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1.
Vertex ; 35(163, ene.-mar.): 88-99, 2024 Apr 10.
Artigo em Espanhol | MEDLINE | ID: mdl-38619993

RESUMO

Includes appreciations of the work: Shock treatments, psychosurgery and other somatic treatments in psychiatry, by Lothar Kalinowsky and Paul Hoch, Editorial Cientifica Médica, Barcelona, ​​1953.


Assuntos
Psiquiatria , Eletrochoque , Terapia Comportamental
2.
Vertex ; 35(163, ene.-mar.): 63-69, 2024 Apr 10.
Artigo em Espanhol | MEDLINE | ID: mdl-38619995

RESUMO

La escritura como la conocemos hoy en día es un desarrollo relativamente nuevo en la historia cultural de la humanidad. Más actual aún es la masividad de la alfabetización de la población. Desde los orígenes de la psiquiatría, la escritura forma parte inherente de ésta en la bibliografía médica pero también como una herramienta aplicada en la práctica en diversos formatos, tanto con fines diagnósticos como terapéuticos. No obstante, frente a las herramientas clásicas de comunicación, como el habla, y en la psiquiatría infantil, también el juego y el dibujo, la escritura parece haber sido relegada. En esta investigación bibliográfica, que no tendría antecedentes en su tipo, se realizó un recorrido histórico de la temática desde el surgimiento de la psiquiatría como especialidad hasta nuestros días; donde hechos como las Guerras Mundiales, la evolución del concepto de discapacidad o la pandemia por COVID-19 parecen haber jugado un papel clave para delimitar variables que caracterizan, al menos, tres períodos históricos y presumir un cuarto en plena gestación. El soporte tecnológico con el que se escribe y el uso y formato dado a la escritura resultaron las principales variables de los distintos períodos. Siendo ésta una época de muy alta demanda en Salud Mental, desafiante en su accesibilidad y la masividad en el uso de la escritura a partir de tecnologías de la información, esta investigación representaría un aporte significativo al desarrollo de la escritura como herramienta para la práctica de la psiquiatría y la salud mental.


Assuntos
Saúde Mental , Psiquiatria , Redação , Estudos Retrospectivos
3.
BMC Med Educ ; 24(1): 416, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38627742

RESUMO

BACKGROUND: Professionals are reluctant to make use of machine learning results for tasks like curriculum development if they do not understand how the results were generated and what they mean. Visualizations of peer reviewed medical literature can summarize enormous amounts of information but are difficult to interpret. This article reports the validation of the meaning of a self-organizing map derived from the Medline/PubMed index of peer reviewed medical literature by its capacity to coherently summarize the references of a core psychiatric textbook. METHODS: Reference lists from ten editions of Kaplan and Sadock's Comprehensive Textbook of Psychiatry were projected onto a self-organizing map trained on Medical Subject Headings annotating the complete set of peer reviewed medical research articles indexed in the Medline/PubMed database (MedSOM). K-means clustering was applied to references from every edition to examine the ability of the self-organizing map to coherently summarize the knowledge contained within the textbook. RESULTS: MedSOM coherently clustered references into six psychiatric knowledge domains across ten editions (1967-2017). Clustering occurred at the abstract level of broad psychiatric practice including General/adult psychiatry, Child psychiatry, and Administrative psychiatry. CONCLUSIONS: The uptake of visualizations of published medical literature by medical experts for purposes like curriculum development depends upon validation of the meaning of the visualizations. The current research demonstrates that a self-organizing map (MedSOM) can validate the stability and coherence of the references used to support the knowledge claims of a standard psychiatric textbook, linking the products of machine learning to a widely accepted standard of knowledge.


Assuntos
Algoritmos , Psiquiatria , Adulto , Criança , Humanos , Aprendizado de Máquina
5.
JMIR Med Educ ; 10: e54067, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38596832

RESUMO

Background: Undergraduate medical studies represent a wide range of learning opportunities served in the form of various teaching-learning modalities for medical learners. A clinical scenario is frequently used as a modality, followed by multiple-choice and open-ended questions among other learning and teaching methods. As such, script concordance tests (SCTs) can be used to promote a higher level of clinical reasoning. Recent technological developments have made generative artificial intelligence (AI)-based systems such as ChatGPT (OpenAI) available to assist clinician-educators in creating instructional materials. Objective: The main objective of this project is to explore how SCTs generated by ChatGPT compared to SCTs produced by clinical experts on 3 major elements: the scenario (stem), clinical questions, and expert opinion. Methods: This mixed method study evaluated 3 ChatGPT-generated SCTs with 3 expert-created SCTs using a predefined framework. Clinician-educators as well as resident doctors in psychiatry involved in undergraduate medical education in Quebec, Canada, evaluated via a web-based survey the 6 SCTs on 3 criteria: the scenario, clinical questions, and expert opinion. They were also asked to describe the strengths and weaknesses of the SCTs. Results: A total of 102 respondents assessed the SCTs. There were no significant distinctions between the 2 types of SCTs concerning the scenario (P=.84), clinical questions (P=.99), and expert opinion (P=.07), as interpretated by the respondents. Indeed, respondents struggled to differentiate between ChatGPT- and expert-generated SCTs. ChatGPT showcased promise in expediting SCT design, aligning well with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, albeit with a tendency toward caricatured scenarios and simplistic content. Conclusions: This study is the first to concentrate on the design of SCTs supported by AI in a period where medicine is changing swiftly and where technologies generated from AI are expanding much faster. This study suggests that ChatGPT can be a valuable tool in creating educational materials, and further validation is essential to ensure educational efficacy and accuracy.


Assuntos
Educação de Graduação em Medicina , Psiquiatria , Humanos , Inteligência Artificial , Aprendizagem , Canadá
7.
Scand J Med Sci Sports ; 34(4): e14627, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38610076

RESUMO

Sports psychiatry is a young field of medicine and psychiatry that focuses on mental health among athletes, and sports and exercise within psychiatry and mental disorders. However, the development of sports psychiatry and its fields of activity vary from region to region and are not uniform yet. Sports psychiatry and the role of sports psychiatrists have also already been discussed in the field of sports and exercise medicine, and within medical teams in competitive and elite sports. A uniform definition on sports psychiatry, its fields of activity, sports psychiatrist, and the essential knowledge, skills, and abilities (plus attitudes, eKSA+A) of the sports psychiatrist were developed as part of an International Society for Sports Psychiatry (ISSP) Summit, as well as First International Consensus Statement on Sports Psychiatry. Three fields of activity can be distinguished within sports psychiatry: (i) mental health and disorders in competitive and elite sports, (ii) sports and exercise in prevention of and treatment for mental disorders, and (iii) mental health and sport-specific mental disorders in recreational sports. Each of these fields have its own eKSA+A. The definitions on sports psychiatry and sports psychiatrists, as well as the framework of eKSA+A in the different fields of activity of sports psychiatrists will help to unify and standardize the future development of sports psychiatry, establish a standard of service within sports psychiatry and together with the neighboring disciplines, and should be included into current, and future sports psychiatry education and training.


Assuntos
Psiquiatria , Esportes , Humanos , 60475 , Exercício Físico , Atletas
8.
Health Aff (Millwood) ; 43(4): 557-566, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38560809

RESUMO

Perinatal psychiatry access programs offer a scalable approach to building the capacity of perinatal professionals to identify, assess, and treat mental health conditions. Little is known about access programs' implementation and the relative merits of differing approaches. We conducted surveys and semistructured interviews with access program staff and reviewed policy and procedure documents from the fifteen access programs that had been implemented in the United States as of March 2021, when the study was conducted. Since then, the number of access programs has grown to thirty state, regional, or national programs. Access programs implemented up to five program components, including telephone consultation with a perinatal psychiatry expert, one-time patient-facing consultation with a perinatal psychiatry expert, resource and referral to perinatal professionals or patients, trainings for perinatal professionals, and practice-level technical assistance. Characterizing population-based intervention models, such as perinatal psychiatry access programs, that address perinatal mental health conditions is a needed step toward evaluating and improving programs' implementation, reach, and effectiveness.


Assuntos
Serviços de Saúde Mental , Psiquiatria , Gravidez , Feminino , Humanos , Estados Unidos , Encaminhamento e Consulta , Saúde Mental , Telefone
9.
Lakartidningen ; 1212024 Apr 04.
Artigo em Sueco | MEDLINE | ID: mdl-38572715

RESUMO

In the last 20 years there has been an increased interest in research on psychedelic compounds for treatment of psychiatric conditions such as depression, anxiety and substance use disorders. Despite existing treatments being efficacious for many patients, this is not the case for up to a third of the patients with depression. Additionally, treatments are often long and associated with side effects. This review focuses on the psychedelic compound psilocybin, a serotonin-2A-receptor agonist that has been seen to reduce depression and anxiety in patients after administration of only a single dose, with effects lasting several weeks. Recent findings from phase II studies suggest that psilocybin treatment for depression is safe and efficacious. A phase III study is currently recruiting. Whether psychedelics will become a part of standard healthcare remains to be seen, but findings do give rise to cautious optimism.


Assuntos
Alucinógenos , Psiquiatria , Humanos , Alucinógenos/efeitos adversos , Psilocibina/efeitos adversos , Transtornos de Ansiedade
10.
Pap. psicol ; 45(1): 48-55, Ene-Abr, 2024. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-229716

RESUMO

Borderline personality (BPD) features and intimate partner violence (IPV) have been seen associated, focusing the research specially into perpetrators. The achievement of this systematic review is to analyze this relation in both victims and perpetrators, using 17 scientific articles published between 2017 and 2021 from different data bases. Most studies were focused on perpetrators, in which both men and women were equally represented as perpetrators. Instead, studies about victims were focused on women. Throughout this review, different factors observed in people with BPD traits who are victims or perpetrators of IPV are mentioned, finding particularities in each profile. These findings allow increase knowledge about the relationship between BPD and IPV, promoting a greater understanding that impacts positively on clinical intervention in this population.(AU)


Los rasgos límites de personalidad (TLP) se han visto asociados a violencia en la pareja, con investigaciones centradas especialmente en quienes la ejercen. El objetivo de esta revisión sistemática es analizar esta relación tanto en víctimas como en perpetradores, utilizando 17 artículos científicos publicados entre 2017 y 2021 en distintas bases de datos. Los estudios analizados se centraron mayoritariamente en perpetradores, encontrándose tanto hombres como mujeres igualmente representadas. En cambio, los estudios sobre víctimas atendían por lo general a mujeres. A lo largo de esta revisión, se mencionan distintos factores observados en personas que presentan rasgos TLP y ejercen o son víctimas de violencia de pareja, encontrando particularidades en cada perfil. Este trabajo permite incrementar el conocimiento sobre la relación existente entre TLP y violencia de pareja, fomentando una mayor comprensión que repercuta positivamente en la intervención clínica de esta población.(AU)


Assuntos
Humanos , Masculino , Feminino , Saúde Mental , Vítimas de Crime , Violência por Parceiro Íntimo , Transtorno da Personalidade Borderline , Psicologia , Psiquiatria
11.
Cult. cuid ; 28(68): 153-164, Abr 10, 2024.
Artigo em Espanhol | IBECS | ID: ibc-VR-418

RESUMO

En esta investigación presentamos una aproximación al cambio de mentalidad respecto a la enfermedad mental propugnada desde las obras de psiquiatras del primer franquismo como Antonio Vallejo-Nágera o Juan José López Ibor. Sus ideas, publicaciones e investigaciones ofrecieron al régimen la posibilidad de modificar las listas de internos e internas de las instituciones psiquiátricas del momento, cuyas camas comenzaron a ser ocupadas por personas procedentes de las cárceles, los hospitales militares o las calles, con el fin de someterlas a tratamientos y medicaciones para modificar unos comportamientos y actitudes señaladas por el saber psiquiátrico franquista como apartadas de lo “correcto” y “normal”.(AU)


Nesta investigação, apresentamos uma abordagem à mudançade mentalidade relativamente à doença mental defendidanas obras dos primeiros psiquiatras franquistas, comoAntonio Vallejo-Nágera e Juan José López Ibor. As suasideias, publicações e investigações ofereceram ao regime apossibilidade de modificar ases listas de internamento dasinstituições psiquiátricas da época, cujas camas passarama ser ocupadas por pessoas provenientes das prisões, doshospitais militares ou das ruas, com o objetivo de as submetera tratamento e medicação para modificar comportamentose atitudes que o saber psiquiátrico franquista consideravalonge de serem “correctos” e “normais”.(AU)


In this research we present an approach to the change ofmentality regarding mental illness advocated in the worksof early Francoist psychiatrists such as Antonio Vallejo-Nágera or Juan José López Ibor. Their ideas, publicationsand research offered the regime the possibility of modifyingthe lists of inmates of the psychiatric institutions of the time,whose beds began to be occupied by people from prisons,military hospitals or the streets, with the aim of subjectingthem to treatments and medications to modify behaviorsand attitudes identified by Franco's psychiatric knowledgeas being far from “correct” and “normal”.(AU)


Assuntos
Humanos , Masculino , Feminino , Transtornos Mentais , Psiquiatria/história , Saúde Mental , Repressão Psicológica
12.
Rev. esp. sanid. penit ; 26(1): 25-34, Ene-Abr. 2024. tab, graf
Artigo em Inglês, Espanhol | IBECS | ID: ibc-231144

RESUMO

Introducción: En el entorno penitenciario, hay una elevada incidencia de conductas autolesivas, con una tasa de suicidio superior a la existente en la población general. Estudios previos describen la asociación de factores sociodemográficos, clínicos y criminológicos, con el riesgo de suicidio en la población penitenciaria masculina, pero hay pocas investigaciones centradas en el análisis de la conducta suicida entre mujeres. El objetivo del trabajo es analizar las características de las internas que ingresan en una unidad psiquiátrica por presentar ideas de suicidio o haber realizado tentativas.Material y método: Análisis descriptivo y comparativo de 97 internos (68 hombres, 29 mujeres) ingresados en la Unidad de Hospitalización Psiquiátrica de la Penitenciaria de Cataluña (UHPP-C), por ideas de suicidio, entre el 1 de enero de 2017 y el 31 de diciembre de 2022. Resultados: Se encuentran diferencias respecto al lugar de nacimiento, con mayor presencia de nacionalidades africanas en varones no nacionales, mientras que las internas extranjeras suelen ser originarias de países latinoamericanos. Los hombres tienen menor edad media, con ingresos más prolongados y una mayor tasa de reingreso. También padecen más trastornos psicóticos y adictivos. Las mujeres presentan mayor prevalencia de trastornos de personalidad y cuadros afectivos. Conclusiones: Hay diferencias sociodemográficas y clínicas entre hombres y mujeres internos en prisión que requieren ingreso por ideación suicida. Incluir la perspectiva de género en los estudios sobre el riesgo suicida en la población penitenciaria puede proporcionar una base sólida para futuros estudios, permitiendo así una comprensión más completa de la ideación suicida y las necesidades de intervención en la población penitenciaria.(AU)


Introduction: There is a high incidence of self-harming behavior in the prison setting, with a suicide rate that is higher than that of the general population. Previous studies describe the association of sociodemographic, clinical, and criminological factors with the risk of suicide in the male prison population, but there is little research that specifically analyses suicidal behavior among women. The objective of this study is to analyze the characteristics of inmates who are admitted to a psychiatric unit for suicidal thoughts or attempted suicide. Material and method: Descriptive and comparative analysis of 97 inmates (68 men, 29 women) admitted to the Unidad de Hospitalización Psiquiátrica Penitenciaria de Cataluña (UHPP-C), for suicidal ideation, between January 1, 2017, and December 31, 2022. Results: There are differences in terms of place of birth, with a more significant presence of African nationalities in non-national males, while foreign inmates tend to come from Latin American countries. Men have a lower mean age, longer admissions, and a higher readmission rate. They also suffer from more psychotic and addictive disorders. Women have a higher prevalence of personality disorders and affective symptoms. Conclusions: There are sociodemographic and clinical differences between male and female prison inmates who require admission for suicidal ideation. Including a gender perspective in studies on suicide risk in the prison population can provide a solid foundation for future studies, thus allowing a more complete understanding of suicidal ideation and intervention needs in theprison population.(AU)


Assuntos
Humanos , Masculino , Feminino , Prisioneiros/psicologia , Perspectiva de Gênero , Comportamento Autodestrutivo , Suicídio , Ideação Suicida , Tentativa de Suicídio , Prisões , Espanha , Psiquiatria , Saúde Mental , Epidemiologia Descritiva
13.
Psychiatr Hung ; 39(1): 4-9, 2024.
Artigo em Húngaro | MEDLINE | ID: mdl-38502013

RESUMO

The relationship of mentally ill patients and the relational society has constantly changed during the course of history. The changes are true reflexions of the given society. In the management of behaviours disturbing community life medical treatment, law enforcement and religious measures change periodically, sometimes one, sometimes the other comes to the fore. One of the most influential spiritual currents of the 20th century has been the dismantling of large institutions, called deinstitutionalisation, which process could be experienced by the currently active professional generations. New ideas have followed each other since the turn of the millennium at an ever-accelerating pace. The postmodern age threatens to fragment our profession. The mentally ill person finds less and less space for the global suffering of his or her person to be heard. The system forces the professional to reflect the mental illness as a malfunction of an organ, or name it in the form of a recently published linguistic invention (diagnostic category). The global nature of the person is lost, in its biological, psychological, social and spiritual wholeness. This paper searches for and tries to articulate modern, forward-looking clues to the identity of psychiatry (and the psychiatrist). The facts of the subject of the person come to the fore, such as self-identity, value-drivenness, intentionality, future-orientation, and the spiritual dimension.


Assuntos
Transtornos Mentais , Psiquiatria , Feminino , Masculino , Humanos , 60475 , Ansiedade , Transtornos Mentais/terapia
14.
Psychiatr Hung ; 39(1): 24-35, 2024.
Artigo em Húngaro | MEDLINE | ID: mdl-38502016

RESUMO

In recent decades a global problem in mental health has been the increase in the relative proportion of patients who do not receive care, which is associated with loss of life years and deterioration in quality of life. The practical application of artificial intelligence (AI) can help in the fields of data analysis, diagnosis, therapy planning, among others in psychiatric care, thus reducing the human resource input. Today's artificial narrow intelligence (ANI), also known as weak AI, can recognise patterns and correlations in large data sets with the help of machine learning procedures and to make autonomous decisions while making its own refinements. The use of AI-based systems may be effective in the classification of mental health disorders, in disease prevention, in clinical diagnosis and treatment without human input, and finally, it can play a supporting role in many areas of data analysis (quality care assessment, research). A key area of diagnostics is the estimation of suicidal risk and the assessment of mood status using machine learning, which can be used to make predictions with high accuracy, by analysing written text or speech. By examining correlations within large data sets, advances in precision medicine could also be made, allowing more accurate prediction of medication. Psychotherapeutic programs using artificial intelligence are already available today, which can provide users with easily accessible help, mainly using cognitive therapy tools. In addition to its obvious benefits, the use of artificial intelligence also raises ethical and methodological questions, making its regulation a key issue for the future.


Assuntos
Terapia Cognitivo-Comportamental , Psiquiatria , Humanos , Inteligência Artificial , Qualidade de Vida , Psicoterapia
15.
Psychiatr Hung ; 39(1): 68-79, 2024.
Artigo em Húngaro | MEDLINE | ID: mdl-38502017

RESUMO

Tivadar Csontváry Kosztka, the great Hungarian artist was called a sort of a "crazy painter" by his contemporaries. Retrospectively, he was diagnosed as suffering not from psychosis but a schizotypal personality disorder based on seven out of nine diagnostic criteria. However, we still need a more precise definition of these criteria. It was also said that his paintings are like those made by the mentally ill. But following the principles and methods of the psychopathological art, especially that of Rennert, we find definitely more dissimilitudes than resemblances. In order to obtain a more accurate profile of this extraordinary creator, we still need further research focusing on the facts.


Assuntos
Pinturas , Psiquiatria , Masculino , Humanos , Hungria , Estudos Retrospectivos , Psicopatologia
16.
Harv Rev Psychiatry ; 32(2): 58-62, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38452285

RESUMO

ABSTRACT: Since the inclusion of gender identity disorder in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), psychiatry and the broader medical field have made substantial alterations in their recognition of and respect for transgender and gender diverse (TGD) identities. As this recognition continues to expand, psychiatrists should be aware of both historical harm and current best care practices, especially in light of psychiatric morbidity in TGD populations relative to the general population. This article contextualizes the history of psychiatry's engagement with TGD patients and presents the gender minority stress and resilience model to frame the mental health disparities experienced by TGD people. We envision a role for psychiatry that goes beyond gatekeeping gender-affirming hormone therapy and surgeries. Instead, we should invest in equitable care across the continuum of mental health needs. We provide an overview of existing literature to help characterize psychiatric epidemiology for this population, with the goal of offering guidance on how psychiatrists can deliver responsive and high-quality care for TGD people. Some key areas of proposed clinical improvement include culturally tailoring interventions for substance use disorders, reducing medical trauma in acute psychiatric care settings, and better understanding the interplay of psychopharmacology and gender-affirming hormone therapy.


Assuntos
Disforia de Gênero , Psiquiatria , Minorias Sexuais e de Gênero , Pessoas Transgênero , Adulto , Humanos , Disforia de Gênero/epidemiologia , Disforia de Gênero/terapia , Hormônios , Masculino , Feminino
18.
Tijdschr Psychiatr ; 66(2): 70-75, 2024.
Artigo em Holandês | MEDLINE | ID: mdl-38512144

RESUMO

Background The prevalence of smoking among patients with psychiatric disorders is 3-4 times higher than the general population. However, smoking is still permitted in many psychiatric clinics. The National Prevention Agreement (2018) mandates that all psychiatric wards be smoke-free by 2025. The UMC Utrecht clinics have been smoke-free since November 2020. Aim To examine healthcare workers’ attitudes before and after implementing the smoke-free policy. Method In an observational study with quantitative data analysis, data were collected in one center from healthcare workers in psychiatry departments with surveys. We collected demographic information, smoking status, attitudes towards the smoke-free policy, and its impact on patients and care. Incidents of aggression were prospectively recorded and reported in the MAP (aggression incidents in patient care). Results Out of 172 healthcare workers invited to participate, 30% (n = 52) completed the pre-implementation survey, and 20% (n = 34) completed the post-implementation survey. Prior to implementation, 62% (n = 32/52) of healthcare workers had a positive attitude towards the smoke-free policy, which increased to 77% (n = 26/34) post-implementation. Expectations of increased aggression incidents were reported by 62% (n = 32/52) during the pre-implementation phase. The number of aggression incidents was 46 in the one-year period before implementation (November 2019 – February 2020) and 45 incidents after implementation (November 2020 – February 2021). Conclusion This study supports the implementation of a smoke-free policy in psychiatric clinics due to the lack of a significant increase in aggression incidents. Healthcare workers perceived this outcome and observed quicker granting of ‘green’ freedoms.


Assuntos
Psiquiatria , Política Antifumo , Humanos , Agressão , Atitude do Pessoal de Saúde , Pessoal de Saúde
19.
Artigo em Inglês | MEDLINE | ID: mdl-38512183

RESUMO

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.Prim Care Companion CNS Disord 2024;26(2):23f03614. Author affiliations are listed at the end of this article.


Assuntos
Psiquiatria , Estimulação Magnética Transcraniana , Humanos , Hospitais Gerais , Pacientes Internados , Atenção Primária à Saúde
20.
Artigo em Inglês | MEDLINE | ID: mdl-38512188

RESUMO

Objective: Proactive consultation-liaison (C-L) psychiatry aims to meet the mental health needs of medical-surgical populations-many of which go unmet by the conventional C-L model-through systematic screening and integrated care. We implemented an automated screening list to enhance case identification of an existing proactive C-L service and evaluated service metrics along with clinician- and patient-reported outcomes.Methods: Service outcomes were evaluated using historical and contemporary comparison data. Adjusted difference-in-difference analyses were used to determine change in consult characteristics, mean length of stay (LOS), and scores on Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). Practitioners and nurses were surveyed regarding service satisfaction, perceived safety, and burnout.Results: During the intervention, the consult rate was 3-fold higher than at baseline. Change in time to consultation was equivocal. Overall mean LOS was not reduced, but observed LOS was 1.2 days shorter than expected among non-COVID patients receiving psychiatric consultation (P = not significant). Mean patient-rated hospital satisfaction on HCAHPS was 1 point higher on intervention units during the intervention. Surveys revealed broad satisfaction with this model among practitioners and improved perception of safety among nurses.Conclusions: Proactive C-L psychiatry enhanced by automated screening was associated with improved service utilization and evidence suggestive of LOS reduction among those most likely to receive direct benefit from this model of care. Further, both patient and clinician ratings were improved during the intervention. Proactive C-L psychiatry provides benefits to patients, clinicians, and health systems and may be poised to achieve the Triple Aim in health care.Prim Care Companion CNS Disord 2024;26(2):23m03647. Author affiliations are listed at the end of this article.


Assuntos
Psiquiatria , Humanos , Hospitais , Tempo de Internação , Saúde Mental , Encaminhamento e Consulta
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