The Role of Family Variables in the Length of Stay of Psychiatric In-patients.

BACKGROUND: In Japan, the number of beds and average length of stay in a psychiatric ward are greater than in other developed countries. OBJECTIVE: The present study aimed to investigate the association between family variables and the length of stay of patients with mental and behavioural disorders in a private psychiatric hospital in Japan. METHODS: The medical records of patients discharged during a one-year period (n=56: men 50.0% excepting 27 patients discharged due to death were re-examined regarding age, laundry type (self-washing of clothes, family washing or supplier washing), number of family visits per one month while hospitalised, and family structure prior to hospitalisation. A length of stay greater than six months was considered the cut-off point for a long hospital stay. Bivariate logistic regression analyses were conducted to identify factors independently associated with the length of stay, adjusted for sex, age, and mental and/or behavioural disorders according to the criteria of the International Statistical Classification of Diseases and Related Health Problems. RESULTS: The bivariate-adjusted odds ratio (95% confidence intervals) for in-patients hospitalised for more than six months was 0.08 (0.01, 0.48) for those who used family washing (p = 0.006) compared with those who used supplier washing. The number of visits per month and family structures before hospitalisation were not significantly associated. CONCLUSION: These results suggest that within a private psychiatric hospital in Japan, family washing is associated with shortened stays and frequency of family visits, while family structure is not associated with these factors.

Regional analysis of differently phosphorylated tau proteins in brains from patients with Alzheimer's disease.

Neurofibrillary tangles (NFT) in Alzheimer's disease (AD) are composed of abnormally phosphorylated tau proteins. Many phosphorylation sites have been reported in the AD brain, and NFT distribution was now roughly classified into 3 stages by Braak stage; this classification is based on pathological studies using the specific silver impregnation technique. The aim of our study was to examine the regional distribution of differently phosphorylated tau proteins with 5 site-specific monoclonal antibodies against the tau proteins, AT8, AT180, HT7, Tau2 and Tau5. We then compared our findings with those obtained from silver-stained NFT in an attempt to clarify the relationship between abnormal phosphorylation sites of the tau protein and NFT development. AT180 and AT8 labeled the highest and Tau2 the lowest density of NFT in any regions, while Tau5 and HT7 showed inconsistent distribution. In the limbic cortex, cornu ammonis, entorhinal cortex and cingulate cortex, silver-stained NFT density significantly correlated with density of NFT labeled with the 5 anti-tau antibodies, but cerebral isocortices showed heterogenous patterns of tau-positive NFT. Quantification of tau-positive regional NFT density showed that the AD-associated phosphorylation process progresses from the C-terminal to the N-terminal of the amino acid sequence, and correlation of Gallyas-stained NFT density with tau-labeled NFT density was more significant in the limbic cortices than the cerebral isocortices, which implies that stereotypical phosphorylation occurs in the limbic structures.