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Biomedical subjects

P G Cotton

Publications and source records attributed to P G Cotton.

16 recordsLinked to original sources
PubMed1986

Depression, hopelessness and suicide in chronic schizophrenia.

Hospital records for 104 schizophrenic patients, 15 of whom subsequently committed suicide, were rated blindly for individual depressive symptoms comprising DSM III major depressive episode, and for hopelessness. Our results indicate that a large proportion of schizophrenic patients experienced major depressive episodes, and that these can be reliably identified. Presuicidal schizophrenics also experienced depressed mood, but only a minority developed the full syndrome; they typically exhibited the psychological, but not somatic symptoms. The relationship between depression and suicide disappears when hopelessness is taken into account.

Adult↗
PubMed1986

Suicide among schizophrenics: a comparison of attempters and completed suicides.

Schizophrenics who completed suicide were compared with those who made suicide attempts, on the basis of blind ratings of previous hospital records and follow-up interviews with treating clinicians. Results indicated that the two groups were relatively distinct. Suicides tended to live alone and to feel depressed, hopeless, worthless, and suicidal. Attempters, on the other hand, lived with their families or others and were less likely to manifest several features of depression during a period in hospital. In evaluating suicide potential among schizophrenics, living situation and mental state changes indicating depression, suicidal intent, worthlessness, and hopelessness are more important than a history of suicidal behaviour.

Female↗
PubMed1984

Suicide among schizophrenics. Who is at risk?

Schizophrenic patients are at high risk for suicide. Most of the clinical features of the illness which have been associated with suicide remain speculative. This study provides an empirical test of hypothetical risk factors from the literature. Results indicate that schizophrenic patients who kill themselves have high internalized standards of performance which are often congruent with past educational attainments. They are also realistically aware of the effects of their illness, feel inadequate in relation to their goals, and fear further mental disintegration. Their affect is depressed, and they express hopelessness about the future. Suicidal ideation and explicit suicide threats often precede death. These results can be used to assess suicide risk among schizophrenic patients.

Adult↗
PubMed1983

Dealing with suicide on a psychiatric inpatient unit.

Suicide on an inpatient unit can cause severe trauma among patients and staff. Consequently both groups may revert to less adaptive coping styles. In general, staff's recovery is gradual and natural and may yield an opportunity for emotional growth; however, prolonged disability may also occur. The authors interviewed 23 staff members who had worked on an inpatient unit during a 16-month period when four patients committed suicide. On the basis of these interviews, the authors have developed a framework for understanding the three phases of staff reaction to suicide and guidelines for helping staff through the recovery process. They recommend that ward administrators monitor and facilitate the group process by providing protection and support during the initial phase of shock, appropriate channels and limits for the intense feelings that occur during the second phase, and constructive forums for more mature coping activities during the third phase, as staff regain their equilibrium.

Adaptation, Psychological↗
PubMed1982

Assessing patient satisfaction with state hospital and aftercare services.

To assess patients' satisfaction with state hospital and aftercare services, the authors administered an open-ended interview to 22 former state hospital patients. The patients expressed marked dissatisfaction with their treatment in the hospital, but 78% said they were helped by the aftercare services. Important components of their satisfaction were feeling helped, feeling understood, and feeling that the aftercare worker was available when needed. Frequency and length of meetings and types of assistance were not related to satisfaction. The patients reported that the psychotherapeutic and task-oriented assistance were equally helpful.

Adult↗
PubMed1980

Transfers from a general hospital psychiatric service to a state hospital.

The authors investigated the marked decline in the number of patients transferred from an inpatient service of a general hospital to a state hospital during a 30-month period. The major reasons for transfer were unmanageable behavior, high risk of suicide or homicide, administrative considerations, and unremitting or deteriorating course. They found that administrative concern about three factors--the many problems of patients likely to be transferred, staff anxiety, and the relationship between the general hospital and state hospital units--can facilitate the decline in the number of patients transferred to a state hospital.

Adolescent↗
PubMed1980

Assessing the acute inpatient psychiatric needs of the state hospital patient.

Regulators have a major opportunity to enhance the community care of former state hospital patients through their power to authorize additional general hospital psychiatric beds. The authors propose a series of clinical criteria for such regulators based on a review of state hospital admissions. These include provisions for patients who have chronic illness with repeated hospitalizations, who are involuntarily admitted, who have alcoholism, and who are impoverished. Further implications for general hospital units include specific changes in their treatment strategy, their links to facilities for ambulatory patients, and their provisions for staff education and support.

Alcoholism↗
PubMed1980

A mental health center's aftercare specialty service for discharged state hospital patients.

To serve discharged state hospital patients from its catchment area, a mental health and retardation center established an ambulatory community service that has total responsiblity for the community care of those patients. The service is staffed primarily by mental health workers and nurses. They become members of the neighborhood-based teams on the state hosptial unit and take part regularly in discharge planning with patients and hospital staff. They also provide a range of continuing outpatient and support services, including medication review, development of housing placements and recreational activities, and psychiatric follow-up. The service operates as a specialized, autonomous unit, which allows it to shift staff resources in line with changes in patient and program needs, to allocate time for program development, and to pressure other agencies to develop needed services.

Adolescent↗
PubMed1979

Predictors of community tenure of discharged state hospital patients.

Community treatment of formerly hospitalized patients is in need of evaluation. The authors evaluated an aftercare program by examining its effect on the amount of time spent in the community by patients discharged from a state mental hospital. They assessed the impact of specific intervention in the areas of housing, employment, finances, psychiatric treatment, medication, and leisure. They conclude that assistance during the transition from the hospital to the community prolonged community tenure, that intervention in the areas of housing, finances, and medication was especially important, and that treatment in the community increased the amount of time spent in the community during the first 6 months after discharge.

Adult↗
PubMed1979

The effect of deinstitutionalization on a general hospital's inpatient psychiatric service.

As a result of the deinstitutionalization movement, increasing numbers of former state hospital patients are being rehospitalized in general hospital psychiatric units. Because of this change in patient population, the general hospital has had to adjust its treatment strategy to emphasize meticulous review of previous psychiatric history, including medications; plans for meeting the patients' posthospital housing, vocational, and social needs; and development of plans with community care-givers for continuing care. General hospital staff members have to be educated to develop competence in working with the new patient population and a tolerance for chronicity; that can be done through several forums ranging from large staff meetings to individual supervision.

Adult↗
PubMed1975

The affective experience of residency training in community psychiatry.

The community setting arouses disturbing feelings (of anxiety, loneliness, anger, and disappointment) within the resident in a manner that is both unique and potentially constructive for his development as a clinician. The examination of these feelings in the supervisory setting and through peer supervision is crucial to the success of the resident's work in the community.

Anger↗