Suchergebnisse

OBJECTIVE: Posttraumatic stress disorder (PTSD) is often accompanied by other mental health conditions, including major depressive disorder (MDD), substance misuse disorders, and anxiety disorders. The objective of the current study is to delineate classes of comorbidity and investigate predictors of comorbidity classes amongst a sample of Canadian Armed Forces (CAF) Regular Force personnel. METHODS: Latent class analyses (LCAs) were applied to cross-sectional data obtained between April and August 2013 from a nationally representative random sample of 6700 CAF Regular Force personnel who deployed to the mission in Afghanistan. RESULTS: MDD was the most common diagnosis (8.0%), followed by PTSD (5.3%) and generalized anxiety disorder (4.7%). Of those with a mental health condition, LCA revealed 3 classes of comorbidity: a highly comorbid class (8.3%), a depressed-only class (4.6%), and an alcohol use–only class (3.1%). Multinomial logit regression showed that women (adjusted relative risk ratio [ARRR] = 2.77; 95% CI, 2.13 to 3.60; P < 0.01) and personnel reporting higher trauma exposure (ARRR = 4.18; 95% CI, 3.13 to 5.57; P < 0.01) were at increased risk of membership in the comorbid class compared to those without a mental health condition. When compared to those with no mental health condition, experiencing childhood abuse increased the risk of being in any comorbidity class. CONCLUSIONS: Results provide further evidence to support screening for and treatment of comorbid mental health conditions. The role of sex, childhood abuse, and combat deployment in determining class membership may also prove valuable for clinicians treating military-related mental health conditions.

Background: The attitudes of psychiatric hospital personnel are critically related to the quality of mental health care, but few studies have investigated this issue. Aims: This study is aimed at an exploration of the attitudes of psychiatric hospital personnel toward people with mental illness and at an examination of the associated factors. Method: A self-report questionnaire, the Mental Illness Attitude Scale (MIAS), was used to collect data from psychiatric hospital personnel in Taiwan ( n = 290). The MIAS included 46 items and 4 dimensions: acceptance, rehabilitation and prognosis, social distance and recommendations for interventions. Results: Rehabilitation and prognosis had the highest item average scores (4.03) and social distance had the lowest item average scores (3.22). Stigmatization and the number of different types of contacted clients were two significantly associated attitude factors. Conclusion: Psychiatric hospital personnel in Taiwan tend to have positive attitudes toward people with mental illness in general situations but hold less positive attitudes in terms of community integration-related issues and intimate relationships. More evidence-based community services should be conducted to decrease personnel concerns about the successful community integration of those who are mentally ill. Future studies can investigate the concept and impact of stigmatization more deeply.

Hintergrund: Im Jahr 2001 wurden die militärischen Laufbahnen der Bundeswehr über den Sanitätsdienst hinaus für weibliche Bewerber geöffnet. Ziel dieser Untersuchung war es, die Entwicklung der Inanspruchnahme psychiatrischer Behandlungen dieser weiblichen Soldaten darzustellen und im Hinblick auf psychosoziale Merkmale zu charakterisieren. Methode: Zum einen wurden die im ambulanten aufgetretenen sowie die stationär in Bundeswehrkrankenhäuser erfassten psychiatrischen Erkrankungen aus dem Jahr 2006 mit den Zahlen des Jahres 2000 verglichen. Des Weiteren wurde eine stationäre weibliche psychiatrische Patientenpopulation (n=83) mit einer militärischen Zufallsstichprobe im Hinblick auf soziodemografische Charakteristika verglichen. Ergebnis: Zwischen 2000 und 2006 stieg die prozentuale Häufigkeit ambulanter psychiatrisch begründeter ärztlicher Kontakte bei Soldaten beiderlei Geschlechts (bei Frauen deutlicher als bei Männern) signifikant an, am stärksten bei belastungsreaktiven Erkrankungen (ICD-10: F43). 2006 war der Gesamtanteil psychiatrischer Behandlungen im ambulanten wie stationären Bereich bei weiblichen Soldaten signifikant höher als bei männlichen, vor allem bei belastungsreaktiven und depressiven Erkrankungen (F32-39) sowie bei Persönlichkeitsstörungen (F60-61). Die stationär behandelten Soldatinnen wiesen signifikant häufiger Partnerschaftskonflikte, einen niedrigeren Bildungsgrad sowie geringeren Dienstgrad auf als die weiblichen Kontrollen. Schlussfolgerung: Die beobachteten Veränderungen können ein Spiegelbild der Entwicklung in der zivilen Gesellschaft darstellen. Jedoch müssen auch militärspezifische Besonderheiten wie Auslandseinsätze betrachtet werden. Die Auswirkungen in Bezug auf die Inanspruchnahme psychiatrischer Behandlungen werden diskutiert. Die Untersuchung gibt Hinweise auf mögliche Risikofaktoren psychiatrischer Erkrankungen bei weiblichen Bundeswehrsoldaten, die für präventive und therapeutische Konzepte von Bedeutung sein können. ; Background: In 2001, women were admitted to all ...

To be included in the forthcoming book, "Selbsthilfe und Selbstorganisation im Gesundheitswesen", edited by Bernhard Badura und Christian von Ferber, Munich, Oldenbourg Verlag.

Abstract. Background and Aim: The Suicide Cognitions Scale (SCS) was developed to assess a broad range of suicide-related cognitions. Research to date supports the scale's factor structure, internal consistency, and construct validity. The present study tested the scale's prospective validity for suicide attempts among 97 military personnel presenting to an emergency department or psychiatric outpatient clinic for an unscheduled walk-in evaluation. Method: Cox regression and receiver operator characteristic analyses were conducted to test the prospective validity of the SCS. Results: Results supported the prospective validity of the SCS (area under the curve [AUC] = 0.69) and indicate the scale's performance is comparable to an empirically supported measure of suicide ideation (AUC = 0.75). The SCS performance was not reduced by removing items containing the word suicide. Limitations: Homogeneous sample comprised of US soldiers, predominantly male, with recent suicidal ideation. Conclusion: Results support the SCS as an indicator of subsequent risk for suicidal behavior when used in acute care settings, and suggest the scale's performance is similar to more traditional suicide risk screening methods that depend on honest self-disclosure of suicidal thoughts.

Intro -- Introduction: Models of Psychiatric Emergency Services That Work -- Contents -- Part I: Models of Emergency Psychiatry Care -- 1: Models of Emergency Psychiatric Care -- 1.1 Introduction -- 1.2 Hospital-Based PES -- 1.3 Regional Dedicated Emergency Psychiatric Facility -- 1.4 Community-Based PES -- 1.5 Systems Integration and Crisis Prevention -- 1.6 Comprehensive Psychiatric Emergency Program -- 1.7 Summary -- References -- 2: Business as Usual: Emergency Rooms with No Psychiatric Coverage at All -- 2.1 Introduction -- 2.2 Limitations and Capabilities of This System -- 2.3 Personnel and Staffing Needed -- 2.4 Patient and Staff Safety Concerns -- 2.5 Collaboration Needed -- 2.6 Expertise Needed -- 2.7 Resources Needed -- 2.8 Consideration of Coordination of Care -- 2.9 Interaction with Probate Courts and Criminal Justice System -- 2.10 Security Needed -- 2.11 Special Considerations -- 2.12 Summary -- References -- 3: Psychiatric Consultation to the Emergency Department and Co-Management Model -- 3.1 Introduction -- 3.2 Liabilities and Capabilities of the System -- 3.3 Limitations of the System -- 3.4 Personnel and Staffing Needed -- 3.5 Patient and Staff Safety Concerns -- 3.6 Collaboration Needed -- 3.7 Expertise Needed -- 3.8 Considerations of Coordination of Care -- 3.9 Interactions with Probate Courts and the Criminal Justice System -- 3.10 Security Needed -- 3.11 Special Considerations -- 3.12 Summary -- References -- 4: Adjacent Psychiatric Emergency Services to the Main Emergency Room -- 4.1 Introduction -- 4.2 Liabilities and Capabilities of the System -- 4.3 Limitations of the System -- 4.4 Personnel and Staffing Needed -- 4.5 Patient and Staff Safety Concerns -- 4.6 Collaboration Needed -- 4.7 Expertise Needed -- 4.8 Resources Needed -- 4.9 Considerations of Coordination of Care.

THE AUTHOR DESCRIBES IN A THEORETICAL MANNER THE COMPONENTS OF AN EFFECTIVE COMPREHENSIVE PSYCHIATRIC SERVICE. HE CONSIDERS SUCH TOPICS AS "QUALITY OF LIFE", INPATIENT SERVICES, OUTPATIENT SERVICES, DAY CARE, NIGHT CARE, WEEKEND CARE, EMERGENCY SERVICES, CONSULTATION AND EDUCATION FOR COMMUNITY AGENCIES AND PROFESSIONAL PERSONNEL. EVALUATION, CUSTODY, SUPPORT, AND CONTROL ARE ALSO DESCRIBED.

Lay Summary There was a growing interest in psychology among British women in the post-war Far East. Military psychiatrists decried what they perceived as a lack of stigma associated with a psychiatric diagnosis and complained that it was the role of medical officers to prevent patients from seeking psychiatric help. Medical officers, however, were overworked and lacked sufficient psychiatric training. Some medical personnel thought this interest was leading to patients diagnosing themselves with psychiatric conditions and was, by extension, causing tension within the doctor-patient relationship.

(1) Background: Military combat impacts the mental health of veterans and active military personnel. Although various studies, the majority of which are from Westernized countries, have provided insight into how combat causes psychiatric disorders, such as post-traumatic stress disorder (PTSD), depression, and anxiety among veterans, there appears to be scant published literature on psychiatric disorders among military personnel in the West African region. It is important to contextually understand the psychiatric disorders among military personnel in this region who may be faced with similar vulnerabilities to their counterparts from Western cultures. (2) Methods: This study follows the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies were included if they were published in English between January 2010 and January 2021 and assessed mental health problems or psychiatric disorders among soldiers in West Africa. (3) Results: All three included studies were from Nigeria. High prevalence rates of substance and alcohol use were reported. (4) Conclusions: This review highlights the need for more research in this population as well as identifying the intervention needs of the soldiers and their implications.

ABSTRACTThe experiences of the placement department of the Mental Health and Manpower Project have demonstrated that an effective team can be created to develop job opportunities for the mentally restored psychiatric patient. Composed of a vocational counselor and a placement counselor, the team is effective in securing meaningful employment and developing re‐education programs in the community. While the vocational counselor provides the clinical information concerning the restored patient‐client, the placement counselor serves as a more personnel oriented individual in finding the appropriate kind of employment position. The team points to the potential that the mental health center possesses in involving the general community in its programs.