General hospital psychiatry
-
The Mini-Mental Status Examination (MMSE) is a brief, structured test of cognitive function. The test is often used as a screening or case-finding instrument for the detection of organic mental disorders or cognitive impairment. However, many clinicians incorporate the MMSE into their clinical mental status examination. ⋯ Scores are interpreted in terms of their consistency or inconsistency with a prior diagnostic impression. This takes prior clinical information and clinical judgment into account. Although different from the traditional way of interpreting the MMSE, the proposed method can be implemented on an intuitive level and does not require mathematical calculations, which are inconvenient at the bedside.
-
The utilization of psychiatric crisis teams in urban hospitals is well documented. However, little is reported describing patients who use crisis teams in suburban general hospital emergency rooms. This is a descriptive survey of 1707 suburban patient visits. ⋯ A regression model is used to analyze the duration of service time and utilization patterns in relation to eight variables: season, month, day, shift, diagnosis, method of payment, age, and disposition. Five predictors are identified as significantly relating to the duration of the psychiatric consultation process. These predictors may enable hospital administrators and medical staff to plan and implement psychiatric emergency room care.
-
Consultation-liaison (C-L) psychiatry as a service entity has developed slowly and to a variable extent in Australia despite the presence of factors conducive to its development. These include a compulsory national health insurance system and a favorable disposition to the biopsychosocial model and to psychoanalytic ideas. ⋯ An Australian and New Zealand C-L psychiatry interest group is being formed. Collaboration with the MICRO-CARES Consortium and the European Consultation-Liaison Workgroup is proving to be a great stimulus.
-
To examine those patients referred to psychiatry for the "problem of coping," a structured clinical databased management system--MICRO-CARES--was employed to identify the frequency, demographic characteristics, psychiatric diagnoses, psychosocial interventions, use of psychopharmacology, number of follow-up visits, and discharge placement of these referrals. Consultations totaling 1,157 from July 1, 1988 through January 1, 1990 were divided into two groups and compared: "Not coping" (N = 456, 28.5%) and "others" (N = 701, 61%). ⋯ Fewer recommendations were made for those with a coping problem, although lag time (admission date to request for consultation), number of follow-ups, and discharge placement were not significantly different between the two groups. Stepwise logistic regression analyses revealed that the aged had lesser risk for being referred with a coping problem; those who were white, had their own income, experienced greater stress prior to hospitalization (Axis IV), and had higher functioning during the last year (Axis V) were at greater risk.
-
A study was conducted of all 51 patients admitted on 64 occasions with self-inflicted burns to the Welsh Regional Burns Unit between January 1979 and January 1991. Two different groups of patients were identified, namely, patients who attempted suicide and patients with self-mutilative behavior. ⋯ At follow-up, no patient had subsequently committed suicide, but the majority of suicide attempters remained in contact with psychiatric services. In view of the considerable psychiatric morbidity of this patient group there is a need for consultation-liasion psychiatrists to provide a service to Burn Units.