Contemporary standards of practice of electroconvulsive therapy with respect to the treatment procedure, clinical indications, and dosage (number of treatments per course) are summarized. The actual clinical practice at one psychiatric hospital over a 16-year period, comprising 22,647 treatments, was compared to those standards. The most significant findings in this series were the over-representation of patients with a diagnosis of schizophrenia and the absence of any clinically significant difference in the treatment dosage for schizophrenia and affective disorders. The significance of these findings is discussed with respect to their identification of patient subgroups that warrant case auditing. In addition, the results are used as a basis for a critical examination of the rationale for the presently recommended maximum treatment dosages.
The aim of the present study was to compare user assessed needs for care for psychiatric patients in inpatient settings with that of residents in supported community residences. The Camberwell Assessment of Need was administered to 75 patients and residents in different housing settings. Residents in supported community settings had more needs for care (8.1), than patients in inpatient settings (5.8), partly because of differences in duration of illness. A greater proportion of those living in supported community residences reported needs in the areas of psychotic symptoms, accommodation, food, daytime activities, sexual expression and looking after the home. There were no differences in numbers of unmet needs. Relatives and friends provided emotional and social support predominantly in the areas of company and psychological distress. In conclusion, living in supported community residences does not imply more unmet needs, or less adequate response to needs from services, despite a greater number of needs being reported. In some areas of need, relatives and friends play an important role in the provision of support.
BACKGROUND: Questionnaires on patient experience are increasingly used as quality indicators in the health services. There is limited evidence relating to alternative approaches to surveying patients within this field. We wanted to assess the effect of different methods of data collection on response rates and scores produced by a self-administered questionnaire on patient experience for adult inpatients receiving mental health care. MATERIAL AND METHODS: Data were collected from adult inpatients treated at three community mental health centres affiliated with the psychiatric clinic at Stavanger University hospital in spring 2005. The inclusion period was nine weeks, with three designs at consecutive time periods: A, a postal survey following discharge; B, a clinical survey before discharge; and C, patients given the choice of A or B. RESULTS: The response rate was highest with the postal design (38% vs. 24% and 23% respectively), but the differences were related to one additional reminder in the postal design. Out of the 11 questions, 4 had significantly poorer scores for the postal design. Questionnaire scores were significantly poorer with the postal design; 50 (on a scale from 0 to 100), vs. 59 and 63 in design B and C respectively. INTERPRETATION: The choice of data collection methods influences the results in user surveys in mental health care. This is an important consideration in the planning of studies and in the interpretation of the results, and in the comparison of results between studies using different data collection methods.
The food served in psychiatric institutions may in general be described as a standard diet similar to that served in somatic hospitals, with no or little adjustment made to the special needs of the individual psychiatric patient. The emphasis on physical activity is also generally low. This paper presents results and strategies in a sample of sixteen Norwegian psychiatric institutions that have undertaken a one-year weight management programme with focus on structural changes in dietary and physical activity practices. Prevention and treatment of weight gain in psychiatric patients is difficult, but not impossible. All institutions included in this project have made changes in the dietary practice and the routines for physical activity, with less severe weight problems in the patients as a result. Coordinated approaches are necessary if the efforts are to succeed.
Alcohol use above hazardous limits is common among persons with psychiatric disorders, and there is limited knowledge about motives for drinking. The objective of this study was to explore the adequacy of the four-factor structure of drinking motives in an adult psychiatric outpatient population in Sweden by confirming the factor structure in the Drinking Motives Questionnaire (DMQ-R) and in alternative models.
In total, 371 patients responded to the DMQ-R along with the Alcohol Use Disorders Identification Test (AUDIT). AUDIT was used to assess frequency of alcohol consumption, number of drinks consumed on a typical occasion and binge drinking frequency. Confirmatory factor analysis was used to examine the construct validity of the DMQ-R and alternative models, including the short form, DMQ-R SF.
Fit statistics suggested that the original four-factor model had questionable fit (root mean square error of approximation [RMSEA]?=?0.10, comparative fit index [CFI]?=?0.89, standardised root mean square residual [SRMR]?=?0.08). The model with the best fit indices was the DMQ-R SF (RMSEA?=?0.07, CFI?=?0.97, SRMR?=?0.04). When using DMQ-R SF in further analyses enhancement, the most strongly endorsed motives were related to quantity and AUDIT sum score. Coping motives were most strongly related to AUDIT sum score, frequency and binge drinking. Social motives were only related to binge drinking, whereas conformity motives were not statistically associated with any motives.
The study implies that the 12-item short form, DMQ-R SF, could be more appropriate than the original DMQ-R in this group. [Öster C, Arinell H, Nehlin C. The Drinking Motives Questionnaire among Swedish psychiatric patients: An exploration of the four-factor structure. Drug Alcohol Rev 2017;36:400-407].
