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Karpenko OA. [Impact of psychoeducation on compliance of inpatients with first episode psychosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:92-98. [PMID: 32729696 DOI: 10.17116/jnevro202012006292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the impact of brief group inpatient psychoeducation interventions on compliance of patients with first episode psychosis (FEP) and emergency hospitalization. MATERIAL AND METHODS One hundred and fifty-eight patients of treatment group and 79 patients of the control group were enrolled into the study. All patients were hospitalized emergently due to psychotic condition. Patients in treatment group had group psychoeducation sessions (5 sessions), patients in the control group received basic treatment only. Before discharge from the hospital, patients were accessed with PANSS, CGI-S, CGI-I and «Medication compliance scale». RESULTS Patient in treatment group showed significantly better results than the control group in medication compliance scale assessment (p<0.001). The rate of readmissions was significantly higher in the control group than in the psychoeducation group (p=0.02). CONCLUSION Brief psychoeducation for inpatients with FEP and emergency hospitalizations has beneficial effect on patients' compliance.
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Affiliation(s)
- O A Karpenko
- Alekseev Psychiatric Clinical Hospital No. 1, Moscow, Russia
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Use of psychiatric inpatient services by heavy users: Findings from a national survey in Italy. Eur Psychiatry 2020; 26:252-9. [PMID: 21296559 DOI: 10.1016/j.eurpsy.2010.11.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 11/11/2010] [Accepted: 11/18/2010] [Indexed: 11/21/2022] Open
Abstract
AbstractPurposeTo analyze factors associated with a patient's probability of being a Heavy User (HU) of inpatient psychiatric services and to compare the HU inpatient population with Non-Heavy Users (NHUs).Patients and methodsThe survey was conducted among inpatients enrolled in the PROGRES-Acute-project, an Italian nationwide survey of public and private inpatient facilities. Patients with three or more admissions over the last 12 months were considered HUs, and patients who had undergone one or two admissions during the same period made up the NHU group.ResultsFour hundred and thirty-five (40.5%) were HUs, and 640 (59.5%) NHUs. HUs were younger, more frequently unmarried, unemployed, receiving a disability-pension, and either homeless or living in a residential facility. HUs were more likely to have experienced conflicts with their partners or family members during the week prior to admission. A logistic regression analysis revealed that age, age at first admission, number of life-time admissions, and having been the victim of violence were the most important predictive factors for the HU phenomenon.ConclusionOur study suggests that specific attention should be given to patients’ family context, due to its crucial role in daily informal care and in the triggering of events leading to rehospitalization.
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Tedeschi F, Donisi V, Salazzari D, Cresswell-Smith J, Wahlbeck K, Amaddeo F. Clinical and organizational factors predicting readmission for mental health patients across Italy. Soc Psychiatry Psychiatr Epidemiol 2020; 55:187-196. [PMID: 31463615 DOI: 10.1007/s00127-019-01766-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The aims of our study are: to explore rehospitalization in mental health services across Italian regions, Local Health Districts (LHDs), and hospitals; to examine the predictive power of different clinical and organizational factors. METHODS The data set included adult patients resident in Italy discharged from a general hospital episode with a main psychiatric diagnosis in 2012. Independent variables at the individual, hospital, LHD, and region levels were used. Outcome variables were individual-level readmission and LHD-level readmission rate to any hospital at 1-year follow-up. The association with readmission of each variable was assessed through both single- and multi-level logistic regression; descriptive statistics were provided to assess geographical variation. Relevance of contextual effects was investigated through a series of random-effects regressions without covariates. RESULTS The national 1-year readmission rate was 43.0%, with a cross-regional coefficient of variation of 6.28%. Predictors of readmission were: admission in the same LHD as residence, psychotic disorder, higher length of stay (LoS), higher rate of public beds in the LHD; protective factors were: young age, involuntary admission, and intermediate number of public healthcare staff at the LHD level. Contextual factors turned out to affect readmission only to a limited degree. CONCLUSIONS Homogeneity of readmission rates across regions, LHDs, hospitals, and groups of patients may be considered as a positive feature in terms of equity of the mental healthcare system. Our results highlight that readmission is mainly determined by individual-level factors. Future research is needed to better explore the relationship between readmission and LoS, discharge decision, and resource availability.
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Affiliation(s)
- Federico Tedeschi
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Ospedale Policlinico "G.B. Rossi", University of Verona, P.le L.A. Scuro, 10, 37134, Verona, Italy.
| | - V Donisi
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Ospedale Policlinico "G.B. Rossi", University of Verona, P.le L.A. Scuro, 10, 37134, Verona, Italy
| | - D Salazzari
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Ospedale Policlinico "G.B. Rossi", University of Verona, P.le L.A. Scuro, 10, 37134, Verona, Italy
| | - J Cresswell-Smith
- Mental Health Unit, National Institute for Health and Welfare (THL), P.O. Box 30, 00271, Helsinki, Finland
| | - K Wahlbeck
- Mental Health Unit, National Institute for Health and Welfare (THL), P.O. Box 30, 00271, Helsinki, Finland
| | - F Amaddeo
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, Ospedale Policlinico "G.B. Rossi", University of Verona, P.le L.A. Scuro, 10, 37134, Verona, Italy
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Liu CC, Shan JC, Chiang CL, Hsieh MH, Liu CM, Chien YL, Chen SC, Hwang TJ. Initiating long-acting injectable antipsychotics during acute admission for patients with schizophrenia--A 3-year follow-up. J Formos Med Assoc 2013; 114:539-45. [PMID: 26062967 DOI: 10.1016/j.jfma.2013.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 01/11/2013] [Accepted: 01/22/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/PURPOSE The debate on whether long-acting injectable antipsychotic (LAIA) medication is superior to oral medication, in preventing rehospitalization of patients with schizophrenia, remains inconclusive. We compared rehospitalization rates over 3 years following discharge from an acute admission, in which patients either began using LAIAs regularly for the first time, or continued to use oral antipsychotics. METHODS A retrospective observational study of 92 inpatients with schizophrenia from a university-based medical center during 2004-2008. The primary outcome measure is the rehospitalization rates between groups, as estimated by Kaplan-Meier survival analysis. RESULTS Eighteen of 47 (38.3%) LAIA patients, and 16 of 45 (35.6%) oral medication patients were rehospitalized (average time to rehospitalization, 378 ± 262 vs. 378 ± 340 days; p = 0.997). The estimated cumulative rates of rehospitalization were similar between groups. The overall odds comparing the LAIA to the oral medication group were 1.085 ± 0.373 (95% confidence interval: 0.553-2.13, p = 0.813). Compared to the oral medication group, the LAIA group had fewer coded with sufficient previous treatment response (32% vs. 69%, p < 0.001), more poorly compliant (91% vs. 56%, p < 0.001), and a slightly longer length of stay at index admission (32.7 ± 11.3vs. 27.6 ± 12.1, p = 0.04). CONCLUSION Initiating LAIAs during admission for an acute psychotic episode, to a group of patients with an inadequate previous treatment response and poorer compliance, might keep their rehospitalization rates to the level of their oral antipsychotic medication treated counterparts.
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Affiliation(s)
- Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Jia-Chi Shan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, Cathy General Hospital, Taipei, Taiwan
| | - Chih-Lin Chiang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Ming H Hsieh
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Shao-Chien Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
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San L, Bernardo M, Gómez A, Peña M. Factors associated with relapse in patients with schizophrenia. Int J Psychiatry Clin Pract 2013; 17:2-9. [PMID: 22731397 DOI: 10.3109/13651501.2012.687452] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To assess risk factors for relapse in patients with schizophrenia attended in daily practice. METHODS Patients with schizophrenia admitted consecutively to short-stay/acute-care psychiatric units over a 6-month period were eligible. Variables statistically significant in the univariate logistic regression analysis were then subjected to multivariate analysis. RESULTS The study population included 1646 patients (67.6% men). In the univariate analysis, low family support, duration of illness > 5 years, number of previous hospitalizations, cocaine and cannabis consumption, and number of different antipsychotic drug classes were risk factors for relapse. In the multivariate analysis, number of previous hospitalizations (odds ratio [OR] 1.29, 95% confidence interval [CI] 1.21-1.36) and number of different antipsychotics previously used (OR = 1.13, 95% CI 1.03-1.24) were significant predictors of relapse. The absence of cannabis consumption was a protective factor (OR = 0.72, 95% CI 0.58-0.89). Neither adherence to treatment in the previous 3 years nor type of antipsychotic regimen was significantly associated with relapse. CONCLUSIONS Number of previous hospitalizations and number of different types of antipsychotic drugs were associated with relapse. Absence of cannabis consumption was a protective factor.
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Affiliation(s)
- Luis San
- Department of Child and Adolescent Psychiatry, Hospital Sant Joan de Déu , CIBERSAM, Esplugues del Llobregat, Barcelona, Spain.
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de Girolamo G, Tansella M. Psychiatric Units in general hospitals. Problems and perspectives in Europe. ACTA ACUST UNITED AC 2011; 15:85-90. [PMID: 16865926 DOI: 10.1017/s1121189x00004255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Relapsing versus non relapsing course of schizophrenia: a cohort study in a community based mental health service. ACTA ACUST UNITED AC 2011. [DOI: 10.1017/s1121189x00004607] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
SUMMARYAim - We examined the effect of several clinical variables on the tendency to relapse and to require hospitalization in a cohort of patients, living in the community and followed up naturalistically for seven years. Method - Forty-six patients affected by schizophrenia and schizoaffective disorder, according to both DSM-IV and ICD-10 criteria, were assessed by Positive and Negative Syndrome Scale and Life Skills Profile (LSP). All patients consecutively enrolled, were assessed in a stable clinical phase of illness and treated as usual by their reference psychiatrist. Social and clinical outcome was assessed yearly for seven years after the study entry and analyzed with survival analysis. Results - Patients who did not relapse, were characterized by higher functioning, lower positive symptoms, higher ability in self-care and non-turbulence and higher IQ at their baseline clinical evaluation. These variables were entered in a Cox regression model to corroborate the predictive power on the relapsing course of illness. Only IQ and non-turbulence scores of LSP were entered in the equation (Wald method: p=0.007 and p=0.002 respectively). Conclusions - Several factors interact with the course of illness and influence the tendency to require hospitalization. In the present study we report that non-turbulence is a significant predictor of a non-relapsing course of illness. Further studies are needed to clarify the role of other mediating variables.Declaration of Interest: none.
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