Search results

Episodic mood disorders are often associated with alcohol dependence. Few studies have explored the contribution of episodic mood disorders to length of stay among those hospitalized with alcohol dependence syndrome. Filling this research gap could improve care for patients while minimizing hospital utilization costs. This study was a cross-sectional analysis of the National Hospital Discharge Survey. ICD-9-CM diagnosis codes were used to identify those admitted to a private or non-profit hospital with alcohol dependence syndrome, and a co-morbid diagnosis of an episodic mood disorder (n=358). Descriptive statistics were used to highlight differences in key demographic and hospital variables between those with and without episodic mood disorders. Negative binomial regression was used to associate episodic mood disorders with hospital length of stay. Incidence rate ratios were calculated. Co-morbid episodic mood disorders ([.beta]=0.31, P=0.001), referral to a hospital by a physician ([.beta]=0.35, P=0.014), and increasing age ([.beta]= 0.01, P=0.001) were associated with longer hospital stays. Hospital patients with an admitting diagnosis of alcohol dependence syndrome were 36% more likely to have a longer hospital stay if they also had a co-morbid diagnosis of an episodic mood disorder (IRR=1.36, CI=1.14-1.62). Patients admitted to a hospital with alcohol dependence syndrome should be routinely screened for episodic mood disorders. Opportunities exist for enhanced transitional care between acute, ambulatory, and community-based care settings to lower hospital utilization.

The purpose of this paper is to illustrate delirium as a possible consequence of the application of symptom-triggered therapy for alcohol withdrawal and to explore alternative treatment modalities. In the management of alcohol withdrawal syndrome, symptom-triggered therapy directs nursing staff to regularly assess patients using standardized instruments, such as the Clinical Institute for Withdrawal Assessment of Alcohol, Revised (CIWA-Ar), and administer benzodiazepines at symptom severity thresholds. Symptom-triggered therapy has been shown to lower total benzodiazepine dosage and treatment duration relative to fixed dosage tapers (Daeppen et al., 2002). However, CIWA-Ar has important limitations. Because of its reliance on patient reporting, it is inappropriate for nonverbal patients, non-English speakers (in the absence of readily available translators) and patients in confusional states including delirium and psychosis. Importantly, it also relies on the appropriate selection of patients and considering alternate etiologies for signs and symptoms also associated with alcohol withdrawal.

The authors report a case of a 47-year-old male admitted for cardiac arrest because of benzodiazepine and alcohol overdose who developed worsening delirium on CIWA-Ar protocol.

While symptom-triggered therapy through instruments such as the CIWA-Ar protocol has shown to lower total benzodiazepine dosage and treatment duration in patients in alcohol withdrawal, over-reliance on such tools may also lead providers to overlook other causes of delirium.

This case illustrates the necessity for providers to consider using other available assessment and treatment options including objective alcohol withdrawal scales, fixed benzodiazepine dosage tapers and even antiepileptic medications in select patients.

Sex and gender are regarded as critical structural determinants of mental health and mental illness. Mental illness is a complex phenomenon, and risky behaviour and substance use commonly occur simultaneously or subsequent to one another. A gendered vulnerability in biological, environmental, and behavioural risk factors has been registered in the development and escalation of mental illness. Studies have found that women who use drugs experience greater physical and mental health repercussions than men. Women who use drugs present higher rates of depression and anxiety, suicidal tendencies, isolation and general psychological distress. This chapter addresses the most common mental illnesses associated with women who use drugs: depression, anxiety, trauma-related disorders, and eating disorders.

The aim was to study how the working-age population's mental symptoms had a relation to the using of the Internet. In addition, the aim was to analyze how the mental symptoms had a relation to background information. The study was carried out as a cross-sectional study by posting a questionnaire to 15,000 working-age (18-65) Finns. Mental symptoms of responses (6121) were analysed using the model factors age, gender and use of the Internet. Only 0.06% mentioned that they were somehow addicted to the Internet. Based on statistical analyses, age and marital status had an influence on many mental symptoms. The use of the Internet at leisure had an influence on substance addiction and fear situations. The importance of the Internet only had an influence on the fear situations. In the future it will be essential to take into account that the use of the internet can affect mental symptoms.

The purpose of this study is to categorize perfectionism and determine how perfectionism impacts the occupations and perceived health of students in a Bachelor of Science in Occupational Science program.

A descriptive study with a survey component was conducted. Participants were categorized as perfectionists or non-perfectionists using the Almost Perfect Scale-Revised (APS-R). Time logs were collected to compare categories of time-use between groups over a one-week period. An online survey was conducted with a sub-sample of the perfectionists.

More students were categorized as perfectionists (N = 41) than non-perfectionists (N = 3). Both groups spent similar amounts of time engaged in productive, pleasurable and restorative occupations. Some perfectionists reported that perfectionism supported health, but others reported negative impacts on well-being.

This study included a small sample size limited to one Occupational Science program in the USA.

Results demonstrated positive and negative health impacts because of perfectionism. The majority of participants were identified as perfectionists; rigorous academic programs may attract students with perfectionistic qualities. Findings are relevant for Occupational Therapy, as these students will become future occupational therapists after completing a Master’s program in Occupational Therapy and may be susceptible to negative outcomes associated with perfectionism such as workaholism and poor health.