Cigarette Smoking in an Acute Partial Hospital Program.

ABSTRACT: This study explored demographic and clinical features, plus clinical outcomes, in a smoke-free acute partial hospital (PH) among current smokers, former smokers, and those who had never smoked (nonsmokers). Compared with nonsmokers, current smokers were younger and more likely to be unmarried and unpartnered, unemployed, or receiving disability benefits. They had more prior inpatient (IP) and PH episodes. They also had more problems with interpersonal relationships, mood lability, psychosis, and substance use. Compared with nonsmokers, current smokers were more likely to miss PH treatment days and drop out. They also had longer time to readmission to PH or IP. Former smokers resembled nonsmokers, except that former smokers also had a high rate of dropout. Changes in symptoms and functioning for patients who completed PH were the same among all groups. In an acute PH setting, smoking is a marker for psychiatric and psychosocial impairment plus treatment interruption.

A Narrative on Career Transitions in Academic Psychiatry.

Navigating and negotiating the stages from instructor to assistant, associate, and full professor to chair is an exciting, if at times exhausting, journey. Becoming a member of an academic department has the allure, and burden, of participating in, and supporting a community of scholars. In addition to proceeding through their career considerations, faculty members go through their own adult developmental stages. Suggested issues to consider that may enhance faculty members' opportunities in academia are listed. The tenure rules and the culture of each department, plus the priorities of the chair, become important when choosing to invest in a new department.

Reasons for Patient Nonattendance During Acute Partial Hospitalization.

OBJECTIVE: This study explored predictors and consequences of nonattendance of a brief, five-day partial hospital program (PHP). METHODS: Patients (N=675; N=744 admissions) who did not attend every day of a PHP, with or without prior excuses, were considered nonattenders and were compared with patients with no missed days on clinical and demographic variables collected from their medical records. Their psychiatrists' conclusions regarding reasons for nonattendance were also collected. RESULTS: Nonattendance occurred in 22% of admissions (7% of patient-days) and was associated with disability, lower income, attending a program for more impaired patients, less education, more previous treatment episodes at the affiliated hospital, and co-occurring or past substance use disorders. Reasons for nonattendance were mostly related to physical or psychiatric symptoms or crucial medical appointments. Nonattendance was associated with dropping out and 30-day readmission. CONCLUSIONS: PHP nonattendance occurred frequently; was associated with disability, ongoing symptoms, high utilization, and substance use disorders; and was predictive of dropout and readmission.