Psychiatric Hospitalizations of Chronic Psychotic Disorder Patients With and Without Dual Diagnosis, Israel, 1963–2016

Florentin, Sharon; Rosca, Paola; Raskin, Sergey; Bdolah‐Abram, Tali; Neumark, Yehuda

doi:10.1080/15504263.2019.1609149

Cited by 10 publications

(8 citation statements)

References 46 publications

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“…Unlike that reported in general psychiatry settings, the diagnosis of lifetime substance use disorders, that was identified in 70% of our sample, was not associated with shorter LoS. Without the legal constraints imposed by the incarceration, a significant proportion of patients with comorbid substance use disorders interrupt their stay due to craving and intolerance to the hospital rules [50,51].…”

Section: Discussioncontrasting

confidence: 77%

Determinants of clinical outcome and length of stay in acute care forensic psychiatry units

et al. 2023

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Criminological and sociodemographic variables, such as previous criminal convictions, increased risk of violence, early onset of mental disorder, antisocial personality, psychosis and low social support, have all been related to longer length of stay (LoS) and poorer outcome in long stay forensic services. The factors impacting on LoS and clinical response in acute care specialized units are poorly documented. To address this issue, we examined the psychiatric records of all cases admitted between January 1st and December 31th 2020 in the sole acute ward for detained persons located in the central prison of the Geneva County, Switzerland. Information on judicial status included pre-trial versus sentence execution, previous incarcerations, and age of the first incarceration. Sociodemographic data included age, gender, marital status, and education attainment. Previous inpatient stays prior to incarceration were recorded. All of the ICD-10 clinical diagnoses were made by two independent, board-certified psychiatrists blind to the scope of the study. The standardized assessment was based on the HoNOS (Health of Nation Outcome Scales) at admission and discharge, HONOS-secure at admission, HCR-20 (Historical Clinical Risk 20) version 2, PCL-R (Psychopathy Checklist Revised), and SAPROF (Structured Assessment of Protective Factors). Stepwise forward multiple linear regression models predicting the LoS and delta HONOS respectively were built with the above mentioned parameters. The selected variables were then used in univariate and multivariable regression models. Higher HCR-scores (mainly on clinical items), and longer LoS were related to higher delta HONOS scores. In contrast, cases in pre-trial detention showed a worst clinical outcome. In multivariable models, all three variables remained independent predictors of the clinical outcome and explained 30.7% of its variance. Only education and diagnosis of borderline personality were related to the LoS and explained 12.6% of its variance in multivariable models. Our results suggest that the use of acute wards specialized in forensic psychiatry are mainly useful for patients with prior inpatient care experience, and higher violence risk during sentence execution. In contrast, they seem to be less performant for persons in pre-trial detention that could benefit from less restrictive clinical settings.

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Section: Discussioncontrasting

confidence: 77%

Determinants of clinical outcome and length of stay in acute care forensic psychiatry units

et al. 2023

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“…Speci cally, there is consistent evidence of the relationship between the association of unemployment with substance abuse in young adults (25, 31, 32,). Besides, almost a third of patients with chronic psychotic disorders meet the criteria for dual illness, with a three-fold higher prevalence in men, in whom a lower age at their rst hospitalization and a greater number of hospitalizations compared to people with similar characteristics, but without a history of consumption (33).…”

Section: Discussionmentioning

confidence: 99%

Use Of Psychoactive Substances And Sociodemographics Characteristics In A Hospitalized Population With Mental Disorders In A Mid-Income Country

Carmona-Huerta¹,

Castiello²,

Aguirre-Ramírez³

et al. 2020

Preprint

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Introduction: The use of psychoactive substances in patients diagnosed with mental illness is an increasing public health problem; the purpose of this work was to carry out a study to identify the most prevalent psychoactive drug abuse patterns in hospitalized patients in a psychiatric hospital, to estimate the severity of substance abuse, as well as to determine the factors associated with drug consumption using multivariate statistical modeling. Methods An analytical, retrospective study was carried out through the review of patient records discharged during 2018. Sociodemographic data, diagnoses, clinical follow-up information, clinimetric score of the alcohol consumption, Tobacco and Substances Detection Test (ASSIST 2.0) were obtained as well as the toxicological profile results. Results A representative sample of 268 participants was obtained, 61.6% men and 38.4% women, 86.6% unemployed, 67.9% single, with an average age of 36 years and 8 years of schooling. The most frequent diagnoses were Schizophrenia (42%), Substance-Induced Psychotic Disorder (22%), and Bipolar Disorder (17.9%). The most frequent substances detected in urine toxicology test were: Cannabis 21.8% (n = 45) and methamphetamines 10.7% (n = 22). The substances with the most frequent consumption in the last 3 months were tobacco, ethanol, cannabis, and methamphetamines. The highest score in the severity of consumption were methamphetamines and cannabis. The most important predictors for ethanol consumption were tobacco and cannabis abuse, for cannabis abuse were schooling years and ethanol consumption, and for methamphetamine consumption, the most important predictors were cocaine and cannabis abuse. Conclusions Young, male, unemployed subjects, with lower educational level, a psychiatric condition, and psychoactive consumption represent an identifiable "sociodemographic phenotype" that has an increased risk of requiring hospital services on a more recurrent basis and that could represent a burden to the health system. Methamphetamines abuse continues to increase and is becoming a significant mental health and public health issue. Cannabis and methamphetamine use are more severe and have more serious repercussions in terms of psychiatric morbidity. Correct public policies must be designed to intervene in this population.

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“…Of the 18,684 patients, 15,145 self-identified as Jewish and 2,556 self-identified as Arabs. As previously described [ 26 – 28 ], we restricted the sample to those persons hospitalized at least once since 2010 in order to ensure that the data and the findings are relevant and timely.…”

Section: Methodsmentioning

confidence: 99%

Patterns of psychiatric hospitalizations of Arab and Jewish adults with chronic psychotic disorders, before and after national mental health reforms, Israel, 1991–2016

Florentin,

Rosca,

Reuveni

et al. 2023

BMC Psychiatry

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Background Members of the Arab minority in Israel are at increased risk of developing mental illness, although less likely to seek care and have accessible treatment. This study compares trends in psychiatric hospitalizations between Arabs and Jews with chronic psychotic disorders, before and after introduction of the Community Rehabilitation of Persons with Mental Disability Law in 2000, and governmental recognition of the need to allocate resources for patients with co-occurring substance use disorder and mental illness in 2010. Methods The National Psychiatric Case Registry provided data on 18,684 adults with schizophrenia/schizoaffective disorder, hospitalized in 1991–2016 (at least once in 2010–2015). Repeated-measures ANOVA was used to measure the effect (and interactions) of population-group (Arabs and Jews), time-period (Period1: 1991–2000, Period2: 2001–2009, Period3: 2010–2016) and sex, on average length of stay (LOS), annual number of hospitalizations and hospitalization days. Results The proportion of Arab patients hospitalized with a diagnosis of chronic psychotic disorder (14.4%) was significantly lower than their proportion in the general population (21%), and their average age at first hospitalization (28.4 years) was older than that of Jewish inpatients (27.0 years). The average number of hospitalization days and LOS of Jewish patients were double that of Arab patients in Period1. Following implementation of the Rehabilitation Law, hospitalization days increased among Arab patients and decreased slightly among Jewish patients, such that by Period3 the average number of hospitalization days was similar among Jewish (41) and Arab (37) patients. The increase in hospitalization days among Arab patients was limited to men with no change noted among women. The number of hospitalization days among Arab women was about half that of Jewish women (p < 0.0001). Conclusions The findings reveal a narrowing of disparities in psychiatric hospitalizations between Arab and Jewish patients in Israel over time. However, among Arab women the number of hospitalization days remains considerably lower than that of Jewish women, raising concerns that Arab women may be receiving insufficient care. Further study is needed to fully understand the underpinnings of these disparities, although increasing the number of Arabic-language mental health services and providing psycho-education, will help further close the gap.

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Psychiatric Hospitalizations of Chronic Psychotic Disorder Patients With and Without Dual Diagnosis, Israel, 1963–2016

Cited by 10 publications

References 46 publications

Determinants of clinical outcome and length of stay in acute care forensic psychiatry units

Determinants of clinical outcome and length of stay in acute care forensic psychiatry units

Use Of Psychoactive Substances And Sociodemographics Characteristics In A Hospitalized Population With Mental Disorders In A Mid-Income Country

Patterns of psychiatric hospitalizations of Arab and Jewish adults with chronic psychotic disorders, before and after national mental health reforms, Israel, 1991–2016

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