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 personality disorder patients improve and do not complete suicide, the potential for suicide contributes to these hospitalizations and a paucity of outpatient services due to treaters' concern over malpractice lawsuits in case of suicide. Communicating with patients' families about the suicide risk has been suggested as a means to mitigate this malpractice risk, but the approach to such communication has not been described. METHOD:Once chronic suicidality is identified, a stepwise approach to communicating with the patient's family is described. RESULTS:The potential benefits of this risk communication are described, for patients, families, treaters, healthcare systems, and health and malpractice insurers. CONCLUSION:It helps to develop an alliance with families and patients around a shared understanding of outcomes in chronic suicidality - most eventually do better, but the risk of completed suicide is real. This enables patients and families to make a more fully informed choice about treatment, which in turn can reduce litigation risk in the minority of cases where the patient completes suicide.
journal_name
Gen Hosp Psychiatryjournal_title
General hospital psychiatryauthors
Mammen O,Tew J,Painter T,Bettinelli E,Beckjord Jdoi
10.1016/j.genhosppsych.2020.08.014subject
Has Abstractpub_date
2020-01-01 00:00:00pages
51-57eissn
0163-8343issn
1873-7714pii
S0163-8343(20)30133-Xjournal_volume
67pub_type
杂志文章,评审abstract：:Catatonia is a rare syndrome that occurs in mood and psychotic disorders, and general medical conditions. Postpartum depression affects 10%-15% of women within 6 months after delivery. Postpartum psychosis affects 0.1%-0.5% of women within weeks after delivery, though it can occur within hours; it carries risk for sui...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2011.11.010
更新日期：2012-07-01 00:00:00
abstract：OBJECTIVE:This article reviews all available literature concerning the implications of Type D personality (the conjoint effects of negative affectivity and social inhibition) among patients with noncardiovascular conditions. METHODS:Published papers were included if they studied Type D personality among noncardiovascu...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/j.genhosppsych.2009.09.010
更新日期：2010-01-01 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：OBJECTIVE:To report a rare case of self-inflicted eye injury secondary to obsessive-compulsive disorder (OCD). METHOD:Case report. RESULTS:A 41 year-old patient had significant bilateral visual loss and blunt trauma through touching his ocular cavities due to recurrent doubts regarding their shape and urges to check ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2008.08.007
更新日期：2009-05-01 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：OBJECTIVE:To determine whether a smartphone application (app) with an electronic headache diary and a progressive muscle relaxation (PMR) intervention is feasible and acceptable to people presenting to the Emergency Department (ED) with migraine. METHODS:This single arm prospective study assessed feasibility by actual...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2020.12.009
更新日期：2021-01-08 00:00:00
abstract：:Psychiatric morbidity among 240 pregnant women attending an antenatal unit was assessed by a two-stage screening procedure, using the General Health Questionnaire (GHQ-30) and Present State Examination Schedule (PSE). The prevalence of psychiatric morbidity was found to be significantly associated with younger age (< ...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(93)90109-2
更新日期：1993-03-01 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：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：:A 29-year-old single Puerto Rican woman with AIDS was admitted to the Medical Service for pneumonia, seen by the Psychiatric Consultation Service, an eventually transferred to the Inpatient Psychiatric Unit with several possible psychiatric diagnoses including major depression, HIV dementia, delirium, and posttraumati...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(94)90119-8
更新日期：1994-11-01 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：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：OBJECTIVE:To investigate the prevalence of depression among otolaryngology patients with medically unexplained symptoms (MUS) and the outcome of treatment with selective serotonin reuptake inhibitors (SSRIs). METHOD:Ninety patients with MUS from a population of 983 consecutive otolaryngology outpatients were enrolled....
journal_title：General hospital psychiatry
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.genhosppsych.2011.09.014
更新日期：2012-03-01 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:Neuropsychiatric symptoms may be the main manifestations and very early symptoms of developing autoimmune diseases. Early detection and treatment could reverse psychotic symptoms and restore cognitive function. CASE REPORT:A 24-year-old woman presented with acute psychotic symptoms. Routine physical examinat...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2012.02.005
更新日期：2012-09-01 00:00:00
abstract：:In this study, 96 frequent attender patients in primary care were compared with 466 other primary care patients. The focus was on psychiatric morbidity, current and former psychiatric treatment, and self-perceived need for treatment. The prevalence of psychiatric illness was much greater among frequent attender patien...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(94)00059-m
更新日期：1995-01-01 00:00:00
abstract：:This study examines 100 consecutive patient referrals from a general medical clinic to psychiatric social work. While much has been written from a theoretical or anecdotal perspective on the contribution of social work to medical care, there have been relatively few attempts to look in detail at actual practices. Of t...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(84)90074-4
更新日期：1984-04-01 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：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：: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：OBJECTIVE:Missed appointments are associated with poorer health outcomes. We predicted that compared to secure attachment style, fearful and dismissing attachment styles would be associated with greater number of missed primary care visits in patients with diabetes. METHODS:In patients with diabetes from nine health m...
journal_title：General hospital psychiatry
pub_type： 杂志文章,多中心研究
doi：10.1016/j.genhosppsych.2005.07.004
更新日期：2006-01-01 00:00:00
abstract：:The microcomputer allows for the design of a system that functions integrally with both the day-to-day and long-term needs of a consultation-liaison psychiatric service. This article describes a microcomputer system and data structure that can accomplish many of the same research tasks as a minicomputer system. In add...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(85)90022-2
更新日期：1985-04-01 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：:A 63-year-old married man with idiopathic terminal cardiomyopathy was admitted to the medical service for treatment of advanced heart failure. A psychiatric consultation was requested to assist the medical treatment team in dealing with the patient's abusive behavior. The case is presented and discussed within the con...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(92)90099-v
更新日期：1992-07-01 00:00:00
abstract：:Appreciation of the role of milieu in psychiatry has waxed and waned in response to various scientific, ideologic, and social pressures. In this review, historical trends in the use of environment in treatment of mental illness are integrated with social science and empirical research studies of milieu. While the insi...
journal_title：General hospital psychiatry
pub_type： 杂志文章,评审
doi：10.1016/0163-8343(82)90030-5
更新日期：1982-04-01 00:00:00
abstract：:Bone marrow transplantation offers new hope for cure in a variety of leukemias, aplastic anemia, and other immunodeficiency and hematologic disorders. But the psychologic circumstances accompanying this procedure are often profoundly stressful. The evolution of consultation--liaison services on a bone marrow transplan...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(88)90006-0
更新日期：1988-09-01 00:00:00
abstract：OBJECTIVE:Multiple barriers to quality health care may affect the outcomes of postacute treatment for individuals with serious mental illness (SMI). This study examined rehospitalization for medical and surgical inpatients with and without a comorbid diagnosis of SMI which included psychotic disorders, bipolar disorder...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/j.genhosppsych.2016.06.002
更新日期：2016-09-01 00:00:00
abstract：:The authors explore the difficulties present in the capacity evaluation of patients with strong religious beliefs. The article reviews the legal protection for treatment refusal on religious grounds as well as psychiatry's approach to religion. Clinical cases encountered in an urban hospital are presented to highlight...
journal_title：General hospital psychiatry
pub_type： 杂志文章
doi：10.1016/0163-8343(96)00003-5
更新日期：1996-05-01 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：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
