Acta psychiatrica Scandinavica
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Acta Psychiatr Scand · Jun 1994
Clinical TrialA blinded, controlled evaluation of anxiety and depressive symptoms in patients with fibromyalgia, as measured by standardized psychometric interview scales.
The objective of the study was to evaluate the presence of psychopathology in fibromyalgia patients compared with a control group of other rheumatologic patients with pain. Forty-nine fibromyalgia patients and 33 control patients were interviewed blinded, using standardized psychometric scales. Pain was scored on a visual analogue scale. ⋯ In both groups a correlation was found between pain score and psychometric scoring. The fibromyalgia patients scored significantly higher on pain than the controls. After correcting for this difference, the fibromyalgia patients still scored higher on anxiety and depression.
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This study attempts to identify variables associated with improved functioning after psychiatric hospitalization. The relationship between 25 clinical and demographic variables and improvements and functioning at discharge of 309 consecutive patients in an open ward over 2 years were studied using stepwise logistic regression. Measures of patients functioning at discharge were score above or below 50 on the (Global Assessment of Functioning scale) (GAF) and 3-point scale of functioning 1 week after discharge (needs constant supervision, functions independently at home, functions on the job). ⋯ It correctly predicted 74% of the lowest level of functioning, 47% of the middle level and 68% of the highest level. The best predictors of improved functioning after discharge were preadmission levels of functioning, psychotherapy in hospital, absence of organic brain syndrome, attendance at occupational therapy and hospitalization less than 4 months. Diagnosis had almost no discernible effect on outcome of hospitalization.
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Acta Psychiatr Scand · Dec 1993
Comparative StudyRisk factors for completed suicide among adolescents with a lifetime history of substance abuse: a case-control study.
The risk factors for suicide in adolescents with substance abuse were assessed by comparing 23 adolescent suicide victims and 12 community controls with a lifetime history of definite or probable DSM-III substance abuse. Suicide victims were more likely than controls to show the following risk factors: active substance abuse, comorbid major depression, suicidal ideation within the past week, family history of depression and substance abuse, legal problems and presence of a handgun in the home. Recommendations for the identification and prevention of suicide among substance-abusing youth on the basis of these findings are presented.
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Acta Psychiatr Scand · Dec 1993
Medical and social paternalism. Regulation of and attitudes towards compulsory psychiatric care.
In Sweden, recommendations and reforms in psychiatric care have increasingly stressed respect for patient autonomy and justice with less emphasis on medical and social paternalism. This is the official policy. ⋯ Strong support for medical and social paternalism was reported, and according to most of the people asked, doctors, not legal authorities, should decide about commitment. These attitudes are discordant with the recent legislative changes in Sweden.
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Acta Psychiatr Scand · Aug 1993
A second labour market? Vocational rehabilitation and work integration of chronically mentally ill people in Germany.
In Germany, the vocational rehabilitation of chronically mentally ill people is concentrated on the sheltered labour market, supplemented by special programmes for the care and reintegration of mentally ill people on the open labour market. Our investigation covered 502 representatively selected patients in sheltered employment (outpatient work therapy, firms for mentally ill people, workshops for the disabled). ⋯ The level of subjective job satisfaction is surprisingly high despite generally inadequate pay, though it has to be pointed out that many long-term patients are presumably resigned to their circumstances. In conclusion, the relationship of the open labour market to sheltered employment is the subject of critical discussion.