General hospital psychiatry
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Gen Hosp Psychiatry · Nov 2012
Prescribed opioid difficulties, depression and opioid dose among chronic opioid therapy patients.
Chronic opioid therapy has increased dramatically, as have complications related to prescription opioids. Little is known about the problems and concerns attributed to opioids by patients receiving different opioid doses. ⋯ Higher opioid doses were associated with somewhat higher pain severity and higher levels of patient-reported opioid-related psychosocial problems, control concerns and depression. These findings may result from patient selection for high-dose therapy or problems caused by higher-dose opioids.
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Gen Hosp Psychiatry · Nov 2012
Feasibility and acceptability of interventions to delay gun access in VA mental health settings.
The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety and interventions to delay gun access during high-risk periods were explored. ⋯ Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully.
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Gen Hosp Psychiatry · Sep 2012
Comorbid psychiatric diagnoses in suicide attempt by charcoal burning: a 10-year study in a general hospital in Taiwan.
Over the last decade, charcoal burning has become a common method of suicide in Taiwan; however, the underlying psychiatric diagnoses and gender differences have yet to be examined. ⋯ There were gender differences in patients of suicide attempt by charcoal burning, in terms of demographic profiles and psychiatric diagnoses. Suicide risk assessment and prevention should be tailored by gender.
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Gen Hosp Psychiatry · Sep 2012
Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993-2008.
The objective was to describe the epidemiology of emergency department (ED) visits for attempted suicide and self-inflicted injury over a 16-year period. ⋯ ED visit volume for attempted suicide and self-inflicted injury has increased over the past two decades in all major demographic groups. Awareness of these longitudinal trends may assist efforts to increase research on suicide prevention. In addition, this information may be used to inform current suicide and self-injury related ED interventions and treatment programs.
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Fibromyalgia is a common and disabling disease, and treatment can be challenging. More recently, pregabalin has been approved to treat pain associated with fibromyalgia. However, it can have serious neuropsychiatric sequelae. ⋯ We describe a case of delirium in a young patient without significant medical problems and in the absence of other potentially causal medications. In this case, pregabalin appears to be the single causal etiology for delirium. We recommend clinicians to consider the causal role it may play in any patient who presents with delirium.