[Homeless persons residing in shelters in the county of Funen I. Psychosocial characteristics and need of treatment]. / Hjemløse på forsorgshjem og herberger i Fyns Amt I. Psykosocial karakteristik og behandlingsbehov.

In the County of Funen (population 460,000) 120 homeless people resided in shelters for homeless people during week 49, 1996. Of these homeless persons, 94 (or 78%) were examined using ICD-10 and the Addiction Severity Index. Ninety percent were men, 90% were aged 20-59 years, 98% were unmarried or separated/divorced. Seventy-one percent had lived alone during the past three years, only 2% were employed, and sources of income for 83% were public assistance or disability pensions. The population of homeless people was divided into three groups: 1) Psychoses were found in 13 cases or 14%--schizophrenia (4%), paranoid psychosis (4%) and affective disorder (5%). About 2/3 had double disorder, psychosis plus substance abuse. 2) Sixty-four or 68% were non-psychotic homeless people, who had alcohol/substance abuse (53 or 83%) and/or personality disorder (57 or 89%). 3) Seventeen or 18% had no mental illness. About 60% had been sentenced to prison at least once. About 20% needed psychiatric treatment.

[Homeless persons residing in shelters in the county of Funen II. Comparison between 1990 and 1996 and occurrence of mental disease]. / Hjemløse på forsorgshjem og herberger i Fyns Amt II. Sammenligning mellem 1990 og 1996 af forekomsten af psykisk lidelse.

The question has been raised whether the change from hospital to community psychiatry is accompanied by an increasing number of the mentally ill in institutions for homeless people. During week 49, 1996, the residents in institutions for homeless people in the County of Funen were interviewed and diagnosed according to ICD-8, and the results were compared with a similar study from week 47, 1990. The prevalence of psychoses was 11% in 1990 and 14% in 1996. This difference was not significant. Significantly fewer psychotic homeless people were treated for their psychotic disorders in 1996 compared with 1990. The prevalence of alcoholics had fallen by 35%, while the prevalence of narcotics and cannabis addicts had risen by 78% and 110%, respectively. These changes were statistically significant. There was still a high prevalence of personality disorders, 70% in 1990 and 60% in 1996. Even though the deinstitutionalization of the psychiatric service has not been accompanied by more psychotic patients in institutions for the homeless, the clientele is still heavily strained with psychosis, personality disorder and substance abuse.

[Differences between male and female alcoholics and differences in their need of treatment]. / Forskelle mellem kvindelige og mandlige alkoholmisbrugere og forskelle i deres behandlingsbehov.

The present study covers 375 consecutive patients referred to the three outpatient clinics at the Psychiatric Department of Odense University Hospital from November 1995 to February 1997. The aim of the study was to describe differences in problem profiles for men and women. All patients were assessed by means of the Addiction Severity Index at admission. All patients needed treatment for alcohol problems. Significantly more female alcoholics, however, had problems with mental health, physical health, drug use and family/social life. More men than women had legal problems. Almost half of the women had previously attempted to commit suicide, and almost one third of the women suffered from anxiety disorder at the time of admission. Significantly more women than men had partner who also had an alcohol problem.

[Factors related to suicidal behavior among alcoholics]. / Faktorer relateret til suicidal adfaerd blandt alkoholmisbrugere.

Of 181 alcoholics who consecutively sought treatment as out- or inpatients, 68 (37.6%) had attempted suicide at least once. Compared with non-attempters, the suicide attempters were significantly more likely to be female, have had a chaotic upbringing and to have known suicide attempts in the family and social circle. Significantly more attempters suffered from depressive disorder, feelings of hopelessness, anxiety attacks, agoraphobia, substance abuse or cluster B personality disorders (dissocial, impulsive, borderline, and histrionic). Also significantly more suicide attempters had committed crimes and received early pension. Assessment of coping showed that suicide attempters had a significantly lower tendency to make plans or to make the best of a stressful situation by growing from it. They were significantly more likely to show mental disengagement, to resort to denial and drink alcohol or take drugs when faced with stressful events or difficulties. When evaluated on the Addiction Severity Index Scale, the suicide attempters were found to have a significantly greater need of treatment.

[The staff's experience of patient violence in a psychiatric department]. / Personalets oplevelse af patientvold på en psykiatrisk afdeling.

Three hundred and thirty individuals (80% of the total staff members at a Department of Psychiatry) completed a questionnaire concerning their exposure to patient violence. It was found that over 90% of physicians, nurses and nursing aides had been subjected to patient violence at least once during the entire course of their employment in departments of psychiatry. The following percentages were found for incidents of patients violence occurring during a one year period towards staff while employed in departments of psychiatry: residents (17%), nurses (36%), and nursing aides (52%). The highest frequency was found for nursing staff working in closed wards (75%). Length of employment, and thereby the staff's experience, was not related to exposure to patient violence. Neither sex nor age of the nursing staff were significantly associated with their exposure to patient violence. About 1/3 of the nurses and nursing aides had considered changing their job because of patient violence.

[Sex differences in alcoholics at a psychiatric emergency clinic]. / Kønsforskelle blandt alkoholmisbrugere på en psykiatrisk skadestue.

All patients attending the psychiatric emergency clinic at Odense University Hospital in the period 2.9-6.10.1985 were interviewed by a psychiatric nurse and physician in order to determine disease pattern and social circumstances. The present investigation deals with sex distribution of alcoholics in the data collected. In the period, 141 patients with alcoholic problems were registered; of these 97 were men and 44 women. It was found that more female alcoholics than male were married/cohabiting. Unemployment was very high for both groups; almost 80 per cent being unemployed. A great number of the women had interpersonal conflicts, but apart from that the sex difference for amount of psychosocial strain was not significant. Drug abuse and affective reactions were significantly more frequent in women. More women than men were found to suffer from character neuroses, and more men than women were deviants, but this may be a reflection of a diagnostic tradition. It must be concluded that more similarities than differences were found between male and female alcoholics attending the psychiatric emergency department.

[Psychosocial strain among patients at a psychiatric emergency unit]. / Psykosocial belastning blandt patienter på psykiatrisk skadestue.

The frequency of psychosocial strain was systematically registered concerning 330 consecutive patients in the psychiatric emergency unit in Odense. Psychosocial strain was found in 211 patients (63.9%). In all, 551 stressful events were reported, which corresponds 2.5 per patient. Distribution of psychosocial strain by age, sex and civil status revealed no statistically significant correlation at the level of p less than 0.05, but there was a tendency towards greater strain among young persons, women and married/cohabiant patients. All those seeking education had psychosocial strain, while there were significantly fewer patients with psychosocial strain among early retirees and old age pensioners. The investigation showed that there were significantly fewer schizophrenic patients with psychosocial strain, and significantly more patients with strain were found among those with affective reactions and attempted suicides compared with the other patient categories. The most frequently occurring form of strain in all diagnosis groups was interpersonal conflict with a close person. In most cases the strain was not the result of an external catastrophe, and often the patient may himself have contributed in causing the psychosocial strain. This opens the possibility for socialpsychiatric intervention.