A cross-sectional study of patients with and without substance use disorders in Community Mental Health Centres

<p>Abstract</p> <p>Background</p> <p>Epidemiological studies have consistently established high comorbidity between psychiatric disorders and substance use disorders (SUD). This comorbidity is even more prominent when psychiatric populations are studied. Previous studies have focused on inpatient populations dominated by psychotic disorders, whereas this paper presents findings on patients in Community Mental Health Centres (CMHCs) where affective and anxiety disorders are most prominent. The purpose of this study is to compare patients in CMHCs with and without SUD in regard to differences in socio-demographic characteristics, level of morbidity, prevalence of different diagnostic categories, health services provided and the level of improvement in psychiatric symptoms.</p> <p>Methods</p> <p>As part of the evaluation of the National Plan for Mental Health, all patients seen in eight CMHCs during a 4-week period in 2007 were studied (n = 2154). The CMHCs were located in rural and urban areas of Norway. The patients were diagnosed according to the ICD-10 diagnoses and assessed with the Health of the Nation Outcome Scales, the Alcohol Use Scale and the Drug Use Scale.</p> <p>Results</p> <p>Patients with SUD in CMHCs are more frequently male, single and living alone, have more severe morbidity, less anxiety and mood disorders, less outpatient treatment and less improvement in regard to recovery from psychological symptoms compared to patients with no SUD.</p> <p>Conclusion</p> <p>CMHCs need to implement systematic screening and diagnostic procedures in order to detect the special needs of these patients and improve their treatment.</p

Satisfaction with cosmesis and priorities for cosmesis design reported by lower limb amputees in the United Kingdom : instrument development and results

Study Design: Cross sectional questionnaire study. Background: Amputee satisfaction with cosmesis and the importance they place on cosmesis design has not been published in the literature. Objectives: Investigate the current satisfaction levels of amputees in the United Kingdom with their cosmesis and the importance placed on attributes of cosmesis design to inform future cosmesis redesign. Methods: Questionnaires were administered to lower limb amputees in the United Kingdom. Satisfaction scores and the overall importance ranking of cosmesis features were calculated. Statistically significant relationships between two demographic, satisfaction, or importance variables were tested using Fisher’s Exact tests (one-tailed) at a significance level p=0.05. Results: Between 49% and 64% of respondents reported neutral or dissatisfied opinions with the cosmesis features (greater than 50% for five of the nine features). The three most important features identified were shape matching the cosmesis to the sound limb, free prosthetic joint movement underneath the cosmesis and natural fit of clothing over the cosmesis. Conclusions: The results indicate that current cosmesis satisfaction levels of amputees in the U.K. are below what the medical device industry and clinical community would desire. The most important cosmesis features identified by the sample can be used to direct future cosmesis design research

Dating and intimate relationships of women with below-knee amputation: An exploratory study

Purpose: This study investigates experiences of dating and intimate relationships amongst women who use a below-knee prosthesis. Method: Four women took part in semi-structured online interviews. Transcripts were subject to interpretative phenomenological analysis (IPA). Results: Five themes were identified: Revealing and Exposing: Disclosing the Amputation and Prosthesis; Judging and Judged: Internal Fears and Self-Doubt; Trusting and Accepting: Good Guy/Bad Guy Elimination; Taking it Further: The Need for Depth; and Realisation: Accepting and Feeling Accepted. Participants described how, despite negative feelings towards their appearance and body image, they chose not to conceal their prosthesis when dating. Rather, it was used as a means of screening potential partners in their search for deep and meaningful relationships. Realising that others were not prejudiced towards people who use a prosthetic had helped them become more comfortable with their own prosthesis. Conclusion: These findings suggest that facilitating contact with other below-knee amputees and, in some cases specialist support, could help those who are struggling with the challenges they face regarding dating and intimate relationships. They also highlight the need for researchers and clinicians to give more attention to these important aspects of amputees' lives.Implications for RehabilitationAmputation can have a significant psychosocial impact for those affected.The relative invisibility of below-knee amputation and prostheses can present particular challenges for amputees looking to establish romantic and intimate relationships, particularly around when and how to disclose the limb loss to potential partners.Developing a sense of resilience to the reactions of other people can help those who have undergone below-knee amputation.Support for people affected by below-knee amputation should routinely consider their needs and concerns in relation to new and established relationships, offer specialist psychosocial input when needed and provide opportunities for support from other amputees. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted