General hospital psychiatry
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Gen Hosp Psychiatry · Mar 2008
Randomized Controlled TrialPrescription medication misuse and substance use disorder in VA primary care patients with chronic pain.
The goal of this paper was to examine the relationship between history of substance use disorder (SUD) and self-reported prescription medication misuse in 127 primary care patients who receive opioid medications for treatment of chronic pain. ⋯ Misuse of prescription medications is a concern among primary care patients with chronic pain. Participants with a lifetime history of SUD are more likely to endorse some aberrant medication-related behaviors. Patients with SUD histories should be carefully evaluated for medication misuse potential and may require more intense assessment and follow-up.
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Gen Hosp Psychiatry · Mar 2008
Clinical utility and validation of two instruments (the Confusion Assessment Method Algorithm and the Chinese version of Nursing Delirium Screening Scale) to detect delirium in geriatric inpatients.
There is no valid instrument to aid delirium detection in Hong Kong. The objective of this study was to investigate the effectiveness of the Confusion Assessment Method Diagnostic Algorithm (CAM algorithm) and the bilingual version of Nursing Delirium Screening Scale (Nu-DESC) among geriatric inpatients in a Chinese population. ⋯ The bilingual version of Nu-DESC is a sensitive screening tool and the CAM algorithm is an accurate diagnostic instrument for detection of delirium in geriatric inpatient population.
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The purpose of this study was to examine the methods by which emergency departments (EDs) manage clients who present with psychiatric and substance abuse issues. ⋯ Further research is needed to identify best-practice standards to enable EDPES to provide optimal patient and organizational outcomes.
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Gen Hosp Psychiatry · Nov 2007
Randomized Controlled TrialStepped Care for Affective Disorders and Musculoskeletal Pain (SCAMP) study: design and practical implications of an intervention for comorbid pain and depression.
Depression and pain are common comorbid conditions that have reciprocal adverse effects on disability and treatment outcomes. The objective of this article is to describe a study that tests the effectiveness of a stepped-care approach using a combined medication-behavioral intervention. ⋯ When completed, SCAMP will test whether optimized antidepressant management improves outcomes in patients with comorbid depression and pain and whether PSM produces additional benefits. The findings will be important for both primary care and mental health clinicians confronted by the prevalent depression-pain dyad.
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Gen Hosp Psychiatry · Sep 2007
Delirium: patient characteristics that predict a missed diagnosis at psychiatric consultation.
This study evaluates patient characteristics that might predict a missed diagnosis of delirium prior to being seen by a psychiatric consultant. ⋯ The consulting physicians of patients with delirium often incorrectly turn to past psychiatric diagnoses and/or are distracted by the presence of pain and, thus, fail to accurately diagnose delirium.