Psychiatrische Praxis最新文献

Objective: Identification of predictors that contribute to explaining regional variance of involuntary admission (IA) in Switzerland.

Methods: Multiple regression analysis including potential predictors and regional rates of IA at the level of utilisation-based care regions.

Results: Authorisation to issue involuntary admission, assistance/guardianship, outpatient consultation rate in psychiatric practices, hospitalisation rate and urbanisation are significantly related to regional variation in IA rates.

Conclusion: Restrictive regulation of the authority to issue IA and voluntary outpatient psychosocial and administrative support measures can contribute to a reduction in the rates of IA.

Objective: There is evidence suggesting that climate change, coupled with an increase in the frequency and severity of heatwaves, affects mental health. The aim of this study was to investigate potential associations between high temperature and the utilization of an emergency department (ED) by individuals with psychiatric disorders.

Methods: A retrospective analysis of all psychiatric emergency patients from 2015 to 2022 (N=15478) was conducted and compared with local temperature data.

Results: Particularly during heatwaves, more psychiatric emergency patients presented to the ED.

Conclusion: Beyond the results identified during heatwaves, our extensive analysis of the examined ED revealed no additional significant effects of heat on psychiatric emergencies. This contradicts findings from other studies. Other systemic influences, such as the utilization of the ED during the Covid-19 pandemic, could have modified the results.

Objective: To examine the specific scope of practice of community mental health nurses (CMHNs) across CMHN roles and care contexts.

Methods: Systematic literature searches in CINAHL, PubMed/Medline, Google and Google Scholar, supplemented by a search of various publishers' databases. Data were analyzed and synthesized using the framework analysis method.

Results: This paper identifies two role profiles in CMHN practice that describe distinct functions in the outpatient care of people with mental illness: (A) Primary Care CMHN and (B) Specialized Care CMHN. For each role profile, contextual factors and specific role content are described and analyzed for similarities and differences.

Conclusions: The described role profiles can serve as a template for the development of curricula in the field of CMHN. It is important to consider the national context as well as the current and future need for psychosocial care.

Objective: Characterization of medical emergencies of patients with psychiatric symptoms or in psychosocial crisis.

Methods: Analysis of emergency medical services (EMS) mission logs from four German EMS stations of patients aged 12-65 from 2019 to 2020.

Results: 23.4% of missions involved patients with psychiatric or psychosocial symptoms (1.6% psychotic, 3.0% suicidal, 7.1% psychosocial crisis, 15.7% intoxicated). On average, these patients were younger than those with other symptoms. 48.9% exhibited additional somatic complaints. The COVID-19 pandemic showed only little impact on the frequency of such emergencies.

Conclusion: Psychiatric and psychosocial symptoms account for a significant proportion of rescue missions in our sample. Managing psychiatric and psychosocial emergencies should be an integral part of the training of medical and paramedical staff.

Objective: The study analyses the number, characteristics and reasons for a length of stay of patients in German psychiatric clinics in excess of 6 months.

Methods: The study was implemented in the form of a nationwide online survey, which was addressed to chief physicians of psychiatric clinics.

Results: In the sample, 174 patients in 80 psychiatric clinics were identified who could not be discharged because no suitable follow-up services were available in the region. The majority of patients are male, often have an F2 diagnosis and exhibit aggressive behaviour during their hospital stay.

Conclusion: To avoid inappropriate health care and prevent prolonged stays for a subgroup of mentally ill people, individual complex services should be implemented in community psychiatry.

Objective: Patient characterization and evaluation of gerontopsychiatric inpatient equivalent treatment (IEHT-G) in a large German city.

Methods: Collection of sociodemographic and clinical data, as well as assessment of clinical severity (CGI), health and social functioning (HoNOS-D) and autonomous performance of activities of daily living (IADL) at the beginning and end of IEHT-G.

Results: 53 subjects (age: MW=74.81; 77.4% women) were analyzed. Main psychiatric diagnoses were affective disorders (n=25), schizophrenia and schizotypal disorders (n=20). 12 patients (22.64%) had a cognitive disorder. The CGI, HoNOS-D and IADL showed a significant improvement over the treatment period (paired t-test, p<0.001).

Conclusion: In an urban gerontopsychiatric population, IEHT-G can be implemented well. Symptom severity, social functioning and autonomy improved significantly.

Objective: This study explores attitudes and expectations of psychotherapists (PT) towards the introduction of digital patient access to clinical notes ("Open Notes"; ON)), including the advantages and disadvantages in psychotherapeutic practice.

Methods: As part of the PEPPPSY study, an online survey was conducted. Free text responses (n = 107) were qualitatively analysed using thematic analysis.

Results: 129 psychological and medical PT took part in the survey. PT saw advantages such as transparency and patient-centred documentation, but feared disadvantages for the therapeutic relationship and an increased workload through the implementation of ON. Concerns were raised about data security and negative effects on treatment. Recommendations for implementation include patient-specific access adaptations and guided access.

Conclusion: PT are ambivalent about ON. Further research and guidelines for the use of ON in psychotherapy are needed.