Abstract：
OBJECTIVE:We investigated the effects of limited time and high patient pressures on the role of gender and other nonpsychiatric factors in diagnostic decision making in psychiatric emergency services (PES). METHODS:We reviewed the records of 1236 adult psychiatric patients treated by 75 clinicians (e.g., psychiatrists, social workers, nurses and psychologists) in an urban university and community PES in early 2000. Patient records were sampled according to each clinician's level of busyness and load, controlling for the average number of patients typically seen and the actual volume of patients seen by the particular clinician during that shift. RESULTS:Multinomial logistic regression analyses reveal that clinicians are more likely to make a bipolar diagnosis when under low patient load [odds ratio (OR)=1.738, 95% confidence interval (CI)=1.186-2.546, P=.005] or when they have more time (OR=1.111, 95% CI=1.017-1.212, P<.019) and particularly when the patient is female (OR=0.286, 95% CI=0.1054-0.7785, P=.014). When clinicians are under high patient load, female patients are much more likely to receive a depressive disorder diagnosis (e.g., major depressive disorder and dysthymia) (OR=3.491, 95% CI=1.285-9.490, P=.014). CONCLUSIONS:The results highlight the potential difficulty of clinicians to differentiate bipolar disorder from other mental disorders when evaluating female patients, especially under high patient load, when social stereotypes may be more influential. The results have important implications for the use of antidepressant medications with female patients.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Muroff JR,Jackson JS,Mowbray CT,Himle JAdoi
10.1016/j.genhosppsych.2007.08.008subject
Has Abstractpub_date
2007-11-01 00:00:00pages
481-8issue
6eissn
0163-8343issn
1873-7714pii
S0163-8343(07)00174-0journal_volume
29pub_type
杂志文章abstract：:We are gaining experience in small intestine transplantation, however, the procedure is still experimental. Morbidity and mortality can be significant with frequent rehospitalizations. The indications for small intestine transplantation are varied though most patients have developed short gut syndrome requiring total ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(96)00079-5
更新日期：1996-11-01 00:00:00
abstract：:Using a standardized measure of health beliefs, this study sought to disentangle factors that contribute to increased medical service use in a sample of 64 high-utilizing elderly patients. In adjusted models, people with depressive symptoms were more likely than those without depression to believe that they were susce...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2004.09.010
更新日期：2005-03-01 00:00:00
abstract：:Ziconotide is used intrathecally in the management of severe chronic pain that contains a warning against neuropsychiatric adverse events. The definition of psychiatric events is broad and management strategies are vague. This case report describes a 49-year-old female who was admitted to the acute psychiatric unit to...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.10.001
更新日期：2015-01-01 00:00:00
abstract：:The differential diagnosis of hypercortisolemia is complex, particularly when the clinician must distinguish Cushing's syndrome (CS) from major depression. The present clinical case history demonstrates that by means of physical and laboratory examinations, the psychiatrist can make the initial differentiation, in con...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/0163-8343(95)00063-w
更新日期：1995-09-01 00:00:00
abstract：:Bupropion, a dual norepinephrine and dopamine reuptake inhibitor, has been approved by the United States Food and Drug Administration for the treatment of major depressive disorder. The most common treatment-emergent adverse events reported with bupropion were headache, dry mouth, nausea and agitation. The following i...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2011.01.010
更新日期：2011-07-01 00:00:00
abstract：:Factitious disorder by proxy (FDP) is a form of abuse in which a caregiver surreptitiously simulates or induces illnesses in a person for whom he or she cares. Typically, a mother is the perpetrator and at least one of her children is victimized. FDP has a high morbidity and mortality rate, and a knowledgeable health ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(95)00127-1
更新日期：1996-03-01 00:00:00
abstract：:This paper reports on the results of a pilot study comparing the efficacy of an experimental case review program between psychiatrists and primary care physicians (PCPs) with PCPs' usual care on the outcome of depressive disorders at 1-year. The secondary aim of the paper is to identify correlates of remission of depr...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(01)00182-7
更新日期：2002-03-01 00:00:00
abstract：OBJECTIVE:We examined the association between panic disorder (PD), physician-diagnosed cardiac disease (CD), and the interaction of these variables in relation to health care utilization, as measured by emergency department (ED) visitations, in an epidemiologic sample. METHODS:Subjects were identified from the Nationa...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2007.03.006
更新日期：2007-07-01 00:00:00
abstract：OBJECTIVE:To assess the following among women hospitalized antenatally due to high-risk pregnancies: (1) rates of depression symptoms and anxiety symptoms, (2) changes in depression symptoms and anxiety symptoms and, (3) rates of mental health treatment. METHODS:Sixty-two participants hospitalized for high-risk obstet...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.07.011
更新日期：2014-11-01 00:00:00
abstract：OBJECTIVE:Thyroid dysfunction is common during pregnancy and the postpartum period and is known to cause psychiatric disturbances. A woman with Graves' disease and psychosis in the postpartum period is described. METHODS:A 22-year-old woman with Graves' disease developed fluctuating orientation, catatonia, delusions o...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.07.003
更新日期：2014-11-01 00:00:00
abstract：:Drug abuse is a prevalent problem in society and often occurs as abuse of multiple substances. The authors present a model for understanding the clinical symptomatology and course of substance-induced organic mental disorders and present a hypothesis that explains how various factors might interact to produce the diso...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(86)90076-9
更新日期：1986-05-01 00:00:00
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 purpose of this study was to determine the effect of adjuvant light therapy with antipsychotic treatment in patients with delirium. METHODS:Thirty-six patients were referred to the consulting psychiatry division of our hospital for a disturbance in consciousness. The patients were randomized to risperido...
journal_title：General hospital psychiatry
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.genhosppsych.2012.05.003
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVE:Over the last decade, charcoal burning has become a common method of suicide in Taiwan; however, the underlying psychiatric diagnoses and gender differences have yet to be examined. METHODS:We conducted a retrospective chart review on inpatients after suicide attempt by charcoal burning during 2000-2010. The...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2012.03.015
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVE:The use of cell phones and short message service (SMS, also called "texting") has become pervasive in Western society and increasingly throughout the world. Despite the importance of this technology in everyday life, little is known about how patients draw on SMS to keep in contact with family and friends dur...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2012.03.006
更新日期：2012-07-01 00:00:00
abstract：:A liaison rounds is presented, one attended by all members of a consultation-liaison (C-L) team along with the medical director of a burn unit. This structure is designated as a "reverse liaison rounds," as it is the opposite of the conventional liaison meeting, which consists of one C-L consultant and the total nonps...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(88)90087-4
更新日期：1988-01-01 00:00:00
abstract：:The author reviews moral arguments supporting a right to medical care, as well as empirical data concerning the effects of mental illness on society, and explores their relevance to a rights-based claim to mental health care. He concludes that there is ample ethical justification for a right to mental health care, giv...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/s0163-8343(99)00047-x
更新日期：2000-01-01 00:00:00
abstract：:Cocaine use is an under-recognized risk factor of antipsychotic-induced acute dystonia. A case of a patient with psychotic illness and concurrent cocaine use developing acute dystonia with ziprasidone is described. ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2007.01.015
更新日期：2007-05-01 00:00:00
abstract：OBJECTIVE:Despite a good prognosis, the typically young age at diagnosis and physical sequelae may cause psychological distress in germ cell tumor survivors. We aimed to determine the frequency of anxiety and depression and analyze the impact of demographic and disease-related factors. METHOD:We enrolled N=164 testicu...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2015.09.001
更新日期：2016-01-01 00:00:00
abstract：OBJECTIVES:We compare treatment for depression among individuals with multiple chronic physical conditions to those with single chronic physical condition, after controlling for demographic, socioeconomic, access to care and the number of outpatient visits. METHODS:Using a cross-sectional study design, we analyzed dat...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2011.02.009
更新日期：2011-05-01 00:00:00
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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：:To test the hypothesis that depression is often inaccurately detected in medical settings, we examined the psychiatric consultations performed at two medical-surgical teaching hospitals. All records for the 4396 consultations seen in a 3-year period were retrospectively reviewed. Consultations were categorized by the ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(95)00089-5
更新日期：1996-01-01 00:00:00
abstract：:Advancing medical technology presents problems to medical professionals previously unforeseen. Psychiatric consultants are frequently called upon to assist staff, patients, and families in addressing these issues. The nursing staff of an infant intensive care unit was surveyed as to their perceptions of their work and...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(89)90037-6
更新日期：1989-05-01 00:00:00
abstract：:Posttraumatic stress disorder (PTSD) is associated with high numbers of self-reported physical symptoms and functional disability in clinical samples, but little is known about the magnitude of these associations in population samples and using actual physician-coded diagnoses. We administered a 22-page survey to 1225...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2004.04.005
更新日期：2004-07-01 00:00:00
abstract：:Utilization review (UR), Quality Assurance (QA), and Peer Review (PR) have become essential aspects in the practice of general hospital psychiatry. This article first defines and elaborates the basic elements of UR, QA, and PR and then outlines the development of a program for these professionally initiated and mainta...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(87)90010-7
更新日期：1987-05-01 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
abstract：:To ascertain how effective the Beck Depression Inventory for Primary Care (BDI-PC) was in screening for DSM-IV major depression disorders (MDD) in outpatients who were scheduled for routine office visits with physicians specializing in internal medicine, the BDI-PC was administered to 60 male and 60 female outpatients...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(98)00070-x
更新日期：1999-03-01 00:00:00
abstract：:In response to the spiraling anger and frustration voiced by the emergency room (ER) medical staff and the observed negative interactions between the alcohol-dependent patient and the ER staff, the author completed a 6-month retrospective review of all patients evaluated by the ER service with a complaint of alcohol a...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(85)90026-x
更新日期：1985-04-01 00:00:00
abstract：OBJECTIVE:The treatment of agitation in drug- and alcohol-using emergency patients is understudied. METHOD:We performed a retrospective chart review of 105 agitated emergency department patients who received either intramuscular (IM) haloperidol or IM olanzapine, comparing prescribing patterns, level of agitation, res...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.04.005
更新日期：2010-07-01 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
