RESUMO
A three-month cohort of admissions (N = 300) to an acute psychiatric inpatient unit of a county general hospital was studied to identify factors that differentiate patients with multiple admissions over a 12-month period from those with only a single admission. Patients with more than one admission made up 32 percent of the cohort. Compared with single-admission patients, they were significantly more likely to be chronically unemployed and to have a diagnosis of schizophrenic or affective disorder. Regression analyses indicated that the number of prior psychiatric hospitalizations was the strongest predictor of both the number of hospitalizations and the number of days hospitalized; other significant predictors were a secondary diagnosis of personality disorder, chronic unemployment, self-referral, and being black. The findings indicate that many of the problems of multiple-admission patients are rooted in social disadvantage, and efforts to devise effective interventions should not focus on psychopathology alone.
Assuntos
Mau Uso de Serviços de Saúde , Serviços de Saúde , Serviços de Saúde Mental/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Doença Aguda , Adulto , Feminino , Hospitais com 300 a 499 Leitos , Humanos , Masculino , Transtornos da Personalidade/psicologia , Probabilidade , São Francisco , DesempregoAssuntos
Serviços de Emergência Psiquiátrica/estatística & dados numéricos , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Unidade Hospitalar de Psiquiatria/estatística & dados numéricos , Adulto , Transtorno Bipolar/terapia , Transtorno da Personalidade Borderline/terapia , Feminino , Hospitais com 300 a 499 Leitos , Humanos , Masculino , Readmissão do Paciente , Fatores de Risco , São Francisco , Esquizofrenia/terapiaRESUMO
The relative efficacy of three oral regimens of haloperidol was compared in a ten-day, double-blind study of 63 acutely ill schizophrenic patients newly admitted to the hospital. One group of patients received 20 mg of haloperidol on day 1, then increasing increments of 20 mg a day, reaching a maximum dosage of 100 mg daily on day 5. Another group received 10 mg of haloperidol on day 1, then increasing increments of 10 mg daily, reaching 100 mg daily on day 10. A third group of patients received a fixed dosage of 10 mg daily for ten days. Haloperidol was well tolerated by the patients; there were no serious adverse reactions. The data indicated that the regimens had similar therapeutic efficacy, suggesting that acutely ill schizophrenic patients respond to a wide range of doses of haloperidol but that onset of response and efficacy are not increased in most patients by providing a high initial loading dosage. Adequate, safe dosage must be determined in each case.
