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Satisfaction of patients with in-patient care is a relatively rare focus of research in mental health.
Objectives
The IDEA-study (inpatient discharge: experiences and analysis) was initiated to shed the light on the issue internationally.
Aim
The IDEA project aimed to:
– develop a collaborative network of young psychiatrists;
– use this network to explore satisfaction of people treated in psychiatric in-patient facilities in a range of high-, middle- and low-income countries.
Methods
Study was conducted in 25 hospitals across 11 countries. We measured satisfaction with in-patient care using the 5-item study-specific questionnaire. Individual and institution level correlates of “low satisfaction” were examined by comparisons of binary and multivariate associations in multilevel regression models.
Results
A final study sample consisted of 673 participants. Total satisfaction scores were highly skewed towards positive responses. After taking clustering into account, the only independent correlates of low satisfaction were schizophrenia diagnosis and low psychiatrist to patient ratio.
Conclusion
We could successfully establish a collaborative network of early career psychiatrists from different parts of the world and collect data in regards to the study aims. The positive skew of satisfaction scores need to be carefully considered in the context of literature and study limitations. In particularly, we suggest further studies on patients’ satisfaction to pay more attention to treatment expectations formed by the previous experience of treatment, service-related knowledge, stigma and patients’ disempowerment, power imbalance.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Little is known about the relative extent of crime against people with
severe mental illness (SMI).
Aims
To assess the prevalence and impact of crime among people with SMI
compared with the general population.
Method
A total of 361 psychiatric patients were interviewed using the national
crime survey questionnaire, and findings compared with those from 3138
general population controls participating in the contemporaneous national
crime survey.
Results
Past-year crime was experienced by 40% of patients v.
14% of controls (adjusted odds ratio (OR) = 2.8, 95% CI 2.0–3.8); and
violent assaults by 19% of patients v. 3% of controls
(adjusted OR = 5.3, 95% CI 3.1–8.8). Women with SMI had four-, ten- and
four-fold increases in the odds of experiencing domestic, community and
sexual violence, respectively. Victims with SMI were more likely to
report psychosocial morbidity following violence than victims from the
general population.
Conclusions
People with SMI are at greatly increased risk of crime and associated
morbidity. Violence prevention policies should be particularly focused on
people with SMI.
The capacitance between arbitrary two sites (vertices) in infinite triangular and honeycomb networks is studied by using Green’s function. Recurrence formulas for capacitance between arbitrary sites of the triangular lattice are obtained. The capacitance for the honeycomb lattice is shown to be expressed in terms of the one for the triangular lattice.
Domestic and sexual violence are significant public health problems but little is known about the extent to which men and women with severe mental illness (SMI) are at risk compared with the general population. We aimed to compare the prevalence and impact of violence against SMI patients and the general population.
Method
Three hundred and three randomly recruited psychiatric patients, in contact with community services for ⩾1 year, were interviewed using the British Crime Survey domestic/sexual violence questionnaire. Prevalence and correlates of violence in this sample were compared with those from 22 606 general population controls participating in the contemporaneous 2011/12 national crime survey.
Results
Past-year domestic violence was reported by 27% v. 9% of SMI and control women, respectively [odds ratio (OR) adjusted for socio-demographics, aOR 2.7, 95% confidence interval (CI) 1.7–4.0], and by 13% v. 5% of SMI and control men, respectively (aOR 1.6, 95% CI 1.0–2.8). Past-year sexual violence was reported by 10% v. 2.0% of SMI and control women respectively (aOR 2.9, 95% CI 1.4–5.8). Family (non-partner) violence comprised a greater proportion of overall domestic violence among SMI than control victims (63% v. 35%, p < 0.01). Adulthood serious sexual assault led to attempted suicide more often among SMI than control female victims (53% v. 3.4%, p < 0.001).
Conclusions
Compared to the general population, patients with SMI are at substantially increased risk of domestic and sexual violence, with a relative excess of family violence and adverse health impact following victimization. Psychiatric services, and public health and criminal justice policies, need to address domestic and sexual violence in this at-risk group.
The extent to which psychiatric disorders are associated with an increased risk of violence to partners is unclear. This review aimed to establish risk of violence against partners among men and women with diagnosed psychiatric disorders.
Methods.
Systematic review and meta-analysis. Searches of eleven electronic databases were supplemented by hand searching, reference screening and citation tracking of included articles, and expert recommendations.
Results.
Seventeen studies were included, reporting on 72 585 participants, but only three reported on past year violence. Pooled risk estimates could not be calculated for past year violence against a partner and the three studies did not consistently report increased risk for any diagnosis. Pooled estimates showed an increased risk of having ever been physically violent towards a partner among men with depression (odds ratio (OR) 2.8, 95% confidence intervals (CI) 2.5–3.3), generalized anxiety disorder (GAD) (OR 3.2, 95% CI 2.3–4.4) and panic disorder (OR 2.5, 95% CI C% 1.7–3.6). Increased risk was also found among women with depression (OR 2.4, 95% CI 2.1–2.8), GAD (OR 2.4, 95% CI 1.9–3.0) and panic disorder (OR 1.9, 95% CI 1.4–2.5).
Conclusions.
Psychiatric disorders are associated with high prevalence and increased odds of having ever been physically violent against a partner. As history of violence is a predictor of current violence, mental health professionals should ask about previous partner violence when assessing risk.
To assess the extent to which being a victim of intimate partner violence (IPV) is associated with psychiatric disorders in men and women.
Methods.
A stratified multistage random sample was used in the third English psychiatric morbidity survey. Psychiatric disorders were measured by the Clinical Interview Schedule (Revised) and screening questionnaires. IPV was measured using British Crime Survey questions.
Results.
18.7% (95% CI 17.1–20.4; n = 595 of 3197) of men had experienced some form of IPV compared with 27.8% of women (95% CI 26.2–29.4; n = 1227 of 4206; p < 0.001). IPV was associated with all disorders measured (except eating disorders in men). Physical IPV was significantly linked to psychosis and with substance and alcohol disorders in men and women, but significant associations with common mental disorders (CMDs), post-traumatic stress disorder (PTSD) and eating disorders were restricted to women. Emotional IPV was associated with CMDs in men and women.
Conclusions.
The high prevalence of experiences of partner violence, and strength of the association with every disorder assessed, suggests enquiry about partner violence is important in identifying a potential risk and maintenance factor for psychiatric disorders, and to ascertain safety, particularly in women as they are at greatest risk of being victims of violence.
The lifetime prevalence of domestic violence in women is 20–25%. There is increasing recognition of the increased vulnerability of psychiatric populations to domestic violence. We therefore aimed to review studies on the prevalence of, and the evidence for the effectiveness of interventions in, psychiatric patients experiencing domestic violence.
Method
Literature search using Medline, PsycINFO and EMBASE applying the following inclusion criteria: English-language papers, data provided on the prevalence of or interventions for domestic violence, adults in contact with mental health services.
Results
Reported lifetime prevalence of severe domestic violence among psychiatric in-patients ranged from 30% to 60%. Lower rates are reported for men when prevalence is reported by gender. No controlled studies were identified. Low rates of detection of domestic violence occur in routine clinical practice and there is some evidence that, when routine enquiry is introduced into services, detection rates improve, but identification of domestic violence is rarely used in treatment planning. There is a lack of evidence on the effectiveness of routine enquiry in terms of morbidity and mortality, and there have been no studies investigating specific domestic violence interventions for psychiatric patients.
Conclusions
There is a high prevalence of domestic violence in psychiatric populations but the extent of the increased risk in psychiatric patients compared with other populations is not clear because of the limitations of the methodology used in the studies identified. There is also very limited evidence on how to address domestic violence with respect to the identification and provision of evidence-based interventions in mental health services.
An infinite regular three-dimensional network is composed of identical
resistors each of resistance R joining adjacent nodes. What is the
equivalent resistance between the lattice site
$\mathaccent"017E{r}_i $
and the lattice
$\mathaccent"017E{r}_j $
site, when two bonds are removed from the perfect network?
Three cases are considered here, and some numerical values are calculated.
Finally, the asymptotic behavior of the equivalent resistance is studied for
large distances between the two sites.
The capacitance between any two arbitrary lattice sites of an infinite
square network consisting of identical capacitors is studied analytically
and numerically for a perturbed network. The perturbation is as a result of
removing the bonds
$(i_{0} j_{0})$
and
$(k_{0} l_{0})$
from the perfect network. The
equivalent capacitance is expressed in terms of the Lattice Green's Function
(LGF) of the perturbed network. Solving Dyson's equation we express the LGF
and the capacitance of the perturbed network in terms of those of the
infinite perfect network. The asymptotic behavior of the perturbed
capacitance is also studied. Finally, some numerical results are presented
for the perturbed infinite square lattice, and a comparison is carried out
for those of the perturbed and perfect infinite square network.
The capacitance between two adjacent nodes on an infinite square grid of
identical capacitors can easily be found by superposition, and the solution
is found by exploiting the symmetry of the grid. The mathematical problem
presented in this work involves the solution of an infinite set of linear,
inhomogeneous difference equations which are solved by the method of
separation of variables.
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