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Intraocular pressure in schizophrenic patients treated with psychiatric medications
Souza, Valéria Barreto Novais e;Moura Filho, Francisco José Rodrigues de;Souza, Fábio Gomes de Matos e;Pereira Filho, Sergio Augusto Carvalho;Coelho, Suele Serra;Furtado, Fernando Ant?nio Mendes Lopes;Gon?alves, Tiago Bessa Almeida;Vasconcelos, Karla Feitosa Ximenes;
Arquivos Brasileiros de Oftalmologia , 2008, DOI: 10.1590/S0004-27492008000500009
Abstract: purpose: in order to assess the occurrence of adverse ocular effects of antipsychotic drugs, we sought to evaluate intraocular pressure of schizophrenic patients treated with psychiatric medications. methods: twenty-eight outpatients with dsm-iv diagnosis of schizophrenia who met both the inclusion and exclusion criteria were submitted to an ophthalmic evaluation for ocular abnormalities which included intraocular pressure measurement with goldmann applanation tonometry. results: raised intraocular pressure was found in three patients (11%). abnormality in cup-disc ratio was seen in only one patient with cup-disc ratio asymmetry of 0.4. all these four patients were taking only ziprasidone. conclusions: patients using ziprasidone were found to have abnormalities in both intraocular pressure and cup-disc ratio.
Hippocampal Physiology, Structure and Function and the Neuroscience of Schizophrenia: A Unified Account of Declarative Memory Deficits, Working Memory Deficits and Schizophrenic Symptoms  [PDF]
Cynthia G. Wible
Behavioral Sciences , 2013, DOI: 10.3390/bs3020298
Abstract: Memory impairment is a consistent feature of the schizophrenic syndrome. Hippocampal dysfunction has also been consistently demonstrated. This review will discuss neurophysiological and neuroanatomical aspects of memory formation and how they relate to memory impairment in schizophrenia. An understanding of the cellular physiology and connectivity of the hippocampus with other regions can also aid in understanding the relationship between schizophrenic declarative or relational memory deficits, working memory deficits and the clinical symptoms of the syndrome.
Factors Associated with Readmission of Patients at a University Hospital Psychiatric Ward in Iran  [PDF]
Majid Barekatain,Mohammad Reza Maracy,Razeyeh Hassannejad,Reihane Hosseini
Psychiatry Journal , 2013, DOI: 10.1155/2013/685625
Abstract: Objectives. Readmission has a major role in the reduction of the quality of life and the increase in the years of lost life. The main objectives of this study were to answer to the following research questions. (a) What was the readmission rate? (b) What were the social, demographic, and clinical characteristics of patients admitted to the Psychiatric Emergency Service at Nour University Hospital, affiliated to Isfahan University of Medical Sciences, Isfahan, Iran? (c) What were the effective factors on readmission? Method. This cross-sectional study was conducted on a total number of 3935 patients who were admitted to Isfahan University Hospital Psychiatric Ward in Isfahan, Iran, from 2004 to 2010. Gender, age, marital status, education, self-report history of previous admission, type of psychiatric disorder, substance misuse, suicide, and the length of the current psychiatric disorder were collected from the registered medical files of patients. The data were analysed using the negative binomial regression model. Results. We found that factors such as psychiatric anxiety disorder, bipolar I, bipolar II, psychotic disorder, depression, and self report history of previous admission were statistically significant in the number of readmissions using the negative binomial model. Conclusion. Readmission to the psychiatric ward is mainly predictable by the type of diagnosis and psychosocial supports. 1. Introduction During the last three decades, the deinstitutionalization of mental health services led to faster transitions from psychiatric hospitals to the community. However, a significant number of patients have had serious problems after being discharged from hospitals which resulted in an increase in the number of psychiatric emergency referrals and readmissions [1]. The greater the number of readmissions, the greater the pressure on hospitals psychiatric wards and their limited resources. Readmission of inpatients has been one of the most important problems in the field of psychiatry for the last decades [2, 3]. The problem has a major role in reducing the quality of life and increasing the years of lost life [4]. About one-third of patients admitted to psychiatric services will probably be readmitted within a year [5]. In previous studies, the rate of readmitted patients has proven to be 22% in America in psychiatric patients aged over 65 years [4], 19% of children admitted at the emergency ward in Baltimore were aged 4–18 [6], 14% of patients admitted at the psychological ward of the army in Washington [7], 33.7% of patients diagnosed with
Motor speed predicts stability of cognitive deficits in both schizophrenic and bipolar I patients at one-year follow-up
Salazar-Fraile,J.; Balanzá-Martínez,V.; Selva-Vera,G.; Martínez-Aran,A.; Sánchez-Moreno,J.; Rubio,C.; Vieta,E.; Gómez-Beneyto,M.; Tabarés-Seisdedos,R.;
The European Journal of Psychiatry , 2009, DOI: 10.4321/S0213-61632009000300007
Abstract: background: we examined whether motor speed assessed by the finger tapping test predicts generalized and specific stable deficits because of a common pathogenic process in bipolar and schizophrenic patients. methods: one hundred and two patients underwent a battery of neuropsychological tests. patients with a score of less than one standard deviation from their siblings', sample in two assessments with an interval of one year were defined as suffering from stable deficits because of a common pathogenic process. in addition to univariate analyses, factor analyses, ordinal logistic regression, and multiple linear regressions were used. a general score was also calculated. results: no differences were found between schizophrenic and bipolar patients in the deficits of verbal fluency, shift reasoning ability and executive attention. schizophrenic patients had greater persistent cognitive deficit because of a common pathogenic factor in the verbal memory dimension than bipolar patients. motor speed predicted the specific deficits of verbal fluency, shift reasoning, executive attention and the general deficit of both bipolar i and schizophrenic patients. bipolar patients suffered a lesser specific deficit in the verbal memory dimension than schizophrenic patients did, this domain not being predicted by motor speed. motor speed predicted the generalized deficit and the specific dimensions in which schizophrenic and bipolar patients showed no differences. conclusions: these results suggest the presence of general and specific stable cognitive deficits because of a common pathogenic factor related to psychomotor slowness. motor speed seems to be suitable endophenocognitype for schizophrenia and bipolar disorder.
Motor speed predicts stability of cognitive deficits in both schizophrenic and bipolar I patients at one-year follow-up  [cached]
J. Salazar-Fraile,V. Balanzá-Martínez,G. Selva-Vera,A. Martínez-Aran
The European Journal of Psychiatry , 2009,
Abstract: Background: We examined whether motor speed assessed by the finger tapping test predicts generalized and specific stable deficits because of a common pathogenic process in bipolar and schizophrenic patients. Methods: One hundred and two patients underwent a battery of neuropsychological tests. Patients with a score of less than one standard deviation from their siblings', sample in two assessments with an interval of one year were defined as suffering from stable deficits because of a common pathogenic process. In addition to univariate analyses, factor analyses, ordinal logistic regression, and multiple linear regressions were used. A general score was also calculated. Results: No differences were found between schizophrenic and bipolar patients in the deficits of verbal fluency, shift reasoning ability and executive attention. Schizophrenic patients had greater persistent cognitive deficit because of a common pathogenic factor in the verbal memory dimension than bipolar patients. Motor speed predicted the specific deficits of verbal fluency, shift reasoning, executive attention and the general deficit of both bipolar I and schizophrenic patients. Bipolar patients suffered a lesser specific deficit in the verbal memory dimension than schizophrenic patients did, this domain not being predicted by motor speed. Motor speed predicted the generalized deficit and the specific dimensions in which schizophrenic and bipolar patients showed no differences. Conclusions: These results suggest the presence of general and specific stable cognitive deficits because of a common pathogenic factor related to psychomotor slowness. Motor speed seems to be suitable endophenocognitype for schizophrenia and bipolar disorder.
God's eyes and the schizophrenic hands: listening to a psychiatric patient
Jardim, Luciane Loss;Dantas, Clarissa R.;Miranda, Fabricio Z.;Banzato, Claudio E.M.;
Revista Latinoamericana de Psicopatologia Fundamental , 2010, DOI: 10.1590/S1415-47142010000400003
Abstract: this article describes the intriguing case of a young female patient first seen in the emergency room and then followed up at the psychiatric outpatient facility of the general hospital at unicamp, brazil. the cooperation that ensued between psychiatrists and a psychoanalyst to reach a psychopathological diagnosis is also presented here. the differential diagnosis is discussed within a psychiatric framework and then contributions from listening to the patient's free associations related to the clarification of her psychopathology are described. the clinical collaboration between psychiatry and psychoanalysis proved effective in this case as a clinical method for approaching the patient.
The ward atmosphere important for the psychosocial work environment of nursing staff in psychiatric in-patient care
Hanna Tuvesson, Christine Wann-Hansson, Mona Eklund
BMC Nursing , 2011, DOI: 10.1186/1472-6955-10-12
Abstract: 93 nursing staff working at 12 general psychiatric in-patient wards in Sweden completed two questionnaires, the Ward Atmosphere Scale and the QPSNordic 34+. Data analyses included descriptive statistics, the Mann-Whitney U-test, Spearman rank correlations and forward stepwise conditional logistic regression analyses.The data revealed that there were no differences between nurses and nurse assistants concerning perceptions of the psychosocial work environment and the ward atmosphere. The ward atmosphere subscales Personal Problem Orientation and Program Clarity were associated with a psychosocial work environment characterized by Empowering Leadership. Program Clarity was related to the staff's perceived Role Clarity, and Practical Orientation and Order and Organization were positively related to staff perceptions of the Organizational Climate.The results from the present study indicate that several ward atmosphere subscales were related to the nursing staff's perceptions of the psychosocial work environment in terms of Empowering Leadership, Role Clarity and Organizational Climate. Improvements in the ward atmosphere could be another way to accomplish improvements in the working conditions of the staff, and such improvements would affect nurses and nurse assistants in similar ways.The nursing staff working in psychiatric care have a demanding work situation, which may be reflected in how they view their psychosocial work environment and the ward atmosphere. Despite an extensive body of research in the field of psychosocial work environment [1-3] and in that of the ward atmosphere [4-6], there is little research that investigates the relationship between these two phenomena in psychiatric care. The psychosocial work environment has to do with the staff's working conditions, including organizational and work characteristics [7], while the ward atmosphere reflects the milieu in which the care takes place and patient - staff relationships are developed [5]. An understan
PSYCHIATRIC WARD IN GENERAL HOSPITAL: PROFESSIONALS VIEW WHO WORKS IN GENERAL HOSPITAL  [PDF]
Jucéli Zimmermann Mion,Jacó Fernando Schneider
Revista Eletr?nica de Enfermagem , 2003,
Abstract: The proposal of this study was the one of looking for the professionals of health that act in generalhospital, the perception and the acceptance of the same ones on the possible implantation of psychiatric beds inthe institution close to in that act. The research was accomplished at five private general hospitals of the city ofCascavel, State of Paraná, that you/they render attendance not only to patient of the municipal district but of everywest area of the state of Paraná.
Suicide amongst psychiatric in-patients who abscond from the ward: a national clinical survey
Isabelle M Hunt, Kirsten Windfuhr, Nicola Swinson, Jenny Shaw, Louis Appleby, Nav Kapur, the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness
BMC Psychiatry , 2010, DOI: 10.1186/1471-244x-10-14
Abstract: We carried out a national clinical survey based on a 10-year (1997-2006) sample of people in England and Wales who had died by suicide. Detailed data were collected on those who had been in contact with mental health services in the year before death.There were 1,851 cases of suicide by current psychiatric in-patients, 14% of all patient suicides. 1,292 (70%) occurred off the ward. Four hundred and sixty-nine of these patients died after absconding from the ward, representing 25% of all in-patient suicides and 38% of those that occurred off the ward. Absconding suicides were characterised by being young, unemployed and homeless compared to those who were off the ward with staff agreement. Schizophrenia was the most common diagnosis, and rates of previous violence and substance misuse were high. Absconders were proportionally more likely than in-patients on agreed leave to have been legally detained for treatment, non-compliant with medication, and to have died in the first week of admission. Whilst absconding patients were significantly more likely to have been under a high level of observation, clinicians reported more problems in observation due to either the ward design or other patients on the ward.Measures that may prevent absconding and subsequent suicide amongst in-patients might include tighter control of ward exits, and more intensive observation of patients, particularly in the early days of admission. Improving the ward environment to provide a supportive and less intimidating experience may contribute to reduced risk.Absconding, or going absent without leave, is a common feature within psychiatric wards, with rates of between 34% and 39% cited [1,2]. Some of the adverse consequences of absconding include loss of treatment, violence to others, self-neglect, self-harm, and suicide [3-5]. Controlled studies have found absconding to be a significant risk factor for suicide amongst psychiatric in-patients [6-8]. In the UK, Powell and colleagues [9] reported t
Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece
Nikolaos Bilanakis, Georgios Papamichael, Vaios Peritogiannis
Annals of General Psychiatry , 2011, DOI: 10.1186/1744-859x-10-4
Abstract: A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010) were examined.Chemical restraint was applied in 33 cases (10.5% of total admissions). From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases), usually in combination with a benzodiazepine (61.7% of cases). In 36.4% of cases the patient was further subjected to restraint or seclusion.In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.Coercive measures are commonly used in psychiatric treatment for the management of behaviour in patients who are disturbed, although the need for alternatives has been widely recognised [1]. Most authors focus on seclusion and physical restraint, whereas chemical (pharmaceutical) restraint or rapid tranquilisation has gained little attention in the recent literature. We have previously reported on the practice of restraint and seclusion in Greece [2] and the patients and families attitudes towards coercive measures [3]. Here, we report on the practice of chemical restraint in a psychiatric ward within a general hospital.A total of 314 admissions in the 11-bed psychiatric ward of the General Hospital of Arta in northwestern Greece from a 2-year-period (March 2008 to March 2010) were examined retrospectively. Rapid tranquilisation (defined as emergency intramuscular drug administration for the management of patients' acute agitation and violent behaviour) was appli
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