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Biomedical subjects

B Verwey

Publications and source records attributed to B Verwey.

12 recordsLinked to original sources
PubMed2004

[Repeated suicide attempts: a need for continued care].

Prevention of deliberate self-harm, especially suicide attempts, remains difficult and this puts a great burden on the family as well as on the health-care professionals. The risk of a subsequent suicide attempt or a successful suicide is high while the behaviour is often met with antipathy, a feeling of helplessness and anger. This is in conflict with the needs of the patient; every suicide attempt requires the health-care professionals involved to exhibit a emphatic, patient and serious attitude, even when patients refuse to cooperate, are restless, aggressive or unwilling to communicate. Prevention of the suicidal behaviour can only be achieved this way.

Adult↗
PubMed2004

[The medical-psychiatric unit: added value for patients, physicians and hospitals].

Physical and mental illnesses commonly occur together. The quality of physical care in institutions for mental health in the Netherlands is not guaranteed. The cases of a 63-year-old woman with a schizoaffective disorder and diabetes mellitus who became delirious after surgery and a 76-year-old suicidal man with a psychotic disorder due to hydrocobalamine deficiency after major heart surgery show that the so-called medical-psychiatric unit, which is a part of the Psychiatric Department of a general hospital, may have several advantages in the treatment of combined physical and mental disorders. Both patients were admitted to such a unit. In this way, the internist of the first patient could continue to treat her and she could be treated with an infusion, urinary catheter and gastric intubation; in addition, laboratory investigations could be performed. The second patient, whose safety required primary attention, could also be treated for his somatic disorders and a delirium could be ruled out. His family was assisted in recovering from their traumatic life experience caused by his suicide attempt.

Aged↗
PubMed2000

Memory impairment in those who attempted suicide by benzodiazepine overdose.

BACKGROUND: A prospective study was conducted to investigate the presence of anterograde amnesia in those who attempted suicide by benzodiazepine overdose and to study the correlation with sedation. METHOD: In 43 patients who attempted suicide by taking benzodiazepines, memory was tested with a 15-word memory recall task. The immediate and delayed recall on the first day after admission (day 1) and 24 hours later (day 2) were rated. Each patient and the interviewer scored the patient's degree of sedation on a visual analogue scale. Patients also had to try to recognize, from photographs, the psychiatrist with whom they had spoken the day before. RESULTS: The ratings of immediate and delayed recall were significantly lower on day 1 than on day 2. Subjective ratings of sedation of the patients were not significantly higher than the ratings of the observer. Less than half of the patients recognized the psychiatrists and knew that they were the ones they had spoken to the day before. CONCLUSION: Anterograde amnesia is present in suicide attempters who take overdoses of benzodiazepines. The implications of this finding for the assessment of suicide attempters during admission are discussed.

Adult↗
PubMed1997

[Guidelines and their observance in the psychiatric care of failed suicides in general hospitals].

OBJECTIVE: To gain insight into the guidelines established for the care of failed suicides in general hospitals, and into the degree to which these guidelines are observed in practice. DESIGN: Descriptive, retrospective. SETTING: Department of Psychiatry, Rijnstate Hospital, Arnhem, the Netherlands. METHOD: An inventory of guidelines for the care of failed suicides was made by interviewing seven psychiatrists on the staff of general hospitals. The inventory was limited to access (interval between admission and referral/consultation), and the coordination of the care (i.e. adjustment to the patient's condition, transfer of information). Subsequently, the cases of all failed suicides admitted to these hospitals in 1991 were studied to find out how these guidelines were observed in practice; use was made for this purpose of data from a more extensive European study. RESULTS: All seven hospitals proved to have rules for coping with tailed suicides. Guidelines concerning accessibility of care were fairly similar in the various hospitals; regarding the coordination of care, more local variants were found to exist. The accessibility of care was found to be mostly in accordance with the guidelines. There were more deviations from the guidelines where the coordination of care was concerned; in addition, there were substantial differences between the hospitals in the degrees to which deviation from the guidelines occurred. CONCLUSION: Guidelines for the care of failed suicides admitted to general hospitals were not in all respects similar; the observance differed markedly, especially regarding the coordination of care.

Adolescent↗
PubMed1997

[Electroconvulsive therapy in late life depression: a review].

Electroconvulsive therapy is an important treatment of depressive states in late life. However in the Netherlands ECT is not often practiced and mostly indicated after a long period of fruitless clinical therapy. The primary aims of this literature study were to review the efficacy of ECT in late life depression, to identify predictors of good response, to discuss contraindications, side effects and finally modifications of technique. Eighteen studies were found addressing the topic of efficacy. Outcome ranged between 50%-100% clinically significant improvement. Positive predictors are melancholic features and delusional depression. Unlike in younger patients hypochondriacal symptoms and anxiety do not predict a negative outcome in older patients. ECT has been used successfully in depression complicated by dementia, cognitive decline and cerebrovascular disease. Depression in Parkinson's disease may be a special indication where ECT may have a positive effect on motor symptoms. There are no firm indications of long term cognitive decline associated with ECT. Guidelines for practicing ECT (unipolar, brief pulse and anaesthesia) are in line with the state of the art in the literature. It is concluded that, especially in severe depression associated with comorbidity, current Dutch practice in using ECT, often leads to unwarranted delay.

Aged↗
PubMed1994

[Successful electroconvulsive therapy in a pregnant woman with neuroleptic malignant syndrome].

Neuroleptic malignant syndrome was diagnosed in a 27-year-old pregnant female with a psychiatric disorder, after treatment with haloperidol. The syndrome did not respond to treatment with dantrolene. Serious vegetative instability weighed against the use of electroconvulsive treatment. After 29 3/7 weeks of amenorrhoea electroconvulsive treatment was started, and the clinical picture gradually improved. Mother and child were discharged in good clinical condition.

Adult↗
PubMed1991

[Electroconvulsive therapy in a peripheral hospital].

The findings are reported of a retrospective study of 25 patients with a refractory depression in the restricted sense, admitted for ECT to a psychiatric department of a general hospital (Rijnstate, Arnhem). The results after ECT and the course during 2 years after the treatment were inventoried and compared with data in the literature. At discharge, 12 patients were classified as 'recovered', 9 were improved and four showed little or no change. After two years, 4 patients had died, one of them having committed suicide. Of the 22 follow-up patients 19 patients were at home: 15 could be classified as cured, 3 considered their condition improved and 4 were unchanged. Twelve were found to have had a recurrence of depression which in ten of them could be controlled with antidepressive drugs or ECT. ECT as a part of treatment of depressions may be regarded as useful and may safely be administered in a psychiatric department of a general hospital.

Adult↗