Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-10T12:59:57.892Z Has data issue: false hasContentIssue false

Med Psych Units: Proceedings and abstracts of the Triptych Workshop 9 december 1999 Maastricht

Published online by Cambridge University Press:  18 September 2015

Extract

Med Psych Units (MPU) are neither clear-cut medical nor psychiatric units. This makes it difficult to acquire funding for these often expensive units. Despite this, there are many reasons why MPU's should be a necessary part of any larger scale inpatient service of a general and teaching hospital. It is therefore even more remarkable that such units hardly exist in Europe and that only about twenty exist in the USA. Five main reasons why such units should be opened are:

  1. The increasing average age of the population of the Western World, with high co-morbidity and polypharmacy in the elderly and elderly elderly.

  2. An increase in the number of chronic physical diseases resulting in co-morbid psychiatric disorders. This increase in chronicity is the consequence of increasingly successful treatment of acute and potentially lethal diseases; for example, acute myocardial infarction and the subsequent development of chronic heart disease.

  3. The decreasing duration of hospital admission. On average the duration of stay in a general hospital in The Netherlands is now nine days. The number of day-treatments has doubled in the last decade. This situation means that it is not possible to observe the behavior of patients on a general medical ward or to carry out a psychiatric consultation.

  4. Inadequate medical evaluation of psychiatric patients. According to a recent survey by the Dutch Ministry of Health, the care given for physical disease to psychiatric patients in mental hospitals in The Netherlands needs much to be desired for.

  5. The psychiatric co-morbidity of somatic diseases is accompanied by a high consumption of medical facilities and high economic losses, unless adequately recognized and treated.

Type
Research Article
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Literature

1.Kathol, RG, Harsch, HH, Hall, RCW, Shakespeare, A, Cowart, T. Categorization of types of medical/psychiatry units based on level of acuity. Psychosomatics 1992; 33: 376–87.CrossRefGoogle ScholarPubMed
2.Huyse, FJ, Hengeveld, MW. The development of c-1 psychiatry in the Netherlands: its social psychiatric heritage. Geni Hosp Psychiatry 1989;11: 915.CrossRefGoogle Scholar
3.Protheroe, D, House, A. In-patient liaison psychiatrisch in the UK. Psychiatr Bull 1999; 23: 525–7.CrossRefGoogle Scholar
4.Herzog, T. In-patient treatment with patients with severe psychosomatic and neurotic disorders: a German perspective. Br J Psychotherapy 1991; 8: 189–98.CrossRefGoogle Scholar
5.Reitsma, J.B.Hart en Vaatziekten in Nederland 1996. Den Haag, 1996.Google Scholar
6. Nota inspectie voor de gezondheidszorg; Somatische zorg in APZ’en. Den Haag, 1999.Google Scholar
7.Katon, WJ, Von Korff, M, Lin, E. Panic disorder: relationship to high medical utilization Am J Med 1992; 92 (suppl. 1A):1A-7S1A-11S.CrossRefGoogle ScholarPubMed
1.Frasure-Smith, N, Lespérance, F, Talajic, M. Depression and 18-month prognosis after myocardial infarction. Circulation 1995; 91: 9991005.CrossRefGoogle ScholarPubMed
2.Frasure-Smith, N, Lespérance, F, Talajic, M. Depression following myocardial infarction. Impact on 6-month survival. JAMA 1993; 270: 1819–25.CrossRefGoogle ScholarPubMed
3.Honig, A, Lousberg, R, Wojciechowski, FL, Cheriex, EC, Wellens, HJJ, van Praag, HM. Depressie na een eerste hartinfarct; over-eenkomsten en verschillen met ‘gewone’ depressie. Ned Tijdschr Geneesk 1997; 141: 196–9.Google Scholar
4.Strik, JJMH, Honig, A, J van, Os, Kuijpers, PMJC, Lousberg, R, Wellens, HJJ, Praag, HM van. Depression following first myocardial infarction: a prospective study of incidence and relationship with size of infarction. Submitted.Google Scholar
5.Carney, RM, Saunders, RD, Freedland, KE, Stein, P, Rich, MW, Jaffe, AS. Association of depression with reduced heart rate variability in coronary artery disease: Am J Cardiol 1995; 76: 562–4.Google Scholar
6.Carney, RM, Freedland, KE, Rich, MW, Smith, LJ, Jaffe, AS. Ventricular tachycardia and psychiatric depression in patients with coronary artery disease. Am J Med 1993; 95: 23–8.CrossRefGoogle ScholarPubMed
7.Roose, SP, Dalack, GW, Woodring, S. Death, depression, and heart disease: J Clin Psychiatry 1991; 52 (6, suppl): 34–9.Google Scholar
8.Musselman, DL, Evans, DL, Nemeroff, CB. The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Arch Gen Psychiatry 1998; 55: 580–92.CrossRefGoogle ScholarPubMed
9.Laghrissi-Thode, F, Wagner, WR, Pollock, BG, Johnson, PC, Finkel, MS. Elevated platelet Factor 4 and ß-thromboglobulin plasma levels in depressed patients with ischemic heart disease. Biol Psychiatry 1997; 42: 290–5.CrossRefGoogle Scholar
10.Musselman, DL, Tomer, A, Manatunga, AK, Knight, BT, Porter, MR, Kasey, S, Marzec, U, Harker, LAet al.Exaggerated platelet reactivity in major depression. Am J Psychiatry 1996; 153 (10): 1313–7.Google ScholarPubMed
11.Kuijpers, PMJC, Honig, A, Griez, E, Braat, S, Wellens, HJJ. Paniek-stoornissen, pijn op de borst en palpitaties: een folie cardiaque? Ned Tijdschr Geneesk, submitted.Google Scholar
12.Leon, AC, Olfson, M, Portera, L. Service utilization and expenditures for the treatment of panic disorder. Gen Hosp Psychiatry 1997; 19: 82–8.CrossRefGoogle ScholarPubMed
13.Salvador-Carulla, , Seguí, J, Fernández-Cano, P, Canet, J. Costs and offset effect in panic disorder. Br J Psychiatry 1995; 166 (suppl 27): 23–8.CrossRefGoogle Scholar
14.Kawachi, I, Colditz, GA, Ascherio, A, Rimm, EB, Giovannucci, E, Stampfer, MJ, Willett, WC. Prospective study of phobic anxiety and risk of coronary heart disease in men. Circulation 1994; 89: 1992–7.CrossRefGoogle ScholarPubMed
15.Smith, R. The Hospital Anxiety Depression Rating Scale. Br J Psychiatry 1982; 141: 518–23.Google Scholar
16.Overbeek, T, Schruers, K, Griez, E (Dutch translation, Maastricht University). Mini International Neuropsychiatrie interview (MINI) version 4.4.Google Scholar
17.Kuijpers, PMJC, Honig, A, Griez, E, Braat, S, Wellens, HJJ. Paniek-stoornissen, pijn op de borst en palpitaties: een pilotstudie op een Nederlandse Eerste Hart Hulp. Ned Tijdschr Geneesk, submitted.Google Scholar
18.Fleet, RP, Dupuis, G, Marchand, A, Burelle, D, Arsenult, A, Beitman, BD. Panic disorder in emergency department chest pain patients: prevalence, comorbidity, suicidal ideation, and physician recognition. Am J Med 1996; 101: 371–80.CrossRefGoogle ScholarPubMed