District General Hospital Psychiatric Unit Research Articles

Mortality in schizophrenia and related psychoses: data from two cohorts, 1875–1924 and 1994–2010

ObjectiveTo investigate death rates in schizophrenia and related psychoses.DesignData from two epidemiologically complete cohorts of patients presenting for the first time to mental health services in North Wales for whom...

The incidence of admissions for schizophrenia and related psychoses in two cohorts: 1875–1924 and 1994–2010

ObjectiveTo investigate changes in incidence of admissions for schizophrenia and related non-affective psychoses in North Wales.DesignData from two epidemiologically complete cohorts of patients presenting for the first time to mental...

What is the usual length of stay in a psychiatric ward?

Introduction:Admission statistics can provide valuable data for planning and policy in the NHS. However, there has been little agreement about meaningful ways of summarising and expressing such data. We set out to (i) explore the distribution of length of inpatient stay and to examine the most appropriate measure of central tendency; and (ii) examine the relationship between severity of mental illness and length of stay.Method:Length of stay was recorded for a 12-month cohort of psychiatric admissions to a district general hospital psychiatric unit. These data were compared with a previous cohort study and also with DoH statistics.Results:Length of inpatient stay followed an exponential decay curve. The median length of stay for all three cohorts examined was approximately 15 days. Absence of serious mental illness was significantly associated with shorter length of stay.Conclusion:Length of stay is not normally distributed and so the median value is the preferred measure of central tendency. All cohorts examined showed a median value of around 15 days. Large numbers of patients are admitted for a week or less which has implications for inpatient and community services. Qnt] Psych Clin Pract 2004; 8: 53–56)

Audit of new long-stay patients in a district general hospital

AbstractObjective: To describe the characteristics of “new” long-stay patients in a district general hospital psychiatric unit. Method: A “new” long-stay patient was defined as a patient aged 18 or more who on the census date had been in a district general hospital psychiatric ward for longer than six months but less than six years. There was no upper age limit but patients with a primary diagnosis of dementia were excluded from the study. Information about each patient was obtained from medical and nursing cases notes. Patients were interviewed by one interviewer to determine their views on discharge from hospital. All the members of the multi-disciplinary team were interviewed by one interviewer to obtain their judgements about future accommodation needs of the patients. Results: “New” long-stay patients are typically single in their mid-forties with no supportive relatives. Most have a primary diagnosis of schizophrenia. They have a long psychiatric history and the majority had been in hospital between 6 months and three years. The principle reasons for prolonged stay were persistence of active psychotic symptomatology, schizophrenic defect state, poor social skills and antisocial behaviour. Conclusion: A group of “new” long-stay patients have accumulated in Wolverhampton district general hospital psychiatric unit, despite modern methods of treatment and the availability of a good range of rehabilitation facilities. They are a diverse group including patients with a severe schizophrenic disorders, affective disorders, personality disorders and organic disorders. Ideally, if these patients are to be placed in the community, rather than remaining as inpatients, then placement would need to be in specialised facilities like hospital hostels.

Christmas census at a district general hospital psychiatric unit

AbstractWe present a descriptive study discussing the reasons why patients remained as in-patients within the psychiatric unit over the Christmas period. In over 50% of cases continuation of in-patient stay was necessitated by the severity of mental illness. However, a significant minority of patients were unable to leave because of either poor family support or reduced input from the community mental health services. There was some evidence of Christmas good will influencing admission policy with a significantly greater number of patients admitted with alcohol problems over the week before Christmas all of whom were lonely and expressed a preference to be in hospital.A more long term problem was also evident as an important minority of patients' hospital stay was unnecessarily prolonged because of unavailability of suitable community placements.

Red cell folate concentrations in psychiatric patients

Red cell folate and vitamin B12 estimations were performed on 243 successively admitted in-patients at a District General Hospital Psychiatric Unit and 42 out-patients (29 attending a lithium clinic). Patients were classified into five diagnostic groups. The mean ages of the manic and schizophrenic patients were lower than of the depressed or euthymic patients but age was not correlated with red cell folate or serum B12 levels in any group. There were 89 (31%) patients with red cell folate below 200 ng/ml and 35 (12%) with concentrations below 150 ng/ml. Significantly more of these low-folate patients were in-patients than out-patients. The mean red cell folate in the depressed patients was significantly lower than in the euthymic, manic and schizophrenic groups. Alcoholics had a similar mean red cell folate to depressed patients which was not quite significantly lower than the other groups. The mean serum B12 level in the alcoholics was, however, significantly raised. There were no significant differences in red cell folate or serum B12 between lithium-treated and untreated euthymic patients. The highest proportions of values below 200 ng/ml and 150 ng/ml were found in depressed and alcoholic patients. Endogenous depressives had the highest percentage of values below 150 ng/ml (folate-deficient) of all psychiatric groups and alcoholic patients. The significance of these findings is discussed.

Care of “new” long‐stay patients in a District General Hospital Psychiatric Unit The first two years of a hospital‐hostel

The paper describes the need for long-term inpatient care in an English health district whose psychiatric services were based on a unit in a District General Hospital. Patients who became long-stay were placed in a new hospital-hostel in a city centre. Three quarters of those eligible could be managed in the hostel, with those rejected posing more control problems. Patients in the hostel became less withdrawn and increased their activity and use of community facilities.

The patterns of mental disorder in Jewish and non-Jewish admissions to a district general hospital psychiatric unit: is manic-depressive illness a typically Jewish disorder?

SynopsisThis is a preliminary investigation of admissions to a district general hospital psychiatric unit over a two-year period, in which patterns of psychiatric diagnoses in Jewish and non-Jewish patients were compared. Among the Jews there were significantly more patients with affective psychoses and fewer with schizophrenia than among the non-Jews. The methodological problems arising in such a study and some possible aetiological factors are discussed.

Thiamine, riboflavin and pyridoxine deficiency in psychiatric in-patients.

One hundred and seventy-two successive admissions to a district general hospital psychiatric unit were examined. Routine psychiatric, drug and dietary histories were taken and signs of avitaminosis B specifically noted. Red cell transketolase (for thiamine deficiency), glutathione reductase (for riboflavin deficiency) and aspartate transaminase (for pyridoxine deficiency) were measured. Of the patients, 53 per cent were deficient in at least one vitamin, 12 per cent in more than one (30 per cent in thiamine, 27 per cent in riboflavin and 9 per cent in pyridoxine). Schizophrenics and alcoholics were significantly over-represent in those patients low in thiamine and in more than one vitamin. Patients with an affective disorder had low riboflavin and low pyridoxine. It is suggested that affective changes are characteristic of riboflavin and pyridoxine deficiency.

Staff Responses To Patients With a Primary Disturbance of the Self

This paper examines response patterns of the staff of a District General Hospital Psychiatric Unit to patients whose nuclear self is vulnerable and fragmented and at certain stage need admission into the Day Hospital or In-Patient area. These patients are potentially amenable to psychotherapy provided that some conditions are met. They present special problems in relation to transference and counter transference. The exposure of the therapist to emotional forces engendered by these patients among the staff is considered. The interference with the therapist's countertransference by responses of other staff members is described as "cross-countertransference".

Group Themes in a District General Hospital Psychiatric Unit - Shrodells, Watford, England

Group Themes in a District General Hospital Psychiatric Unit - Shrodells, Watford, England

Experience in a District General-Hospital Comprehensive Psychiatric Unit

It has been the policy of the British Department of Health since the mid-1960s to close the large mental hospitals in this country and replace them with comprehensive psychiatric services, based in district general hospitals. The most recent details of this policy have been documented in the publication Better services for the mentally ill (Department of Health and Social Security, 1975). The decision to adopt this policy has been based on a number of factors: 1. There is an obvious desire to dispense with the large, impersonal institution, frequently housing more than a thousand patients and often situated some distance from the community it serves. Instead there is to be a centrally situated service, convenient for, and identified with, the people using it. 2. Including psychiatric patients in a general hospital reduces the stigma that has for years been attached to the treatment of mental disorder. This results in better community relationships and greater public interest in such matters. 3. The therapeutic results claimed by existing psychiatric departments in general hospitals have seemed impressive. 4. The desire of psychiatrists to be identified with mainstream medicine has caused the staff of such departments to have close working relationships with their medical colleagues in other specialties and has promoted common interests. This has, in turn, led to a reidentification of psychiatric illness as an integral part of general medicine and has assisted in the management of cases that cross the boundaries of different specialties. There has also