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 and interventions to delay gun access during high-risk periods were explored. METHODS:Ten focus groups and four individual interviews were conducted with key stakeholders, including VA mental health patients, mental health clinicians, family members and VA facility leaders (N=60). Transcripts were consensus-coded by two independent coders, and structured summaries were developed and reviewed using a consensus process. RESULTS:All stakeholder groups indicated that VA health system providers had a role in increasing patient safety and emphasized the need for providers to address gun access with their at-risk patients. However, VA mental health patients and clinicians reported limited discussion regarding gun access in VA mental health settings during routine care. Most, although not all, patients and clinicians indicated that routine screening for gun access was acceptable, with several noting that it was more acceptable for mental health patients. Most participants suggested that family and friends be involved in reducing gun access, but expressed concerns about potential family member safety. Participants generally found distribution of trigger locks acceptable, but were skeptical about its effectiveness. Involving Veteran Service Organizations or other individuals in temporarily holding guns during high-risk periods was acceptable to many participants but only with numerous caveats. CONCLUSIONS:Patients, clinicians and family members consider the VA health system to have a legitimate role in addressing gun safety. Several measures to delay gun access during high-risk periods for suicide were seen as acceptable and feasible if implemented thoughtfully.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Walters H,Kulkarni M,Forman J,Roeder K,Travis J,Valenstein Mdoi
10.1016/j.genhosppsych.2012.07.012subject
Has Abstractpub_date
2012-11-01 00:00:00pages
692-8issue
6eissn
0163-8343issn
1873-7714pii
S0163-8343(12)00261-7journal_volume
34pub_type
杂志文章abstract:OBJECTIVES:We examined whether primary care patients were more likely to perceive a current health problem as 'physical illness only' as opposed to entailing psychological difficulties if they had a comorbid somatoform disorder compared to patients who had (a) both comorbid somatoform disorder and anxiety/depression or...
journal_title:General hospital psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.genhosppsych.2015.01.002
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:Optimism is prospectively and independently associated with superior cardiac outcomes, but there has been minimal study of optimism-specific interventions in persons with cardiovascular illness. We aimed to examine the feasibility and impact of an optimism-promoting program among patients with heart disease i...
journal_title:General hospital psychiatry
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.genhosppsych.2017.12.004
更新日期:2018-01-01 00:00:00
abstract::Forty consecutive patients with disabling tinnitus were interviewed using a structured psychiatric interview and were asked to complete the Hopkins Symptom Checklist (SCL-90), the Chronic Illness Problem Inventory, and the Revised Ways of Coping Checklist. They were compared to a control group of 14 patients attending...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(88)90037-0
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence, correlates and recognition of depression among inpatients of general hospitals in Wuhan, China. METHOD:A total of 513 patients were randomly selected from 1923 inpatients from three general hospitals and evaluated with a Chinese version of the Structured Clinical Interview for Di...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2010.01.016
更新日期:2010-05-01 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:OBJECTIVE:Hospital crowding is a public health problem that may impact on the quality of medical treatment and increase the risk of developing traumatic stress, e.g., after myocardial infarction (MI). This study examines whether subjective appraisal of crowding at hospital admission due to MI is associated with acute s...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2015.11.004
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:Individuals with borderline personality disorder (BPD) consistently demonstrate high patterns of utilization in both mental health and non-psychiatric settings. However, utilization of primary care physicians by these individuals has not been examined. In this study, we examined physician use patterns and hyp...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2011.04.006
更新日期:2011-07-01 00:00:00
abstract::Sexual abuse is a common problem among female primary care medical patients. There is a wide spectrum of long-term sequelae, ranging from mild to the complex symptom profiles consistent with the theories of a posttraumatic sense of identity. Generally, the latter occurs in the context of severe, chronic abuse, beginni...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(98)00021-8
更新日期:1998-07-01 00:00:00
abstract::Somatization is a common phenomenon that has been defined in many ways. The two most widely used diagnoses, Somatization Disorder (SD) and Abridged Somatization Disorder (ASD), are based on lifetime unexplained symptoms. However, reports indicate instability in lifetime symptom recall among somatizing patients. Multis...
journal_title:General hospital psychiatry
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0163-8343(02)00247-5
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:The objective was to estimate the prevalence of both dementia and depression among community-dwelling older Americans and to determine if hospitalization is independently associated with dementia or depression in this population. METHOD:This cross-sectional study utilized data from a nationally representativ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2013.11.008
更新日期:2014-03-01 00:00:00
abstract::Several predictors of the course of depression and generalized anxiety have been identified. Whether these predictors provide a solid basis for primary care physicians (PCPs) to give an accurate prognosis remains unclear. A parallel study showed modest agreement between PCP prognosis and observed course (kappa< or = 0...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(02)00183-4
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:Anxiety and depressive disorders are widely prevalent, but patients are only treated in a minority of cases. In this study, the explanation of receiving mental health treatment is sought in predisposing and enabling characteristics and indicators for objective and self-perceived need. METHODS:Cross-sectional...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2008.09.011
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:Individuals with schizophrenia are more likely to develop diabetes than individuals without schizophrenia. The objective of this study was to determine the quality of diabetes care and diabetes-related health outcomes among individuals with and without schizophrenia. METHOD:We conducted a retrospective cohor...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2017.02.001
更新日期:2017-05-01 00:00:00
abstract::Children (N = 110) hospitalized on a child psychiatric unit improved significantly in psychological functioning at discharge and 1- and 6-months follow-up relative to their functioning at admission. Children who were more impaired at admission made more progress during admission but were more impaired at follow-up tha...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(01)00153-0
更新日期:2001-09-01 00:00:00
abstract::The Ras-Raf-mitogen-activated protein kinase/extracellular signal-regulated kinase (ERK) kinase (MEK)-ERK cascade is important in the intra-cellular transduction of neurotransmitters, such as dopamine and glutamate. Sorafenib (Nexavar), a multi-kinase inhibitor targeting Raf kinase, vascular endothelial growth factor ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2012.03.001
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:This study examined age group differences in the rates of depression diagnosis and treatment using a national probability sample. METHODS:Using data from the 2012 National Ambulatory Medical Care Survey (n=62,723 visits by patients aged 18+ years), we used bivariate and multivariable binary logistic regressi...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2016.08.002
更新日期:2016-01-01 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::The treatment of adolescents in a general hospital setting is fraught with difficulty. There are significant limitations to time, space, finances, and the physical plant. There are limitations to the numbers, types, mix of patients with other patients, and the types of treatment available. To deal with these issues, a...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(88)90097-7
更新日期:1988-03-01 00:00:00
abstract::Pernicious anemia has been associated with various psychiatric manifestations, such as depression, mania and psychosis. Psychiatric symptoms can sometimes occur without hematological and neurological abnormalities and can be prodromal of vitamin B12 deficiency. We report a case of autoimmune B12 deficiency presenting ...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2015.02.003
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:There is widespread concern about access to good quality health care for ethnic minority groups. This study investigates differences between ethnic groups regarding prevalence of anxiety and depression, and adherence to treatment guidelines by family practitioners in urban areas in the Netherlands. METHOD:Da...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2010.04.010
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:Catatonia is classically associated with psychiatric conditions but may occur in medical and neurologic disorders. Status epilepticus (SE) is a seizure lasting more than five minutes or two or more seizures within a five-minute period without interictal recovery of consciousness. Non-convulsive status epil...
journal_title:General hospital psychiatry
pub_type: 杂志文章,评审
doi:10.1016/j.genhosppsych.2020.11.008
更新日期:2021-01-01 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::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::Trichotillomania represents a syndrome of hair pulling in which patients compulsively and ritualistically pluck their hair in response to a sense of tension or urgency. This report documents a case of hair pulling associated with dementia. Neuropsychological testing demonstrated the deficits to be localized predominan...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/s0163-8343(01)00138-4
更新日期:2001-05-01 00:00:00
abstract::The following case presents a 22-year-old woman with relapsing polychondritis and depression treated in liaison, consultation, and outpatient settings by one psychiatrist using a variety of techniques. The discussion focuses on the implications of the case for integrated medical model and psychotherapeutic care, and f...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(83)90010-5
更新日期:1983-12-01 00:00:00
abstract:OBJECTIVE:Factors determining community tenure (CT) between subsequent referrals to a psychiatric emergency room (PER) are only partly understood. We investigated the differential effect of patient and health system characteristics on the CT of patients with a previous referral to a PER. METHOD:Data were collected for...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2005.04.003
更新日期:2005-07-01 00:00:00
abstract::Critical, intertwined objectives for consultation psychiatry include 1) the development of data-based clinical practices, and 2) heightening the effectiveness of consultation. Toward these ends, the Consultation Psychiatry Service at the University of Minnesota has previously conducted systematic studies of consultati...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/0163-8343(85)90020-9
更新日期:1985-04-01 00:00:00
abstract:OBJECTIVE:The distinction between acute and chronic suicidality is important, because interventions designed to address acute suicidality can worsen chronic suicidality, resulting in an escalating cycle of suicide threats, suicide attempts, and futile hospitalizations. Though most chronically suicidal borderline person...
journal_title:General hospital psychiatry
pub_type: 杂志文章,评审
doi:10.1016/j.genhosppsych.2020.08.014
更新日期:2020-01-01 00:00:00
abstract::Hashimoto's encephalopathy (HE), which carries kaleidoscopic clinical presentations, is easily misdiagnosed in clinical practice. Early diagnosis and prompt initiation of steroid therapy are associated with good prognosis. We describe a 50-year-old female patient who had subclinical hypothyroidism and who presented he...
journal_title:General hospital psychiatry
pub_type: 杂志文章
doi:10.1016/j.genhosppsych.2014.01.006
更新日期:2014-05-01 00:00:00
abstract::Family systems theory provides the physician with a comprehensive paradigm to investigate the social and interpersonal context of physical illness. All physical illnesses, particularly life-threatening and chronic ones, profoundly affect the family life of the patient, and the changed family circumstances in turn have...
journal_title:General hospital psychiatry
pub_type: 杂志文章,评审
doi:10.1016/0163-8343(90)90003-u
更新日期:1990-11-01 00:00:00