Strategies for preventing excess mortality after discharge from psychiatric emergency room.

Main Article Content

Jørgen Aagaard Mikkel Bak Jensen

Abstract

Abstract

Patients with severe mental illness have increased risk for severe physical diseases. In addition, there is evidence that this patient group is less likely to receive standard levels of care for most physical diseases, which may contribute to their shortened life expectancy. Further, illness behaviour among individuals with schizophrenia is different as they are less likely to seek medical attention, which emphasise the need for increased awareness and early intervention when visiting an emergency psychiatric facility. Adults with severe mental illness have increased rates of substance abuse, which adversely affect their illness and outcome. Separate and parallel mental health and substance abuse treatment systems do not offer interventions that are integrated or personalised for the presence of substance abuse concurrent with severe mental illness. Therefore, the authors suggest an establishment of multidisciplinary teams capable of delivering a full range of psychiatric interventions and integrated treatment for substance use disorder in the community and psychiatric emergency room to those who otherwise would have required admission to an acute hospital bed.

 

 

Keywords:
Psychiatric emergency room; Crisis resolution; mortality; severe mental illness

Article Details

How to Cite
AAGAARD, Jørgen; JENSEN, Mikkel Bak. Strategies for preventing excess mortality after discharge from psychiatric emergency room.. Medical Research Archives, [S.l.], v. 5, n. 7, july 2017. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/1383>. Date accessed: 24 dec. 2024.
Keywords
Psychiatric emergency room; Crisis resolution; mortality; severe mental illness
Section
Review Articles

References

1. Laursen TM, Munk-Olsen T, Agerbo E, Gasse C, Mortensen PB. Somatic Hospital Contacts, Invasive Cardiac Procedures, and Mortality From Heart Disease in Patients With Severe Mental Disorder. Arch Gen Psychiatry. 2009;66(7):713. doi:10.1001/archgenpsychiatry.2009.61.

2. Laursen TM. Life expectancy among persons with schizophrenia or bipolar affective disorder. Schizophr Res. 2011;131(1-3):101-104. doi:10.1016/j.schres.2011.06.008.

3. Nielsen RE, Uggerby AS, Jensen SOW, McGrath JJ. Increasing mortality gap for patients diagnosed with schizophrenia over the last three decades - A Danish nationwide study from 1980 to 2010. Schizophr Res. 2013;146(1-3):22-27. doi:10.1016/j.schres.2013.02.025.

4. Laursen TM, Wahlbeck K, Hällgren J, et al. Life Expectancy and Death by Diseases of the Circulatory System in Patients with Bipolar Disorder or Schizophrenia in the Nordic Countries. PLoS One. 2013;8(6). doi:10.1371/journal.pone.0067133.

5. Moore S, Shiers D, Daly B, Mitchell AJ, Gaughran F. Promoting physical health for people with schizophrenia by reducing disparities in medical and dental care. Acta Psychiatr Scand. 2015;132(2):109-121. doi:10.1111/acps.12431.

6. Qin P, Nordentoft M. Suicide Risk in Relation to Psychiatric Hospitalization. Arch Gen Psychiatry. 2005;62(4):427-432. doi:10.1001/archpsyc.62.4.427.

7. De Hert M, Corell CU, Bobes Ju, et al. Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry. 2011;10(1):52-77. doi:10.1002/j.2051-5545.2011.tb00014.x.

8. Maj M. Physical health care in persons with severe mental illness: a public health and ethical priority. World Psychiatry. 2009;8(1):1-2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645006/.

9. Leucht S, Burkard T, Henderson J, Maj M, Sartorius N. Physical illness and schizophrenia: A review of the literature. Acta Psychiatr Scand. 2007;116(5):317-333. doi:10.1111/j.1600-0447.2007.01095.x.

10. Aagaard J, Aagaard A, Buus N. Predictors of frequent visits to a psychiatric emergency room: A large-scale register study combined with a small-scale interview study. Int J Nurs Stud. 2014;51(7):1003-1013. doi:10.1016/j.ijnurstu.2013.11.002.

11. Aagaard J, Buus N, Wernlund AG, Foldager L, Merinder L. Clinically useful predictors for premature mortality among psychiatric patients visiting a psychiatric emergency room. Int J Soc Psychiatry. 2016;62(5):462-470. doi:10.1177/0020764016642490.

12. Hansen SS, Munk-Jørgensen P, Guldbaek B, et al. Psychoactive substance use diagnoses among psychiatric in-patients. Acta Psychiatr Scand. 2000;102(6):432-438. doi:10.1034/j.1600-0447.2000.102006432.x.

13. Munk-Jørgensen P, Mors O, Mortensen PB, Ewald H. The schizophrenic patient in the somatic hospital. Acta Psychiatr Scand Suppl. 2000;102(407):96-99. doi:10.1034/j.1600-0447.2000.00019.x.

14. Honkonen H, Mattila AK, Lehtinen K, Elo T, Haataja R, Joukamaa M. Mortality of Finnish acute psychiatric hospital patients. Soc Psychiatry Psychiatr Epidemiol. 2008;43(8):660-666. doi:10.1007/s00127-008-0344-y.

15. Laursen TM, Nordentoft M, Mortensen PB. Excess Early Mortality in Schizophrenia. Annu Rev Clin Psychol. 2014;10(1):425-448. doi:10.1146/annurev-clinpsy-032813-153657.

16. Allison DB, Mentore JL, Heo M, et al. Antipsychotic-induced weight gain: A comprehensive research synthesis. Am J Psychiatry. 1999;156(11):1686-1696. doi:10.1176/ajp.156.11.1686.

17. Polonsky TS. Coronary Artery Calcium Score and Risk Classification for Coronary Heart Disease Prediction. Jama. 2010;303(16):1610. doi:10.1001/jama.2010.461.

18. Shaw LJ, Raggi P, Schisterman E, Berman DS, Callister TQ. Prognostic Value of Cardiac Risk Factors and Coronary Artery Calcium Screening for All-Cause Mortality. Radiology. 2003;228(3):826-833. doi:10.1148/radiol.2283021006.

19. Budoff MJ, Shaw LJ, Liu ST, et al. Long-Term Prognosis Associated With Coronary Calcification. Observations From a Registry of 25,253 Patients. J Am Coll Cardiol. 2007;49(18):1860-1870. doi:10.1016/j.jacc.2006.10.079.

20. Aagaard J, Kugathasan P, Jensen SE, others. Coronary artery disease as a cause of morbidity and mortality in patients suffering from schizophrenia: protocol for a prospective cohort study with long-term follow-up. Clin Trials Degener Dis. 2016;1(4):141.

21. Drake RE, Mueser KT, Brunette MF. Management of persons with co-occurring severe mental illness and substance use disorder: program implications. World Psychiatry. 2007;6(3):131-136.

22. Drake RE, Essock SM, Shaner A, et al. Implementing Dual Diagnosis Services for Clients With Severe Mental Illness. Psychiatr Serv. 2001;52(4):469-476. doi:10.1176/appi.ps.52.4.469.

23. Johnson S. Crisis resolution and home treatment teams: an evolving model. Adv Psychiatr Treat. 2013;19(2):115-123. doi:10.1192/apt.bp.107.004192.

24. Johnson S. Randomised controlled trial of acute mental health care by a crisis resolution team: the north Islington crisis study. Bmj. 2005;331(7517):599-0. doi:10.1136/bmj.38519.678148.8F.

25. Cherpitel CJ, Ye Y. Drug use and problem drinking associated with primary care and emergency room utilization in the US general population: Data from the 2005 national alcohol survey. Drug Alcohol Depend. 2008;97(3):226-230. doi:10.1016/j.drugalcdep.2008.03.033.

26. Jethwa K, Galappathie N, Hewson P. Effects of a crisis resolution and home treatment team on in-patient admissions. Psychiatr Bull. 2007;31(5):170-172. doi:10.1192/pb.bp.106.010389.