Psychiatrische Praxis最新文献

Objective: To investigate psychiatric service use depending on distances (travel times) to inpatient and outpatient service sites.

Methods: Retrospective cohort analysis of all patients aged 18-64 years who had been treated in a Swiss psychiatric services system in 2022.

Results: Outpatient service utilization rates decreased statistically significantly with increasing distance (travel time by public transportation) between the place of residence and the responsible outpatient clinic. For inpatient utilization, the distance decay effects were much less strong and did not always reach a statistically significant level.

Conclusion: In an easily accessible and economically reasonable psychiatric services system, inpatient and specialized services should be organized centrally, while general outpatient psychiatric services should be planned decentralized and close to the communities where people live.

This study focuses on the development of a possible future scenario for mental health nursing in Germany. Based on the identified trends in mental health care, important implications for the design of future-oriented mental health nursing were identified and discussed. The developed model describes a type of mental health nursing that takes place on an "extended" or "advanced" level, close to the community and in a multi-professional setting in the living environment of the affected persons and their relatives. It integrates digital elements of mental health care, while practicing person-centered, diversity- and trauma-informed approaches. Although this describes an approach to mental health nursing that could meet the expected trends and developments in mental health care, critical discussion and reflected consensus on these ideas is needed in an interdisciplinary body.

Objective: To investigate variations in intended utilization in cases of an acute psychotic episode, an alcohol related or depressive disorder depending on different case characteristics.

Methods: A telephone survey with case vignettes was conducted (N=1,200). Vignettes varied in terms of urgency of symptoms, daytime, sex of the afflicted person and age/mental disorder. The respondents were asked to indicate whom they would contact first in the described case.

Results: Outpatient physicians were named most frequently as the first point of contact (61.1%) while only 6.5% of the respondents named emergency medicine including the medical on call service (8.1% in high urgency cases, i. e. emergencies that did not tolerate any delay). Intended utilization varied by urgency and age/mental illness.

Conclusion: More Information about the need to seek medical help immediately in cases of mental illnesses with high urgency should be provided.

In order to provide an up-to-date overview on changes in population's mental health during the COVID-19 pandemic, a continuous literature review was conducted. Building on a rapid review, systematic and hand searches were conducted monthly until December 31, 2022. Studies were assessed for observation periods, risk of bias and outcomes. Trends in depressive symptoms in adults were summarized by vote counting. 102 publications were included from 62 studies in the adult population. Studies declined over the course of the pandemic. Overall, 37% of the studies and 56% of the publications can assess trends in the population reliably. Among evidence for changes in depressive symptoms deteriorations predominated at last. The heterogeneity of results published by the end of 2022 limits evidence syntheses. Evidence of deterioration requires further surveillance. A continuous review can indicate evidence gaps at an early stage.

This part of the AKtiV Study focuses on treatment satisfaction of patients and their relatives within Inpatient Equivalent Home Treatment (IEHT) and regular treatment. Stress of relatives and job satisfaction and workload of employees in IEHT is also considered. Relevant Parameters were collected via established as well as newly adapted questionnaires at the end of treatment. Patients and relatives in IEHT are significantly more satisfied. The stress experienced by relatives is reduced in both forms of treatment. Employees in IEHT are generally very satisfied, although there is no correlation with the satisfaction of relatives and patients. Known limitations of satisfaction surveys must be taken into account. In general these results encourage the expansion and continuous development of this new form of treatment in Germany.

Objectives: Due to insufficient empirical data on the occupational participation of people affected by severe mental illness receiving integration assistance, routine data from a community psychiatry service were evaluated.

Methods: Reference workers filled out a short questionnaire on different occupational and employment aspects of their clients from supported housing/floating outreach. In addition to descriptive and exploratory analyses, overall results from previous survey rounds were also evaluated.

Results: N=1418 individuals (M=47.6 years) could be included, of whom approximately 45% had no job, sheltered employment, or daytime service. This percentage has remained almost unchanged over the last decades.

Conclusion: Overall, there is an urgent need for action to improve occupational participation opportunities for people with mental illness and substance addiction.

Background: Evaluation of the practice of coercive treatment in Germany after the Constiutional Court's decision in 2011.

Methods: The documented emergency treatments (N=86) and judicially approved compulsory treatments (N=62) in 2015 and 2016 at 6 hospital locations in Baden-Württemberg were retrospectively analysed.

Results: Patients had an average of 8 previous psychiatric hospitalisations with a cumulative duration of 645 days on average and 87% had a psychotic disorder. 34% received subsequent compulsory treatment within one year. The median duration of compulsory treatment was 15 days. 92% of the patients were taking an antipsychotic at discharge, 45% received further treatment in a day hospital or a psychiatric outpatient clinic.

Conclusion: Coercive treatment affects a relatively small, chronically severely ill group of patients and is frequently recurrent among them. For considerable part, no consecutive treatment setting can be established after discharge.