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[PMID]:29179833
[Au] Autor:Aagaard J; Tuszewski B; Kølbæk P
[Ad] Endereço:Aarhus University Hospital, Risskov DK-8240, Denmark; Aalborg University Hospital, Psychiatric Hospital, Center for Psychosis Research, Aalborg DK-9000, Denmark. Electronic address: joaa@rn.dk.
[Ti] Título:Does Assertive Community Treatment Reduce the Use of Compulsory Admissions?
[So] Source:Arch Psychiatr Nurs;31(6):641-646, 2017 12.
[Is] ISSN:1532-8228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The growing number of compulsory admissions in Denmark and other countries is a compelling challenge. We hypothesized that Assertive Community Treatment (ACT) may have the quality to reduce the use of several type of coercion including compulsory admissions. Although ACT is not designed for coercion prevention, it may prove efficient in averting major crisis among the included patients. Studies in Denmark showed that ACT has a major and significant advantage in reducing number and length of admissions. METHODS/DESIGN: We collected service data from National Case Register at three psychiatric hospitals, which constitutes the inpatient and outpatient mental health services in the North Denmark Region. Data included psychiatric and somatic service use among 240 patients starting in ACT. Primary measure concerned the extent to which ACT might reduce compulsory admissions. RESULTS: During a five years period patients allocated to ACT show decreasing admission trends. In comparison with all other psychiatric service users, we found a significant difference in trends concerning voluntary admissions and involuntary admissions according to the dangerous criterion, and decrease in number of contacts to Psychiatric Emergency Room (PER) CONCLUSION: An assertive approach undoubtedly reduces hospitalization including some involuntary admissions. ACT is preferable from both team and patient perspectives, and further caused reduction of PER visits compared to standard treatment. PERSPECTIVES: The criterion of Severe Mental Illness (SMI) may be revised to facilitate ACT to be offered to a larger group of SMI patients. In addition, introduction of Crisis Intervention Teams should be considered and allocated to PER.
[Mh] Termos MeSH primário: Coerção
Internação Compulsória de Doente Mental/estatística & dados numéricos
Serviços Comunitários de Saúde Mental/utilização
Transtornos Mentais/terapia
[Mh] Termos MeSH secundário: Adulto
Serviços Comunitários de Saúde Mental/estatística & dados numéricos
Intervenção na Crise/métodos
Dinamarca
Feminino
Hospitais Psiquiátricos
Seres Humanos
Pacientes Internados/estatística & dados numéricos
Masculino
Transtornos Mentais/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:28465383
[Au] Autor:Newton-Howes G; Ryan CJ
[Ad] Endereço:Giles Newton-Howes, MBChB, MRCPsych, FRANZCP, Department of Psychological Medicine, University of Otago, Wellington, New Zealand; Christopher James Ryan, MBBS, MHL, FRANZCP, Discipline of Psychiatry and the Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, Australia giles.newton-howes@otago.ac.nz.
[Ti] Título:The use of community treatment orders in competent patients is not justified.
[So] Source:Br J Psychiatry;210(5):311-312, 2017 05.
[Is] ISSN:1472-1465
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Empirical evidence for the effectiveness of community treatment orders (CTOs) is at best mixed. We examine CTOs through the prism of human rights and discrimination, bearing the evidence in mind, and argue that a necessary condition for their use is that a person lacks decision-making capacity.
[Mh] Termos MeSH primário: Internação Compulsória de Doente Mental/legislação & jurisprudência
Serviços Comunitários de Saúde Mental/legislação & jurisprudência
Competência Mental/legislação & jurisprudência
Transtornos Mentais/terapia
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Violações dos Direitos Humanos/legislação & jurisprudência
Seres Humanos
Direitos do Paciente/legislação & jurisprudência
Psiquiatria
Reino Unido
[Pt] Tipo de publicação:EDITORIAL
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1192/bjp.bp.116.193920


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[PMID]:28464805
[Au] Autor:Riley H; Straume B; Høyer G
[Ad] Endereço:Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway. henriette.riley@uit.no.
[Ti] Título:Patients on outpatient commitment orders in Northern Norway.
[So] Source:BMC Psychiatry;17(1):157, 2017 05 02.
[Is] ISSN:1471-244X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In recent years, an increasing number of countries have introduced outpatient commitment orders (OC), which imply that patients can be subject to compulsory follow-up and treatment while living in the community. However, few studies on how OC is practised have been published. METHOD: Retrospective case register study based on medical files of all patients receiving an OC order in 2008-2012. We used a pre/post design, recording the use of inpatient services three years before and three years after for those patients who received their first ever OC order in 2008 and 2009. RESULTS: A total of 345 OC orders applying to 286 persons were identified in the study period 2008-2012. Incidence and prevalence rates were relatively stable, but decreased during the last years of the study period. For all the 54 patients receiving their first ever OC order in 2008 and 2009, need for treatment was the reason for imposing OC, and all received psychotropic medication. The number of inpatient admissions and inpatient days was greater, while the number of days for each admission was lower three years after the OC order than three years before. The first ever OC lasted under a year for 76% of the patients. Receiving depot medication and follow-up by psychiatrists predicted longer OC durations than such treatment and care by psychologists. Only nine patients were not hospitalized during the three-year follow-up after the first ever OC order. CONCLUSION: Patients on first ever OC orders in Northern Norway used inpatient services more after OC orders than before. Further studies are needed to explore whether increased use of inpatient services by OC patients is beneficial or a failure of OC.
[Mh] Termos MeSH primário: Assistência Ambulatorial/estatística & dados numéricos
Internação Compulsória de Doente Mental
Transtornos Mentais/epidemiologia
Serviços de Saúde Mental/estatística & dados numéricos
Aceitação pelo Paciente de Cuidados de Saúde
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Incidência
Masculino
Transtornos Mentais/terapia
Meia-Idade
Noruega/epidemiologia
Prevalência
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s12888-017-1331-1


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[PMID]:29210256
[Au] Autor:Dute J
[Ti] Título:European Court of Human Rights.
[So] Source:Eur J Health Law;24(1):105-12, 2017 Mar.
[Is] ISSN:0929-0273
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Alcoolismo/complicações
Internação Compulsória de Doente Mental/legislação & jurisprudência
Demência/induzido quimicamente
Competência Mental/legislação & jurisprudência
[Mh] Termos MeSH secundário: República Tcheca
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE; LEGAL CASES
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:29210250
[Au] Autor:Dute J
[Ti] Título:European Court of Human Rights.
[So] Source:Eur J Health Law;23(5):525-37, 2016 Dec.
[Is] ISSN:0929-0273
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Mh] Termos MeSH primário: Prisioneiros/legislação & jurisprudência
[Mh] Termos MeSH secundário: Internação Compulsória de Doente Mental/legislação & jurisprudência
Alemanha
Hepatite/tratamento farmacológico
Dependência de Heroína/tratamento farmacológico
Seres Humanos
Masculino
Tratamento de Substituição de Opiáceos
Federação Russa
Esquizofrenia Paranoide
Tuberculose/tratamento farmacológico
Ucrânia
[Pt] Tipo de publicação:JOURNAL ARTICLE; LEGAL CASES
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171228
[Lr] Data última revisão:
171228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


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[PMID]:27777274
[Au] Autor:Swartz MS; Bhattacharya S; Robertson AG; Swanson JW
[Ad] Endereço:1 Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
[Ti] Título:Involuntary Outpatient Commitment and the Elusive Pursuit of Violence Prevention.
[So] Source:Can J Psychiatry;62(2):102-108, 2017 Feb.
[Is] ISSN:1497-0015
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Involuntary outpatient commitment (OPC)-also referred to as 'assisted outpatient treatment' or 'community treatment orders'-are civil court orders whereby persons with serious mental illness and repeated hospitalisations are ordered to adhere to community-based treatment. Increasingly, in the United States, OPC is promoted to policy makers as a means to prevent violence committed by persons with mental illness. This article reviews the background and context for promotion of OPC for violence prevention and the empirical evidence for the use of OPC for this goal. METHOD: Relevant publications were identified for review in PubMed, Ovid Medline, PsycINFO, personal communications, and relevant Internet searches of advocacy and policy-related publications. RESULTS: Most research on OPC has focussed on outcomes such as community functioning and hospital recidivism and not on interpersonal violence. As a result, research on violence towards others has been limited but suggests that low-level acts of interpersonal violence such as minor, noninjurious altercations without weapon use and arrests can be reduced by OPC, but there is no evidence that OPC can reduce major acts of violence resulting in injury or weapon use. The impact of OPC on major violence, including mass shootings, is difficult to assess because of their low base rates. CONCLUSIONS: Effective implementation of OPC, when combined with intensive community services and applied for an adequate duration to take effect, can improve treatment adherence and related outcomes, but its promise as an effective means to reduce serious acts of violence is unknown.
[Mh] Termos MeSH primário: Internação Compulsória de Doente Mental
Transtornos Mentais/terapia
Violência/prevenção & controle
[Mh] Termos MeSH secundário: Seres Humanos
Transtornos Mentais/complicações
Transtornos Mentais/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171208
[Lr] Data última revisão:
171208
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1177/0706743716675857


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[PMID]:28792578
[Au] Autor:Thibault I; Pauzé R; Lavoie É; Mercier M; Pesant C; Monthuy-Blanc J; Gagnon-Girouard MP
[Ad] Endereço:Département de psychoéducation, Université de Sherbrooke.
[Ti] Título:[Identification of promising practices in the treatment of anorexia nervosa].
[Ti] Título:Identification des pratiques prometteuses dans le traitement de l'anorexie mentale..
[So] Source:Sante Ment Que;42(1):379-390, 2017.
[Is] ISSN:0383-6320
[Cp] País de publicação:Canada
[La] Idioma:fre
[Ab] Resumo:Anorexia nervosa concerned, firstly, because this disorder is associated with many medical complications and secondly, because it is linked with a poor prognosis. Given these facts, it is imperative that effective treatments be available for anorexia nervosa. This article aims to present a systematic review of the literature on the best therapeutic modalities in the field of anorexia nervosa. Among these, we find outpatient treatment, importance of multidisciplinary team and various therapeutic approachs, like familial therapy.
[Mh] Termos MeSH primário: Anorexia Nervosa/terapia
[Mh] Termos MeSH secundário: Terapia Cognitiva
Internação Compulsória de Doente Mental
Terapia Familiar
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE


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[PMID]:29073180
[Au] Autor:Hung YY; Chan HY; Pan YJ
[Ad] Endereço:Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan.
[Ti] Título:Risk factors for readmission in schizophrenia patients following involuntary admission.
[So] Source:PLoS One;12(10):e0186768, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Individuals with schizophrenia who are involuntarily admitted may have poorer prognosis, including higher readmission rates, than those voluntarily admitted. However, little is known about the risk factors for readmission in those schizophrenia patients who are involuntarily admitted. AIMS: We aim to explore the risk factors for readmission in this population. METHOD: We enrolled 138 schizophrenia patients with involuntary admission from July 2008 to June 2013 and followed those patients for readmission outcomes at 3 months and at 1 year. RESULTS: The one-year and 3-months readmission rates were 33.3% and 15.2%, respectively. Unmarried status (adjusted odds ratio (aOR) = 6.28, 95% CI: 1.48-26.62), previous history of involuntary admission (aOR = 4.08, 95% CI: 1.19-14.02), longer involuntary admission days (aOR = 1.04, 95% CI: 1.01-1.07) and shorter total admission days (aOR = 1.03, 95% CI: 1.01-1.05) were associated with increased risk for 1-year readmission. Younger age (aOR = 1.10, 95% CI 1.02-1.18) was associated with increased risk for 3-months readmission. CONCLUSIONS: Unmarried status, prior history of involuntary admission, longer involuntary admission days and shorter total admission days were associated with increased risk for 1-year readmission. Healthcare providers may need to focus on patients with these risk factors to reduce subsequent readmissions.
[Mh] Termos MeSH primário: Internação Compulsória de Doente Mental
Readmissão do Paciente
Esquizofrenia/terapia
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Fatores de Risco
Fatores Socioeconômicos
Taiwan
Fatores de Tempo
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171027
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186768


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[PMID]:28987051
[Au] Autor:Heitzman J; Markiewicz I
[Ad] Endereço:Instytut Psychiatrii i Neurologii, Klinika Psychiatrii Sadowej.
[Ti] Título:Financing of forensic psychiatry in view of treatment quality and threat to public safety.
[Ti] Título:Finansowanie psychiatrii sadowej a jakosc leczenia i zagrozenie bezpieczenstwa publicznego..
[So] Source:Psychiatr Pol;51(4):599-608, 2017 Aug 29.
[Is] ISSN:2391-5854
[Cp] País de publicação:Poland
[La] Idioma:eng; pol
[Ab] Resumo:Stay in a psychiatric hospital of persons who committed the gravest criminal acts while in a state of insanity aims to ensure their effective treatment (therapeutic function), but above all to prevent the repetition of prohibited acts of significant harm to the community (preventive function). Forensic patients are provided with suitable medical, psychiatric, rehabilitation and resocialization care. The court imposes an indefinite detention. In view of the dual purpose of the stay in a psychiatric hospital, both therapeutic and preventive, the treatment costs generated by forensic wards are higher than those of general psychiatric wards. This prompts person from outside psychiatry, who do not understand the nature of preventive measures, to call for continuing reductions in the expenditure on forensic psychiatric care. It is, therefore, worth analyzing the possible meaning and results of the attempts to economizeforensic psychiatry, to find savings and to manipulate financing system under the pretence of economic incentive to improve treatment quality. In this paper, the authors address and discuss the above and other issues.
[Mh] Termos MeSH primário: Internação Compulsória de Doente Mental/legislação & jurisprudência
Serviços Comunitários de Saúde Mental/legislação & jurisprudência
Reforma dos Serviços de Saúde/legislação & jurisprudência
Necessidades e Demandas de Serviços de Saúde/legislação & jurisprudência
Segurança/legislação & jurisprudência
[Mh] Termos MeSH secundário: Hospitais Psiquiátricos/legislação & jurisprudência
Seres Humanos
Alta do Paciente/legislação & jurisprudência
Competência Profissional/legislação & jurisprudência
Saúde Pública/legislação & jurisprudência
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171008
[St] Status:MEDLINE


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[PMID]:28837717
[Au] Autor:Sisti DA
[Ad] Endereço:Department of Medical Ethics and Health Policy, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
[Ti] Título:Nonvoluntary Psychiatric Treatment Is Distinct From Involuntary Psychiatric Treatment.
[So] Source:JAMA;318(11):999-1000, 2017 Sep 19.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Temas Bioéticos
Internação Compulsória de Doente Mental
Transtornos Mentais/terapia
Terminologia como Assunto
[Mh] Termos MeSH secundário: Diretivas Antecipadas
Internação Compulsória de Doente Mental/legislação & jurisprudência
Hospitais Psiquiátricos
Seres Humanos
Competência Mental
Semântica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170825
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.10318



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