Variables associated with the hospitalization of psychiatric emergencies evaluated in the community

We investigated hospitalization factors in acutely ill patients visited by psychiatrists at home. A series of 100 consecutive calls for psychiatric emergencies of a community mental health centre were investigated with a structured evaluation of psychiatric symptoms and aggressiveness (IEF, GAS, and VSAS). First order interactions were tested, and selected variables were tested with logistic regression analysis. Admission was significantly associated with GAS scores (low scores were found in 92.6% of admitted patients vs. 43.8% of patients not admitted), paranoid delusions (66.7 vs. 39.7%), and lack of social support (70.4 vs. 30.1%). Multivariate analysis confirmed a significant independent effect only for low GAS score and lack of social support. The study replicated some findings from research on hospitalization in emergency wards, while other factors, such as 'diagnosis' and 'suicide risk', were not significant.

Affective disorders among elderly general practice patients. A two-phase survey in Brescia, Italy

BACKGROUND

We investigated the prevalence of depression among 255 elderly general practice patients and the practitioners' performance in identifying depression.

METHOD

Elderly patients attending 14 general practices entered a screening phase with GHQ-12 and MMSE. Those positive were then interviewed with GMS and HAS.

RESULTS

DSM-III-R major depression affected 22.4%, dysthymic disorder 6.3%, not otherwise specified (n.o.s.) depression 7.1%. General practitioners performed fairly well: identification index 88.4%, accuracy 0.49, bias 1.85.

CONCLUSIONS

Depression was markedly high. A selective progression of depressed elderly from the community to general practitioners is implied.

Immunoreactive met-enkephalin plasma concentrations in chronic alcoholics and in children born from alcoholic mothers

Several experimental and clinical observations indicate that ethanol ingestion induces specific neurochemical modifications in the Central Nervous System. In particular, an involvement of endogenous opiates has been suggested in the case of alcohol addiction. In this light, the plasma concentrations of met-enkephalin immunoreactive peptides (ME-IR) have been measured in selected groups of chronic alcoholics and in children whose mothers were ethanol addicts. Both groups revealed a marked reduction of ME-IR plasma concentrations when compared with sex and age matched controls.