Psychiatric services (Washington, D.C.)最新文献_第8页

Adapting the Cultural Formulation Interview for the Military. 适应军队文化公式化面试。

IF 3.8

Psychiatric services (Washington, D.C.) Pub Date : 2022-09-01 Epub Date: 2022-02-23 DOI: 10.1176/appi.ps.202100523

Eric G Meyer, Ravi B DeSilva, Michael C Hann, Neil K Aggarwal, William L Brim, Charles C Engel, Francis G Lu, Roberto Lewis-Fernández

{"title":"Adapting the Cultural Formulation Interview for the Military.","authors":"Eric G Meyer, Ravi B DeSilva, Michael C Hann, Neil K Aggarwal, William L Brim, Charles C Engel, Francis G Lu, Roberto Lewis-Fernández","doi":"10.1176/appi.ps.202100523","DOIUrl":"https://doi.org/10.1176/appi.ps.202100523","url":null,"abstract":"Objective: U.S. military service members, veterans, and their families increasingly seek care from providers with limited knowledge of military culture. The 16-item core DSM-5 Cultural Formulation Interview (CFI) was designed to integrate cultural factors into assessment and treatment of mental disorders. Although the CFI was designed for use with all patients, it is unknown whether the CFI adequately assesses military culture. The authors describe a methodology to determine the need for specific CFI versions and how to create a version for use with persons affiliated with the military.Methods: Published articles on cultural competence in the military were systematically reviewed. Cultural domains were abstracted from each article, inductively coded, and hierarchically organized for assessment against the core CFI. A military CFI was created with additional implementation instructions, questions, and probes when the core CFI was inadequate for eliciting relevant cultural domains.Results: Sixty-three articles were included. Coding revealed 22 military culture domains, of which only five would be elicited in the core CFI without additional guidance. Twelve of 16 questions in the core CFI required additional instructions, five benefited from question edits, and 10 needed additional probing questions. On the basis of these results, the authors crafted a military version of the CFI for service members, veterans, and their families.Conclusions: The military CFI for clinicians assesses aspects of military culture that are not comprehensively evaluated through the core CFI. The development process described in this article may inform the creation of other versions when the core CFI does not comprehensively assess cultural needs for specific populations.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"978-983"},"PeriodicalIF":3.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39641144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Treatment of Patients Presenting With Suicidal Behavior in North American Pediatric Emergency Departments. 北美儿科急诊科自杀行为患者的治疗

IF 3.8

Psychiatric services (Washington, D.C.) Pub Date : 2022-09-01 Epub Date: 2022-03-23 DOI: 10.1176/appi.ps.202100206

Megan M Mroczkowski, Alison M Lake, Marjorie Kleinman, F Meridith Sonnett, Saba Chowdhury, Madelyn S Gould

{"title":"Treatment of Patients Presenting With Suicidal Behavior in North American Pediatric Emergency Departments.","authors":"Megan M Mroczkowski, Alison M Lake, Marjorie Kleinman, F Meridith Sonnett, Saba Chowdhury, Madelyn S Gould","doi":"10.1176/appi.ps.202100206","DOIUrl":"https://doi.org/10.1176/appi.ps.202100206","url":null,"abstract":"Objective: This study sought to identify current practices for the treatment of patients presenting with suicidal ideation or a recent suicide attempt in pediatric emergency departments (EDs) in North America.Methods: From October 10, 2018, to January 19, 2020, the authors conducted a cross-sectional online survey on current practices of pediatric emergency medicine chiefs practicing in the United States and Canada.Results: Forty-six (34%) of 136 chiefs of pediatric emergency medicine responded to the survey. The three most frequent improvements chiefs reported they would like to see in the care of young patients with suicidal ideation or suicide attempt were easier access to mental health personnel for evaluations, having mental health personnel take primary responsibility for patient evaluation and treatment, and better access to mental health personnel for dispositional planning.Conclusions: The findings highlight the need for better mental health care in pediatric EDs to serve patients at increased risk for suicide.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"1047-1050"},"PeriodicalIF":3.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40315526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Methodologies to Advance a "Science of How": Identifying and Engaging Intervention Targets and Outcomes. 推进“如何做的科学”的方法:确定和参与干预目标和结果。

IF 3.8

Psychiatric services (Washington, D.C.) Pub Date : 2022-09-01 Epub Date: 2022-02-17 DOI: 10.1176/appi.ps.202100202

Michelle R Munson, Ramesh Raghavan, Rei Shimizu, Aaron H Rodwin, James Jaccard

{"title":"Methodologies to Advance a \"Science of How\": Identifying and Engaging Intervention Targets and Outcomes.","authors":"Michelle R Munson, Ramesh Raghavan, Rei Shimizu, Aaron H Rodwin, James Jaccard","doi":"10.1176/appi.ps.202100202","DOIUrl":"https://doi.org/10.1176/appi.ps.202100202","url":null,"abstract":"Objective: Although implementation science has taken hold in many areas of psychiatric services research, a need remains for developing effective, low-cost interventions for specific subpopulations with mental health conditions. The experimental therapeutics approach has gained momentum as a framework for developing effective interventions. However, few studies have taken steps to rigorously apply experimental therapeutics. This article provides a blueprint for applying this approach.Methods: A focused literature review was conducted to document the frequency of the application of experimental therapeutics among articles published between 2011 and 2021 in some of the American Psychiatric Association's journals. Independently of the review, the authors delineated a four-component approach for applying experimental therapeutics in research and present practical, innovative strategies to advance psychiatric services research.Results: The four-component approach includes outlining prerequisites, identifying target mechanisms, proposing intervention strategies to address target mechanisms, and using advanced analytic methods. The strategies described for each component are not exhaustive; rather, they suggest promising avenues for research that can lead to more effective interventions and deeper understanding of how, and for whom, an intervention works.Conclusions: The application of experimental therapeutics in psychiatric services research can lead to increased development, refinement, and implementation of effective interventions for specific populations or conditions.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"1039-1046"},"PeriodicalIF":3.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39929272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Online Psychosis Screening: Characterizing an Underexamined Population to Improve Access and Equity. 在线精神病筛查:表征未充分检查的人群，以改善获取和公平。

IF 3.8

Psychiatric services (Washington, D.C.) Pub Date : 2022-09-01 Epub Date: 2022-02-17 DOI: 10.1176/appi.ps.202100257

Mark Savill, Theresa Nguyen, Ruth S Shim, Rachel L Loewy

{"title":"Online Psychosis Screening: Characterizing an Underexamined Population to Improve Access and Equity.","authors":"Mark Savill, Theresa Nguyen, Ruth S Shim, Rachel L Loewy","doi":"10.1176/appi.ps.202100257","DOIUrl":"https://doi.org/10.1176/appi.ps.202100257","url":null,"abstract":"Objective: Online resources represent an important avenue to identify and support individuals who may be experiencing symptoms of psychosis but have yet to engage in care. Understanding the experiences and needs of this group is critical to inform outreach for early psychosis and improve outcomes by addressing barriers to early treatment.Methods: The authors conducted a retrospective, explorative, cross-sectional analysis by using data collected by Mental Health America as part of their online psychosis screening and support program. Data included scores from the Prodromal Questionnaire-Brief, basic demographic information, and respondents' plans for next steps.Results: Of 120,937 respondents, most (82.1%) reported distressing psychosis-like experiences at levels sufficient to merit a referral to specialty care for additional evaluation. However, only 17.1% planned to seek treatment as a next step, with most (53.6%) wanting instead more information. Higher distress was only weakly associated with the plan to seek treatment. In the multivariable analysis, respondents who were younger; lesbian, gay, bisexual, transgender, or queer; or Native American or who had lower income reported the greatest symptom-related distress. Younger and higher-income respondents were less likely to plan to seek treatment next. Across race-ethnicity, African Americans were most likely to plan to seek treatment.Conclusions: Most respondents reported that psychosis-like experiences caused significant distress, but they did not plan to seek treatment next. Addressing this treatment gap requires careful consideration regarding what services individuals want, how services should be presented, and what barriers may limit help seeking. These steps are critical to improve access to early intervention for individuals with psychosis spectrum disorders.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"1005-1012"},"PeriodicalIF":3.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39929271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Implementing Collaborative Care in Low-Resource Government, Research, and Academic Settings in Rural Nepal. 在尼泊尔农村低资源的政府、研究和学术环境中实施协作式护理。

IF 3.8

Psychiatric services (Washington, D.C.) Pub Date : 2022-09-01 Epub Date: 2022-02-17 DOI: 10.1176/appi.ps.202100421

James Jackson, Rajkumar Dangal, Binod Dangal, Tula Gupta, Sunita Jirel, Sangeeta Khadka, Pragya Rimal, Bibhav Acharya

引用次数: 0

Cost-Effectiveness of Early Intervention in Psychosis: A Modeling Study. 精神病早期干预的成本效益:一项模型研究。

IF 3.8

Psychiatric services (Washington, D.C.) Pub Date : 2022-09-01 Epub Date: 2022-02-23 DOI: 10.1176/appi.ps.202100161

Saadia Sediqzadah, Allison Portnoy, Jane J Kim, Matcheri Keshavan, Ankur Pandya

{"title":"Cost-Effectiveness of Early Intervention in Psychosis: A Modeling Study.","authors":"Saadia Sediqzadah, Allison Portnoy, Jane J Kim, Matcheri Keshavan, Ankur Pandya","doi":"10.1176/appi.ps.202100161","DOIUrl":"https://doi.org/10.1176/appi.ps.202100161","url":null,"abstract":"Objective: Programs for early intervention in psychosis have shown clinical efficacy. The authors aimed to evaluate the cost-effectiveness of early intervention programs compared with standard care for the treatment of first-episode psychosis in the United States.Methods: A decision-analytic model integrating published data on clinical efficacy, costs, and health utilities was developed to evaluate early intervention versus standard care over the lifetime of patients after their first psychotic episode. Model input data were derived from meta-analyses, clinical trials, and U.S. national data. The main outcomes included hospitalizations, employment rate, quality-adjusted life years (QALYs), lifetime health care costs, and incremental cost-effectiveness ratios (ICERs).Results: Compared with patients receiving standard care, patients in the early intervention strategy had 3.2 fewer hospitalizations and 2.7 more years of employment over the course of their remaining life expectancy. From a health care perspective, early intervention had an ICER of approximately $51,600 per QALY. From a societal perspective, early intervention saved costs (i.e., yielded greater health benefits and had lower costs compared with standard care). Results were sensitive to the effect of early intervention on suicide, cost of standard care, cost of early intervention, and the effect (relative risk) of early intervention on employment. A scenario analysis that excluded the effect (i.e., hazard ratio) of early intervention on suicide yielded an ICER of approximately $197,000 per QALY.Conclusions: These results suggest that it is economically beneficial to fund early intervention in psychosis programs in the United States. The findings indicate that early intervention in psychosis saves costs (from the societal perspective) and is cost-effective (health care sector perspective).","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"970-977"},"PeriodicalIF":3.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39945234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Trends in Alcohol Use Disorder Treatment Utilization and Setting From 2008 to 2017. 2008 - 2017年酒精使用障碍治疗、利用和设置趋势

IF 3.8

Psychiatric services (Washington, D.C.) Pub Date : 2022-09-01 Epub Date: 2022-02-23 DOI: 10.1176/appi.ps.202000323

Aidan R Larsen, Janet R Cummings, Silke A von Esenwein, Benjamin G Druss

{"title":"Trends in Alcohol Use Disorder Treatment Utilization and Setting From 2008 to 2017.","authors":"Aidan R Larsen, Janet R Cummings, Silke A von Esenwein, Benjamin G Druss","doi":"10.1176/appi.ps.202000323","DOIUrl":"https://doi.org/10.1176/appi.ps.202000323","url":null,"abstract":"Objective: Little is known about recent trends in treatment for alcohol use disorder. The authors used national data to examine treatment trends among individuals with alcohol use disorder.Methods: A sample of nonelderly adults (ages 18-64 years, N=36,707) with alcohol use disorder was identified from the National Survey on Drug Use and Health. Multinomial logistic regression analysis was conducted to examine trends in treatment for alcohol use disorder in 2008-2010, 2011-2013, and 2014-2017 in any medical setting (hospitals, rehabilitation centers, mental health centers, emergency departments, and private doctors' offices), self-help groups only (no medical setting), and no setting (i.e., no treatment). Additional analyses investigated trends in mental health treatment. Regression models adjusted for predisposing, enabling, and need-related characteristics.Results: Among those with an alcohol use disorder, the percentage who received any treatment was significantly lower in 2011-2013 (5.6%) than in 2008-2010 (6.9%) (p<0.05). In adjusted analyses, the probability of receiving no treatment increased by 1.5 percentage points in 2014-2017 (95% CI=0.5-2.5) compared with the 2008-2010 baseline. Significant declines were observed in the receipt of any treatment in a medical setting (marginal effect [ME]=-1.0%, 95% CI=-2.0 to -0.0) and self-help treatment only (ME=-0.5%, 95% CI=-0.8 to -0.1) in 2014-2017 compared with the baseline period. The probability of receiving any mental health treatment did not change during the study period.Conclusions: Among persons with an alcohol use disorder, treatment declined from 2008 to 2017. Future studies should examine the mechanisms that may be responsible for this decline.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"991-998"},"PeriodicalIF":3.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39641143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Meaningful Participatory Research in a Multistakeholder Collaboration on Youth Pathways to Care: Implementation and Reflections. 青年关怀之路多利益相关方合作中的有意义参与性研究:实施与反思。

IF 3.8

Psychiatric services (Washington, D.C.) Pub Date : 2022-09-01 Epub Date: 2022-02-17 DOI: 10.1176/appi.ps.202100567

Linda M Callejas, Nev Jones

引用次数: 1

A Brief Text-Messaging Intervention for Suicidal Youths After Emergency Department Discharge. 急诊科出院后对自杀青少年的简短短信干预

IF 3.8

Psychiatric services (Washington, D.C.) Pub Date : 2022-08-01 Epub Date: 2022-02-17 DOI: 10.1176/appi.ps.202000559

Taylor C Ryan, Shawn Chambers, Michel Gravey, Samantha Y Jay, Holly C Wilcox, Mary Cwik

引用次数: 1

Housing Outcomes of Adults Who Were Homeless at Admission to Substance Use Disorder Treatment Programs Nationwide. 全国范围内接受药物使用障碍治疗项目的无家可归成年人的住房结果。

IF 3.8

Psychiatric services (Washington, D.C.) Pub Date : 2022-08-01 Epub Date: 2022-01-18 DOI: 10.1176/appi.ps.202100430

Emma Ava Lo, Taeho Greg Rhee, Robert A Rosenheck

{"title":"Housing Outcomes of Adults Who Were Homeless at Admission to Substance Use Disorder Treatment Programs Nationwide.","authors":"Emma Ava Lo, Taeho Greg Rhee, Robert A Rosenheck","doi":"10.1176/appi.ps.202100430","DOIUrl":"https://doi.org/10.1176/appi.ps.202100430","url":null,"abstract":"Objective: Substance use disorders affect 30%-50% of single homeless adults, and specialized homelessness service programs enable homeless persons to exit homelessness at rates of about 80%. However, many such adults are treated in substance use disorder treatment programs. This study examined housing outcomes in these programs.Methods: Data from the Treatment Episode Data Set: Discharges database were used to examine housing status at discharge from substance use disorder treatment programs of adults who were homeless at admission. Associations of outcomes with sociodemographic characteristics, treatment programs and processes, and clinical variables were further evaluated with bivariate and multivariate logistic regressions. Odds ratios of ≥1.5 or ≤0.67 were considered meaningful.Results: Of 1,200,105 persons admitted to the programs, 192,838 (16.1%) were homeless at admission; 68.7% remained homeless at discharge, 16.3% were discharged to dependent housing, and only 15.0% were discharged to independent housing. Factors associated with remaining homeless included being age ≥55 years, being unemployed, admission for detoxification (vs. rehabilitation or residential treatment or ambulatory treatment), shorter stays, and program noncompletion. Factors associated with discharge to independent versus dependent housing included employment, admission to nonintensive outpatient treatment, and, unexpectedly, shorter stays.Conclusions: Most adults experiencing homelessness at admission to substance use disorder treatment programs remained homeless at discharge, and only half of those no longer homeless were independently housed. These outcomes are considerably worse than outcomes typically reported by specialized homelessness service programs. Evidence-based service models that support exit from homelessness could be provided through augmented internal programming or links with specialized programs.","PeriodicalId":520759,"journal":{"name":"Psychiatric services (Washington, D.C.)","volume":" ","pages":"872-879"},"PeriodicalIF":3.8,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39830443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1