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[Description of a group of psychiatric patients difficult to place]

https://arctichealth.org/en/permalink/ahliterature71949
Source
Ugeskr Laeger. 2001 May 14;163(20):2786-91
Publication Type
Article
Date
May-14-2001
Author
L F Nielsen
L. Petersen
G. Werdelin
B J Hou
A. Lindhardt
Author Affiliation
Roskilde Amtssygehus Fjorden.
Source
Ugeskr Laeger. 2001 May 14;163(20):2786-91
Date
May-14-2001
Language
Danish
Publication Type
Article
Keywords
Adult
Aged
Denmark
Diagnosis, Dual (Psychiatry)
English Abstract
Female
Humans
Long-Term Care
Male
Mental Disorders - diagnosis - psychology - therapy
Mental health services
Middle Aged
Needs Assessment
Patient Admission
Patient Readmission
Schizophrenia - diagnosis - therapy
Socioeconomic Factors
Substance-Related Disorders - diagnosis - psychology - therapy
Abstract
INTRODUCTION: There are long-term patients in psychiatric hospitals, who are often referred to as new long-stay patients: the heavy users consumers of psychiatric services and difficult-to-place patients. MATERIAL AND METHOD: Social characteristics, diagnosis, need for care, function, and admission patterns were compared in a group of heavy user patients (N = 39) and a group of difficult-to-place patients (N = 14). RESULTS AND DISCUSSION: The difficult-to-place patients were more often men, more often had a diagnosis of schizophrenia, had a lower socio-economic status, and lower GAF scores. The difficult-to-place patients rated the same amount of need for care as did the heavy users, but were assessed by the staff to have a greater need for care. The results support the view that the difficult-to-place patients comprise a distinct group. Services for the difficult-to-place patients must combine highly differentiated care with few demands and greater tolerance with respect to problem behaviour.
PubMed ID
11374215 View in PubMed
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Do we agree about when patients are psychotic?

https://arctichealth.org/en/permalink/ahliterature155418
Source
Acta Psychiatr Scand. 2008 Oct;118(4):330-3
Publication Type
Article
Date
Oct-2008
Author
J. Nielsen
B. Mogensen
K. Martiny
K B Stage
J K Larsen
A. Lindhardt
A. Bertelsen
Author Affiliation
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aalborg, Denmark. jin@rn.dk
Source
Acta Psychiatr Scand. 2008 Oct;118(4):330-3
Date
Oct-2008
Language
English
Publication Type
Article
Keywords
Denmark
Female
Humans
Male
Middle Aged
Psychotic Disorders - classification - diagnosis - psychology
Questionnaires - standards
Reality Testing
Sensitivity and specificity
Abstract
To investigate into the use of the term 'psychotic' as defined by ICD-10 or by the concept of impaired reality testing, among psychiatric staff members.
Questionnaire investigation using 11 short case vignettes.
Responses were received from 266 psychiatric staff members: psychiatrists, nursing staff and psychologists. When using ICD-10, patients were identified as psychotic with a sensitivity ranging from 90% to 55%. Specificity ranged from 60% to 75%. According to the concept of impaired reality testing, all three groups showed a sensitivity of about 60%, whereas specificity ranged from 65% to 50%. The combined use of the terms correlated significantly with responses regarding indication for legal detention for psychiatrists and nursing staff.
In identifying a patient as 'psychotic' a broad concept of impaired reality testing was widely used particularly in cases with legal issues. Psychotic symptoms, however, were identified with high sensitivity and specificity.
PubMed ID
18759806 View in PubMed
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[Emergency psychiatry. I. A study of the function of the emergency psychiatric admission and the activity involved in a population of first referrals]

https://arctichealth.org/en/permalink/ahliterature74193
Source
Ugeskr Laeger. 1985 Jan 21;147(4):343-8
Publication Type
Article
Date
Jan-21-1985

Evaluation of community psychiatry: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature73507
Source
Acta Psychiatr Scand. 1992 Mar;85(3):183-8
Publication Type
Article
Date
Mar-1992
Author
K. Valbak
L V Sørensen
A. Lindhardt
Author Affiliation
Department C, Aarhus Psychiatric Hospital, Risskov, Denmark.
Source
Acta Psychiatr Scand. 1992 Mar;85(3):183-8
Date
Mar-1992
Language
English
Publication Type
Article
Keywords
Adult
Ambulatory Care - utilization
Community Mental Health Services - utilization
Cross-Sectional Studies
Day Care - utilization
Deinstitutionalization - trends
Denmark - epidemiology
Female
Hospitals, Psychiatric - utilization
Humans
Incidence
Male
Mental Disorders - epidemiology - psychology - therapy
Patient Admission - trends
Research Support, Non-U.S. Gov't
Schizophrenia - epidemiology - therapy
Schizophrenic Psychology
Abstract
This study demonstrates a simple epidemiological method to evaluate the changes in service pattern for a defined catchment area after the establishment of a hospital-based community psychiatry service in Denmark. It measures the number of patients in contact with the service on 2 census days, before the new service was introduced and 3 years later, and deals with quantitative measures of sex, age, diagnosis and type of service contact. The services for 2 other areas are used as controls. A new community psychiatry service with an office situated outside the hospital is described and is shown to be superior to both the psychiatry service from the hospital and the rest of the hospital service: the number of inpatients and day patients were reduced by 42% vs 12% and 16% respectively. The number of outpatients increased by 104% in the new service compared with 23% for the service located at the hospital. The increase in outpatient care for the service outside the hospital was mainly caused by contact with middle-aged women with personality disorders.
PubMed ID
1561888 View in PubMed
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Factors associated with referral to psychiatric care by general practitioners compared with self-referrals.

https://arctichealth.org/en/permalink/ahliterature72577
Source
Psychol Med. 1998 Mar;28(2):427-36
Publication Type
Article
Date
Mar-1998
Author
T. Oiesvold
M. Sandlund
L. Hansson
L. Christiansen
G. Göstas
A. Lindhardt
O. Saarento
S. Sytema
T. Zandrén
Author Affiliation
Salten Psychiatric Center, Nordland Psychiatric Hospital, Bodø, Norway.
Source
Psychol Med. 1998 Mar;28(2):427-36
Date
Mar-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Catchment Area (Health) - statistics & numerical data
Confidence Intervals
Critical Pathways - statistics & numerical data
Denmark - epidemiology
Female
Finland - epidemiology
Hospitalization - statistics & numerical data
Humans
Logistic Models
Male
Mental Health Services - statistics & numerical data - utilization
Middle Aged
Multivariate Analysis
Odds Ratio
Patient Acceptance of Health Care - statistics & numerical data
Primary Health Care - statistics & numerical data
Prospective Studies
Psychotic Disorders - epidemiology - therapy
Referral and Consultation - statistics & numerical data
Research Support, Non-U.S. Gov't
Sex Factors
Survival Analysis
Sweden - epidemiology
Abstract
BACKGROUND: The gatekeeper function of the general practitioner (GP) in the pathway to specialized psychiatric services was investigated in this study, which is part of the Nordic Comparative Study on Sectorized Psychiatry. The question addressed in this paper is whether different sociodemographic and clinical factors as well as factors related to service utilization are associated with referral from the GP compared with self-referrals (including referrals from relatives). METHODS: The study comprised a total of 1413 consecutive patients, admitted during 1 year to five psychiatric centres in four Nordic countries. The centres included in this study were those that accepted non-medical referrals. Only new patients (not in contact with the service for at least 18 months) were included. RESULTS: Increasing age was the only sociodemographic factor significantly associated with referral by the GP. The clinical factors (psychosis, being totally new to psychiatry and being in need of in-patient treatment) and some treatment characteristics (planned out-patient treatment and involuntary in-patient treatment), were all significantly associated with referral by the GP. Some indication was found that self-referred patients have shorter episodes of care. CONCLUSIONS: The findings were remarkably stable across the different centres indicating a general pattern. This study extends previous work on the role of GPs in the pathway to specialized psychiatric services and indicates that the GP has an important gatekeeper function for the most disabled patients.
PubMed ID
9572099 View in PubMed
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[Methods of evaluating community psychiatric services. Outpatient and inpatient treatment in psychiatric hospital services].

https://arctichealth.org/en/permalink/ahliterature232448
Source
Ugeskr Laeger. 1988 Sep 26;150(39):2343-7
Publication Type
Article
Date
Sep-26-1988

The Nordic Comparative Study on Sectorized Psychiatry. III. Accessibility of psychiatric services, degree of urbanization and treated incidence.

https://arctichealth.org/en/permalink/ahliterature72851
Source
Soc Psychiatry Psychiatr Epidemiol. 1996 Sep;31(5):259-65
Publication Type
Article
Date
Sep-1996
Author
O. Saarento
T. Oiesvold
G. Göstas
L W Christiansen
A. Lindhardt
O. Lönnerberg
M. Sandlund
L. Hansson
Author Affiliation
Department of Psychiatry, University of Oulu, Finland.
Source
Soc Psychiatry Psychiatr Epidemiol. 1996 Sep;31(5):259-65
Date
Sep-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Catchment Area (Health) - statistics & numerical data
Cohort Studies
Community Mental Health Services - statistics & numerical data
Female
Health Services Accessibility - statistics & numerical data
Humans
Male
Mental Disorders - epidemiology - rehabilitation
Middle Aged
National Health Programs - statistics & numerical data
Psychiatry - statistics & numerical data
Research Support, Non-U.S. Gov't
Scandinavia - epidemiology
Urbanization
Abstract
As part of a Nordic Comparative Study on Sectorized Psychiatry, accessibility of psychiatric services and degree of urbanization in seven catchment areas were related to treated incidence. One-year treated incidence cohorts were used. Accessibility was assessed according to referral practice, existence of a round the clock emergency service and geographical location of the services. Accessibility was surprisingly weakly associated with treated incidence. Easy access to the psychiatric services was not related to a high treated incidence of less severe psychiatric problems at the expense of patients suffering from severe illness. Geographical distance to the services did not predict the demand for services. A positive correlation was found between the degree of urbanization and treated incidence of psychoses but not of other diagnostic groups.
PubMed ID
8909115 View in PubMed
Less detail

The Nordic comparative study on sectorized psychiatry. II. Resources of the psychiatric services and treated incidence.

https://arctichealth.org/en/permalink/ahliterature73010
Source
Acta Psychiatr Scand. 1995 Sep;92(3):202-7
Publication Type
Article
Date
Sep-1995
Author
O. Saarento
T. Oiesvold
G. Göstas
A. Lindhardt
M. Sandlund
H R Vinding
T. Zandrén
L. Hansson
Author Affiliation
Department of Psychiatry, University of Oulu, Finland.
Source
Acta Psychiatr Scand. 1995 Sep;92(3):202-7
Date
Sep-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Ambulatory Care - utilization
Cohort Studies
Cross-Cultural Comparison
Cross-Sectional Studies
Female
Finland - epidemiology
Health Care Rationing - statistics & numerical data
Health Resources - statistics & numerical data
Hospital Bed Capacity - statistics & numerical data
Humans
Incidence
Male
Mental Disorders - epidemiology - rehabilitation
Mental Health Services - utilization
Middle Aged
Patient Admission - statistics & numerical data
Patient Care Team - utilization
Psychiatry - manpower
Research Support, Non-U.S. Gov't
Scandinavia - epidemiology
Abstract
As a part of a Nordic comparative study on sectorized psychiatry, treated incidence was related to the resources and dynamic qualities of psychiatric services in 7 catchment areas. One-year treated incidence cohorts were used. Data was collected concerning number of beds and staff, number of long-term patients and turnover rate of patients in the services and availability of specialized services. A positive correlation was found between rates of outpatient staff and treated incidence. No statistically significant correlation was found between the dynamic qualities of the services and treated incidence. Treated incidence of dependence was the highest in a center that had a special service unit for abusers. Special services for young and old people were not clearly reflected in treated incidence in respective patient groups.
PubMed ID
7484199 View in PubMed
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The Nordic comparative study on sectorized psychiatry. Part IV. The influence of patient social characteristics on treated incidence.

https://arctichealth.org/en/permalink/ahliterature52756
Source
Acta Psychiatr Scand. 1996 May;93(5):339-44
Publication Type
Article
Date
May-1996
Author
H R Vinding
L. Hansson
T. Zandrén
G. Göstas
A. Lindhardt
O. Saarento
M. Sandlund
T. Oiesvold
Author Affiliation
Roskilde County Hospital, Fjorden, Denmark.
Source
Acta Psychiatr Scand. 1996 May;93(5):339-44
Date
May-1996
Language
English
Publication Type
Article
Keywords
Adult
Aged
Catchment Area (Health) - statistics & numerical data
Community Mental Health Services - utilization
Cross-Sectional Studies
Female
Health Resources - utilization
Humans
Incidence
Male
Mental Disorders - epidemiology - psychology - rehabilitation
Middle Aged
Patient Admission - statistics & numerical data
Patient Care Team - utilization
Research Support, Non-U.S. Gov't
Risk
Scandinavia - epidemiology
Abstract
As part of a Nordic comparative study on sectorized psychiatry, sociodemographic characteristics (gender, age and marital status) were studied in relation to treated incidence in eight diagnostic subgroups. One-year incidence cohorts in seven sectorized psychiatric services were used. Women with a neurosis diagnosis had a significantly higher relative probability of contact with all services. Men with a dependence diagnosis had a significantly higher relative probability of contact with four of the seven services. Older people had a significantly higher relative risk for affective psychosis in six of the seven centres, and younger individuals had a significantly higher relative risk for personality disorders in six of the seven centres. Unmarried people showed a higher relative risk for functional psychosis and personality disorders in five of the seven services.
PubMed ID
8792902 View in PubMed
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22 records – page 1 of 3.