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2 results

  • Chapter 18 - Parkinson’s Disease and Related Disorders in Acute Hospitals

  • Edited by George Tadros, Aston University, Birmingham, George Crowther, Leeds and York Partnership NHS Foundation Trust, Leeds
  • Book:
    Handbook of Old Age Liaison Psychiatry
    Published online:
    04 April 2024
    Print publication:
    11 April 2024, pp 266-282

  • Summary

    Parkinson’s is a commonly encountered condition in both acute hospitals and rehabilitation settings, particularly among older adults. It is also a true neuropsychiatric condition. People with Parkinson’s have both physical health and mental health morbidity, and the likelihood of a liaison psychiatrist being called to assess someone with Parkinson’s is therefore high. However, since this condition is often primarily thought of as a movement disorder rather thanas a neuropsychiatric disorder, the liaison psychiatrist may not have had much training in it, particularly in the physical problems that can occur. This chapter aims to provide the reader with a basic overview of Parkinson’s and related disorders, focusing on emergency presentations and problems that may occur during an acute admission, since these are the situations in which the liaison psychiatrist is most likely to be involved. Formatted to include tables and boxes, the chapter gives the reader easily digestible and clinically relevant information, with emphasis on the practical management of commonly encountered clinical problems rather than on theoretical information.

  • Use of ‘acute behavioural disturbance’ in mental health records: differences over time and by ethnicity in a London NHS mental health Trust

  • Catherine Polling, Preety Das, Kevin Ariyo, Natalie Creary, Shubulade Smith
  • Journal:
    BJPsych Open / Volume 9 / Issue 4 / July 2023
    Published online by Cambridge University Press:
    24 July 2023, e133
    • Article
      • You have access
      • Open access
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  • Background

    Acute behavioural disturbance (ABD) is a controversial descriptor for presentations of severe agitation, aggression and physiological compromise.

    Aims

    To characterise the use of ABD-related terms in the electronic record of a large UK provider of mental health services during 2006–2021.

    Method

    The free text of all records relating to patient contacts with acute assessment mental health teams during 2006–2021 were searched for references to ABD. Identified text was coded for context of use and presence of clinical features of ABD described in the literature. Poisson regression was used to analyse differences in rates of use over time and between demographic groups.

    Results

    Mentions of ABD increased by an average of 1.12 (95% confidence interval (CI), 1.08–1.17) per year, with the greatest increase from 2019 to 2021. Black people were more than twice as likely as White people to have reference to ABD included in their assessments (rate: 2.4/1000 (95% CI 1.8–3.1) in Black people compared with 1.0/1000 (95% CI 0.8–1.3) in White people). The clinical characteristics in notes describing a current presentation of ABD rarely corresponded to those included in UK medical guidelines on ABD.

    Conclusions

    The term ABD in mental health notes appears to often, but not exclusively, be a synonym for severe agitation and conveys little meaning beyond this. However, the term's connection to a literature emphasising the high risk of physical health collapse and need for urgent treatment means that its disproportionate use in Black people may contribute to existing racial inequalities in the use of coercive measures during crisis presentations.