Social psychiatry and psychiatric epidemiology
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Soc Psychiatry Psychiatr Epidemiol · Jul 2000
Dual diagnosis in the suburbs: prevalence, need, and in-patient service use.
Previous research has found comorbid severe mental illness and substance misuse (dual diagnosis) to be highly prevalent and to be associated with serious clinical and social problems, and increased service use in inner-city populations. The present study measures the prevalence of dual diagnosis, patterns of substance misuse, and associated in-patient use in a more demographically representative population in a suburban area of South London. ⋯ The prevalence of substance misuse in patients with severe mental disorders in a suburban area is about as high as that for similar patients in inner-city London. While DD patients are not admitted more often than patients with psychosis alone, they have double the length of in-patient stay, which may be attributable to higher levels of unmet need.
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Soc Psychiatry Psychiatr Epidemiol · Dec 1999
Suicide attempts by psychiatric patients in acute inpatient, long-stay inpatient and community care.
This study examined rates of and risk factors associated with suicide attempts by psychiatric patients under active care. It was especially focussed on the relative rates across three standard treatment settings: acute inpatient care, long-stay inpatient care and community-based care. ⋯ Rates of suicide attempts among psychiatric patients are a major issue facing contemporary mental health care systems, and risk factors vary across different treatment settings.
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Soc Psychiatry Psychiatr Epidemiol · Jun 1999
Multicenter StudyMental health, "burnout" and job satisfaction in a longitudinal study of mental health staff.
This study examines whether the adoption of a more community based model in an inner city psychiatry service is accompanied by increasing "burnout", deteriorating mental health and decreasing job satisfaction amongst staff. ⋯ These results suggested that working in the community may be more stressful than working in in-patient services. However, there was no evidence to suggest that levels of stress are increasing over time, either in community-based or hospital-based staff.
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Soc Psychiatry Psychiatr Epidemiol · Dec 1998
Randomized Controlled Trial Clinical TrialTaking the wrong drugs: the role of substance abuse and medication noncompliance in violence among severely mentally ill individuals.
Increasing numbers of severely mentally ill individuals are being treated in nonhospital, community-based settings and public concern about potential violence by these individuals has increased, often as a result of tragic, albeit uncommon events. The present study examines potential predictors of serious violence among persons with severe mental illness (SMI), with a specific focus on the joint effect of substance abuse and medication noncompliance. Subjects in the study are involuntarily admitted inpatients with SMI awaiting a period of court-ordered outpatient treatment, termed "involuntary outpatient commitment". ⋯ The combination of medication noncompliance and substance abuse was a significant predictor of serious violent acts in the community. Individuals who had problems with both alcohol and illicit drug abuse appear to be at greatest risk for violence. These results suggest that reducing violence risk among persons with SMI requires an aggressive approach to improving medication adherence in the context of integrated mental health and substance abuse treatment.
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Soc Psychiatry Psychiatr Epidemiol · Oct 1998
Comparative StudyPostnatal depression and social supports in Vietnamese, Arabic and Anglo-Celtic mothers.
The significance of a western woman's social supports to postnatal depression is well documented. We examine which deficits in components of their social support network are associated with postnatal depression in women from a non-English-speaking background. The social support network and postnatal mood of 105 Anglo-Celtic, 113 Vietnamese and 98 Arabic women were assessed at 6 weeks postpartum. ⋯ For Vietnamese women, low postnatal mood was associated with poor quality of relationship with the partner and a perceived need for more practical help from him. For Arabic women, low postnatal mood was associated with perceived need for more emotional support from partners. We conclude that cultural factors mediate the relation between social supports and postnatal depression more likely to become clinically depressed (Lovestone and Kumar 1993) and infants may have adverse cognitive, behavioural and emotional outcomes, which can be linked to the postnatal depression (Murray and Cooper 1996).