Outcomes of inpatients with severe mental illness: a naturalistic descriptive study

Nuernberg, Gabriela Lotin; Baeza, Fernanda Lucia Capitanio; Fleck, Marcelo Pio de Almeida; Rocha, Neusa Sica da

doi:10.1590/1516-4446-2014-1643

Cited by 9 publications

(5 citation statements)

References 32 publications

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“…Unlike common mental disorders, the National Institute of Mental Health (NIMH) defines a severe mental disorder as a mental, behavioral, or emotional disorder that results in severe functional impairment, which substantially interferes with or limits one or more life activities [ 1 ]. These diseases include psychoses (mainly schizophrenia and bipolar affective disorder) and severe mood disorders characterized by long-term treatment, lasting 2 years or more and profound disability in social and occupational performance and daily activities, if left untreated [ 2 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics

Portela¹,

Wainberg

Castel

et al. 2022

BMC Psychiatry

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Background The aim of this study was to assess the risk of readmission in patients with severe mental disorders, compare it between patients using different types of antipsychotics and determine risk factors for psychiatric readmission. Methods Medical records of a non-concurrent cohort of 625 patients with severe mental disorders (such as psychoses and severe mood disorders) who were first discharged from January to December 2012 (entry into the cohort), with longitudinal follow-up until December 2017 constitute the sample. Descriptive statistical analysis of characteristics of study sample was performed. The risk factors for readmission were assessed using Cox regression. Results Males represented 51.5% of the cohort, and 75.6% of the patients had no partner. Most patients (89.9%) lived with relatives, and 64.7% did not complete elementary school. Only 17.1% used more than one antipsychotic, 34.2% did not adhere to the treatment, and 13.9% discontinued the medication due to unavailability in public pharmacies. There was a need to change the antipsychotic due to the lack of therapeutic response (11.2% of the patients) and adverse reactions to the antipsychotic (5.3% of the patients). Cox regression showed that the risk of readmission was increased by 25.0% (RR, 1.25; 95% CI, 1.03–1.52) when used typical antipsychotics, compared to those who used atypical ones, and by 92.0% (RR, 1.92; 95% CI, 1.63–2.27) when patients did not adhere to maintenance treatment compared to those who adhered. Conclusions Use of atypical antipsychotics and adherence to treatment were associated with a lower risk of psychiatric readmissions.

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Section: Introductionmentioning

confidence: 99%

Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics

Portela¹,

Wainberg

Castel

et al. 2022

BMC Psychiatry

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show abstract

“…Regarding the biological factors, studies of biomarkers such as BDNF may provide insights into the possible mechanisms of illness and recovery from serious disorders such as depression, bipolar disorder, and schizophrenia (22). A few studies have evaluated this neutrotrophin in the context of psychotherapies (29, 55).…”

Section: Discussionmentioning

confidence: 99%

“…BDNF is a neurotrophin distributed largely by the central nervous system that is involved in neuron growth, development, and plasticity (20, 21). It is associated with both mental disorders and physiological states such as sleep and alterations after interventions like electroconvulsive therapy (ECT) and antidepressants (19, 22).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Investigation of Psychotherapy Outcomes (LIPO): Description of the Study Protocol

et al. 2019

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Background: Despite extensive research in the field of psychotherapies, few studies have compared the primary psychotherapies of naturalistic design, which represents real-life situations. Objective: The objectives of this study were to evaluate three modalities of evidence-based psychotherapy for clinical, psychosocial, and biological outcomes and to identify the mediators and confounders of this process. Our primary hypothesis is that all psychotherapies will improve clinical and psychosocial outcomes and will increase BDNF levels. Methods: Design: longitudinal, naturalistic. Participants: One hundred twenty-six patients who underwent one of three evidence-based modalities of individual psychotherapy [psychodynamic psychotherapy (PDT), interpersonal psychotherapy (IPT), and cognitive–behavioral psychotherapy (CBT)] were included. Measure: Primary outcomes are divided into three domains of variables: clinical (general psychiatric symptoms), biological (serum BDNF levels), and psychosocial (resilience, quality of life, coping strategies, social support, and quality of life-adjusted years of life). Confounding/mediator variables included clinical (personality traits, type of psychotherapy, number of sessions, concomitant use of pharmacological treatment, history of previous psychotherapeutic treatment, medical and psychiatric comorbidities, and psychiatric diagnosis), psychosocial (psychosocial stressors, therapeutic alliance, and defense mechanism style), and other (religiosity) factors. Procedure: The follow-up period will be baseline and 6 months and 1 year after entering the study. The study will include 42 controls for biological variables only. Sample size calculation considered a significance level of 5% and a power of 80% to detect a difference of 0.22 with a standard deviation of 0.43, assuming losses of 20–30% of patients. The comparison between the modalities of psychotherapy will be by generalized estimating equations (GEE) model, the analysis of mediators by the Hayes method, and confounders by multivariate logistic regression. Discussion: The findings of this study are intended to demonstrate the outcomes of evidence-based psychotherapies for clinical, psychosocial, and biological parameters and to understand the mediators and confounders of this process in a real-life setting for patients with severe mental illness, thus contributing to the establishment of evidence-based public health policies in the field of psychological interventions.

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“…There are a few outcome studies in this country, but most of them have assessed clinical profile and outcomes. [11][12][13][14][15] To the authors' knowledge, only one study has evaluated the outcome based on the patient's outlook. 5 Satisfaction with treatment is an important factor in the quality of treatment and is related to greater adherence, greater frequency of service use and reduction of treatment abandonment rates.…”

Section: Introductionmentioning

confidence: 99%

Satisfaction with care in a Brazilian psychiatric inpatient unit: differences in perceptions among patients according to type of health insurance

Godoy

Pavan

Monteiro

et al. 2019

Trends Psychiatry Psychother.

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Introduction User satisfaction assessment in mental health services is an important indicator of treatment quality. The objective of this study was to evaluate treatment satisfaction in a sample of inpatients with mental disorders and the associations between levels of satisfaction and clinical/sociodemographic variables. Methods This exploratory study investigated 227 psychiatric inpatients who answered the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and the Perception of Change Scale (EMP). SATIS scores were analyzed according to associations with clinical and sociodemographic data. Pearson correlations were used to correlate SATIS scores with other variables. Results We found a high degree of satisfaction with care at the psychiatric inpatient unit assessed. In general, patients rated maximum satisfaction for most items. The highest satisfaction scores were associated with patients receiving treatment through the Brazilian Unified Health System (SUS) and with less education. SATIS showed a moderate positive correlation with EMP. The worst evaluated dimension was physical facilities and comfort of the ward. Conclusion Patients treated via SUS may be more satisfied than patients with private health insurance when treated in the same facility. The evaluation of treatment satisfaction can be used to reorganize services at psychiatric inpatient units.

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Outcomes of inpatients with severe mental illness: a naturalistic descriptive study

Cited by 9 publications

References 32 publications

Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics

Risk factors associated with readmissions of patients with severe mental disorders under treatment with antipsychotics

Longitudinal Investigation of Psychotherapy Outcomes (LIPO): Description of the Study Protocol

Satisfaction with care in a Brazilian psychiatric inpatient unit: differences in perceptions among patients according to type of health insurance

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