General hospital psychiatry
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Gen Hosp Psychiatry · Nov 2010
Prevalence and associated factors for delirium in critically ill patients at a Japanese intensive care unit.
To investigate the prevalence and associated factors of delirium in critically ill patients during an intensive care unit (ICU) stay. ⋯ The prevalence of delirium was 20% in ICU patients and 80% in ventilated patients in a Japanese ICU.
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Gen Hosp Psychiatry · Nov 2010
Case ReportsDuloxetine treatment of long-term ketamine abuse-related lower urinary tract symptoms: a case report.
To report a case of ketamine abuse-related lower urinary tract symptoms (LUTS) in a depressed patient, who was successfully treated with duloxetine. ⋯ Duloxetine can be considered as one of the therapeutic drugs of choice for depressive patients with significant LUTS.
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We examined the prevalence of pain and pain severity in a sample of psychiatric inpatients. Currently, scant information exists about which patient groups are most affected by pain. ⋯ Within a group of psychiatric inpatients, pain is associated with PTSD in women and with adverse childhood experiences in both men and women. Attention should therefore be paid towards such high-risk groups and the consequences that the pain might entail for physical and mental health.
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Gen Hosp Psychiatry · Sep 2010
Collaborative depression care: history, evolution and ways to enhance dissemination and sustainability.
To describe the history and evolution of the collaborative depression care model and new research aimed at enhancing dissemination. ⋯ Collaborative depression care has extensive research supporting the effectiveness of this model. New research and demonstration projects have focused on adapting this model to new populations and medical settings and on studying ways to optimally disseminate this approach to care, including developing financial models to incentivize dissemination and partnerships with community populations to enhance sustainability and to decrease disparities in quality of mental health care.
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Because one in five Americans die in the intensive care unit (ICU), the potential role of palliative care is considerable. End-of-life (EOL) communication is essential for the implementation of ICU palliative care. The objective of this review was to summarize current research and recommendations for ICU EOL communication. ⋯ Because the ICU is now a well-established site for death, ICU physicians should be trained with EOL communication skills so as to facilitate palliative care more hospitably in this challenging setting. Patient/family outcomes are important ways of measuring the quality of ICU palliative care and EOL communication.