OBJECTIVES:The aim of this study was to determine the readmission rates of Acute and Transient Psychotic Disorders (ATPD) who were admitted for the first time in the National Center of Mental Health from January to December 2012.
METHODOLOGY: This study used the retrospective cohort method. Patients included in the study were admitted for the first time with a diagnosis of Acute and Transient Psychotic Disorders (ATPD) during the period of January to December 2012. The source of data involved the chart review during the first admission and the subsequent admission. Patients who were readmitted beyond one year from time of admission were excluded.
RESULTS:Results showed that 25 out of 204 (12.26%) patients diagnosed with an ATPD were readmitted within one year. The most common diagnosis of ATPD upon admission were: Acute Schizophrenia-Like Psychotic Disorder (n=95), Other Schizophrenia (n=90) and Acute Polymorphic Psychotic Disorder (n=19). ATPD's with the highest 1 year readmission rates were Acute Polymorphic Psychotic Disorder (3/19),Other Schizophrenia (13/90) and Acute Schizophrenia-Like Psychotic Disorder(9/95).Those that were readmitted had a different discharge diagnosis in their second admission.The three most common diagnosis upon readmission were Undifferentiated Schizophrenia (36%), Bipolar Affective Disorder, current episode manic, with psychotic symptoms (24%) and Other Schizophrenia (12%). Acute Schizophrenia-Like Psychotic Disorder were mostly readmitted as Bipolar Affective Disorder in 44% of patients; Acute Polymorphic Psychotic Disorder (APPD) were readmitted as another ATPD (66.6%); and Other Schizophrenia was diagnosed as Undifferentiated Schizophrenia (54%).
CONCLUSION:Only a small percentage of patients with ATPD were readmitted one year from admission and those who were readmitted revealed that they may have actually been suffering from or developed another more chronic psychotic disorder.

Human ; Female ; Middle Aged ; Adult ; Schizophrenia ; Bipolar Disorder ; Psychotic Disorders

OBJECTIVES: This study looked into the relationship between stress and the level of job satisfaction among the Burnt Unit staff of UP-PGH. Emphasis was placed in identifying the common stressors that the Burn Unit Staff of UP-PGH experience as a result of their day to day work in a critical care setting.The level of job satisfaction among staff was also determined.
METHODOLOGY: Questionnaires assessing stress and job satisfaction were handed out to all the 31 participants of the study. The study population included 10 doctors and 21 nurses who had worked at the Burn Unit during the period of March to September 2007. Odds ratios were computed to determine if the presence of stress affects the level of job satisfaction among the Burn Unit Staff of UP-PGH. The resulting odds ratios were further tested for statistical significance using Fisher exact test and confidence limits.
RESULTS: Of the 31 survey forms initially handed out to the Burn Unit staff, only 28 forms were completed and returned to the investigator at the end of the study period. Two items in the Stressful Situations Questionnaire were rated to be "stressful" by majority (>50%) of the respondents. Twenty-five percent of the respondents obtained positive scores in the Job Dissatisfaction Scale and were classified as being "dissatisfied" with their jobs. Twenty-two situations in the Stressful Situations Questionnaire were found to be significantly associated with job dissatisfaction among the Burn Unit staff of UP-PGH. These situations concerned the following areas: relationship with patients, family rejection, identification with the patient, deterioration and complications, job criticism, workspace, daily work, and therapeutic decisions.
CONCLUSIONS: From the results of the study, recommendations were made to promote a system of stress-reduction for the Burn Unit staff. Regular group psychosocial processing sessions can be provided to allow the staff to ventilate their thoughts and feelings regarding personal and professional concerns. Team building activities for the staff can likewise be scheduled regularly to help solidify the group and resolve interpersonal conflicts among them. Future researchers could explore if a difference exists between the nurses and surgery residents in terms of their perceived stressors and their level of job satisfaction with their work in the Burn Unit.

Human ; Male ; Female ; Job Satisfaction ; Nurses ; Critical Care ; Questionnaires

INTRODUCTION: Although Battered Woman Syndrome is not listed in the DSM 5 and the ICD 10 as an official diagnosis, it is undeniable that women suffering Intimate Partner Violence (IPV) experience the same cycle of violence, suffer from a common range of symptoms, and have a predictable prognosis. While psychosocial guidelines and support are available, like in our Women and Child Protection Units (WCPU), there is also a gap in the clinical guidelines in treating and managing these cases, which might present with a combination of posttraumatic and depressive symptomatology. In this report, we discuss the case of a 32 year old woman who was subjected to severe physical and emotional abuse by her longtime romantic partner. She consulted at our center seeking help for a psychiatric evaluation for the case she was going to pursue in court but it was apparent she was suffering from posttraumatic, somatic, and depressive symptoms. Supportive therapy was initially done and she was started on Escitalopram and low dose Quetiapine for sleep problems. As her case started gathering steam, issues about the court process, possible setback with her church and possible retaliation from her partner weighed heavily on her. Possible issues were discussed beforehand and successfully faced up to her partner in a church related tribunal and in the fiscal's office. Using an Eye Movement Desensitization and Reprocessing(EMDR) variant, Unfinished Trauma Episode Protocol (U-TEP), her posttraumatic symptoms were eventually addressed. As she started having faith in the legal system and her church, she had restored self-esteem, was active in her social circle and become an advocate in helping other women get proper treatment and to fight for their rights. Besides the clinician advocated treatment along with the services delivered via the WCPU network, the perception of getting justice from social institutions like the judiciary and the church helped in the recovery of this patient. Clinicians dealing with Battered Woman Syndrome should be aware of issues the patient might go through the stages of her fight and that the process of seeking for justice is also a process of mental healing.

Human ; Female ; Adult ; Depressive Disorder, Major ; Jurisprudence ; Battered Women ; Wounds And Injuries ; Violence ; Dependent Personality Disorder

Life for the Filipino psychiatrist living and practicing in the Philippines has been multi-faceted in its scope, its demands and its possibilities. Despite countless hours helping our patient live examined-lives, Filipino psychiatrists have not collectively analyzed their own. A qualitative analysis was done of data gathered from the responses of 57 (11.3%) pyschiatrists who were given a questionnaire, conversations with colleagues and the author's reflections on her own experiences. (Appendix 1) The salient points of this paper are: 1) How do we see ourselves? How do others (colleagues, community) see us, and how does their view influence the Filipino psychiatrist?; 2)What work do we do among Filipinos? Does our work help us find meaning and personal satisfaction?; 3) Why and how do these personal and professional challenges i.e. patients who die, legal and internal revenue concerns, overlapping responsibilities, stigmatized field of practices, affect our personhood?

Human ; Male ; Female ; Philippines ; Psychiatry ; Personal Satisfaction

Human ; Male ; Middle Aged ; Psychiatry ; Informed Consent

Mental Health ; Public Health ; World Health Organization ; Philippines

Mental Health ; Capacity Building

OBJECTIVES: This study aims to describe the trends of psychiatric referrals for international self-harm from January 2005 until December 2009.
METHODOLOGY: A retrospective descriptive study using chart review of all patients with ICD code X60-X84 during the 5 year study period was done. Demographic data of all subjects and the psychiatric diagnoses of those referred were obtained. The distribution of referral status according to patient profile was likewise described.
RESULTS: There were 195 charts reviewed wherein the ff data was gathered:66% were female, 59% were less than 30 years old, 64% were single, 84% were Catholics, while 31% were students and 28% were unemployed. Fifty seven percent had no medical illness and 78% had no known psychiatric illness. Of the 35 who were diagnosed to have a psychiatric illlness (35/195=18%), most (49% were depressed while 17% had bipolar disorder. Eighty percent had a stressor prior to self harm and 51% had intention of killing self. One third (36%) had no previous episode of intentional self harm while 33% did have a previous episode. With regards method of self harm, 89% ingested either drugs (129/195=66%) or chemicals (44/195=23%). Seventy seven percent were admitted by internal medicine, 82% had a hospital stay of 3 days or less and 81% were discharged improved. When comparing the frequency trends of psychiatric referrals for intentional self harm from 2005-2009, the highest rate of referrals were in 2009 at 68% while the lowest rate of referring patients to psychiatry was in 2006 at 26%. Referral was higher among those with co morbid medical illness but also had the higher refusal rate. Non-referral was higher among those without co-morbid medical illness. Referral was highest among those who had known psychiatric illnesses. Those whose psychiatric conditions were not stated had the highest non-referrals and refusal rates. Referral rates were highest among patients who were admitted under the OB-Gynecology, ENT and Anesthesiology departments while non-referral was highest among those admitted under pediatrics department.
CONCLUSIONS: Majority of patients were referred but there were no noted trend when annual percentages of psychiatric referral were compared. Non-referral was consistently greater than refusal in 2005-08 but reversed in 2009.

Human ; Male ; Female ; Middle Aged ; Adult ; Patients ; Psychiatry

Human ; Female ; Adult ; Palliative Care ; Psychiatry ; Lymphoma

OBJECTIVES:The main objectives of the Adherence in Schizophrenia (ADHES) survey in the Philippines were to: (1) describe the insights of Filipino psychiatrists on the level of adherence to treatment of patients with schizophrenia; and (2) to identify possible main challenges for treatment adherence in schizophrenia.
METHODOLOGY:The 2012 ADHES Asia Pacific (APAC) survey was a questionnaire-based survey with 4,661responding psychiatrists (24% of recipients) in 13 countries in the Asia-Pacific region, which was administered from January 2012 to April 2012. In the Philippines (n=17), the survey was conducted between March and April 2012 and distributed to psychiatrists by Janssen personnel. The 20-item questionnaire was devised to ascertain psychiatrists' preferred methods of assessing perceptions of the levels of adherence, reasons for non-adherence to treatment in schizophrenia patients, their perceptions of the levels of adherence, reasons for non-adherence and strategies to improve adherence. Gender, age and practice setting of the psychiatrists were also collected for analysis.
RESULTS:A total of 71 psychiatrists responded to the ADHES Survey in the Philippines. The most common approaches used by the psychiatrists in assessing adherence to prescribed doses were asking an informant (e.g. relative, friend, caregiver) (96%) and asking the patient directly (94%). About 48% of the patients were "fully-adherent" or took at least 90% of prescribed doses as assessed by the psychiatrists who were included in the survey. Meanwhile, 23% of the patients were "non-adherent" or took 30% of prescribed doses. According to the psychiatrists, the most were lack of insight (28%) and cognitive impairment (24%). However, the most common reason for stopping medication among the respondents' patients was due to insufficient efficacy of the antipsychotic or having experienced psychotic symptoms with the medication they are taking (30%). Lastly, the most preferred pharmacological strategies used by the respondents to address an adherence problem in patients with schizophrenia were switching to a long-acting anti psychotic medication (27%) and switching to a different oral antipsychotic (23%).
CONCLUSION:Partial or non-compliance to medication is a serious issue in schizophrenia, and insight into illness in schizophrenia, and insight into illness in schizophrenia is the most important reason for treatment non-adherence. Thu, there is a need to continuously assess the level of insight in patients with schizophrenia and institute more pro-active interventions such as direct-observation treatment for oral medications or long-acting injectable antipsychotics. The more wide-spread use objective assessments of medication  compliance can also be explored.

 

 

Human ; Male ; Female ; Antipsychotic Agents ; Asia ; Caregivers ; Cognitive Dysfunction ; Medication Adherence ; Philippines ; Psychiatry ; Psychotic Disorders ; Schizophrenia ; Surveys And Questionnaires ; Patient Compliance ; Patients