Background Many young people who harm themselves have chronic mental hearth or social problems or are at risk of future self-harm or even suicide. The accident and emergency (A&E) clinic is an important gateway to...
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Background Many young people who harm themselves have chronic mental hearth or social problems or are at risk of future self-harm or even suicide. The accident and emergency (A&E) clinic is an important gateway to treatment. Aims To describe the psychosocial assessment of 12- to 24-year-old patients attending A&E clinics following deliberate self-harm (DSH) and to identify features of service management and provision which maximise specialist assessment. Method A postal questionnaire wa;sent to a sample of one in three A&E departments in England. In a representative sample of 18 of these hospitals, staff were interviewed and 50 case notes per hospital were examined. Results Psychosocial assessment by non-specialist doctors in A&E departments tended to be of variable quality, focused on short-term risk. Around 43% of patients aged 12-24 were assessed by a specialist;specialist assessment was associated with high admission rates and the presence of on-site psychiatric departments and DSH teams, Conclusions Young DSH patients at risk often go unidentified;as a result their psychological problems may not be treated. Hospitals are frequently unaware of the proportion of patients discharged without adequate assessment. Declaration of interest This work was funded by the Department of Health.
In Japan, as in some other countries, not all cancer patients are informed of their diagnosis and expected prognosis. However, we no not know enough about the relationship between the kind of information given to canc...
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In Japan, as in some other countries, not all cancer patients are informed of their diagnosis and expected prognosis. However, we no not know enough about the relationship between the kind of information given to cancer patients and their mental state. The following is a study that examines this relationship. The subjects were 81 adult cancer inpatients referred to psychiatrists. Those with mental disorders before admission or with delirium were excluded. The subjects were classified into three groups according to the kind of information given to them: 28 were not informed of a diagnosis cancer, 36 were informed of a diagnosis of cancer, and 17 were informed of both a diagnosis of cancer and a pool prognosis. The distributions of DSM-IV Axis I diagnoses were nearly equal among the three groups of patients. In each group, more than 90% of patients were diagnosed as having either major depressive disorder or adjustment disorders. bz the results of HAM-D, HAM-A, and a question about irritability, the mean total HAM-A scores and mean scores for the factors of Suicide, Behavior at Interview, and Irritability, differed significantly among the three groups. They were highest in patients who were not informed of a diagnosis of cancer. The authors discuss the nature of relationship between the disclosure of information and the mental state in cancer patients. (C) 1999 Elsevier Science Inc.
Previous surveys of public and community psychiatrists have demonstrated that medical directors perform a wider variety of tasks, and experience increased job satisfaction, compared to staff psychiatrists. Notwithstan...
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Previous surveys of public and community psychiatrists have demonstrated that medical directors perform a wider variety of tasks, and experience increased job satisfaction, compared to staff psychiatrists. Notwithstanding respondents' belief that clinical collaboration tasks contribute most to job satisfaction, the performance of administrative tasks is most highly correlated with overall job satisfaction. The current survey was undertaken to determine whether these findings could be replicated among hospital-based psychiatrists. Demographic and job characteristic profiles of hospital-based psychiatrists were clearly distinguished from those of community psychiatrists. Despite these differences, task profiles and job satisfaction parameters of hospital-based psychiatrists were comparable to those previously reported for community psychiatrists.
The authors identified variations in the characteristics of patients referred to 56 consultation-liaison (C-L) services in II European countries. The authors found differences in the types of patients referred to the ...
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The authors identified variations in the characteristics of patients referred to 56 consultation-liaison (C-L) services in II European countries. The authors found differences in the types of patients referred to the services, and there were significant differences between countries. The first difference lays in whether services saw patients for deliberate self-harm and for substance abuse. German psychosomatic C-L services saw virtually no such patients, although in other C-L services these patients constituted one-quarter to one-third of the patients referred The second difference lays in the remaining group of referred patients. This group is best characterized by two dimensions. One describes the severity of psychopathology - ranging from organic mental conditions to somatization. The other describes the clarity of the physical diagnosis - ranging from patients referred by surgical wards to those referred by general medicine and neurology wards.
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