Characterizing inpatient care for adults with schizophrenia using the Health Quality Ontario indices: A single-centre retrospective cohort study.

PURPOSE: This single-center retrospective cohort study is one of the first reports to evaluate the inpatient care provided to persons diagnosed with schizophrenia in Canada. METHODS: This study examined all admissions for adults diagnosed with schizophrenia over a 6-month period in 2017 to an inpatient psychiatric unit situated in a nonprofit general hospital in Kingston, Ontario, Canada. The Health Quality Ontario standards for the inpatient care of adults with schizophrenia were used to assess the quality of care provided in hospital. Standards were determined to have been met by doing a thorough chart review for each patient, reviewing all documentation in progress notes, admission notes, discharge notes and emergency room notes for quality standard completion. RESULTS: The average length of stay per patient was 18.64 days. The treatment at this facility largely focused on medication management of schizophrenia; however, it was found that several areas of care did not meet the standard of care as set by the Health Quality Ontario Quality Standards for Schizophrenia Care for Adults in Hospitals, which was set in 2016. Problematic areas were promoting physical activity and healthy eating (4.9% compliance), treatment with clozapine (13.1% compliance) and cognitive behavioural therapy (9.8% compliance). The study site is fully accredited and attending physicians were all psychiatrists. How pervasive these deficiencies are in other settings is not known.

Lithium: contributor to movement disorder sensitivity after anoxic brain injury?

Although lithium-induced dystonia has been well documented in the literature, conflicting evidence discusses whether a patient may be susceptible to adverse effects from the drug after an anoxic brain injury. More recent literature discusses that lithium may, in fact, be neuroprotective. This case report presents a 35-year-old male who, after an anoxic brain injury after a suicide attempt, developed lithium-induced dystonia with characteristic symptoms of sustained muscle contractions, repetitive movements, and postures, which was not markedly improved with benztropine or benzodiazepines. It is postulated that because this patient received a depot neuroleptic with a subsequent anoxic brain injury, he may have become more sensitive to lithium and its rare complications.

Chronic prostatitis-like symptoms in African males aged 16-19 years.

INTRODUCTION: To estimate the prevalence of chronic prostatitis (CP)-like symptoms in African adolescents, examining the impact of demographic factors, CP-like symptoms (i.e., pain, urinary) and depressive symptoms on quality of life (QoL). MATERIALS AND METHODS: Community dwelling African males aged 16-19 years (M = 16.97; SD = .88; n = 166), attending secondary school participated. CP-like case identification was based on NIH-Chronic Prostatitis Symptom Index definition (NIH-CPSI; pain in perineum and/or with ejaculation and NIH-CPSI total pain score of ≥ 4 [mild] and ≥ 8 [moderate-severe]). The Patient Health Questionnaire (PHQ) assessed depressive symptoms. CP-like point prevalence was estimated and multivariable regressions predicted diminished QoL as screened in the NIH-CPSI QoL domain. Participants were consented by field researchers and all potential participants agreed to complete the measures in classroom setting. RESULTS: Prevalence of at least mild CP-like symptoms by NIH-CPSI case identification was 13.3%, with 5.4% of adolescents reporting moderate-severe symptoms. Greater pain, urinary and depressive symptoms and rural setting of school were associated with diminished QoL, and pain (ß = .36) most strongly predicted poorer QoL. CONCLUSIONS: As in North American adults and adolescents, African adolescents report CP-like symptom occurrence with pain associated with lower QoL. The data suggest an adolescent CP syndrome is an internationally important and understudied area for future epidemiological and clinical investigations.