Intérêt de l'analyse toxicologique urinaire aux urgences psychiatriques

Objectif : Evaluer au travers dune revue systématique de la littérature internationale lintérêt de réaliser une analyse toxicologique urinaire chez les patients aux urgences psychiatriques. Méthode : Les études qui examinent lintérêt, le rôle de lanalyse toxicologique urinaire aux urgences psychiatriques sont recherchées dans les banques de données informatiques MEDLINE, Psy INFO, Cochrane controlled trials register, ToxNet, CHU Rouen. Résultats : Neuf études sont sélectionnées, quatre études prospectives, quatre études rétrospectives et un essai randomisé contrôlé. Dans les différentes études, les substances recherchées dans les urines sont identiques (alcool, cocaïne, cannabis, opiacés, phencyclidine, benzodiazépines, amphétamines) à lexception de létude de Schiller qui ne recherche pas la consommation de cannabis. Il ressort de ces études que lanalyse toxicologique urinaire est fréquemment demandée spontanément par le psychiatre. Des divergences apparaissent dans les études quant à la précision du diagnostic clinique de consommation de substance. Les patients pour lesquels lanalyse toxicologique urinaire est négative ont une probabilité accrue dêtre hospitalisés. Deux des trois études prospectives qui comparent lefficacité entre lanalyse toxicologique et des questionnaires standardisés sur labus de substance aboutissent à des divergences, parfois importantes, entre les résultats obtenus par lanalyse toxicologique et ceux des questionnaires standardisés. Conclusion : Cette revue de la littérature ne permet pas de dégager des recommandations claires quant à lusage de lanalyse toxicologique urinaire aux urgences psychiatriques. En moyenne, environ un patient sur trois aux urgences psychiatriques a une analyse toxicologique urinaire positive. Devant lampleur de ce problème de nouvelles études sont nécessaires. (Résumé d'auteur

The personal social network of psychiatric service users

Background: For psychiatric service users, the personal social network offers resources such as behavioural guidance, social support, and coherence of care delivery. So far, most research on the subject has assessed the availability of these resources using size and composition measures. However, the availability of network resources also depends on the cohesion of the relationships between network members, a topic that is rarely addressed in the literature. Aims: In this article, we aim to describe the cohesion of psychiatric service users’ networks. Method: We carried out a personal network survey and collected data on the social networks of 380 service users recruited in outpatient and inpatient services in Belgium. We used an ego-network mapping technique. The data were analysed using several structural metrics describing size, composition, and cohesion. We carried out analysis of variance (ANOVA) in relation to residential status, level of education, psychiatric history, and psychosocial functioning and analysed three cohesion indicators (density, fragmentation, and centralisation) with regression analyses. Results: Personal social networks were small and not very cohesive. Most were composed of a dense subgroup as well as several isolated network members. The analyses revealed that highly educated psychiatric service users had more fragmented networks, while users living in independent accommodation had less dense networks. Density and fragmentation were not associated with the severity of psychosocial functioning, whereas centralisation was. Conclusions: The low level of cohesion may indicate that service users aim to access multiple and diverse social resources and that better-off service users are more successful at doing so. On the whole, however, these personal social networks were fragile, because they contained a high number of isolated network members. Finally, it could be beneficial for professionals to pay special attention to the central persons within the networks of psychiatric service users

Belgian Superior Health Council advises against the use of the DSM categories

info:eu-repo/semantics/publishe

Belgian Governmental Superior Health Council advises against the use of the DSM categories and promotes contextualising psychiatric diagnosis.

info:eu-repo/semantics/publishe

Refugees in DeKalb County: A Capstone Project

The refugee population within the United States is very dynamic, creating new challenges for county boards of health every day. To assist refugee groups in their transition to life in America, their needs must be thoroughly understood. County officials must also recognize their own limitations and be able to overcome them. Appropriate coordination with community resources relieves boards of health of some of the burden. However, county officials must also ensure that services provided in their domain are exceptional. This project aims to aid in this process for the DeKalb County Board of Health (DCBOH) and incoming refugees. A physician directory was created to improve the coordination between the DCBOH and community resources. In addition, a health manual geared towards informing refugees was updated and prepared for distribution