No abstract

Inpatient mental health readmission rates have increased dramatically in recent years, with a subset of consumers referred to as revolving-door patients. In an effort to reduce the financial burden associated with these patients and increase treatment efficacy, researchers have begun to explore factors associated with increased service utilization. To date, predictors of increased service usage are remarkably discrepant across studies. Further exploration, therefore, is needed to better explicate the relevance of "traditional" predictors and also to identify alternate strategies that may assist in predicting rehospitalization. One method that may be helpful in identifying patients at high risk is the development of a psychometric screening procedure. As a means to this end, the present study was designed to assess the potential usefulness of psychometric data in predicting mental health service utilization. The sample consisted of 131 patients hospitalized during an index period of 8 months at an acute-care psychiatric hospital. Number of readmissions was recorded in a 9 month post-index period. Measures completed during the index admission included the Brief Psychiatric Rating Scale-Anchored (BPRS-A), Symptom Checklist-90-Revised (SCL-90-R), Kaufman Brief Intelligence Test (K-BIT), and the Beck Depression Inventory (BDI). Results indicated that psychometric data accounted for significant variance in predicting past, present and future mental health service utilization. The BPRS-A, SCL-90-R, and BDI show particular promise as time efficient psychometric screening instruments that may better enable practitioners to identify patients proactively who are at increased risk for rehospitalization. Implications are discussed with regard to patient-treatment matching and discharge planning.

No abstract

Differences in response to psychopharmacologic agents according to race has so far primarily focused on investigations related to the response of Asian-American patients to neuroleptics and lithium. In this article, we present evidence which depicts that black patients need lower doses of tricyclic antidepressants (TCAs) than white patients to attain a similar response in the treatment of major depression. Likewise, we also advance that black patients might need lower doses of selective serotonin re-uptake inhibitor antidepressants (SSRIs) than white patients to attain a similar response in the treatment of major depression. Further studies are suggested to confirm these findings.

Ethnic differences in psychopharmacological treatment have received much attention in the last two decades. Most of the research efforts conducted so far in the field of ethnopsychopharmacology have focused on comparative responses to neuroleptics and lithium between white and Asian-American patients, and on comparative responses to tricyclic antidepressants among white, African-American and Hispanic patients. In this article we focus on the response to neuroleptic treatment among white, African-American and Hispanic patients suffering from schizophrenia. Our findings suggest that Hispanic patients need lower doses of neuroleptics than white or African-American patients to attain a similar response in the treatment of schizophrenia. Additionally, our study suggests that, if weight is taken to consideration, African-American patients need the same dose of neuroleptics as do white patients in order to attain a similar response in the treatment of schizophrenia. Further studies are suggested to confirm our findings.