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Objectives. We examined risk factors for long-term homelessness among newly homeless men and women who were admitted to New York City shelters in 2001 and 2002. Methods. Interviews were conducted with 377 study participants upon entry into the shelter and at 6-month intervals for 18 months. Standardized assessments of psychiatric diagnosis, systoms, and coping skills; social and family history; and service use were analyzed. Kaplan-Meier survival analysis and Cox regression were used to examine the association between baseline assessments and duration of homelessness. Results. Eighty-one percent of participants returned to community housing during the follow-up period; the meridian duration of homelessness was 190 days. Kaplan-Meier survival analysis showed that a shorter duration of homelessness was associated with younger age, current or recent employment, earned income, good coping skills, adequate family support, absence of a substance abuse treatment history, and absence of an arrest history. Cox regression showed that older age group (P Conclusions. Identification of risk factors for long-term homelessness can guide efforts to reduce lengths of stay in homeless shelters and to develop new preventive interventinos. (Am J Public Health. 2005;95: 1753-1759. doi: 10.2105/AJPH. 2005.063321)

Overview: Psychiatric adverse effects, including aggression, have been reported with the use of statin medications; however, there is little data to support or refute the theory that statins or low serum cholesterol do in fact increase a patient's risk of aggression. Objective: This study examined 1) statin use and increased aggression, measured by the requirement of either emergent psychiatric intervention referred to as "Code Green" (CG) or "Restraint and Seclusion" (RS) and 2) cholesterol level and increased aggression in psychiatric inpatients. Materials and Methods: Patient charts from January 1, 2011, to December 31, 2015 were reviewed. Statin therapy, lipid panel, and requirement of a psychiatric emergency code CG or RS were noted. Inpatients who did not receive cholesterol-lowering therapy were used as controls. Analyses of variance (ANOVAs) were used to examine the relationship between statin use and increased aggression. Results: Eleven (9.6%) patients receiving statins required a total of 57 CGs, and five (4.4%) required 27 RSs. Conversely, 33 (28.9%) patients not receiving statins required a total of 64 CGs, and 14 (12.3%) required 27 RSs. No statistically significant relationship between statin therapy and agitation was found as evidenced by a CG (F=0.068; p=0.795) or RS (F=0.001; p=1.000). A statistically significant relationship was found between total cholesterol level and requirement of a CG (F=1.435; p=0.029) or RS (F=2.89; p=0.000). Conclusion: It is evident that psychiatric inpatients with lower total cholesterol levels are at an increased risk for loss of behavioral control. [ABSTRACT FROM AUTHOR]

A new clinician rating measure, the Symptoms of Trauma Scale (SOTS), was administered to adult psychiatric outpatients (46 men, 47 women) with severe mental illness who reported a history of trauma exposure and had recently been discharged from inpatient psychiatric treatment. SOTS composite severity scores forDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition, andDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition, posttraumatic stress disorder (PTSD), complex PTSD (cPTSD), and total PTSD/cPTSD severity had acceptable internal consistency reliability. SOTS scores’ construct and convergent validity was supported by correlations with self-report measures of childhood and adult trauma history and PTSD, dissociation, and anger symptoms. For men, SOTS scores were associated with childhood sexual and emotional abuse and self-reported anger problems, whereas for women SOTS scores were most consistently and strongly associated with childhood family adversity and self-reported PTSD symptoms. Results provide preliminary support for the reliability and validity of the SOTS with adults with severe mental illness and suggest directions for replication, measure refinement, and research on gender differences. [ABSTRACT FROM PUBLISHER]

Vitamin D supplementation has become an increasingly popular prescribing practice, despite our limited knowledge of both the definition and degree of deficiency as well as the expected benefits or risks of exogenous administration. Many of the hypothesized benefits of vitamin D supplementation include a variety of improvements in mental health; however, these claims are not consistently or robustly supported by current research. In this paper, we provide a brief overview of what is currently known about vitamin D deficiency and about outcomes of supplementation as well as a summary of the data relative to prescribing practices for inpatients in an urban psychiatric hospital. [ABSTRACT FROM AUTHOR]

The article provides an update on the treatment recommendations for schizophrenia with comorbidity. It highlights that publication of the fifth edition of "Diagnostic and Statistical Manual for Mental Disorders," led to discussions regarding psychiatric diagnoses. It looks at research conducted on the sources of co-morbidity and dimensional classification of disorders. The importance of combining categorical and dimensional approaches in treating psychiatric disorders is also emphasized.

Positive and negative syndromes were studied in relation to demographic, historical, genealogical, clinical, psychometric, extrapyramidal, and follow-up measures of 101 chronic schizophrenic patients. The criterion scales proved to be reliable, normally distributed, and strongly correlated with general psychopathology, but otherwise inversely related to one another. Multiple regression analysis identified sets of 4-6 independent variables that explained 74%-81% of the scales' variance. A positive syndrome was associated chiefly with productive features, family history of sociopathy, more previous hospital admissions, and longer in-patient stay during the 30-month follow-up period. A negative syndrome correlated with deficits in cognitive, affective, social, and motor spheres, higher incidence of major psychiatric illness but less affective disorder among relatives, lower education, and greater cognitive developmental impairment. The results underscore the importance of genetic and biodevelopmental variables for understanding schizophrenic syndromes. [ABSTRACT FROM AUTHOR]

Objectives. To identify risk factors for homelessness among the severely mentally ill, we conducted a case-control study of 100 indigent schizophrenic men meeting criteria for literal homelessness and 100 such men with no homeless history. Methods. Subjects were recruited from shelter, clinic, and inpatient psychiatric programs in Upper Manhattan. Clinical interviewers employed standardized research instruments to probe three domains of risk factors: severity of mental illness, family background, and prior mental health service use. Results. Homeless subjects showed significantly higher levels of positive symptoms, higher rates of a concurrent diagnosis of drug abuse, and higher rates of antisocial personality disorder. Homeless subjects experienced greater disorganization in family settings from birth to 18 years and less adequate current family support. Fewer homeless subjects than subjects in the never-homeless comparison group had a long-term therapist. These differences remained when demographic variables were adjusted statistically. Conclusions. Homeless schizophrenic men differed from their domiciled counterparts in all three domains we investigated; family background, nature of illness, and service use history. Findings are discussed in relation to policy and programs for the severely mentally ill. [ABSTRACT FROM AUTHOR]