| 1 | Indian J Psychiatry 2007 Apr 49: 91-5 |
|---|---|
| PMID | 20711389 |
| Title | Seasonal pattern of psychiatry service utilization in a tertiary care hospital. |
| Abstract | Seasonal and monthly variations in utilization of psychiatric services have been inadequately studied in India. This study sought to determine the pattern of psychiatric services utilization by patients with four broad categories of diagnosis (mood disorders (F30-39): neurotic stress-related and somatoform disorders (F40-48), schizophrenia, schizotypal and delusional disorders (F20-29) and mental and behavioral disorders due to psychoactive substance use (F10-19) in different seasons and months of the last six years. We conducted a teaching hospital data-based study of new patients diagnosed with psychiatric illness in the department of psychiatry, Government Medical College and Hospital, Chandigarh. Four diagnostic groups consisting of 12058 psychiatric patients who had been diagnosed and treated in the department of psychiatry of this institute from 1999-2004 were included in this evaluation. Bed occupancy rate (BOR), average length of stay (ALOS) of inpatients and seasonal index were determined. Information about weather variables (mean daily temperature, mean rainfall) was collected from the meterological department of Chandigarh. Psychiatric services were utilized by 31.1% of patients with mood disorders in the summer and by 34.23% of patients with neurotic, stress-related and somatoform disorders in the autumn. Statistical analysis revealed significant difference in new cases of these two groups of disorders in different seasons. Our study showed a significant relationship between utilization of psychiatric patients especially with mood disorders and neurotic, stress related and somatoform disorders with season (summer and autumn respectively). |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 2 | Indian J Psychiatry 2007 Apr 49: 91-5 |
| PMID | 20711389 |
| Title | Seasonal pattern of psychiatry service utilization in a tertiary care hospital. |
| Abstract | Seasonal and monthly variations in utilization of psychiatric services have been inadequately studied in India. This study sought to determine the pattern of psychiatric services utilization by patients with four broad categories of diagnosis (mood disorders (F30-39): neurotic stress-related and somatoform disorders (F40-48), schizophrenia, schizotypal and delusional disorders (F20-29) and mental and behavioral disorders due to psychoactive substance use (F10-19) in different seasons and months of the last six years. We conducted a teaching hospital data-based study of new patients diagnosed with psychiatric illness in the department of psychiatry, Government Medical College and Hospital, Chandigarh. Four diagnostic groups consisting of 12058 psychiatric patients who had been diagnosed and treated in the department of psychiatry of this institute from 1999-2004 were included in this evaluation. Bed occupancy rate (BOR), average length of stay (ALOS) of inpatients and seasonal index were determined. Information about weather variables (mean daily temperature, mean rainfall) was collected from the meterological department of Chandigarh. Psychiatric services were utilized by 31.1% of patients with mood disorders in the summer and by 34.23% of patients with neurotic, stress-related and somatoform disorders in the autumn. Statistical analysis revealed significant difference in new cases of these two groups of disorders in different seasons. Our study showed a significant relationship between utilization of psychiatric patients especially with mood disorders and neurotic, stress related and somatoform disorders with season (summer and autumn respectively). |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 3 | Int. J. Neuropsychopharmacol. 2007 Oct 10: 653-60 |
| PMID | 17076934 |
| Title | The efficacy of the dopamine D2/D3 antagonist tiapride in maintaining abstinence: a randomized, double-blind, placebo-controlled trial in 299 alcohol-dependent patients. |
| Abstract | In this investigation, the hypothesis was tested whether the selective dopamine D2/D3 receptor antagonist tiapride is effective in maintaining abstinence after detoxification in alcohol-dependent patients. The rationale of the study was based on the relevance of the dopaminergic system for addictive behaviour as well as some preliminary studies. A multi-centre, randomized, double-blind, placebo-controlled, parallel-group study was conducted. A total of 299 detoxified alcohol-dependent patients (ICD-10: F10.2) received either tiapride (300 mg/d) or placebo over a 24-wk study period. Subjects with severe comorbid psychiatric disorder such as schizophrenia or Wernicke-Korsakoff syndrome were excluded. Primary outcome variable was the time to first relapse with relapse defined as any alcohol consumption after detoxification. Data analysis was done with Kaplan-Meier estimates with log-rank test (one-sided, p<0.05). Tiapride was not superior to placebo in maintaining abstinence. The time to first relapse was 71 d in the tiapride group and 92 d in the placebo group (log-rank test, p=0.9895). Relapse rate was higher in the intervention group (54.4%) than in the control group (40.7%). Like the dopamine antagonist flupenthixol, tiapride was not effective in maintaining alcohol abstinence. Regarding the high success rate in the placebo group the influence of psychosocial treatment in studies investigating drug effects on the course of alcohol dependence has to be considered. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 4 | Psychiatr Prax 2008 Sep 35: 279-85 |
| PMID | 18773374 |
| Title | [The regional psychiatry budget: costs and effects of a new multisector financing model for psychiatric care]. |
| Abstract | To evaluate a new multi-sector financing model for psychiatric care based on the capitation principle (Regional Psychiatry Budget, RPB). Patients with a diagnosis according to ICD-10 F10, F2, and F3 were interviewed in the model region (MR, N=258) and a control region (CR, N=244) financed according to the fee-for-service principle. Effectiveness of care was assessed before RPB-introduction and after 1.5 years. Use of care was determined semi-annually. Costs of inpatient psychiatric treatment decreased more strongly in the MR, while hospital based outpatient care and day clinic treatment were intensified in comparison to the CR. Quality of life, severity of illness and illness-specific symptoms in patients improved similarly in MR and CR. The functional level improved more in the MR than in the CR, which was especially evident in schizophrenia patients. Inpatient psychiatric care costs can be reduced with the RPB without compromising the quality of care. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 5 | J Prev Med Public Health 2009 Nov 42: 416-23 |
| PMID | 20009489 |
| Title | [Medical care utilization status and associated factors with extended hospitalization of psychiatric patients in Korea]. |
| Abstract | This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 6 | Psychiatr Prax 2010 Jan 37: 34-42 |
| PMID | 20072988 |
| Title | [The regional psychiatry budget (RPB): a model for a new payment system of hospital based mental health care services]. |
| Abstract | To analyze the impact of a capitated multi-sector-financing model for psychiatric care (RPB) on costs and effectiveness of care. Patients with a diagnosis according to ICD-10 F10, F2 or F3 were interviewed in the model region (MR, n = 258) and a control region (CR, n = 244) financed according to the fee-for-service principle. At baseline, 1.5 years and 3.5 years follow-up patients were interviewed using measures of psychopathology (CGI-S, HoNOS, SCL-90R, PANSS, BRMAS / BRMES), functioning (GAF, SOFAS) and quality of life (WHOQOL-BREF, EQ-5D). Use of care was determined semi-annually. There were no significant differences in the development of psychopathology and quality of life between MR and CR. In the MR, functioning of patients with schizophrenia and affective disorders improved significantly more strongly. The development of total mental health care costs was not different between MR and CR. However, the costs of office based mental health care increased slightly more strongly in the MR, indicating a small cost-shift from the RPB to extrabudgetary financed services. The RPB showed slight advantages regarding the effectiveness of care and did not significantly change the total mental health care costs. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 7 | Psychiatry Res 2011 Jan 185: 261-8 |
| PMID | 20537717 |
| Title | Accuracy of self-reports of mental health care utilization and calculated costs compared to hospital records. |
| Abstract | Assessments of service utilization is often based on self-reports. Concerns regarding the accuracy of self-reports are raised especially in mental health care. The purpose of this study was to analyze the accuracy of self-reports and calculated costs of mental health services. In a prospective cohort study in Germany, self-reports regarding psychiatric inpatient and day-care use collected by telephone interviews based on the Client Socio-Demographic and Service Receipt Inventory (CSSRI) as well as calculated costs were compared to computerized hospital records. The sample consisted of patients with mental and behavioral disorders resulting from alcohol (ICD-10 F10, n=84), schizophrenia, schizophrenic and delusional disturbances (F2, n=122) and affective disorders (F3, n=124). Agreement was assessed using the concordance correlation coefficient (CCC), mean difference (95% confidence intervals (CI)) and the 95% limits of agreement. Predictors for disagreement were derived. Overall agreement of mean total costs was excellent (CCC=0.8432). Costs calculated based on self-reports were higher than costs calculated based on hospital records (15 EUR (95% CI -434 to 405)). Overall agreement of total costs for F2 patients was CCC=0.8651, for F3 CCC=0.7850 and for F10 CCC=0.6180. Depending on type of service, measure of service utilization and costs agreement ranged from excellent to poor and varied substantially between individuals. The number of admissions documented in hospital records was significantly associated with disagreement. Telephone interviews can be an accurate data collection method for calculating mean total costs in mental health care. In the future more standardization is needed. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 8 | Psychiatry Res 2011 Jan 185: 261-8 |
| PMID | 20537717 |
| Title | Accuracy of self-reports of mental health care utilization and calculated costs compared to hospital records. |
| Abstract | Assessments of service utilization is often based on self-reports. Concerns regarding the accuracy of self-reports are raised especially in mental health care. The purpose of this study was to analyze the accuracy of self-reports and calculated costs of mental health services. In a prospective cohort study in Germany, self-reports regarding psychiatric inpatient and day-care use collected by telephone interviews based on the Client Socio-Demographic and Service Receipt Inventory (CSSRI) as well as calculated costs were compared to computerized hospital records. The sample consisted of patients with mental and behavioral disorders resulting from alcohol (ICD-10 F10, n=84), schizophrenia, schizophrenic and delusional disturbances (F2, n=122) and affective disorders (F3, n=124). Agreement was assessed using the concordance correlation coefficient (CCC), mean difference (95% confidence intervals (CI)) and the 95% limits of agreement. Predictors for disagreement were derived. Overall agreement of mean total costs was excellent (CCC=0.8432). Costs calculated based on self-reports were higher than costs calculated based on hospital records (15 EUR (95% CI -434 to 405)). Overall agreement of total costs for F2 patients was CCC=0.8651, for F3 CCC=0.7850 and for F10 CCC=0.6180. Depending on type of service, measure of service utilization and costs agreement ranged from excellent to poor and varied substantially between individuals. The number of admissions documented in hospital records was significantly associated with disagreement. Telephone interviews can be an accurate data collection method for calculating mean total costs in mental health care. In the future more standardization is needed. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 9 | Psychol Med 2011 May 41: 949-58 |
| PMID | 21205440 |
| Title | Administrative incidence of psychosis assessed in an early intervention service in England: first epidemiological evidence from a diverse, rural and urban setting. |
| Abstract | Early Intervention in Psychosis Services (EIS) for young people in England experiencing first-episode psychosis (FEP) were commissioned in 2002, based on an expected incidence of 15 cases per 100 000 person-years, as reported by schizophrenia epidemiology in highly urban settings. Unconfirmed reports from EIS thereafter have suggested higher than anticipated rates. The aim of this study was to compare the observed with the expected incidence and delineate the clinical epidemiology of FEP using epidemiologically complete data from the CAMEO EIS, over a 6-year period in Cambridgeshire, for a mixed rural-urban population. A population-based study of FEP (ICD-10, F10-39) in people aged 17-35 years referred between 2002 and 2007; the denominator was estimated from mid-year census statistics. Sociodemographic variation was explored by Poisson regression. Crude and directly standardized rates (for age, sex and ethnicity) were compared with pre-EIS rates from two major epidemiological FEP studies conducted in urban English settings. A total of 285 cases met FEP diagnoses in CAMEO, yielding a crude incidence of 50 per 100 000 person-years [95% confidence interval (CI) 44.5-56.2]. Age- and sex-adjusted rates were raised for people from black ethnic groups compared with the white British [incidence rate ratio (IRR) 2.1, 95% CI 1.1-3.8]. Rates in our EIS were comparable with pre-EIS rates observed in more urban areas after age, sex and ethnicity standardization. Our findings suggest that the incidence observed in EIS is far higher than originally anticipated and is comparable to rates observed in more urban settings prior to the advent of EIS. Sociodemographic variation due to ethnicity and other factors extend beyond urban populations. Our results have implications for psychosis aetiology and service planning. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 10 | Srp Arh Celok Lek 2011 Dec 139 Suppl 1: 57-60 |
| PMID | 22352205 |
| Title | Hetero-aggressive outbursts in patients' behaviour in emergency psychiatry. |
| Abstract | Hetero-aggressive behaviour in patients with mental disorders is frequent and requires special skills of doctors and other medical staff in order to urgently protect the patient and indicate hospitalization. The objective of this paper was to examine the frequency of the most common diagnostic categories in psychiatric patients with hetero-aggressive behaviour. The secondary objective was to examine aspects of realized hospitalization (voluntary, involuntary) and socio-demographic characteristics of these patients. The sample was formed of 100 patients who expressed hetero-aggressive behaviour just before and during admission for hospital treatment. The data was collected from auto-anamnesis and hetero-anamnesis, and they were based on general somatic, neurological and psychiatric examination. The statistical analysis used descriptive analysis and Pearson's chi2-test. The frequency of the most common diagnostic categories was: F20-F29 73%; F10-F19 19%; F60-F69 11%; F00-F09 8%; F30-F39 and F70-F79 6%. Involuntary hospitalization was implemented in 56%. Socio-demographic characteristics of examinees revealed that the most common were: male gender (63%) and younger age, dominant secondary school qualification (74%), unmarried (76%), unemployed (76%), frequently repeated hospitalizations (66%). The most common diagnostic categories to which the patients with hetero-aggressive behavioural outbursts belonged were from the schizophrenic circuit, followed by substance abuse, personality disorders, etc. Involuntary hospitalization was the most common form of hospitalization in patients with violent behaviour. Socio-demographic characteristics of examinees revealed this profile as the most common: male gender, younger age, secondary education, unmarried and unemployed, repeatedly hospitalized. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 11 | Psychiatry Clin. Neurosci. 2013 Sep 67: 405-11 |
| PMID | 23941159 |
| Title | Influence of patient characteristics on duration of seclusion/restrain in acute psychiatric settings in Japan. |
| Abstract | The aim of this study was to investigate the current state of duration of seclusion/restraint in acute psychiatric settings in Japan and the effect of patient characteristics on duration of seclusion/restraint. During an 8-month period starting from November 2008, duration of seclusion/restraint and patient characteristics were investigated in 694 psychiatric inpatients who experienced seclusion/restraint in three emergency and three acute wards at four psychiatric hospitals. Reasons for starting seclusion/restraint were also assessed. Analysis was performed using generalized linear models, with the duration of seclusion/restraint as the dependent variable and patient characteristics and reasons for starting seclusion/restraint as independent variables. Of the patients secluded/restrained, 58.6% had a primary diagnosis of schizophrenia (F20-F29) and a large proportion (37.9%) were secluded/restrained due to hurting others. Median hours ofseclusion/restraint were 204 and 82?h, respectively. The duration of seclusion was longer for patients with F20-F29 than those with disorders due to psychoactive substance use (F10-F19) or other diagnoses (F40-F99), and when the reason was danger of hurting others. In contrast, the duration of restraint in female patients and in patients with F10-F19 diagnosis was shorter. The duration of seclusion/restraint at acute psychiatric care wards in Japan are much longer than those reported by previous overseas studies. Although Japanese structure issues such as more patients per ward and a lower ratio of nurses need to be considered, skills for dealing with patients with primary diagnosis of F20-F29 secluded due to danger posed to others should be improved. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 12 | J Clin Psychiatry 2013 Jan 74: e94-9 |
| PMID | 23419236 |
| Title | Substance-induced psychoses converting into schizophrenia: a register-based study of 18,478 Finnish inpatient cases. |
| Abstract | Despite the clinical importance of substance-induced psychosis (SIP), few studies have examined the course of this condition after its acute manifestation. To investigate the rate of SIP conversion to a schizophrenia spectrum disorder and the length of follow-up needed to catch the majority of these patients whose diagnoses change. In addition to the conversion rate and pattern, we wanted to look for possible related factors. Using the nationwide Finnish Hospital Discharge Register, we followed all patients (N = 18,478) since their first inpatient hospital admission with a diagnosis of SIP (codes 2921 and 2928 in DSM-III-R and codes F10-F19 in ICD-10 with a third digit of 4, 5, or 7) between January 1987 and December 2003 in Finland. Patients (mean age = 43.7 years, standard deviation = 13.5 years) were followed until first occurrence of schizophrenia spectrum disorder, death, or the end of December 2003, whichever took place first. Conversions of discharge diagnoses into schizophrenia spectrum disorders (codes 2951-2959 and 2971 in DSM-III-R and codes F20, F22, and F23 in ICD-10) were recorded at follow-up. Eight-year cumulative risk to receive a schizophrenia spectrum diagnosis was 46% (95% CI, 35%-57%) for persons with a diagnosis of cannabis-induced psychosis and 30% (95% CI, 14%-46%) for those with an amphetamine-induced psychosis. Although alcohol-induced psychosis was the most common type of SIP, 8-year cumulative risk for subsequent schizophrenia spectrum diagnosis was only 5.0% (95% CI, 4.6%-5.5%). No differences were detected with regard to gender, except for amphetamine-induced psychosis, which converted into a schizophrenia spectrum disorder significantly more often in men (P = .04). The majority of conversions to a schizophrenia spectrum diagnosis occurred during the first 3 years following the index treatment period, especially for cannabis-induced psychosis. Substance-induced psychotic disorders predict schizophrenia spectrum disorders to a greater extent than previously thought. The intensity of clinical attention focused on substance-induced psychotic disorders should be increased. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 13 | BMC Psychiatry 2013 -1 13: 13 |
| PMID | 23297686 |
| Title | Diagnosing comorbidity in psychiatric hospital: challenging the validity of administrative registers. |
| Abstract | This study will explore the validity of psychiatric diagnoses in administrative registers with special emphasis on comorbid anxiety and substance use disorders. All new patients admitted to psychiatric hospital in northern Norway during one year were asked to participate. Of 477 patients found eligible, 272 gave their informed consent. 250 patients (52%) with hospital diagnoses comprised the study sample. Expert diagnoses were given on the basis of a structured diagnostic interview (M.I.N.I.PLUS) together with retrospective checking of the records. The hospital diagnoses were blind to the expert. The agreement between the expert's and the clinicians' diagnoses was estimated using Cohen's kappa statistics. The expert gave a mean of 3.4 diagnoses per patient, the clinicians gave 1.4. The agreement ranged from poor to good (schizophrenia). For anxiety disorders (F40-41) the agreement is poor (kappa = 0.12). While the expert gave an anxiety disorder diagnosis to 122 patients, the clinicians only gave it to 17. The agreement is fair concerning substance use disorders (F10-19) (kappa = 0.27). Only two out of 76 patients with concurrent anxiety and substance use disorders were identified by the clinicians. The validity of administrative registers in psychiatry seems dubious for research purposes and even for administrative and clinical purposes. The diagnostic process in the clinic should be more structured and treatment guidelines should include comorbidity. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 14 | Int J Biomed Sci 2014 Mar 10: 61-8 |
| PMID | 24711751 |
| Title | Socio-Demographic, Clinical and Behavioral Characteristics Associated with a History of Suicide Attempts among Psychiatric Outpatients: A Case Control Study in a Northern Mexican City. |
| Abstract | Little is known about the epidemiology of suicide attempts among psychiatric outpatients in Mexico. This study was aimed to determine the socio-demographic, clinical and behavioral characteristics associated with suicide attempts in psychiatric outpatients in two public hospitals in Durango, Mexico. Two hundred seventy six psychiatric outpatients (154 suicide attempters and 122 patients without suicide attempt history) attended the two public hospitals in Durango City, Mexico were included in this study. Socio-demographic, clinical and behavioral characteristics were obtained retrospectively from all outpatients and compared in relation to the presence or absence of suicide attempt history. Increased prevalence of suicide attempts was associated with mental and behavioral disorders due to psychoactive substance use (F10-19) (P=0.01), schizophrenia, schizotypal and delusional disorders (F20-29) (P=0.02), mood (affective) disorders (F30-39) (P<0.001), and disorders of adult personality and behavior (F60-69) (P<0.001). Multivariate analysis showed that suicide attempts were associated with young age (OR=1.21, 95% CI: 1.06-1.39; P=0.003), female gender (OR=2.98, 95% CI: 1.55-5.73; P=0.001), urban residence (OR=2.31, 95% CI: 1.17-4.57; P=0.01), memory impairment (OR=1.91, 95% CI: 1.07-3.40; P=0.02), alcohol consumption (OR=2.39, 95% CI: 1.21-4.70; P=0.01), and sexual promiscuity (OR=3.90, 95% CI: 1.74-8.77; P<0.001). We report the association of suicide attempts with socio-demographic, clinical and behavioral characteristics in psychiatric outpatients in Mexico. Results may be useful for an optimal planning of preventive measures against suicide attempts in psychiatric outpatients. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 15 | Int J Biomed Sci 2014 Mar 10: 61-8 |
| PMID | 24711751 |
| Title | Socio-Demographic, Clinical and Behavioral Characteristics Associated with a History of Suicide Attempts among Psychiatric Outpatients: A Case Control Study in a Northern Mexican City. |
| Abstract | Little is known about the epidemiology of suicide attempts among psychiatric outpatients in Mexico. This study was aimed to determine the socio-demographic, clinical and behavioral characteristics associated with suicide attempts in psychiatric outpatients in two public hospitals in Durango, Mexico. Two hundred seventy six psychiatric outpatients (154 suicide attempters and 122 patients without suicide attempt history) attended the two public hospitals in Durango City, Mexico were included in this study. Socio-demographic, clinical and behavioral characteristics were obtained retrospectively from all outpatients and compared in relation to the presence or absence of suicide attempt history. Increased prevalence of suicide attempts was associated with mental and behavioral disorders due to psychoactive substance use (F10-19) (P=0.01), schizophrenia, schizotypal and delusional disorders (F20-29) (P=0.02), mood (affective) disorders (F30-39) (P<0.001), and disorders of adult personality and behavior (F60-69) (P<0.001). Multivariate analysis showed that suicide attempts were associated with young age (OR=1.21, 95% CI: 1.06-1.39; P=0.003), female gender (OR=2.98, 95% CI: 1.55-5.73; P=0.001), urban residence (OR=2.31, 95% CI: 1.17-4.57; P=0.01), memory impairment (OR=1.91, 95% CI: 1.07-3.40; P=0.02), alcohol consumption (OR=2.39, 95% CI: 1.21-4.70; P=0.01), and sexual promiscuity (OR=3.90, 95% CI: 1.74-8.77; P<0.001). We report the association of suicide attempts with socio-demographic, clinical and behavioral characteristics in psychiatric outpatients in Mexico. Results may be useful for an optimal planning of preventive measures against suicide attempts in psychiatric outpatients. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 16 | Psychol Med 2014 Aug 44: 2419-30 |
| PMID | 24443807 |
| Title | The effect of the environment on symptom dimensions in the first episode of psychosis: a multilevel study. |
| Abstract | The extent to which different symptom dimensions vary according to epidemiological factors associated with categorical definitions of first-episode psychosis (FEP) is unknown. We hypothesized that positive psychotic symptoms, including paranoid delusions and depressive symptoms, would be more prominent in more urban environments. We collected clinical and epidemiological data on 469 people with FEP (ICD-10 F10-F33) in two centres of the Aetiology and Ethnicity in schizophrenia and Other Psychoses (AESOP) study: Southeast London and Nottinghamshire. We used multilevel regression models to examine neighbourhood-level and between-centre differences in five symptom dimensions (reality distortion, negative symptoms, manic symptoms, depressive symptoms and disorganization) underpinning Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Item Group Checklist (IGC) symptoms. Delusions of persecution and reference, along with other individual IGC symptoms, were inspected for area-level variation. Reality distortion [estimated effect size (EES) 0.15, 95% confidence interval (CI) 0.06-0.24] and depressive symptoms (EES 0.21, 95% CI 0.07-0.34) were elevated in people with FEP living in more urban Southeast London but disorganized symptomatology was lower (EES -0.06, 95% CI -0.10 to -0.02), after controlling for confounders. Delusions of persecution were not associated with increased neighbourhood population density [adjusted odds ratio (aOR) 1.01, 95% CI 0.83-1.23], although an effect was observed for delusions of reference (aOR 1.41, 95% CI 1.12-1.77). Hallucinatory symptoms showed consistent elevation in more densely populated neighbourhoods (aOR 1.32, 95% CI 1.09-1.61). In people experiencing FEP, elevated levels of reality distortion and depressive symptoms were observed in more urban, densely populated neighbourhoods. No clear association was observed for paranoid delusions; hallucinations were consistently associated with increased population density. These results suggest that urban environments may affect the syndromal presentation of psychotic disorders. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 17 | Assessment 2016 May -1: -1 |
| PMID | 27161505 |
| Title | Development and Psychometric Properties of the Taiwan Odd-Even Number Sequencing Test: A Nonalphabetic Measure of Working Memory. |
| Abstract | Alphabetic working memory (WM) tests, such as the Wechsler Adult Intelligence Scale-III and IV Letter Number Sequencing, are not appropriate for nonalphabetic cultures. This study examined the psychometric properties of the Taiwan Odd-Even Number Sequencing Test (TOENST) and identified representative norms. The TOENST and other mental screening tasks were administered to 300 randomly selected healthy participants, 32 purposive sampling patients with schizophrenia, and 32 quota sampling controls. To investigate reliability and validity, a subset of the 300 healthy participants was randomly selected to receive a second TOENST (n = 30) or conventional WM tests (n = 42). The split-half reliability of the TOENST ranged from 0.69 to 0.95, and its test-retest reliability was 0.75. Criterion validity was demonstrated by significant correlations with conventional WM measures (all p < .05, except semantic verbal fluency), and construct validity was demonstrated by significant correlations with aging (main effect, F10,259 = 10.99, p < .001). Normative data were established, and performance was significantly associated with age and education. TOENST scores of patients with schizophrenia were significantly lower and correlated with frontal lobe tests, but not demographical or clinical characteristics. The TOENST has adequate psychometric properties and clinical utility and is as a viable alternative WM task for nonalphabetic cultures. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |
| 18 | J Prev Med Public Health 2016 Jan 49: 53-60 |
| PMID | 26841885 |
| Title | Factors Affecting the Downward Mobility of Psychiatric Patients: A Korean Study of National Health Insurance Beneficiaries. |
| Abstract | The purpose of this study is to examine the magnitude of and the factors associated with the downward mobility of first-episode psychiatric patients. This study used the claims data from the Korean Health Insurance Review and Assessment Service. The study population included 19 293 first-episode psychiatric inpatients diagnosed with alcohol use disorder (International Classification of Diseases, 10th revision [ICD-10] code F10), schizophrenia and related disorders (ICD-10 codes F20-F29), and mood disorders (ICD-10 codes F30-F33) in the first half of 2005. This study included only National Health Insurance beneficiaries in 2005. The dependent variable was the occurrence of downward mobility, which was defined as a health insurance status change from National Health Insurance to Medical Aid. Logistic regression analysis was used to assess factors associated with downward drift of first-episode psychiatric patients. About 10% of the study population who were National Health Insurance beneficiaries in 2005 became Medical Aid recipients in 2007. The logistic regression analysis showed that age, gender, primary diagnosis, type of hospital at first admission, regular use of outpatient clinic, and long-term hospitalization are significant predictors in determining downward drift in newly diagnosed psychiatric patients. This research showed that the downward mobility of psychiatric patients is affected by long-term hospitalization and medical care utilization. The findings suggest that early intensive intervention might reduce long-term hospitalization and the downward mobility of psychiatric patients. |
| SCZ Keywords | schizophrenia, schizophrenic, schizophrenics, schizotypal |