Number Of Inpatient Treatments Research Articles

Association of hypertension, type 2 diabetes mellitus and dyslipidemia with the duration of inpatient treatments and recurrence of schizophrenia

ObjectivePeople with schizophrenia have an increased cardiovascular risk with higher mortality than the general population. Only a few studies have investigated the impact of cardiovascular risk on the later course of schizophrenia. This study aims to explore the association of cardiovascular risk factors, as detected during an index inpatient treatment for schizophrenia, with the duration of psychiatric inpatient treatments and number of inpatient admissions in the subsequent 10 years, in patients with schizophrenia. MethodsCardiovascular risk factors of 736 patients with schizophrenia, identified through retrospective chart review, were assessed by hypertension, type 2 diabetes mellitus and dyslipidemia during an index inpatient stay. The duration of inpatient treatments, assessed by the total duration of psychiatric inpatient treatments in days, and the number of inpatient admissions, over the next 10 years were assessed and analyzed for an association with cardiovascular risk factors. ResultsHypertension associated with longer duration of inpatient treatments and higher number of inpatient admissions. Type 2 diabetes mellitus and dyslipidemia associated with a higher number of psychiatric inpatient treatments. Hypertension remained significantly associated with the duration of inpatient treatments (β = 0.174; p < 0.001) and the number of inpatient treatments (β = 0.144; p < 0.001), when adjusting for age, sex and BMI. ConclusionOut of the investigated cardiovascular risk factors documented during an index inpatient stay for schizophrenia, only hypertension associated with an increased duration of in-hospital stay and an increased number of re-hospitalizations during the subsequent ten years when adjusting for confounders. Screening for hypertension should be considered in all patients with schizophrenia.

Inpatient Treatment for the Middle-aged and Elderly in Central China.

Compared to outpatient treatment and self-treatment, inpatient treatment corresponds to more severe illness and poses more serious health and financial burden to patients. The goal of this study is to provide an updated and comprehensive description of the prevalence, characteristics, and cost of inpatient treatment for the middle-aged and elderly in Central China, which is highly populated, less-developed, and agriculture-dominating. A survey was conducted in August 2013 in the Henan province. Data on 1,464 subjects were collected. Among the surveyed subjects, 582 had at least one episode of inpatient treatment. Subjects with different inpatient treatment status differ in the distributions of age, education, occupation, area, health insurance coverage, physical condition, and presence of chronic disease. The surveyed subjects had up to six inpatient treatments within 12 months. Different episodes have different characteristics. Age and the presence of chronic disease are significantly associated with the number of inpatient treatments. The utilization of grade III hospital for inpatient treatment is associated with gender, marital status, and per capita income. The total and out-of-pocket costs are associated with education, utilization of type III hospital, and insurance utilization. This study has provided a comprehensive description of inpatient treatment for Central China, an area with low developmental and economic status. The observations may assist improving health conditions and disease treatment for this less-advantaged area.

Did female prisoners with mental disorders receive psychiatric treatment before imprisonment?

BackgroundThroughout the world, high prevalence rates of mental disorders have been found in prison populations, especially in females. It has been suggested that these populations do not access psychiatric treatment. The aim of this study was to establish rates of psychiatric in- and outpatient treatments prior to imprisonment in female prisoners and to explore reasons for discontinuation of such treatments.Methods150 consecutively admitted female prisoners were interviewed in Berlin, Germany. Socio-demographic characteristics, mental disorders, and previous psychiatric in- and outpatient treatments were assessed by trained researchers. Open questions were used to explore reasons for ending previous psychiatric treatment.ResultsA vast majority of 99 prisoners (66%; 95% CI: 58–73) of the total sample reported that they had previously been in psychiatric treatment, 80 (53%; 95 CI: 45–61) in inpatient treatment, 62 (41%; 95 CI: 34–49) in outpatient treatment and 42 (29%; 21–39) in both in- and outpatient treatments. All prisoners with psychosis and 72% of the ones with any lifetime mental health disorder had been in previous treatment. The number of inpatient treatments and imprisonments were positively correlated (rho = 0.27; p < 0.01). Inpatient treatment was described as successfully completed by 56% (N = 41) of those having given reasons for ending such treatment, whilst various reasons were reported for prematurely ending outpatient treatments.ConclusionThe data do not support the notion of a general ‘mental health treatment gap’ in female prisoners. Although inpatient care is often successfully completed, repeated inpatient treatments are not linked with fewer imprisonments. Improved transition from inpatient to outpatient treatment and services that engage female prisoners to sustained outpatient treatments are needed.

EPA-1422 – Duration of untreated illness predicting a more severe course of illness in bipolar disorder

Introduction Longer duration of untreated bipolar disorder (DUB) can lead to a prolonged exposure to inflammatory and neurodegenerative processes, that are believed to underlie etiopathogenesis of bipolar affective disorder (BAD), and thus cause a more severe course of illness as well as difficulties in the maintenance of remission. Aim The aim was to determine the relationship between DUB and socio-demographic characteristics, along with clinical characteristics related to the course of illness, applied psychopharmacotherapy and the ability to maintain an adequate remission over 24 months period following hospital treatment. Methods The study used retrospective design and included patients with BAD (n = 127), hospitalized between 2006 and 2010. We acquired data on socio-demographic and clinical characteristics, previous treatment and the information on posthospital period between 0 and 24 months. Results The average DUB was 130.59 ± 108.44 months. Patients with longer DUB presented with higher number of mood episodes of BAP, higher number of inpatient treatments, and required a significantly higher dose of lithium in the remission period. Female patients and those with metabolic syndrome more frequently failed to maintain remission for more than 24 months. Conclusions Interventions for monitoring of DUB, its diminishing duration, early detection and recognition, and timely treatment, would be useful for fewer relapses and therefore a better course and outcome of BAP. Furthermore, the results of the study strongly imply that a systematic, longitudinal monitoring of the course of illness and potential inflammatory, endocrine and metabolic markers that underlie its systemic nature is recommended.

Patient satisfaction and clinical parameters in psychiatric inpatients—the prevailing role of symptom severity and pharmacologic disturbances

ObjectiveA high degree of satisfaction is probably one of the most important aims for each patient during medical treatment. However, database on the influencing variables in a general psychiatric inpatient sample is still small. Therefore, the objective of this study is to identify clinical variables related to patients' treatment satisfaction. MethodsIn 113 patients (59 females; mean age, 48.3 ± 16.6 years; mean treatment duration, 1.4 ± 1.2 months) admitted to a psychiatric hospital, data were assessed on treatment satisfaction using the ZUF-8 questionnaire (“Fragebogen zur Patientenzufriedenheit”; questionnaire of patient satisfaction) at discharge and on general treatment variables as well as the psychosocial functioning using the “Basisdokumentation” (basic documentation) questionnaire including Clinical Global Impression scale (CGI) and Global Assessment of Functioning scale (GAF) at admission and discharge. Student t tests, univariate variance analyses, and Pearson correlations were performed. ResultsZUF-8 sum score correlated significantly negatively with CGI score at discharge (part 1: P = .036), positively with GAF at discharge (P = .011), and as a trend with the reduction of CGI during the treatment (CGI change; P = .050). Patients with pharmacologic disturbances (P = .003) and with a schizophrenia spectrum disorder or a personality disorder were less content (trend; P = .071). Satisfaction did not differ in dependency of the variables age, sex, native language, number of inpatient treatments, therapeutic setting of the ward, duration of disorder or treatment, level of school education, bodily impairment, number of somatic diagnoses, psychopharmacologic treatment (vs none), antidepressants, body weight, or body weight change. ConclusionThe results of the study suggest that patient satisfaction is dependent on symptom severity and global functioning at discharge, on pharmacologic disturbances during treatment, and on the diagnostic group. Therefore, symptom relief and reduction of adverse side effects as far as possible should be the primary aim of an inpatient treatment.

Objectification of the diminished responsibility criteria

The aim of the study is objectification of the diminished responsibility criteria.Methods:Clinical psychopathological, statistical analysis.Results:Decision of diminished responsibility in 70% of patients was connected with assessment of the severity of disorder, that were mainly psychopathic and organic syndromes non specific in relation to forensic psychiatric decision. There is a need in non-clinical parameter helpful to assess a tendency of psychopathological condition. The social adjustment indices found out to be such a parameter. The indices included: educational level; employment and its concordance with patient's education; registration at the dispensary (outpatient mental health clinic); number of inpatient treatment; marital status, family relationships, patient's position in a group of reference. The study has shown the lower level of social adjustment in the group of diminished responsible patients. They were more often registered at the dispensaries and had a history of inpatient mental health treatment. They were low educated and engaged in lower paid and low qualification job. More than 50% did not have family.Thus, assessing the patients with clinically similar parameters it is necessary to take into account the social adjustment parameters to objectify the forensic psychiatric decision.