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PubMed1994

Clinical and treatment correlates of access to Section 8 certificates for homeless mentally ill persons.

OBJECTIVE: The study assessed how clients' housing preference and other variables were related to the acquisition of Section 8 certificates, facilitating independent living, for homeless persons with severe mental illness who were being served by an experimental assertive community treatment team. METHODS: For 77 clients, demographic and clinical differences between receivers and nonreceivers of certificates were examined, and correlates of time from referral to the team to completion of the Section 8 application were analyzed. Reasons clients did not receive certificates and housing outcomes were summarized in relation to client preference. RESULTS: The 34 clients who received certificates (44 percent) had significantly less psychopathology after three months than did nonreceivers and tended to have affective disorders rather than schizophrenia. Of the 43 nonreceivers, the two largest groups were 19 clients who did not want certificates and ten clients who wanted certificates but whom staff considered unable to live safely in an unsupervised apartment. The mean +/- SD length of time for application for a certificate was 5.7 +/- 5.8 months. Longer time to apply was significantly associated with having schizophrenia, having the team as a representative payee, and showing increased psychotic symptoms at referral and at three months. CONCLUSIONS: The study suggests that it is possible to honor the housing preferences of the majority of homeless persons with severe mental illness if adequate resources are provided. However, staff may view persons who have schizophrenia and more symptoms as needing more supervision than those clients prefer. Homeless mentally ill persons may also take longer than more symptomatic persons to pursue independent living through a Section 8 certificate.

Adult↗
PubMed1994

The relationship between acute psychiatric symptoms, diagnosis, and short-term risk of violence.

OBJECTIVE: Previous research on violence and mental disorder has typically focused on the relationship between diagnosis and risk of violence or between symptoms within a particular diagnostic category and risk of violence. The authors' goal was to evaluate whether the pattern of symptoms associated with short-term risk of violence varies depending on patients' diagnoses. METHODS: Subjects were 330 patients with a variety of diagnoses who were hospitalized on a university-based, locked psychiatric inpatient unit. At hospital admission, physicians rated patients' symptoms using the Brief Psychiatric Rating Scale. Nurses rated whether patients became violent during hospitalization by completing the Overt Aggression Scale at the end of each shift. RESULTS: Assaultive patients had different symptom patterns than nonassaultive patients. Symptoms patterns varied significantly across diagnostic groups, and the symptom patterns associated with violence also varied significantly across diagnostic groups. Higher levels of hostile-suspiciousness, agitation-excitement, and thinking disturbance were generally associated with violence, although these symptoms were less predictive of assaultiveness among schizophrenic patients than among patients in other diagnostic groups. CONCLUSIONS: Symptom profiles represent a useful level of analysis for understanding the relationship between violence and psychopathology. However, the value of particular symptom profiles as indicators of imminent violence varies with diagnosis.

Acute Disease↗
PubMed1996

A survey on use of advance directives for mental health treatment in Oregon.

Oregon is one of three states that allows persons to prepare a legal document-and advance directive-to stipulate the mental health treatment they wish to receive should they lose their decision-making capacity. An informal one-page questionnaire on the use of advance directives for mental health treatment in the state was enclosed in newsletters sent to families and care providers of persons with severe and persistent mental disorders. Responses were received from 156 people; they reported that 64 advance directives had been completed by consumers, 40 surrogate decision makers had been appointed, and ten consumers had used their advance directives when in crisis. In each case, the consumer's wishes were honored. The small response to this preliminary survey suggests the need for further education about advance directives among mental health care consumers, their families, and providers.

Advance Directives↗
PubMed1986

Socio-economic status and mental disorder--profile of a Nigerian psychiatric inpatient population.

A study of the socio-economic and diagnostic profile of psychiatric patients treated at a mental hospital in Nigeria over a period of six months was conducted. Schizophrenia, organic psychosis, and mental sub-normality were found to have been diagnosed more often among under privileged persons from lower socio-economic classes; while affective disorder (manic depression) and neurotic illness were commoner among persons from economically more fortunate higher social classes. Males exceeded females in the cohort and the patients generally exhibited upward social mobility when compared with their parents. Possible socio-cultural factors contributing to the findings have been discussed. A suggestion is made for a more elaborate field work to study the relationship between socio-economic class and psychopathology in a developing country like Nigeria.

Adult↗
PubMedDate not supplied

A prototype decision support system for differential diagnosis of psychotic, mood, and organic mental disorders.

The authors designed a decision support system to assist mental health professionals to perform differential diagnoses of psychotic, mood, and organic mental disorders in accordance with the American Psychiatric Association's revised third edition of the Diagnostic and Statistical Manual of Mental Disorders. A prototype system arrived at through a rigorous methodology illustrates a style of development that attempts to ensure system maintainability, correctness, and consistency of deduction and promotes high quality in software.

Decision Making, Computer-Assisted↗
PubMedDate not supplied

Prototype decision support system for a differential diagnosis of psychotic, mood, and organic mental disorders: Part II.

This paper presents a prototype parallel-processing decision support system, based on the ALICE graph reduction machine, for the differential diagnosis of psychotic, mood, and organic mental disorders in accordance with the American Psychiatric Association's revised third edition of the Diagnostic and Statistical Manual of Mental Disorders. The paper extends the authors' earlier work where the same domain was implemented on an expert-system shell using a rule-based representation.

Computer Graphics↗
PubMed1980

Treatment of the elderly on a general hospital psychiatric short-stay unit.

Two out of seven general hospital psychiatric units and the local mental hospital in the Vancouver area set an arbitrary age limit of 65 or 70 on admissions. Administrative reasons given for this include the presumed likelihood of organicity and chronicity, implying difficulties in disposition, and problems in maintaining an active therapeutic milieu with patients of other ages. Data are presented on 40 patients who were over the age of 65 and accounted for 8% of all admissions during 1977 to a Psychiatric Short-Stay Unit in a downtown general hospital. It was found that over three-quarters of the admissions had a primary functional diagnosis, that the mean duration of stay was 5.73 days, that two-thirds of the patients were able to return to their former place of living on discharge and that over one-half of the patients located on follow-up, 18 to 24 months later, were still residing in the same situation. During hospitalization, almost one-half of the patients received no psychotropic prescription and almost one-third, no physical prescription. Some of the psychosocial factors in the treatment program are presented. It is concluded that this preliminary study suggests that the administrative apprehensions in relation to treatment of the elderly in general hospital psychiatric units and mental hospitals can be countered.

Aged↗