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 diabetes in a safety net clinic, and included 634 primary care clinic patients with hemoglobin A1c (HbA1c)>9%. HbA1c, blood pressure, and depression severity were assessed at the initial visit and at the end of treatment, and compared to those of patients who were not referred to the team. RESULTS:The 151 patients referred to the program between March 2013 and November 2014 had a higher initial mean HbA1c: 10.6% vs. 9.4%, and were more likely to have depression (p=0.006), anxiety (p=0.04), and bipolar disorder (p=0.03), compared to the 483 patients who were not referred. During the 18-month study period, there was a mean decrease in HbA1c of 0.9 (10.6 to 9.4) among those referred to the team, compared to a mean decrease of 0.2 (9.4 to 9.2) among those not referred. This was a significantly greater percent change in HbA1c (p=0.008). CONCLUSION:The integration of behavioral healthcare into chronic care management of patients with diabetes is a promising strategy to improve outcomes among the high risk population in safety net settings.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Chwastiak LA,Jackson SL,Russo J,DeKeyser P,Kiefer M,Belyeu B,Mertens K,Chew L,Lin Edoi
10.1016/j.genhosppsych.2016.10.005subject
Has Abstractpub_date
2017-01-01 00:00:00pages
10-15eissn
0163-8343issn
1873-7714pii
S0163-8343(16)30214-6journal_volume
44pub_type
杂志文章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
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：:Outpatient consultation-liaison (C-L) psychiatry has been beset with problems concerning funding and patient acceptance. Though the consultation, liaison, and referral clinic models for outpatient C-L psychiatry each offer advantages, they have not conquered these fundamental problems. This paper introduces the multid...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(93)90005-9
更新日期：1993-11-01 00:00:00
abstract：OBJECTIVE:Previous epidemiologic studies have documented a link between anxiety disorders and ulcer among adults. Few studies have examined these associations over time and little is understood about the pathways underlying these relationships. METHOD:Data were drawn from n = 2101 adult participants in the Midlife Dev...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.07.005
更新日期：2014-11-01 00:00:00
abstract：INTRODUCTION:Chemical restraint is controversial. Appropriate use is ill-defined and chemical restraint may be overutilized. During the period of an unrelated observational study for patients with acute psychomotor agitation in a psychiatric emergency service, we noticed a significant reduction in the number of involun...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2006.06.001
更新日期：2006-09-01 00:00:00
abstract：:A common problem facing the psychiatric consultant and the medical practitioner is evaluating depression in patients with concurrent medical illnesses. Depression is difficult to recognize in the medically ill, often presenting with "masked" symptoms and organized into unique syndromes. A primary concern of the clinic...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/0163-8343(92)90024-5
更新日期：1992-01-01 00:00:00
abstract：OBJECTIVE:This study sought to identify patient characteristics and care processes related to reengagement in VA psychotherapy. METHODS:Using national VA data, a retrospective cohort was constructed (N=24,492) of veterans who received a new PTSD diagnosis in FY08/FY09 and attended only one to five PTSD psychotherapy s...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2017.06.009
更新日期：2017-09-01 00:00:00
abstract：:Eating disorders like bulimia nervosa, generally considered to be rare in Asian countries, are currently on the rise among the youth, probably secondary to rapid westernization and globalization of the orient. Clinical manifestations of these disorders, which were previously thought to be different in the oriental cou...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.05.006
更新日期：2014-09-01 00:00:00
abstract：:Hyperthyroidism has profound effects on mental health. The literature is sparse, however, with regard to suicide attempts related to untreated hyperthyroidism. This case report illustrates the presentation of a patient in the intensive care unit after a life-threatening Tylenol overdose presumed to be secondary to adj...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2012.12.006
更新日期：2013-09-01 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：:Posterior reversible encephalopathy syndrome (PRES) is known to be caused by a variety of clinical disorders. The authors encountered a case of PRES associated with acute pancreatitis and chronic alcoholism. A 49-year-old man presented with altered mental status. Magnetic resonance imaging (MRI) displayed vasogenic ed...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.12.004
更新日期：2015-03-01 00:00:00
abstract：OBJECTIVES:This study aimed to compare the characteristics of psychiatric and nonpsychiatric suicidal inpatients in one general hospital and examine the predictors of completed suicide in the patients with suicidal acts during hospitalization. METHODS:One hundred ten study subjects were identified by the adverse event...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2008.12.008
更新日期：2009-03-01 00:00:00
abstract：:The biopsychosocial model has been promoted for its advantages in many important health problems. However, the lack of administrative practice models specifically designed to develop and promote the model hinder the development of systematic clinical applications. This article describes a successful clinical teaching ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(90)90045-e
更新日期：1990-09-01 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：:The aim of this study was to assess the prevalence of alcohol abuse in a general hospital inpatient population. The study population consisted of 1138 consecutive admissions to three surgical and two medical wards of the University Hospital Rotterdam during a 6-month period. According to the Munich Alcoholism Test (MA...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(94)90056-6
更新日期：1994-03-01 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：:We performed a randomized trial to prevent depression relapse in primary care by evaluating intervention effects on medication attitudes and self-management of depression. Three hundred and eighty six primary care patients at high risk for recurrent depression were randomized to receive a 12-month intervention. Interv...
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(03)00074-4
更新日期：2003-09-01 00:00:00
abstract：OBJECTIVE:Demoralization, a state of lowered morale and poor coping, has a prevalence of 13-18% among patients with advanced cancer. We surveyed clinicians' perspectives of the utility of "with demoralization" as a diagnostic specifier for adjustment and depressive disorders. METHOD:Using comparative clinical vignette...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2017.01.007
更新日期：2017-05-01 00:00:00
abstract：OBJECTIVE:This study aims to compare the prevalence of obsessive-compulsive spectrum disorders (OCSD) in psychiatric outpatients with and without a history of rheumatic fever (RF). METHODS:An analytical cross-sectional study assessing a large sample of consecutive psychiatric outpatients at a Brazilian private practic...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2008.11.003
更新日期：2009-03-01 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：:Alcohol use disorders (AUDs) are common among inpatients in general hospitals and often cause excess mortality. This study investigates the prevalence of AUDs among nonpsychiatric inpatients in one general hospital and evaluates the ability of medical staff to identify such morbidity. A two-phase case-identification s...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2004.01.001
更新日期：2004-05-01 00:00:00
abstract：OBJECTIVE:To report a case of Alzheimer's disease (AD) following mild traumatic brain injury (TBI). METHOD:Case report. RESULTS:We report the time course of AD following mild TBI with evidence of AD pathology. A patient complained of minor memory disturbance 6 months after TBI and was diagnosed with mild cognitive im...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2014.09.016
更新日期：2015-01-01 00:00:00
abstract：:Both electroconvulsive therapy (ECT) and paliperidone (PLP) can induce, though infrequently, severe cardiac side-effects. Thus far, no studies are available on the cardiac safety of their co-administration. We report on the cardiac safety of the ECT-PLP combination in nine female inpatients who underwent this treatmen...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2010.09.012
更新日期：2011-01-01 00:00:00
abstract：:Barriers to clear communication, such as culture, language, and other aspects of self-presentation may have an important impact on the doctor-patient relationship. When not addressed, cultural and linguistic issues can result in unreliable clinical histories, noncompliance with medical treatment, misinterpretation of ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/s0163-8343(03)00065-3
更新日期：2003-09-01 00:00:00
abstract：:This paper presents a checklist of conceptual issues and operational guidelines determining the organization of clinical services within a general hospital department of psychiatry. Issues emphasized include philosophy, target population, definition, structure, location, financing, and cost effectiveness of services, ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(81)90039-6
更新日期：1981-12-01 00:00:00
abstract：OBJECTIVE:To assess the performance of the Japanese version of the Patient Health Questionnaire-9 (J-PHQ-9) for depression in primary care. METHODS:Participants in both phases completed the J-PHQ-9, while patients in the second phase also completed the SF-8 (the short form for the health-related QOL scale SF-36). Subj...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2018.03.007
更新日期：2018-01-01 00:00:00
abstract：OBJECTIVE:Patients with factitious disorder (FD) fabricate illness, injury or impairment for psychological reasons and, as a result, misapply medical resources. The demographic and clinical profile of these patients has yet to be described in a sufficiently large sample, which has prevented clinicians from adopting an ...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/j.genhosppsych.2016.05.002
更新日期：2016-07-01 00:00:00
abstract：OBJECTIVE:To investigate longitudinal associations of burnout with heart rate variability (HRV) in patients after their first events of acute coronary syndrome (ACS). METHODS:In total, two hundred eight patients participated in this one-year follow-up study. On the day before discharge, their personal burnout level wa...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2018.05.008
更新日期：2018-01-01 00:00:00
abstract：:In this preliminary study, the experimental presence of a consulting psychiatrist at medical rounds was instituted in a busy city hospital emergency room. The psychiatrist was instructed only to respond to questions on psychiatric topics. Students were asked to record data from the discussions which occurred both with...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(84)90063-x
更新日期：1984-01-01 00:00:00
abstract：OBJECTIVE:The study sought to (1) understand the perspectives of perinatal psychiatric and antenatal health service workers on the service and support needs of mothers with schizophrenia; (2) obtain their views on the feasibility and potential effectiveness of a proposed parenting intervention tailored for this group. ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2007.12.001
更新日期：2008-03-01 00:00:00
