Abstract:
INTRODUCTION:Rural populations remain underserved in terms of psychiatric services. This study assesses changes over time in the utilization of telepsychiatric services by individual primary care providers (PCPs) and clinics in rural areas, specifically: (a) types of referrals for telepsychiatry service; (b) PCPs' knowledge and skills related to medication dosing; and (c) PCPs' satisfaction with telepsychiatry. METHODS:Data with regard to patient demographics, diagnoses, reason for consultation, medication dosing and satisfaction were prospectively collected on the first 200 and the subsequent 200 telepsychiatric initial consultations. A number of educational interventions were implemented during the project. RESULTS:Adult patients were primarily referred for mood and anxiety disorders, particularly for diagnosis and medication treatment planning. Over time, PCPs significantly improved medication dosing and asked for more treatment planning help. PCPs' satisfaction also improved over time. DISCUSSION:Telepsychiatric consultation, in combination with specific educational interventions, appears to facilitate the enhancement of skills and knowledge of PCPs. "Developmental" steps in provider and clinic evolution, along with interventions specific to a given provider's and a given site's needs, ought to be further elucidated.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Hilty DM,Yellowlees PM,Nesbitt TSdoi
10.1016/j.genhosppsych.2006.05.009subject
Has Abstractpub_date
2006-09-01 00:00:00pages
367-73issue
5eissn
0163-8343issn
1873-7714pii
S0163-8343(06)00094-6journal_volume
28pub_type
杂志文章abstract::Issues of suicidal ideation, life-threatening behavior, and vulnerability in cancer patients are addressed. A review of pertinent literature is presented, including the areas of: suicide as a taboo topic; incidence of suicide in cancer patients; identifying patients' suicide potential; and suicide as coping behavior. ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(79)90055-0
更新日期:1979-07-01 00:00:00
abstract:OBJECTIVE:The objective was to examine the feasibility, acceptability and preliminary effectiveness of a brief version of Interpersonal Psychotherapy for Depressed Adolescents (BIPT-A) in low-income Latino adolescents treated in an urban pediatric primary care setting. METHOD:Ten adolescents, ages 12 to 19 years, who ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2015.04.013
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Oral loading with the delayed release formulation of divalproex sodium is widely used for the treatment of patients with acute mania and produces rapid attainment of therapeutic serum levels. Recently, an extended release formulation of divalproex sodium (divalproex ER) was approved for treatment of migraine...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2005.02.001
更新日期:2005-05-01 00:00:00
abstract::Efforts to improve the care of depression in primary care patients have largely ignored the potential of obstetrics/gynecology (OB/GYN) practices. We describe feasibility studies of a depression screening and care management intervention in three diverse OB/GYN practices. Patients were screened using the Patient Healt...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(03)00006-9
更新日期:2003-03-01 00:00:00
abstract::The occurrence of malignant catatonia in pregnancy is a psychiatric emergency. In this article, we present the case of a pregnant woman with a first psychotic episode with catatonic features, autonomic abnormalities and elevated creatinine phosphokinase levels in the context of a severe adverse reaction to antipsychot...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2006.10.003
更新日期:2007-01-01 00:00:00
abstract::Of growing concern has been the phenomenon of psychoactive chemicals legally marketed as a variety of products such as "bath salts" or "herbal incense." There is little in the formal literature about actual adverse effects of such chemicals. We have two cases of a paranoid psychosis in individuals consuming methylened...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2011.04.010
更新日期:2011-11-01 00:00:00
abstract::The present study aims to validate the Spanish version of the Hospital Anxiety and Depression Scale (HADS) and to determine the use of this tool for screening mood and anxiety disorders. Psychometric properties of the HADS were assessed in different groups of general medical outpatients attending the Hospital Clínic i...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(03)00043-4
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:To characterize temporal trends and outcomes of invasive mechanical ventilation (MV) for people with severe mental disorders (SMD) admitted due to natural causes. METHODS:We identified all 224,507 hospitalizations of patients aged 15-69 who underwent MV in Spain between 2000 and 2015, excluding poisonings an...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2020.04.007
更新日期:2020-01-01 00:00:00
abstract::This article presents research involving the comparison of levels of occupational stress across multiple units of a large teaching hospital. Using a scale designed to measure a four-component model of occupational stress in medical environments, the results indicated that a significant amount of the variation in this ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(87)90053-3
更新日期:1987-11-01 00:00:00
abstract::Psychological intervention studies designed to reduce cardiac morbidity are reviewed. Preliminary findings suggest that various psychotherapeutic modalities may be effective. Such studies also provide an avenue through which the physical and psychological mechanisms involved in coronary heart disease and their interac...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(79)90074-4
更新日期:1979-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to examine the extent of health care utilisation (excluding costs) of diabetic patients with and without depressive symptoms attending a specialist clinic in Singapore. METHODS:A total of 537 Asian outpatients (aged 21 years and above) who were attending a Diabetes Centre were...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2009.01.001
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the association between alcohol use routinely reported during outpatient mental healthcare visits and short-term risk of subsequent suicide attempt. METHODS:Using a longitudinal retrospective-cohort design, electronic health records identified adult outpatient visits to a mental health provider (...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2019.12.002
更新日期:2020-01-01 00:00:00
abstract::This paper, the first in a series commissioned by NIMH for the "Challenges for the 21st Century: Mental Health Services Research Conference," seeks to provide a broad perspective on the primary care/mental health interface in the United States. The manuscript examines both the care of mental disorders in medical setti...
journal_title:General hospital psychiatry
pub_type: 历史文章,杂志文章
doi:10.1016/s0163-8343(02)00170-6
更新日期:2002-07-01 00:00:00
abstract::As part of a population study on the prevalence of psychopathology, users of "Over-The-Counter" Psychotropics (OTC-Ps) were studied. First, their mental health profile was examined by a number of subjective and objective assessments. Second, the medical consumption of the users was studied with special attention to th...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(00)00078-5
更新日期:2000-07-01 00:00:00
abstract::Cannabis in its various forms has been known since time immemorial, the use of which has been rising steadily in India. 'Bad trips' have been documented after cannabis use, manifestations ranging from vague anxiety and fear to profoundly disturbing states of terror and psychosis. Cannabis is known to affect various ne...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2013.06.010
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:This study examined if associations between body mass index (BMI) and mental and physical health were independent of genetic and familial factors. METHOD:Data from 2831 twins (66% female) were used in an epidemiological co-twin control design with measures of BMI and mental and physical health outcomes. Gene...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2013.04.004
更新日期:2013-09-01 00:00:00
abstract::This study documents the effect of an untimely death on a group of patients in a psychiatric inpatient unit. The large community meeting was used as a forum to characterize unique bereavement patterns in a subgroup of schizophrenic patients. Nonschizophrenic patients tended to reach out to obtain comfort and support, ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(96)00040-0
更新日期:1996-07-01 00:00:00
abstract::The authors present a case of dietary vitamin B12 deficiency in a patient with multiple sclerosis. A simple schemata for evaluating patients for vitamin B12 deficiency is included as a clinical aid for physicians. ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(94)90105-8
更新日期:1994-05-01 00:00:00
abstract::The relationships specified in DSM-III between somatization disorder and depression, and somatization disorder and hypochondriasis require further validation and easier methods of detection for use by primary care physicians. The authors investigated hypochondriacal and depressive symptoms in 13 family practice outpat...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(85)90045-3
更新日期:1985-10-01 00:00:00
abstract::Additional psychiatric disorders in eating disorders patients may contribute to the risk of suicide and suicide attempts. The aim of this study was to examine associations between Axes I and II comorbidity and suicidality in a large sample of women currently suffering from an eating disorder (ED). In a sample of 288 w...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2003.10.005
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Delusional disorder is an uncommon psychotic disorder. The first-line treatments for this chronic and resistant condition are antipsychotic medications, usually associated with several side effects that can exacerbate poor adherence. Conversely, aripiprazole is a well-tolerated antipsychotic drug that is eff...
journal_title:General hospital psychiatry
pub_type: 杂志文章,评审
doi:10.1016/j.genhosppsych.2020.06.012
更新日期:2020-01-01 00:00:00
abstract::Prospective data were gathered from 388 psychiatric consultations performed in a general hospital setting. Data included demographic, medical, psychiatric, and illness behavior characteristics of the patients seen, as well as consultant functions and recommendations. Results indicate that consulted patients suffer fro...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(80)90063-8
更新日期:1980-09-01 00:00:00
abstract::Every day there are 6000-7000 papers published in science. Since the C-L psychiatrist may be asked to consult on a patient with any medical illness, and who may be on any medical drug, methods need to be developed to review the recent literature and have an awareness of current findings. At the same time, teachers nee...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(99)00049-3
更新日期:1999-11-01 00:00:00
abstract::We assessed differences in the referral rates of African-American and Caucasian elderly for geropsychiatric consultation. Reasons for referral, assigned diagnoses, and interventions made were also compared. A retrospective chart review of psychiatric consultations was completed for patients aged 65 years and older for...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(97)00004-2
更新日期:1997-05-01 00:00:00
abstract::Piracetam is a cognitive-enhancing agent that is used for the treatment of cognitive impairments of various etiologies. Little is known about its side effect profile, especially in those with psychiatric illness. We herewith present two cases with cognitive impairment who had contrasting responses to piracetam. One of...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2012.05.009
更新日期:2013-07-01 00:00:00
abstract::This study examines the recognition and treatment of emotional distress in physically healthy primary care patients who perceive themselves to be in fair or poor physical health. Patients (N = 892) from three private primary care practices completed a mental health screening form prior to their medical visit which inc...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(95)00023-k
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVES:The majority of VA patient suicides are completed with firearms. Interventions that delay patients' gun access during high-risk periods may reduce suicide, but may not be acceptable to VA stakeholders or may be challenging to implement. Using qualitative methods, stakeholders' perceptions about gun safety an...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2012.07.012
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:Demonstrate the feasibility of implementing a collaborative care program for poorly-controlled type 2 diabetes and complex behavioral health disorders in an urban academically-affiliated safety net primary care clinic. METHODS:This retrospective cohort study evaluates multidisciplinary team care approach to ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2016.10.005
更新日期:2017-01-01 00:00:00
abstract::Systematic assessment of the effect of clinical research studies on child and parent participants has been limited. Such assessment could provide an empirical basis for the ethical conduct of research, assisting investigators and institutional review boards in balancing the need for sound research with the need to pro...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(02)00200-1
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:Psychogenic factors may play a contributory role in the development or persistence of lichen simplex chronicus (LSC). The objective of this study was to evaluate the psychiatric profile of patients with LSC including depression and dissociative experiences. METHOD:Dermatology outpatients with a LSC (n=30) we...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2007.01.006
更新日期:2007-05-01 00:00:00