It is important to accurately diagnose ADHD, BD, and BPD to ensure correct targeting of treatments and improvements in patient outcomes. However, there is a shortage of data about treatment of adults with ADHD and comorbid BD or BPD.
BackgroundSolutions for Wellness (SfW) is an educational 3-month program concerning nutrition and exercise for persons with psychiatric disorders on psychotropic medication, who have weight problems. This observational study assessed the impact of SfW on subjective well-being, weight and waist circumference (WC).MethodsData was collected at 49 psychiatric clinics. Where the SfW program was offered patients could enter the intervention group; where not, the control group. Subjective well-being was measured by the Subjective Well-being under Neuroleptics scale (SWN), at baseline, at the end of SfW participation, and at a follow-up 6 months after baseline. Demographic, disease and treatment data was also collected.Results314 patients enrolled in the SfW group, 59 in the control group. 54% of the patients had schizophrenia, 67% received atypical antipsychotics, 56% were female. They averaged 41 ± 12.06 years and had a BMI of 31.4 ± 6.35. There were significant differences at baseline between groups for weight, SWN total score and other factors. Stepwise logistic models controlling for baseline covariates yielded an adjusted non-significant association between SfW program participation and response in subjective well-being (SWN increase). However, statistically significant associations were found between program participation and weight-response (weight loss or gain < 1 kg) OR = 2; 95% CI [1.1; 3.7] and between program participation and WC-response (WC decrease or increase < 2 cm) OR = 5; 95% CI [2.4; 10.3]), at 3 months after baseline.ConclusionsSfW program participation was associated with maintaining or decreasing weight and WC but not with improved subjective well-being as measured with the SWN scale.
In this assessment of patients with MDD, the HAM-D6 was shown to be more sensitive compared with the HAM-D17 at detecting treatment effects. These findings are consistent with published results of other effective antidepressants.
Objectives: Knowledge of resource use and costs can be useful when
evaluating existing services or planning new services. This study investigates
the use of health care and social services during the first year after a
stroke. Total costs are calculated, costs are compared across subgroups of
patients, and resource items of major importance for the total costs are
identified.Methods: The study is based on a database comprising data on all
stroke patients admitted to a university hospital in Copenhagen, Denmark, over
a 1-year period, 1994–95. Patients were followed for 1 year after the
stroke, and data on resource use during and after hospitalization were
collected prospectively at interviews. This paper focuses on a subset of 385
patients who were admitted because of cerebral infarct or unspecified stroke.Results: The mean cost, based on all patients, of health care and
social services during the first year was 142,900 DKK (US $25,500). The
hospital care until the first discharge, including acute care and
rehabilitation, cost 101,600 Danish krones (DKK) (US $18,100), i.e., 71% of
the total cost. Major resource items after discharge were nursing homes,
readmissions, outpatient rehabilitation, and home help. The cost during the
first year varied with a number of factors, with the most important being
survival and degree of disability. Patients who survived the acute phase and
who had severe disability (Barthel Activities of Daily Living [ADL]
Index: 0–9) 7–10 days after admission had a total cost during the
first year that was five times as high as patients with no disability (Barthel
ADL Index: 20).Conclusion: Costs of health care and social services during the
first year after a stroke vary considerably. Disability as measured with the
Barthel ADL Index is a stronger predictor of costs than Scandinavian Stroke
Scale scores and other clinical and demographic variables.
The mean cost of treatment, care and rehabilitation during the first year after intracerebral hemorrhage was 123200 DKK, of which the primary hospital stay constituted 73%.
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