Medical illness in psychiatric patients in the emergency department

A survey of four Edmonton hospital emergency department records for a one month period was carried out to determine the frequency of utilization by patients suffering from psychiatric disorders. Male attenders outnumbered females and the majority of patients fell into the 21 — 50 year age range. Alcohol-related illness was almost three times more frequent in males than females, whereas females were more frequently categorized as suffering “personal distress” or presented as suicide attempts. Overall, seventy-three percent of the patients were discharged; of those admitted, females outnumbered males. The changing pattern of emergency department utilization was compared by examining data from one hospital for the years 1972, 1974 and 1976. During this four-year period the annual number of visits by psychiatric patients increased by almost eighty percent, largely due to dramatic increases in alcohol related problems in males and those described as “personal distress” in females. The establishment of intoxication recovery centres in 1973 paralleled a drop in the proportion of patients admitted to inpatient wards for alcohol-related, street drugs and overdose problems. The results of the present survey are compared to those reported in the relevant literature, and the methodological problems encountered in carrying out a retrospective study of emergency services from clinical records are described.

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Prevalence of Somatic Indicators of Distress in Diabetes Patients: Comparison to Psychiatric Patients and Community Nonpatients

The International Journal of Psychiatry in Medicine ◽

10.2190/rj82-3jkb-ykem-bnu0 ◽

1998 ◽

Vol 28 (3) ◽

pp. 265-272 ◽

Cited By ~ 4

Author(s):

James E. Aikens

Keyword(s):

Psychiatric Patients ◽

Screening Methods ◽

Medical Illness ◽

Medically Ill ◽

Somatic Distress ◽

Memory Problems ◽

Insulin Dependent ◽

Patient Groups ◽

Case Classification ◽

Diabetes Patients

Objective: Because psychiatric screening methods are usually developed using psychiatric samples but not medical samples, they often include distress indicators that overlap with medical illness. This potentially inflates psychopathology estimates for medically ill patient groups. The objective of this study was to determine whether somatic distress indicator base rates are elevated in diabetes patients. Method: The occurrence of Symptom Checklist 90-R (SLC-90-R) somatic symptoms was studied in fifty-six diabetes mellitus patients (27 insulin dependent, 29 non-insulin dependent) with non-elevated SLC-90-R profiles, as compared to both community nonpatient and psychiatric patient norms. Results: Of the fifteen SCL-90-R items rated by endocrinologists as most likely to be diabetes-related, nine were endorsed more frequently by diabetes patients than by nonpatients: faintness/dizziness (endorsed by 36% of diabetics), reduced libido (endorsed by 41%), anenergia (68%), memory problems (66%), trembling (18%), numbness (55%), weakness (39%), overeating (59%), and somatic concerns (41%). Anergia and faintness/dizziness were endorsed more frequently by psychiatric patients than diabetes patients, whereas numbness was endorsed more often by diabetes patients. Conclusions: Conservatism is warranted when applying these somatic indicators of distress to diabetes patients. Further studies are needed to determine whether such illness overlap biases case classification.

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Comparison of the Contamination Rate and Risk Factor Profile of Blood Culture Done in Emergency Department and MHDU/MICUs

Global Journal of Medical Research ◽

10.34257/mrcvol21is2pg1 ◽

2021 ◽

pp. 1-8

Author(s):

Dr. Pankaj Kumar Singh

Keyword(s):

Risk Factors ◽

Emergency Department ◽

Risk Factor ◽

Blood Culture ◽

Observational Study ◽

Prospective Observational Study ◽

Contamination Rate ◽

Medical Illness ◽

Inclusion Criteria ◽

Factors Associated

Aims and objectives: To determine the risk factors of blood culture contamination done in ED and those done in the MHDU/MICU among patients admitted with medical illness. Material and Methods: This is a two months’ prospective observational study comparing blood culture contamination rate and risk factors associated with contamination between ED and MICU/MHDU. A total of 998 patients were included in the study who underwent blood culture in ED and MICU/MHDU. 570 in ED and 428 in MICU/MHDU were included after meeting exclusion and inclusion criteria. Results: Blood culture growths were higher in ED (19%). Most common growth was CoNS (4%). The overall contamination rate in this study was (4.8%) The contamination rate was lower in ED (4.4%) when compared to MICU/MHDU (5.4%).

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Appraisal and discernment of prevalent drug-drug interactions in patients with psychiatric disorders

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20212931 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1005

Author(s):

Axa Jacob ◽

Cristin Simon Thomas ◽

Anay Deore ◽

Prasanna Deshpande

Keyword(s):

Drug Interactions ◽

Hospital Admissions ◽

Psychiatric Patients ◽

Medical Complications ◽

Medical Illness ◽

Inclusion Criteria ◽

Potential Ddis ◽

Careful Monitoring ◽

Mechanistic Approach ◽

High Prevalence

Background: Drug-drug interactions (DDIs) contribute majorly to hospital admissions, treatment failures, avoidable medical complications and subsequent healthcare costs. Thus, we employ a mechanistic approach to prospectively investigate the incidence of potential DDIs in the psychiatric patients in a clinical setting.Methods: In this prospective, observational, multi centred study conducted for a span of 6 months, psychiatric inpatients (≥18 years) prescribed with 2 or more medications daily for any medical illness were included. The secured prescriptions of the inpatients selected in accordance to the inclusion criteria were then assessed for DDIs using Micromedex(TM) as a standard.Results: Of the total 400 enrolled participants, 383 (95%) of them showed at least one pDDI regardless of the severity. An average of 7.33 interactions per patient was also deduced. A high prevalence of pDDIs totalling to 2900 was recorded in our study with an average of 7.33 interactions per patient. Most of the interactions were of major (56.52%) and moderate severity (39.07) followed by contraindicated (2.55) and minor (1.83). Cardiovascular system (41.77%) had the highest potential to be affected due to the pDDIs identified. Trihexyphenidyl, haloperidol, promethazine, amisulpride, risperidone, divalproex, trifluoperazine, olanzapine and clozapine where among the most commonly encountered drugs in these interactions.Conclusions: A high prevalence of pDDIs totalling to 2900 was recorded in our study with an average of 7.33 interactions per patient. A significant association of the pDDIs with variables such as age, gender, diagnosis and total number of drugs used was identified. More studies are required to explore the overall pattern of DDIs in psychiatric patients along with their levels and correlation with different risk factors. Careful monitoring and documentation are necessary to prevent further complications thereby improving the therapeutic outcome.

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