Anxiety, psychosis and substance use: prevalence, correlates and recognition in an outpatient mental health setting.

OBJECTIVE: The current study examined anxiety in people with substance use disorder (SUD) and a psychotic disorder. It is hypothesised that: anxiety disorders (AD) would be highly prevalent (greater than 20%) in people identified as having SUD and psychotic disorders; those with comorbid AD would fair worse than those without, on measures of quality of life, severity of substance dependence, locus of control, suicidality and psychotic symptoms; and, the presence of such anxiety disorder symptomatology would be under-detected by their mental health case managers. METHOD: Outpatients with co-occurring substance use disorder and psychosis were interviewed to collect data about their diagnosis, depressive and psychotic symptoms, severity of dependence on substances, quality of life and locus of control. Participants' case managers made blind ratings of the presence and severity of participants' anxiety. RESULTS: Fifty eight percent of participants had at least one anxiety disorder. Of these, 56% - 70% had case managers who had identified them as having an anxiety problem. The occurrence of anxiety disorder was associated with more external locus of control, greater intensity of suicidal thinking, worse psychotic symptoms, lower quality of life and greater severity of dependence on substances. CONCLUSION: This research suggests anxiety in people with substance use disorder and psychosis is highly prevalent, is associated with poorer outcomes, and is under detected by case managers. Further examination of this issue may lead to important advances in the treatment and prognosis of people with substance use disorder and psychosis.

Education day. The evolution of a learning experience.

Education Day in our hospital was created as a way of increasing attendance at annual mandatory inservices. Since beginning the program, compliance with mandatory inservice has increased from 50% to 97%. The Education Day format consolidates resources and provides consistency in the delivery of required information. The format is also flexible; it responds to changes and specialized educational needs of the nursing staff.

The financial management of laser therapy.

The development of a financially viable laser program within any health care organization requires detailed resource analysis and planning of each phase. After implementation, administration must constantly monitor all costs associated with care delivery, as well as the reimbursement for services and revenue generated.

Cinnarizine in the treatment of chronic asthma.

1 Cinnarizine, an inhibitor of calcium ion transport across smooth muscle cell membrane, has been shown to exert an anti-asthmatic effect in patients with chronic asthma. 2 It is postulated that antagonism to calcium ion transport across the mast cell membrane may cause the compound to have a pharmacological effect similar to sodium cromoglycate. 3 Cinnarizine is orally active and its therapeutic effect is demonstrated in a double-blind, cross-over, placebo controlled study. 4 Patient benefit was shown by a significant improvement in peak flow rate. A non-significant trend towards a reduction in symptomatic bronchodilator usage and a decrease in asthma symptom score was also shown. 5 It is concluded that cinnarizine could well prove to be the first of a new family of anti-asthmatic drugs offering a protective effect when taken systemically.