To explore the pattern of health service utilization over 2 years following a first admission for psychosis and the baseline characteristics predicting readmission.
Patients included in a cohort of first-admitted subjects with psychosis (n = 84) were assessed at the end of a 2-year follow-up using multiple sources of information.
At the end of the follow-up, one of three subjects had no contact with any mental health professional, and 38% of subjects had no contact with a psychiatrist. Half of the patients were readmitted over the 2-year follow-up. The baseline characteristics independently predicting psychiatric readmission were a high number of helping contacts before first admission and persistence of psychotic symptoms at discharge.
Decreasing the frequency of readmission in the early course of psychosis is a public health priority. Development of psychotherapeutic programs for subjects with early psychosis who have enduring psychotic symptoms at first discharge should be promoted.
[Show abstract][Hide abstract] ABSTRACT: Electroconvulsive therapy (ECT) is an effective treatment for major mental illnesses. It is used to achieve rapid and short-term improvement of severe symptoms after an adequate trial of other treatment options have proven ineffective. Relapse rates following ECT are high and leading to early readmission. Objective: To study the early readmission rate in patients had received ECT and its relation with age, gender, race and clinical diagnosis. Methods: This is a retrospective descriptive study of patients who had received ECT in 1-year period. Subjects were identified from the ECT record book. Case notes of these patients were then traced and reviewed. Clinical diagnosis and demographic data were collected. Patients readmitted within 6 months after being discharged were identified. The data was compared for the readmitted and not readmitted group. Result: A total of 156 subjects who had received ECT were included in this study. Mean age was 40 years old, 51% were female and the main diagnosis was bipolar affective disorder (42.9%). Early readmission rate was 30.1%. Mean time to relapse was 5.3 months. Chi Square analysis indicated that younger age was significantly associated with early readmission among ECT patients. Conclusion: ECT patients had high early readmission rate. Adequate post ECT psychosocial intervention and pharmacotherapy may help to reduce the readmission rate.
[Show abstract][Hide abstract] ABSTRACT: One of the most significant recent developments in computer
processor technology is the RISC (reduction-instruction-set-computer)
microprocessor. Under certain circumstances, RISC devices offer
significant advantages over their conventional CISC
(complex-instruction-set-computer) counterparts. A brief comparison of
the principal features of both RISC and CISC processors is presented
System Theory, 1990., Twenty-Second Southeastern Symposium on; 04/1990
[Show abstract][Hide abstract] ABSTRACT: To examine the relapse rate achievable in a real-life early psychosis treatment service.
A 2-year longitudinal cohort study of consecutive admissions to an early psychosis programme which served the entire population in a catchment area. The primary outcome measure was relapse.
One hundred and forty-eight consecutive consenting admissions were recruited, 124 (83.8%) of whom were followed for 1 year and 116 (78.4%) for 2 years. Relapse was assessed by clinicians using structured criteria. The 2-year relapse rate among subjects with complete data collection was 34/95 (35.7%, 95% CI 26.2-46.3). A Kaplan-Meier life table censoring subjects lost to follow-up yielded a comparable estimate of the proportion not relapsing: 68% (95% CI 58-76%).
These estimates compare favourably with a published range of 2-year relapse from 55% to 70% in the older literature and are comparable with the results in recent clinical trials.
Melanie E Bennett, Clayton H Brown, Lan Li, Seth Himelhoch, Alan Bellack, Lisa Dixon
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