Psychiatric services最新文献_第6页

Outcomes of a Depression Screening and Postscreen Intervention Pilot Program in Specialty Clinics. 专科诊所抑郁筛查和筛查后干预试点项目的成果。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-01 Epub Date: 2024-09-23 DOI: 10.1176/appi.ps.20240049

Sarah E Asuquo, Patricia Girardi, Danica Dummer, Amanda V Bakian, Rachel A Weir

{"title":"Outcomes of a Depression Screening and Postscreen Intervention Pilot Program in Specialty Clinics.","authors":"Sarah E Asuquo, Patricia Girardi, Danica Dummer, Amanda V Bakian, Rachel A Weir","doi":"10.1176/appi.ps.20240049","DOIUrl":"10.1176/appi.ps.20240049","url":null,"abstract":"Objective: The authors evaluated the feasibility of automated depression screening and a follow-up postscreening protocol.Methods: Patient Health Questionnaire-2 (PHQ-2) and PHQ-9 screeners were sent to 20 specialty clinics and administered to patients who were ages ≥18 years, had not completed a PHQ-2 or PHQ-9 within the past 9 months, had no psychiatric diagnosis within the past 2 years, and had no behavioral health appointment within the previous year or an upcoming behavioral health appointment. In a two-pronged approach, patients with scores indicating moderate or moderately severe depression but with no indication of possible suicidal ideation were offered behavioral health resources (first prong), or patients with scores indicating severe depression or with possible suicidal ideation were contacted via telephone and requested to schedule a behavioral health appointment (second prong).Results: The PHQ-2 was offered to 21,674 patients, with 38.1% (N=8,247) completing the screening; 13.1% (N=1,084) of those with completed screens had a positive depression score. Of patients who completed the PHQ-9, 44.5% (N=650) were eligible for the first prong of the intervention and 31.1% (N=455) for the second prong. Depression screening completion rates differed significantly by multiple sociodemographic factors. Mean±SD lag times from screening completion to successful contact and from contact to appointment completion were 7±6 and 5±4 days, respectively.Conclusions: Automated depression screening with outreach based on depression severity is feasible and provides potentially efficient use of scarce resources. More research is needed on the mechanisms for automated screening and follow-up to examine factors such as patient engagement after a positive screening.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"163-168"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using Technology to Support Measurement-Based Care: Design and Implementation of the Measurement-Assisted Care Program. 利用技术支持基于测量的护理：测量辅助护理计划的设计与实施。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-01 Epub Date: 2024-10-23 DOI: 10.1176/appi.ps.20240135

Dana Steidtmann, Katie E Raffel, Joel Green, Edward MacPhee, Sarah Nagle-Yang, Sarah Schwenk, Danielle Cooke, Alejandra C Santisteban, Allison G Dempsey

{"title":"Using Technology to Support Measurement-Based Care: Design and Implementation of the Measurement-Assisted Care Program.","authors":"Dana Steidtmann, Katie E Raffel, Joel Green, Edward MacPhee, Sarah Nagle-Yang, Sarah Schwenk, Danielle Cooke, Alejandra C Santisteban, Allison G Dempsey","doi":"10.1176/appi.ps.20240135","DOIUrl":"10.1176/appi.ps.20240135","url":null,"abstract":"Objective: The authors aimed to increase measurement-based care in an outpatient academic psychiatry service.Methods: The Measurement-Assisted Care program (MAC) was implemented as a clinical quality-improvement effort that included 4,665 unique patients and 176 clinicians over 12 months. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder scale (GAD-7), PTSD Checklist for DSM-5, and Brief Inventory of Thriving were automatically included in the patient electronic check-in process for new visits; the PHQ-9 and GAD-7 were included for return visits. Patient responses were automatically routed to clinicians' electronic health record inboxes and documentation templates. MAC was rolled out in two phases, and clinicians were surveyed about their use of MAC data 3-6 months after the start of the program.Results: After implementation of MAC, PHQ-9 completion rates increased from 5% to 66% of visits for phase 1 and from 5% to 60% for phase 2. Post-MAC completion rates were higher for telehealth (70%) than for in-person (40%) visits. More than 90% of clinicians reported that MAC was useful with at least one of their three most recent patients, and 51% reported that it was useful with all three of their three most recent patients. Clinician adoption was high, with 78% reporting that they use MAC data to guide care.Conclusions: MAC increased the completion rate of patient-reported outcome measures, especially for telehealth visits. Clinicians reported that they frequently use and discuss MAC data with patients, implying that technology-supported workflows can help systems with high telehealth utilization capture and use patient-reported outcomes.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"126-132"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reply to Munetz.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-01 DOI: 10.1176/appi.ps.20240504

Rocksheng Zhong, Tobias Wasser

引用次数: 0

Advancing Measurement-Informed Care in Outpatient Community Behavioral Health. 在门诊社区行为健康中推进以测量为依据的护理。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-01 Epub Date: 2024-08-27 DOI: 10.1176/appi.ps.20240082

Deborah Scharf, Henry Chung, Joseph Parks

引用次数: 0

Cultural Conversations in Therapy: How Often Clients Talk About Their Identities. 治疗中的文化对话：客户谈论其身份的频率。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-01 Epub Date: 2024-10-29 DOI: 10.1176/appi.ps.20230266

Patty B Kuo, Brendalisse Rudecindo, Joanna M Drinane, Karen Tao, Jake Van Epps, Zac E Imel

{"title":"Cultural Conversations in Therapy: How Often Clients Talk About Their Identities.","authors":"Patty B Kuo, Brendalisse Rudecindo, Joanna M Drinane, Karen Tao, Jake Van Epps, Zac E Imel","doi":"10.1176/appi.ps.20230266","DOIUrl":"10.1176/appi.ps.20230266","url":null,"abstract":"Objective: The purpose of this study was to examine how often clients report discussing cultural identities during counseling sessions; the extent to which discussion of cultural identities during treatment varies across therapists; whether identifying as BIPOC (Black, Indigenous, and people of color) predicts clients' discussion of cultural identities in sessions; and whether differences in the frequency of cultural conversations (i.e., dialogue that focuses on client cultural identities) across client groups depend on the therapist.Methods: This study examined variation in reports of engagement in cultural conversations during sessions (N=10,731) with 1,997 clients and 72 therapists from a university counseling center. Data were analyzed by using Bayesian multilevel models.Results: Overall, clients reported having cultural conversations in 48.4% of sessions. Cultural conversations were much more likely to occur in sessions with BIPOC clients than with White clients: 66.2% of sessions with BIPOC clients involved conversations about cultural identities, compared with only 39.8% of sessions with White clients. Of note, the magnitude of this difference varied by therapist.Conclusion: Cultural conversations were more likely to occur in treatment with BIPOC clients than with White clients, and the presence of cultural conversations in treatment varied by therapist.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"133-138"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142522807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Psychotropic Polypharmacy Combinations and Duration of Polypharmacy Among Medicaid-Enrolled Youths. 医疗补助计划（Medicaid）参保青少年的精神药物复方组合和复方用药持续时间。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-01 Epub Date: 2024-08-14 DOI: 10.1176/appi.ps.20240113

Yueh-Yi Chiang, Alejandro Amill-Rosario, Phuong Tran, Susan dosReis

{"title":"Psychotropic Polypharmacy Combinations and Duration of Polypharmacy Among Medicaid-Enrolled Youths.","authors":"Yueh-Yi Chiang, Alejandro Amill-Rosario, Phuong Tran, Susan dosReis","doi":"10.1176/appi.ps.20240113","DOIUrl":"10.1176/appi.ps.20240113","url":null,"abstract":"Objective: This study evaluated psychotropic polypharmacy frequency and patterns of use among Medicaid-enrolled youths.Methods: A cross-sectional study of a state Medicaid claims database (2015-2020) focused on youths (≤17 years old) with at least one psychotropic medication claim and ≥90 continuous days of Medicaid enrollment. Psychotropic polypharmacy (claims for three or more therapeutic classes of psychotropics for ≥90 consecutive days) was analyzed as average annual days and annual prevalence of class combinations. Multivariable negative binomial regression models assessed changes in annual psychotropic polypharmacy days.Results: A total of 126,972 unique youths were identified. Almost all youths with psychotropic polypharmacy had three-class combinations, the most common of which included attention-deficit hyperactivity disorder medications, antipsychotics, and antidepressants. The number of polypharmacy days increased from a mean±SD of 227.8±90.3 in 2015 to 235.7±97.5 in 2020. Polypharmacy days significantly increased year over year (rate ratio=1.01, 95% CI=1.00-1.01).Conclusions: Psychotropic polypharmacy regimens reflect chronic use that is increasing over time.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"196-199"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

National Trends and Disparities in Suicidal Ideation, Attempts, and Health Care Utilization Among U.S. Adults. 美国成年人自杀意念、自杀未遂和使用医疗服务的全国趋势和差异。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-01 Epub Date: 2024-09-23 DOI: 10.1176/appi.ps.20230466

Hillary Samples, Naomi Cruz, Allison Corr, Farzana Akkas

{"title":"National Trends and Disparities in Suicidal Ideation, Attempts, and Health Care Utilization Among U.S. Adults.","authors":"Hillary Samples, Naomi Cruz, Allison Corr, Farzana Akkas","doi":"10.1176/appi.ps.20230466","DOIUrl":"10.1176/appi.ps.20230466","url":null,"abstract":"Objective: Recent trends in U.S. suicide rates underscore a need for research on the risk for suicidality. The authors aimed to estimate national trends in suicidal ideation, suicide attempts, and health care utilization by using data from the 2015-2019 National Survey on Drug Use and Health.Methods: Logistic regression was used to estimate the adjusted odds of past-year suicidal ideation and, among individuals with ideation, past-year suicide attempts, with separate interaction models estimating time trends by sex, age, and race-ethnicity. Time trends were further examined with logistic regression to estimate annual prevalence, overall and by sociodemographic, behavioral, and clinical characteristics. Logistic regression was used to estimate past-year general and mental health care utilization among adults with suicidal ideation. Analyses were survey weighted.Results: Overall, 4.3% (N=13,195) of adults (N=214,505) reported suicidal ideation, and 13.0% (N=2,009) of those with ideation reported suicide attempts. Increases in prevalence of suicidal ideation, from 4.0% in 2015 to 4.9% in 2019, were significantly higher for young adults ages 18-25 years (p=0.001) than for older adults. Decreases in prevalence of suicide attempts among White adults (by 32.9%) were offset by increases among adults reporting Black (by 48.0%) and multiracial or other (by 82.3%) race-ethnicity. Less than half of adults with suicidal ideation (47.8%) received past-year mental health care, with significantly lower receipt for nearly all minoritized racial-ethnic groups, compared with White adults.Conclusions: Widening racial-ethnic disparities in suicide attempts and lower mental health care utilization for minoritized groups underscore the importance of developing and implementing equity-focused, evidence-based suicide prevention strategies across health care settings.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"110-119"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

National Trends in and Concentration of Industry Payments to U.S. Psychiatrists, 2015-2021. 2015-2021 年美国精神病医生行业薪酬的全国趋势和集中度。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-01 Epub Date: 2024-10-23 DOI: 10.1176/appi.ps.20240218

John L Havlik, Lydia Ososanya, Deanna Tang, Syed Wahid, Joseph S Ross, Taeho Greg Rhee

引用次数: 0

Finding Alternatives to Futility for Gravely Disabling Serious Mental Illness.

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-01 DOI: 10.1176/appi.ps.20240449

Mark R Munetz

引用次数: 0

Understanding Involuntary Hospitalization Applications Submitted to an Urban Police Department. 了解向城市警察局提交的非自愿住院申请。

IF 3.3 3区医学

Psychiatric services Pub Date : 2025-02-01 Epub Date: 2024-11-05 DOI: 10.1176/appi.ps.20230411

Kevin M Simon, Jenna Savage, Lauryn Krebs, Trinity Wegiel, Melissa S Morabito

{"title":"Understanding Involuntary Hospitalization Applications Submitted to an Urban Police Department.","authors":"Kevin M Simon, Jenna Savage, Lauryn Krebs, Trinity Wegiel, Melissa S Morabito","doi":"10.1176/appi.ps.20230411","DOIUrl":"10.1176/appi.ps.20230411","url":null,"abstract":"Objective: To improve understanding of the application process for temporary involuntary hospitalization (Section 12 of the Massachusetts General Laws) in Boston, the authors focused on cases involving the Boston Police Department (PD) and the information shared about the individuals involved.Methods: A retrospective analysis was conducted on all Section 12 applications submitted to the Boston PD by external clinicians from July 14, 2021, to June 30, 2022. The authors analyzed 488 applications processed by the Boston PD's Street Outreach Unit, examining demographic information, reasons for requests, information provided by petitioners, and the status of the applications (completed vs. not).Results: The analysis revealed racial disparities: 41% of involuntary hospitalization applications were for individuals identified as Black or African American, but this racial group represents only 23% of Boston's population. Racial-ethnic data were based on police perceptions, and 21% of cases lacked race-ethnicity data. Seventy-six percent of applications were submitted without a direct clinical examination by petitioners, who did not justify the omission. The Boston PD completed 70% of the requested involuntary hospitalization orders.Conclusions: This study identified substantial racial disparities in Section 12 applications, which disproportionately involved Black or African American individuals. The frequent absence of direct clinical examinations before application submissions and the lack of justification indicated a need for regulatory oversight and enhanced petitioner training. Incomplete demographic data underscored the need for improved data collection and reporting practices. These findings highlight the need for reforms to ensure equitable, transparent, and best practice-aligned involuntary hospitalization processes.","PeriodicalId":20878,"journal":{"name":"Psychiatric services","volume":" ","pages":"120-125"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0