General hospital psychiatry
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Gen Hosp Psychiatry · Jan 2019
Predictors of self-harm emergency department visits in adolescents: A statewide longitudinal study.
This study investigated patient- and area-level characteristics associated with adolescent emergency department (ED) patients' risk of subsequent ED visits for self-harm. ⋯ A range of patient- and area-level characteristics observable in ED settings are associated with risk for subsequent self-harm among adolescents, suggesting new targets for intervention in this clinical context.
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Gen Hosp Psychiatry · Jan 2019
Bringing close others to the emergency department for an acute coronary event is associated with increased patient perception of threat.
Relationship quality is one of the most consistent psychosocial predictors of physical and mental health. Yet, little research examines relationship types or support within the immediate context of acute health events. We tested the unexplored role that close others play in patients' experience of threat during evaluation for acute coronary syndrome (ACS) in the Emergency Department (ED), as well as the indirect effect of close others on ACS-induced posttraumatic stress disorder (PTSD). ⋯ Close others were associated with recalling greater threat during ED evaluation, which predicted ACS-induced PTSD. ACS-induced PTSD is associated with medication nonadherence, event recurrence, and mortality, highlighting the need to develop a greater understanding of the impact stressful medical environments have on patients and close others.
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Gen Hosp Psychiatry · Nov 2018
ReviewSuicidal ideation and behaviors among women veterans with recent exposure to intimate partner violence.
Women veterans have disproportionately high risk for both suicide and intimate partner violence compared to women non-veterans. The objective of this study was to assess the relationship between intimate partner violence (IPV) and suicidal ideation and suicidal or self-harm behaviors among women veterans. ⋯ There is a strong association between positive IPV screen and suicidal ideation and self-harm behaviors among VHA-engaged women veterans. Documentation of either event is an important marker for the other. Integration of suicide prevention with IPV services may enhance identification of women at risk and speed service uptake. Suicidal ideation and behaviors should be assessed among women with positive IPV screens, and identification of suicide risk should trigger IPV assessment.
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Gen Hosp Psychiatry · Jul 2018
Randomized Controlled TrialAmbivalence over emotional expression and perceived social constraints as moderators of relaxation training and emotional awareness and expression training for irritable bowel syndrome.
Psychological treatments are generally beneficial for patients with irritable bowel syndrome (IBS), but patients' responses vary. A prior randomized controlled trial found that both relaxation training (RT) and emotional awareness and expression training (EAET) were superior to a waitlist control condition for IBS symptoms, quality of life, depression, and anxiety among IBS patients (Thakur et al., 2017). ⋯ These findings suggest that RT might be particularly helpful for people who tend to avoid emotional disclosure and expression, supporting the possible benefit of targeting treatments to patient characteristics and preferences, whereas EAET might be helpful for a broader range of patients with IBS.
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Gen Hosp Psychiatry · Jul 2018
Posttraumatic stress and depressive symptoms characterize cardiac arrest survivors' perceived recovery at hospital discharge.
To test the hypothesis that posttraumatic stress and depressive symptoms, not cognitive or functional impairment, are associated with cardiac arrest survivors' negative recovery perceptions at hospital discharge. ⋯ Within one month after a cardiac arrest event, survivors' negative recovery perceptions are associated with psychological distress.