted cessation) were analyzed. During cessation, subjects taking doxepin reported significantly less craving for cigarettes. Results from this study and others suggest that antidepressants may attenuate the severity of symptoms during withdrawal from addictive substances.

Substance abuse patterns reveal contrasting personal traits.

The Eysenck Personality Questionnaire (EPQ) responses of 202 male and 95 female substance users taken during 21 months at a public-sector hospital facility were studied. Collectively, inpatients were more impulsive (high P), introverted (low E), and anxious (high N) than same-sexed normals on the main EPQ scales (p less than .001). The alcohol, cocaine, opioid, and polysubstance users and a residual mixed group differed on all EPQ scales (ps less than .05). Cocaine users were the most impulsive, with alcohol and opioid users least so. The polysubstance and residual mixed groups were the most extroverted, with opioid users least. The alcohol and residual mixed groups were the most anxious, and cocaine users least so. Alcohol users earned the highest "lie" (L) scores, with opioid users lowest. When the residual mixed group was excluded from analyses the results were little changed.

Doxepin as an adjunct to smoking cessation: a double-blind pilot study.

In a double-blind study, 19 adults received bedtime doses of either 150 mg of doxepin hydrochloride (N = 9) or placebo (N = 10). After 3 weeks the subjects were instructed to stop smoking and continue taking medication for 4 additional weeks. Cessation was reported by all nine doxepin subjects 1 week after cessation and by seven doxepin subjects 9 weeks after cessation. One placebo subject reported cessation. Cotinine assays generally confirmed cessation but were subject to interpretation. Doxepin assays suggested that the precessation level was associated with cessation. Further studies with larger samples and extended follow-up are needed to determine the reliability of these results.

A comparison of intensive psychiatric services for children and adolescents: cost of day treatment versus hospitalization.

Proponents of day treatment for children and adolescents assert that this mode of intervention is a viable alternative to hospitalization based on both treatment and cost effectiveness. Preliminary studies on treatment effectiveness are beginning to appear in the literature. This paper focuses on the relative cost difference of treating children and adolescents in a day-treatment program vs three inpatient-hospital settings. The study finds that the populations in the two settings are similar with regard to demographic and diagnostic characteristics and that day treatment is significantly less costly on a daily basis. A conservative conclusion, based on the findings reported, is that over the course of treatment partial hospitalization is equal or less costly than hospitalization. The authors conclude that further research exploring both treatment efficacy and cost effectiveness is in order to define what role day treatment should serve in the continuum of mental health-care services for children and adults.

A survey of child and adolescent day-treatment programs: establishing definitions and standards.

A survey of 82 programs operating nationally is used to assess the present status of child and adolescent day-treatment services. Overwhelming variability in the responses leads the authors to suggest criteria for standards and definition. Survey results are presented for programming issues, patients, staff, clinical issues, funding, and research, followed by specific recommendations in each area. The authors conclude that without substantial changes toward standardization, child and adolescent day-treatment programs will continue to struggle in the highly competitive mental health-care market.

Child and adolescent day treatment: a descriptive analysis of a model program.

Since the inception of the University of Tennessee Child and Adolescent Day Treatment Program in 1982, a total of 53 patients has received services. This paper provides a broad overview of the patient population as well as descriptive data accumulated during the first 18 months of operation of the program. Several factors which determined patient eligibility and availability are briefly described. Special attention is given to the following variables: (1) age, (2) sex, (3) referral source to the program, (4) diagnosis, (5) length of stay in the program, and (6) discharge disposition. Interrelationships among these variables are also discussed.