Defining Chronic Mental Illness: A Concept Paper

Bachrach, Leona L.

doi:10.1176/ps.39.4.383

Cited by 66 publications

(43 citation statements)

References 8 publications

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“…Some support only, as the statistical significance reaches only as far as the 0.1 level. A much larger sample size is necessary to give more solid ground to our hypothesis, as chronic psychiatric patients are a heterogeneous group, and vary widely in both psychiatric diagnosis and sociode mographic variables [1]. Our hypothesis will therefore not be true for all groups of psy chiatric patients, especially for those who are severely limited in coordinating and in ex pressing their thoughts and feelings, a wellknown phenomenon in psychotic disorders.…”

Section: Discussionmentioning

confidence: 91%

The Influence of Consensus on the Assessment of Physical Disease in Chronic Community Psychiatric Patients

Honig

Tan²,

Pop³

et al. 1989

Psychother Psychosom

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Physical disease is a frequent concomitant of mental disease. The majority of chronic psychiatric patients have physical complaints. Screening physical disease on a regular basis in an ambulatory setting for chronic psychiatric patients is often impossible if only for lack of medical manpower and facilities. Especially for the nonmedical personnel of a community psychiatric unit (CPU) for chronic patients, approaching and handling physical complaints and diseases poses a formidable problem. This paper addresses the issue of screening physical disease from a completely different viewpoint than that of the often advocated but just as often infeasible routine physical examination and laboratory workup. It is argued that consensus (i.e., agreement and mutual understanding) between patient and therapist on the physical well-being of the patient may increase the accuracy with which a CPU therapist, irrespective of his/her discipline, assesses physical disease. This hypothesis was tested in a sample of 156 chronic ambulatory psychiatric patients. Consensus between patient and CPU therapist was measured by means of a questionnaire. The CPU therapist assessment on physical disease in both the consensus and no consensus group was compared with those of two external medical observers; the patients’ general practitioner and a specialist in internal medicine, who followed a protocolized physical screening procedure. The results tend to support the proposed hypothesis. Replication of this study using a larger sample is recommended in order to confirm the value of consensus in the assessment of physical disease in at least some subgroups of chronic ambulatory psychiatric patients and for the implications that consensus could have for daily community psychiatric practice.

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Section: Discussionmentioning

confidence: 91%

The Influence of Consensus on the Assessment of Physical Disease in Chronic Community Psychiatric Patients

Honig

Tan²,

Pop³

et al. 1989

Psychother Psychosom

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“…As in the Toronto study (1986) on chronically suicidal patients, the data from the present study suggest that many chroni cally suicidal patients are also chronically mentally ill. Specifically, this is borne out by the fact that many repeaters are living alone in boarding houses, have histories of past psychiatric hospitalizations in the pub lic sector (Worcester State Hospital), carry diagnoses of schizophrenia and personality disorder, and are on antipsychotic and antiparkinson medications and are socially iso lated [15].…”

Section: Discussionmentioning

confidence: 99%

Repetitive Suicidal Crises: Characteristics of Repeating versus Nonrepeating Suicidal Visitors to a Psychiatric Emergency Service

Peterson¹,

Bongar²

1990

Psychopathology

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The present study involves a retrospective chart review of all patients who visited the Emergency Mental Health Service during the period of July, 1, 1985 to June, 30, 1986 (total visits = 2,772). It compares those ‘suicidal’ patients seen only once during the index year with those seen multiple times (comparison of first visit only for both ‘one-timers’ and ‘repeaters’). The ‘repeaters’ were generally found to be older and were more likely to have a diagnosis of schizophrenia and personality disorder. Unlike previous studies, substance abuse and affective disorder did not significantly differentiate the two groups. The ‘repeaters’ were also more likely to be taking antipsychotic and antiparkinson medications, have histories of past psychiatric hospitalizations in the public sector, be living alone, and most importantly, to have made a previous suicide attempt.

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“…Selection criteria for these people usually consist of three main ones which have to be satisfied: diagnosis, disability and duration (Giel, 1986; cal. 198I; Goldman & Manderschield, 1987;Bachrach, 1988). Social disability needs to be sufficiently severe to have a significant impact on role performance (although there appears to be no clear agreement on which aspects of social functioning should be regarded as more important than others).…”

Section: Who Should Be Targetedmentioning

confidence: 99%