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Biomedical subjects

M Olfson

Publications and source records attributed to M Olfson.

At least 109 records · Page 6Linked to original sources
PubMed1991

Primary care patients who refuse specialized mental health services.

The charts of 65 patients who completed mental health care referrals were compared with those of 65 patients who failed to complete such referrals. In the year before referral, the noncompliant patients made 37% more medical visits than the compliant patients. As compared with the compliant patients, a significantly greater proportion of the noncompliant patients' medical visits were for difficult-to-explain somatic symptoms. Mental health referrals from some physicians were much more successful than referrals from other physicians. By attending to their patients' pattern of health care utilization, primary care physicians may be able to identify patients at high risk for noncompliance with mental health referrals.

Adult↗
PubMed1990

A controlled evaluation of inpatient crisis treatment for acute schizophrenic episodes.

Acutely ill chronic schizophrenic patients requiring hospitalization were assigned to either an intensive crisis oriented (five day) or a short term (twenty-one day) inpatient unit. Despite intensive psychosocial treatment and initial rapid symptom reduction, the crisis patients could not be successfully discharged earlier than the short term patients. The crisis patients more frequently utilized day hospital aftercare and did not differ from the short term patients in symptom level or global functioning at three month follow-up. Limitations of very brief crisis oriented inpatient care for acutely ill schizophrenia patients are discussed.

Acute Disease↗
PubMed1990

Treatment of depressed patients in general hospitals with scatter beds, cluster beds, and psychiatric units.

Records of 725 patients with a primary discharge diagnosis of depression were reviewed at nine general hospitals: three with psychiatric units, three in which patients were treated in beds grouped together on a medical or surgical floor (cluster beds), and three in which patients were treated in beds dispersed among medical and surgical beds (scatter beds). Patients treated in psychiatric units most commonly presented with suicidal or homicidal indicators, most frequently received antidepressants, and had the longest stays. Patients treated in scatter beds tended to present with somatic complaints, were least likely to receive antidepressants, and had the shortest hospital stays. Patients treated in cluster beds presented with intermediate symptoms and had stays of intermediate duration. Although dangerous or psychotic patients may be most appropriately treated in units, other patient groups may be safely and effectively treated at lower cost in less specialized inpatient settings.

Adult↗
PubMed1990

Assertive community treatment: an evaluation of the experimental evidence.

Experimental studies of assertive community treatment programs based on the Training in Community Living model are reviewed. In most of the programs studied, interdisciplinary treatment teams met with patients in the community, taught them to take care of basic needs, and ensured that they received adequate material support and medical care. Across the service settings and patient populations studied, assertive community treatment reduced hospital utilization. Although early researchers provided evidence that the approach was more effective than conventional treatment in controlling symptoms, promoting social functioning, and improving occupational performance, recent studies have generally not replicated these findings. Defining the conditions under which assertive community treatment achieves superior functional outcomes remains an important challenge for future research.

Clinical Trials as Topic↗
PubMed1988

Emergency room dispositions of professionally referred psychiatric patients.

Emergency room records of professionally referred and nonprofessionally referred patients are reviewed. Professionally referred patients were significantly more likely to be admitted than non professionally referred patients. Female, white, and employed patients were all overrepresented among the professionally referred. Suicidality, homicidality, and depression were also more common in this group. After accounting for the clinical and demographic differences, referral source did not significantly modify the disposition from the emergency room. Among schizophrenic patients, however, professional referral independently improved the likelihood of admission. These results are discussed in terms of social factors which may influence emergency room decision making.

Adolescent↗
PubMed1987

Current referral practices of mental health care providers.

Psychiatric referral practices of the clergy, primary care physicians, and mental health care specialists are examined in relation to the three stages of the referral process: the identification of a mental health problem, the decision to refer, and the selection of a treating professional. Referral practices within health maintenance organizations are also described to illustrate how organizational structure affects this process. Based on a literature review, the authors identify and discuss ten major factors that shape and define all referrals. They are the practitioner's capacity to recognize and define mental illness, the availability of resources, economic incentives, the amount of clinical information available, patient attitudes toward referral, the practitioner's therapeutic background, the practitioner's role perception, practitioner-patient interaction, interpractitioner relations, and provider group influences. The authors end with a critique of current mental health referrals.

Clergy↗