Effects of a psychiatric intensive care unit in an acute psychiatric department

Abstract

Psychiatric acute units use different levels of segregation to satisfy needs for containment and decrease in sensory input for behaviourally disturbed patients. Controlled studies evaluating the effects of the procedure are lacking. The aim of the present study was to compare effects in acutely admitted patients with the use of a psychiatric intensive care unit (PICU) and not in a psychiatric acute department. In a naturalistic study, one group of consecutively referred patients had access only to the PICU, the other group to the whole acute unit. Data were obtained for 56 and 62 patients using several scales. There were significant differences in reduction of behaviour associated with imminent, threatening incidents (Broset Violence Checklist), and actual number of such incidents (Staff Observation Aggression Scale-Revised) in favour of the group that was treated in a PICU. The principles of patient segregation in PICUs have favourable effects on behaviours associated with and the actual numbers of violent and threatening incidents.

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

“…There are, however, studies using PANSS among acute admissions and among patients with bipolar disorders, for example, and serious validity problems have not been reported (80,175). Also, its face validity was good, and in unpublished material from a psychiatric intensive care unit, excellent inter-rater reliability was found in assessing 12 consecutively admitted in-patients (102).…”

“…Also, diagnostic interviews ideally presuppose that substances were not used during the four previous weeks, which rarely is the case among acute admissions with high rates of substance use and short length of hospital stay. Few instruments are tailored for acute care settings (102), which partly may explain why many studies reported routine clinical diagnoses only (Table A1). …”

Skjerming i akuttpsykiatrien

“…Nasjonalt senter for erfaringskompetanse innen psykisk helse har bidratt med utdypende litteratursøk om brukeres skjermingserfaringer. Vi fant én semirandomisert studie (4).…”

“…Det gis imidlertid her begrenset vitenskapelig kunnskap om skjermingsmetodens innhold og effekter, spesielt i større utvalg. Det finnes kun én større spesifikk og systematisk behandlingsstudie av skjerming (4). Denne inkluderer fire delstudier om skjerming i forhold til interiør, lukket avsnitt og effekt ved volds-og rusproblematikk.…”

“…Skjerming blir også omtalt som mestringsmåte (32) og som et fysisk atskilt område for intensiv psykiatrisk behandling (4). Skjermingsmetoden skal bidra til behovet for orden på posten, skal bedre personalets arbeidsmiljø og optimalisere muligheten til å følge opp pasienten.…”