General hospital psychiatry
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Gen Hosp Psychiatry · Mar 2012
Psychiatric morbidity predicts perceived burn-specific health 1 year after a burn.
Individual factors such as gender, age, coping and personality traits and injury-related factors such as injury severity have been implicated as risk factors for poor perceived health after burns. As psychiatric morbidity is common in individuals who sustain burns, the aim of this study was to examine the effect of preinjury psychiatric problems on perceived health after injury. ⋯ The results show that a history of preinjury psychiatric disorders, especially during the year before the burn, affects perceived outcome regarding both physical and psychological aspects of health 1 year after injury and that it is a risk factor for worse perceived outcome.
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Gen Hosp Psychiatry · Mar 2012
Review Case ReportsLow-dose escitalopram for 2 days associated with corrected QT interval prolongation in a middle-aged woman: a case report and literature review.
Prolongation of the corrected QT interval (QTc) on the electrocardiography is an important clinical condition because it increases the risk of torsade de pointes, a medical emergency that can cause sudden cardiac death. QTc prolongation can be induced by many drugs, including antipsychotics and tricyclic antidepressants (TCAs). Compared with TCAs, use of selective serotonin reuptake inhibitors (SSRIs) was less likely to cause severe cardiac adverse effects. ⋯ Here, we present one female patient showing QTc prolongation induced by low-dose (5 mg/day) treatment of escitalopram for 2 days. The QTc returned to normal soon after discontinuation of escitalopram. Clinicians should be cautious about cardiac effects when using a SSRI, even in a low dose.
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Gen Hosp Psychiatry · Mar 2012
Suicidality and panic in emergency department patients with unexplained chest pain.
The present study aims to document the problem of suicidality in emergency department (ED) patients with unexplained chest pain and to assess the strength and independence of the relationship between panic and suicidal ideation (SI) in this population. ⋯ Suicidality and SI were common and often severe in our sample of ED patients with unexplained chest pain.
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The Risk Model for Delirium (RD) score is a 10-item questionnaire that allocates hip fracture patients after admission to hospital to be either at high or at low risk for delirium. This allows targeted preventive actions. Clinical reliability, validity and feasibility of the RD score are discussed. ⋯ The RD score is a reliable, feasible and valid instrument for predicting delirium in hip fracture patients.
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Gen Hosp Psychiatry · Jan 2012
Psychiatric disorders as assessed with SCID in chronic pain patients: the anxiety disorders precede the onset of pain.
The aim of the study was to determine the prevalence of psychiatric disorders in patients referred to a tertiary pain clinic. The temporal relationship between the onset of pain and depression and anxiety and the association of psychiatric disorders with pain intensity were also analyzed. ⋯ Chronic pain patients have a remarkable psychiatric morbidity. A structured diagnostic interview, covering a large range of psychiatric diagnoses, allows a more comprehensive approach to the assessment of the patient. This should improve the management of chronic pain. However, prospective studies are needed to show this.