Treatment, psychiatric hospitalization

Fortunately, new treatments have greatly improved the plight of the patient with schizophrenia. Thanks in large part to the introduction of newer antipsychotic medications, few patients with this disease spend their lives in long-term psychiatric hospitals anymore. However, we have a long way to go. Individuals with schizophrenia are currently a sizeable proportion of both the homeless population and the prison population in the United States. Even with the great advances in schizophrenia treatment in the last 50 years, this illness still takes a tremendous toll on the lives of its sufferers and their families. 

Pfeffer, C.R., Jiang H., and Domeshek, L.J. (1997) Buspirone treatment of psychiatrically hospitalized prepubertal children with symptoms of anxiey and moderately severe aggression. J Child Adolesc Psychopharmacol 7 145—155. 

Buitelaar, J.K. (2000) Open-label treatment with risperidone of 26 psychiatrically hospitalized children and adolescents with mixed diagnoses and aggressive behavior. / Child Adolesc Psychopharmacol 10 19-26. 

McElroy SL, Keck PE Jr, Pope EIG Jr, et al Valproate in primary psychiatric disorders literature review and clinical experience in a private psychiatric hospital, in Use of Anticonvulsants in Psychiatry Recent Advances. Edited by McElroy SL, Pope HG Jr. Clifton, NJ, Oxford Health Care, 1988b McElroy SL, Keck PE Jr, Pope HG Jr, et al Valproate in the treatment of rapid-cycling bipolar disorder. J Clin Psychopharmacol 8 275-279, 1988c McElroy SL, Sessain EC, Pope HG Jr, et al Clozapine in the treatment of psychotic mood disorders, schizoaffective disorder and schizophrenia. J Clin Psychiatry 52 411-414, 1991a... 

After 3,4 and 5 years the long-term effects of these treatments were examined. The criterion of success was taken to be the number of days spent by the patients in psychiatric hospitals since the firsi hospitalization and since their discharge from first hospitalization. 

FYRof Macedonia ARQ 2005 98.7% - - - 1.3% - - 902 Psychiatric Hospital "Skopje", in-patient and out-patient facilities, 5 new Services for prevention and treatment of drug use and neuro-psychiatrics departments in aeneral hosDitals... 

The importance of this history is that it meant there was a precedent for the use of lithium as a medicine. It also meant that lithium was readily available for experimentation in the pharmacies of psychiatric hospitals. Therefore when John Cade, an Australian psychiatrist, suggested that lithium might be a useful treatment in people with mania in the 1940s, it did not seem curious. Cade also experimented with use of the elements strontium and cerium in the treatment of psychiatric disorders, but they never caught on in the same way because there was no prior history of medicinal use. 

About half of ah people being treated for MPD require brief hospitalization, and only 5% are primarily or exclusively treated in psychiatric hospitals. According to the NIMH (National Institute of Mental Health) study, although sometimes mood altering medications such as tranquilizers or antidepressants are prescribed for MPD patients, they are often diagnosed as having anxiety or depression rather than the multiple personality disorder. The treatment of MPD lasts an average of four years. 

Flynn J, Grieger TA, Benedeck DM. Pharmacologic treatment of hospitalized patients with schizoaffective disorder. Psychiatric Serv 2002 53 94-96. 

We, as doctors, want our psychiatric hospitals. .. to be looked upon as treatment centers for sick people in the same sense that general hospitals are so viewed. ... 

These finding s demonstrate the immense economic dependence of psychiatrists on institutional employment. In other Western countries, where economic opportunities and social demands for private psychiatric services are much less than in the United States, the proportion of psychiatrists working in mental and other institutions is even greater. In Britain, for example, only 4.5 percent of the psychiatrists spend more than half their working time in private practice 69 percent are employed on a full-time basis in the National Health Service and 77 percent spend at least part of their time engaged in the treatment of hospital inpatients (as against 51 percent of American psychiatrists). In communist countries, all psychiatry is, of course. Institutional Psychiatry. 

The first MHA was passed in 1959, bringing together various statutes and case law. This allowed both voluntary and conpulsory admission, and treatment of patients in psychiatric hospitals. It was replaced by the MHA 1983, which remains in force, adding statutory powers to manage patients in the community. 

Another challenge involves how community-based mental health clinicians can complement the delivery of services by school personnel. Sometimes, school personnel may turn to community-based mental health providers to assist students in need of more acutely intensive services provided through a continuum of care in the community (e.g., family stabilization teams, emergency room coverage, and psychiatric hospitalization). In these instances, collaboration between school and community mental health personnel is essential to engage the student and family in treatment to ensure necessary consultation and follow-up. 

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