[Report of sickness and use of consulting physicians. A study at the Skedsmo social security office].
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Biomedical subjects
Publications and source records attributed to K Noreik.
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The present study was undertaken at Dikemark Hospital where the authors studied all first-time admissions in 1970, over a period of 4-5 years. The aim was to study the course of the illness, focusing on the problem: who become long-stay patients in a psychiatric hospital? Which factors relate to prolonged hospital stay and chronicity? Is it possible, at an early stage, to predict the "chronic"? It is possible to do more to prevent chronicity of patients in psychiatric hospitals? These were some of the questions to be studied. We present here some of the results of the inquiry. The conclusion is: it is important to make greater efforts to diagnose patients in danger of becoming long-stay patients. The following proposal is put forth and argued for: all patients staying in hospital for more than 6 months should be examined and reassessed by an interdisciplinary team with regard to intensive treatment and possible rehabilitation.
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The occupational status of a group of 100 male patients, 35 to 68 years of age, with chronic ischaemic heart disease was studied, and related to the severity and distribution of coronary artery stenosis seen on the arteriograms and to left ventricular function. In this series of patients 31 per cent were working, 31 per cent were recorded as temporarily sick, and 38 per cent as permanently disabled. It appears that while the type of previous occupation and physical activity associated with the job were of importance, there was no correlation between employability on the one hand and severity and distribution of coronary artery disease on the other. 'Blue-collar' workers had a higher rate of unemployment than those in 'white collar' occupations, but this could not be explained by differences in severity of coronary artery disease.
A total of 2,243 first admissions to Gaustad Hospital between 1938 and 1961 diagnosed as functional psychotics were either followed up to the time of their death within 5 years, or observed over a period of 5 years, and then reexamined. Of these patients, 325 had attempted suicide prior to their admission. The frequency of attempted suicide was equal in both sexes. Men appeared to use more dangerous methods, and to have more serious intentions. The psychosis appears to have been of importance when considering whether, but not how the suicide should be attempted. The greatest risk of attempted suicide was to be found amongst patients with psychoses of a depressive nature. Twenty-eight of the 2,243 patients in this study committed suicide within 5 years following their discharge, and a further 20 took their own lives prior to the reexamination. A certain connection can be seen between attempted suicide and psychotic symptoms.
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