Preventing compulsory admission to psychiatric inpatient care using psycho-education and monitoring: feasibility and outcomes after 12 months

The aim of this study was to evaluate an intervention programme for people with severe mental illness that targets the reduction in compulsory psychiatric admissions. In the current study, we examine the feasibility of retaining patients in this programme and compare outcomes over the first 12 months to those after treatment as usual (TAU). Study participants were recruited in four psychiatric hospitals in the Canton of Zurich, Switzerland. Patients were eligible if they had at least one compulsory admission during the past 24 months. Participants were assigned at random to the intervention or to the TAU group. The intervention programme consists of individualised psycho-education focusing on behaviours prior to illness-related crisis, crisis cards and, after discharge from the psychiatric hospital, a 24-month preventive monitoring. In total, 238 (of 756 approached) inpatients were included in the trial. After 12 months, 80 (67.2 %) in the intervention group and 102 (85.7 %) in the TAU group were still participating in the trial. Of these, 22.5 % in the intervention group (35.3 % TAU) had been compulsorily readmitted to psychiatry; results suggest a significantly lower number of compulsory readmissions per patient (0.3 intervention; 0.7 TAU). Dropouts are characterised by younger age and unemployment. This interim analysis suggests beneficial effects of this intervention for targeted psychiatric patients

A Time-resolved Spectroscopic Comparison of the Photoisomerization of Small beta-Turn-forming Thioxopeptides

The monosubstituted thioxopeptide Boe-Ala-Pro-psi(SC-NH)-Aib-Ala-OMe is investigated by time-resolved UV-pump/IR-probe and IR-pump/IR-probe spectroscopy, steady-state FTIR-spectroscopy, and NMR-techniques. The compound has a high propensity to adopt a i --> i + 3 hydrogen-bonded conformation. Time-resolved infrared measurements reveal the opening of this beta-turn structure upon trans --> cis photo isomerization of the thioamide bond. Comparison is made with three protected tripeptides containing the -SC-NH-Aib- moiety with different thio-substituted residues. Very similar photo isomerization dynamics and comparable quantum efficiencies are found. Differences are seen for the thermally activated cis --> trans relaxation in the electronic ground state, where thioxopeptides with larger residues next to the thioamide moiety exhibit subsecond isomerization times. Anisotropy measurements indicate a very rigid Aib-containing core structure for all four thioxopeptides in acetonitrile solution