To see, if voluntary admission for treatment in first-episode psychosis results in better adherence to treatment and more favourable outcome than involuntary admission.
We compared consecutively first-admitted, hospitalised patients from a voluntary (n = 91) with an involuntary (n = 126) group as to psychopathology and functioning using Positive and Negative Syndrome Scale and Global Assessment of Functioning Scales at baseline, after 3 months and at 2 year follow-up. Moreover, duration of supportive psychotherapy, medication and number of hospitalisations during the 2 years were measured.
More women than men were admitted involuntarily. Voluntary patients had less psychopathology and better functioning than involuntary patients at baseline. No significant difference as to duration of psychotherapy and medication between groups was found. No significant difference was found as to psychopathology and functioning between voluntarily and involuntarily admitted patients at follow-up.
Legal admission status per se did not seem to influence treatment adherence and outcome.
The study aimed to determine rates and types of patient restraint, and their relationship to age, gender and immigrant background. The study retrospectively examined routinely collected data and data from restraint protocols in a department of acute psychiatry over a 2-year period. Each patient is only counted once in this period, controlling for readmission. Of 960 admitted patients, 14% were exposed to the use of restraints. The rate was significantly higher among patients with immigrant background, especially in the younger age groups. Most commonly used were mechanical restraint alone for native-born patients and a combination of mechanical and pharmacological restraints for patients with immigrant background. The use of restraints decreased when patients reached 60 years. Both patients' age and immigrant background seem to have an impact on the use of restraint.
To describe 1-year outcome in a large clinical epidemiologic sample of first-episode psychosis and its predictors.
A total of 301 patients with first-episode psychosis from four healthcare sectors in Norway and Denmark receiving common assessments and standardized treatment were evaluated at baseline, at 3 months, and at 1 year.
Substantial clinical and social improvements occurred within the first 3 months. At 1-year 66% were in remission, 11% in relapse, and 23% continuously psychotic. Female gender and better premorbid functioning were predictive of less severe negative symptoms. Shorter DUP was predictive for shorter time to remission, stable remission, less severe positive symptoms, and better social functioning. Female gender, better premorbid social functioning and more education also contributed to a better social functioning.
This first-episode sample, being well treated, may be typical of the early course of schizophrenia in contemporary centers.
A cohort of 214 drug addicts with serum hepatitis and a cohort of 193 hepatitis patients without drug addiction were examined in respect of death rates, causes of death and a number of risk factors for reduced survival. The death rate was significantly higher among the drug addicts than among non-addicts. The annual mortality rate was 1.5% in the drug addict group and 0.7% in the non-addict group. The highest relative risk of death was 860 for female drug addicts in age group 15-24 compared to females of the same age in the general population. The most prevalent cause of death in the drug addict group was drug overdose (53%), whereas in the other group 66% died from various somatic diseases. Hepatitis or complications of viral hepatitis played no role as cause of death among the drug addicts, and infections as a whole were also responsible for very few deaths. For male drug addicts, imprisonment before admission and leaving hospital without the doctors' permission were risk factors for early death.
Of a large sample of patients with paranoid psychoses consecutively admitted to the Psychiatric Department, University of Oslo, during a period after World War II, 10 patients (6.3%, 9 women and 1 man) became ill through accusations of unpatriotic conduct during the war. The psychosis seemed precipitated in connection with legal procedures against the patient in 3 cases, and against close relatives in 2 patients. In 2 cases mixed precipitating events were present, while the psychosis in 3 cases had a connection with the woman being intimate with occupation soldiers. Discharge diagnosis according to DSM-III was schizophrenia (n = 2), schizophreniform disorder (n = 4), schizoaffective disorder (n = 1), major depressive disorder (n = 1), mania (n = 1), and atypical psychosis (n = 1). The patients have been followed up twice, with a mean 31 years of observation. Course and outcome varied, mostly according to the diagnosis. Most patients had a favorable global outcome, although they had a tendency to keep up their social isolation. None of the patients felt they had done anything wrong or regretted their behavior during the war.
The aim of this study was to examine the risk of depression in the postpartum period (first four months after delivery) as compared to the remaining postnatal year and the pregnancy period. All postpartum women from two municipalities in Norway were included in a questionnaire study of mental health (n = 416). Over 50% of the women (n = 259) answered an identical questionnaire at an additional time either before or after the postpartum period. The level of depression was measured by the Edinburgh Postnatal Depression Scale (EPDS) and the Hopkins Symptom Check List-25 items (SCL-25). The point prevalence of depression (EPDS> or =10) in the first four months postpartum did not differ significantly as compared to other time periods during pregnancy and the postnatal year. This finding remained also after controlling for other risk factors of depression; high score on the life event scale, prior depression and poor partner relationship. There was a non-significant trend of lower prevalence of depression during early pregnancy and after the first eight postnatal months. In conclusion, our findings suggest that the first four months postpartum were not distinguished by higher depression prevalence as compared to other time periods during pregnancy and the first postnatal year.
OBJECTIVE: The aim of the study was to assess the prevalence of depression in postpartum women as compared with non-postpartum women, and to identify risk factors of depression in both groups. METHOD: A population based questionnaire study was performed among women 18-40 years in two municipalities in Norway in 1998-1999. A total of 2,730 women were included, of whom 416 were in the postpartum period. RESULTS: The prevalence of depression was higher in non-postpartum as compared with postpartum women. High scores on the life event scale, a history of depression and a poor relationship to the partner were associated with depression in both postpartum and non-postpartum women. When controlling for the identified risk factors of depression the odds-ratio for depression in the postpartum period was 1.6 (95% CI: 1.0-2.6). CONCLUSION: The risk for depression was increased in the postpartum period, when controlling for the uneven distribution of risk factors.