Mood disorders (MD) are often associated with a higher incidence of suicidal behavior, especially in adolescent patients. However, the mechanisms by which depression affects suicide attempts in ...adolescents with MD remain poorly elucidated. Therefore, the purpose of this study was to determine the incidence, risk factors, and clinical correlates of suicide attempts in Chinese adolescent patients with MD, as well as the inter-relationship between depressive symptoms, rumination, and suicide attempts, and the role of rumination in mediating depression and suicide attempts. A total of 331 MD adolescent patients aged 11 ~ 18 years were recruited from a psychiatric hospital. Suicide attempts were assessed with the MINI Suicide Scale. Depressed symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9). To assess rumination, we used the 21-item Chinese version of the Ruminative Responses Scale (RRS). Overall, the percentage of suicide attempts among MD adolescents was 51.96%, with a higher percentage of females (58.62%) than males (36.36%). Compared to non-suicide attempters, suicide attempters had higher scores on PHQ-9, RRS, depression-related, brooding, and reflective pondering. Gender and RRS were independently associated with suicide attempts. Rumination played a fully mediating role between depression and suicide attempts. In addition, the mediating effect of depression between rumination and suicide attempts was not significant. The incidence of suicide attempts was higher in MD adolescents than in general adolescents. Gender and rumination were associated with suicide attempts in MD adolescents. Moreover, rumination mediated the correlation between depressive symptoms and suicide attempts, suggesting that rumination may be an important intervention component for clinical staff to prevent suicidal behavior in adolescents with MD.
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DOBA, EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
The COVID-19 pandemic brought a burden and represented a challenge for the Romanian medical system. This study explored the consequences that COVID epidemiological measures had on the quality of the ...mental health care provided to hospitalized patients in a regional psychiatric hospital in Romania.
Both patient-level and hospital-level indicators were considered for this comparative retrospective study. On the one hand, we extracted patient-level indicators, such as sociodemographics, diagnosis, admission, and discharge dates for 7026 hospitalized patients (3701 women, average age = 55.14) from hospital records. On the other hand, for the hospital-level indicators, we included indicators referring to the aggregated concept of mental health services, such as case mix index, length of stay, bed occupancy rate and patients' degree of satisfaction. Data extracted covered a period of two years (1 March 2019-28 February 2021) before and during the first year of the COVID-19 pandemic.
We found that, compared to the pre-pandemic period, the pandemic period was marked by a drastic decrease in hospitalized patient admissions, coupled with an increase in emergency-based admissions. Other management indicators, such as the case mix index, the number of cases contracted/performed, and the degree of patient satisfaction, decreased. In contrast, the average length of stay and bed occupancy rate increased.
The COVID-19 pandemic, especially in the first year, raised multiple difficult issues for the management of psychiatric hospitals. It imposed an application of strict measures designed to face these new and unprecedented challenges. Our findings offer a detailed snapshot of the first year of the COVID-19 pandemic in terms of its impact on mental health services and suggest some future directions. Implications for hospital management are discussed.
Purpose: To clarify the factors that influence recovery-oriented practice for inpatients as recognized by the nursing directors of psychiatric hospitals.Methods: A semi-structured interview survey ...was conducted to 20 nursing directors of psychiatric hospitals in Japan. The interview data were transcribed verbatim, and qualitative descriptive analysis was performed with reference to the data analysis method of Graneheim.Results: In terms of the factors influencing the practices facilitating the recovery of inpatients recognized by the nursing directors, 325 codes were extracted and classified into 21 categories and four core categories: nursing director’s recovery-orientation and communication to the staff, existence of colleagues who approve the idea of the nursing director, sense of professional fulfillment during discharge support, and culture and climate of the hospital organization.Conclusion: The following points were suggested for the introduction of practices facilitating recovery in psychiatric hospitals in the future. There is a need for education that enhances recovery-oriented attitudes of nursing directors, education on patient recovery for the hospital as a whole, including multiple occupations and other departments, and a need for seeing and listening to patients’ experience of the recovery process, including understanding of the patients’ lives after hospital discharge.
Objective: To investigate whether electroencephalogram (EEG) requests at a psychiatric tertiary care center in urban Oman are being made according to guidelines for best practice. Methods: This study ...was carried out at a psychiatry tertiary care hospital in Muscat providing the most comprehensive psychiatric service in the country. Cases were examined retrospectively for11months from January to December 2018. Relevant information was recorded on a proforma prepared for this study. The request was judged as being appropriate or otherwise according to international best practice. Results: During the study period, 421 patients were referred to the EEG laboratory. Approximately 71% of them were males and 29% were females. Approximately 94% of EEG results were deemed as being normal. In terms of appropriateness of requesting EEG, only 5% of the requests were considered "appropriate" according to the guidelines. The factors associated with the appropriateness of requests included age, abnormality in EEG, and the reason given for the request. Conclusions: The majority of EEG referrals were not being made per guidelines. More studies are needed to uncover and examine the factors contributing to the overprescription of EEG among physicians in Oman. Educating the physicians on the judicious use of EEG is therefore warranted.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Introduction: National strategy for an inclusive and community-based living (NSCIL) for persons with mental health issues 2019 report informs us that the length of stay (LOS) of 36% of inpatients in ...43 state-funded tertiary care psychiatric hospitals (TCPHs) is above one year. This is concerning and its public health implications are not studied.
Objectives: This study was carried out to estimate the average duration of hospitalization by persons with prolonged hospitalization (PPH) in TCPH and to estimate the number of additional inpatient admissions that could have been offered.
Methodology: We analyzed the data in NSICL for calculating cumulative hospitalization years and the mean duration of stay by all PPH under each state. Based on the presumption that each psychiatric bed could cater to at least four admissions, a prediction is made on the number of additional inpatient admissions that could have been offered.
Results: The mean duration LOS of 4869 people in these TCPHs is 9.6 years (range 1 - more than 25 years) with significant variation between the states. An additional 190,153 persons could have been offered inpatient care in these TCPHs over 25 years duration, and a minimum of 7606 additional admissions could be accommodated every year.
Conclusions: Our predictions suggest a need for research on the possibility of deferred inpatient care to others with acute mental health needs and the scope for inpatient care to as many as in need by unblocking these beds.
There is limited evidence on the reliability and validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in an Asian patient population with mental and ...physical disorders. The current study aimed to examine the psychometric properties of the WHODAS 2.0 among patients with schizophrenia, depression, anxiety, and diabetes. A total of 1076 patients (M = 40.9 years, SD = 14.7) were recruited from the outpatient clinics of a tertiary psychiatric hospital and a primary care clinic. Internal consistency and test-retest reliability, structural validity, convergent validity, agreement, and floor and ceiling effects were examined. Our confirmatory factor analysis (CFA) showed that the 1-factor model fits our data. Multigroup CFA demonstrated metric and scalar invariance, indicating the scores can be compared across the four conditions. The WHODAS 2.0 scale had excellent reliability in the overall sample and good to excellent reliability across conditions. The test-retest reliability and agreement between self-administered and interviewer-administered modes were good. The WHODAS 2.0 scores had moderate to strong correlations with the Social and Occupational Functioning Scale and the Sheehan Disability Scale scores in the overall sample and across four conditions.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Workplace violence is worrisome in the mental health sector. Little is understood about it in sub-Saharan Africa. Consequently, we decided to investigate the prevalence, related factors, and the ...available sources of support for the victims of workplace violence in a mental referral hospital in Botswana.
We conducted a cross-sectional retrospective survey of 201 mental health staff (MHS) of Sbrana Psychiatric Hospital, Botswana. We used a self-administered questionnaire to obtain information on socio-demographics and various aspects of work-related violence and available source of supports. We also used Andrew and Withey Job Satisfaction Questionnaire to assess the workers' level of job satisfaction.
One hundred and seventy-nine questionnaires out of the two hundred and one returned were analyzed. One hundred and twenty-five (69.8%) of the respondents reported a lifetime experience of physical violence, while 44.1% experienced the same during the previous 12 months. Nursing services (χ2 = 29.95, p < 0.01) and long duration of service (χ2 = 29.95, p < 0.01) were associated with lifetime encounter of physical violence. Those who reported a physical assault had a higher level of job dissatisfaction than staff who never experienced violence (t = - 3.07, p = 0.02).
The rate of physical violence among mental health workers in Botswana is comparably high, and nurses are the most exposed members of staff. Protocol development and periodic training on violence prevention are hence recommended, especially for the most exposed members of staff.
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CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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