General hospital psychiatry
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Gen Hosp Psychiatry · Sep 2009
The accuracy of Patient Health Questionnaire-9 in detecting depression and measuring depression severity in high-risk groups in primary care.
Only half of patients with depressive disorder are diagnosed by their family physicians. Screening in high-risk groups might reduce this hidden morbidity. This study aims to determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9) in (a) screening for depressive disorder, (b) diagnosing depressive disorder and (c) measuring the severity of depressive disorder in groups that are at high risk for depressive disorder. ⋯ The PHQ-9 performs well as a screening instrument, but in diagnosing depressive disorder, a formal diagnostic process following the PHQ-9 remains imperative. The PHQ-9 does not seem adequate for measuring severity.
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Gen Hosp Psychiatry · Jul 2009
Review Case ReportsGamma-hydroxybutyrate withdrawal syndrome: dangerous but not well-known.
Gamma-hydroxybutyrate (GHB) is an endogenous inhibitory neurotransmitter and anesthetic agent that is being abused as a 'club drug.' Withdrawal symptoms after cessation of GHB use are common and depend on the intensity of use. However, GHB withdrawal syndrome and delirium are unfamiliar to most psychiatrists, probably due to the fact that neither textbooks nor guidelines cover the subject. ⋯ In those severe cases, admission to a general hospital and involvement of a psychiatrist become necessary. We present two cases of severe GHB withdrawal delirium, provide an overview of the literature and conclude with treatment recommendations.
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Gen Hosp Psychiatry · Jul 2009
Major depression and health-related quality of life in Parkinson's disease.
Depression is a common psychiatric condition in Parkinson's disease (PD), yet the burden of depression on health-related quality of life (HRQL) has not been clearly delineated in this patient population. ⋯ Substantial impact of depression and life stress, two modifiable factors, on HRQL is seen in PD. HRQL may be improved by clinical management of these nonmotor symptoms in PD.
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Gen Hosp Psychiatry · Jul 2009
Mortality in medical-surgical inpatients referred for psychiatric consultation.
The purpose of this study is to calculate the 1-year mortality rate of medical-surgical inpatients referred for psychiatric consultation and to determine factors associated with mortality in this population. ⋯ The 1-year mortality rate in this group of medical-surgical inpatients referred for psychiatric consultation was 15.2%. Mortality was independently associated with delirium and cancer. Mortality was also associated with greater length of time from admission to consultation, which raises a question about whether earlier psychiatry consultation may have a positive impact on survival.
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Severe acute respiratory syndrome (SARS) was the first massive infectious disease outbreak of the 21st century. However, it is unlikely that this outbreak will be the last. This study aimed to evaluate the long-term psychiatric morbidities in survivors of SARS. ⋯ The outbreak of SARS can be regarded as a mental health catastrophe. PTSD was the most prevalent long-term psychiatric condition, followed by depressive disorders. Our results highlight the need to enhance preparedness and competence of health care professionals in detecting and managing the psychological sequelae of future comparable infectious disease outbreaks.