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Biomedical subjects

M Nordentoft

Publications and source records attributed to M Nordentoft.

At least 37 records · Page 2Linked to original sources
PubMed1994

[High mortality from both natural and unnatural causes. A 10-year follow-up of patients admitted to a center for poisoning treatment after attempted suicide].

While it is well known that suicide rates for suicide attempters are high, mortality rates for all causes needed to be more thoroughly investigated. A Danish 10-year follow-up study of patients who in 1980 were admitted to a poisoning treatment centre after attempted suicide was carried out with the purpose of describing mortality by suicide and other causes of death, and to identify predictive factors. A total of 974 patients aged 15 and over referred to a poisoning treatment centre after deliberate self-poisoning were included in the study. Death by different causes registered in the Danish Death Cause Register was the outcome measure. Over a 10-year follow-up period 306 patients had died; 103 by suicide, 131 from natural causes, 31 by accidents, five were murdered and in 36 cases the cause of death was uncertain. The Standard Mortality Rate (SMR) was 550. The cause-specific SMRs were for suicide 2960, for natural causes 236, for accidents 1256 and for uncertain causes 5459. In Cox-regression analysis high-risk factors for later suicide were more than one previous suicide attempt (relative risk (RR) 2.25), living alone (RR 2.28) and age (RR 1.03 per year). Predictors of death by natural causes were pension (RR 1.69), drug abuse (RR 2.72), more than one previous suicide attempt (RR 2.25), age (RR 1.06 per year) and male sex (RR 2.49). The group of patients fulfilling at least one high-risk criteria for later suicide differed significantly from the rest of the patient group regarding frequency of suicide, but both sensitivity and specificity remain low.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Homeless on the streets of Copenhagen].

A group of homeless people living in the streets is described with the purpose of gaining the knowledge necessary to prevent development of homelessness and establishing programmes for the homeless. Out-reach work in the streets and cooperation with private and religious organisations was conducted during a two-year period and 59 homeless persons were interviewed. Fifteen were women and 44 were men. Upbringing, social conditions, daily living, physical and mental health and contact with health services, social security and private organisations were highlighted in a structured and semistructured interview. Compared with the background population the homeless had much more frequently childhood experience of parents' divorce or death of one of the parents. The women were significantly older than the men and the majority of the women were suffering from schizophrenia and had very little contact with network and public services. The majority of the men were abusing alcohol or drugs, many had had a troublesome childhood with stays in institutions. Many had had many contacts with different social institutions and a criminal record. Among the homeless in the streets of Copenhagen, the prevalence of mental illness, especially schizophrenia, is high. It is recommended that homelessness among the mentally ill is prevented by a special effort directed towards the patient group at risk of becoming homeless and through establishing different housing facilities with varying degrees of professional support. Out-reach work towards the homeless mentally ill should be carried out with the purpose of establishing contact with psychiatric services and securing the possibility of compulsory admission.

Adolescent↗
PubMed1994

Prenatal stressors of human life affect fetal brain development.

In a population-based study, 3021 women in a central Copenhagen district received a questionnaire on environmental and psychological factors during mid-gestation. Of these, 70 women were selected consecutively on the basis of moderate to severe stressful life-events (DSM-III-R categories 3 to 5), in combination with an inadequate social network. They were compared with 50 non-stressed women with an intact social network. Stress and smoking significantly affected birthweight and head circumference. When birthweight was corrected, stress remained a significant determinant of small head circumference, indicating a specific effect on brain development. Stress also led to a suboptimal Prechtl neonatal neurological score. These findings suggest the existence of a fetal stress syndrome with adverse effects on fetal development, including deficient brain development.

Brain↗
PubMed1993

[Relatives of psychotic patients: effect of group discussions and group education].

Forty relatives of young psychotic patients participated in psychoeducative groups for eight sessions and filled in questionnaires at the first and the last session. They were questioned about user satisfaction, degree of strain, knowledge, attitude and behaviour in relation to mental illness, and the emotional climate in the family. The emotional climate in the family was investigated by means of the Family Questionnaire and divided in subscales, measuring criticism and over-involvement. The relatives had experienced strain in relation to the patient's behaviour. Aggression, unpredictability, dependence/helplessness were factors which the relatives felt most straining. The relatives' burden of care had consequences in economy, private life and working life. The relatives complained of lack of continuity in the treatment of the patient. Information about the condition, diagnosis and prognosis of the patient was criticized for being unsatisfactory, too vague or too scarce. After the psychoeducative group sessions, both criticism and over-involvement tended to fall (non-significant). The relatives were very satisfied with the group sessions. It is concluded that psychoeducative group sessions with relatives of psychotic patients are effective in influencing the emotional climate in the families in a desirable way. Better cooperation between psychiatric department/community mental health care centre, patient and relative can increase compliance with medical treatment and increase the relatives' ability to handle problems related to the patient's disease.

Adolescent↗
PubMed1993

High mortality by natural and unnatural causes: a 10 year follow up study of patients admitted to a poisoning treatment centre after suicide attempts.

OBJECTIVE: To describe mortality by suicide and other causes of death in a group of patients who attempted suicide, and to identify predictive factors. DESIGN: 10 year follow up study based on records of suicide attempters in 1980. SETTING: Poisoning treatment centre at a general hospital. SUBJECTS: 974 patients aged 15 and over referred to the poisoning treatment centre after deliberate self poisoning. MAIN OUTCOME MEASURES: Death by different causes registered in the Danish death cause register. RESULTS: In 10 years of follow up 306 patients died: 103 by suicide, 131 from natural causes, and 31 by accident; five were murdered, and in 36 cases the cause of death was uncertain. The standard mortality ratio was 550. Cause specific standardised mortality rates were 2960 for suicide, 236 for natural causes, 1256 for accidents, and 5459 for uncertain causes. In a Cox regression analysis, high risk factors for subsequent suicide were: more than one previous suicide attempt (relative risk 2.25), living alone (2.28), and age (1.03 per year). Predictors of death by natural causes were receiving a pension (1.69), drug misuse (2.72), more than one previous suicide attempt (2.25), age (1.06 per year), and male sex (2.49). The group of patients fulfilling at least one high risk criterion for later suicide differed significantly from the rest of the patient group in incidence of suicide, but both sensitivity and specificity were low. CONCLUSIONS: Most patients who attempted suicide were at high risk of succeeding because the risk factors, though significant, are not very specific. A strategy to prevent suicide must be directed toward the majority of those who attempt suicide.

Adolescent↗
PubMed1993

Thiamine pyrophosphate effect and erythrocyte transketolase activity during severe alcohol withdrawal syndrome.

The thiamine pyrophosphate (TPP) effect and erythrocyte transketolase activity (ETKA) in a group of 28 patients admitted to a psychiatric emergency ward because of severe alcohol withdrawal syndrome were compared with the TPP effect and ETKA in a control group of 20 healthy nonalcoholic volunteers. The patients were treated with 300 mg thiamine 3 times daily as intramuscular injections, and the TPP effect and ETKA were measured after 1 and 4 days of treatment. No difference was found between the patient group and the control group with regard to the TPP effect and ETKA and no decline in the TPP effect was found in the patient group after 4 days of intensive treatment with thiamine. ETKA increased with intensive thiamine treatment, which suggests that ETKA is a sensitive indicator of thiamine deficiency. Serum magnesium, which is a cofactor for thiamine pyrophosphate, decreased significantly with the disappearance of alcohol from the blood in patients with high initial blood alcohol levels, but this shift did not interfere with biological thiamine activity.

Adult↗
PubMed1993

Mental illness and social integration among suicide attempters in Copenhagen. Comparison with the general population and a four-year follow-up study of 100 patients.

In order to describe a population of suicide attempters in an affluent suburb of Copenhagen, 100 patients were interviewed, randomly chosen from a group of 246 patients referred to psychiatric consultation after a suicide attempt. The group consisted of 71 women and 29 men. Single status, abuse, and previous suicide attempts occurred frequently as did suicide among first-degree relatives. The most frequent reason for a suicide attempt was conflict with partners. In comparison with the normal population in the same catchment area, the patients were alone and felt lonely, but no difference was found in the group's relation to the labor market. After a four-year follow-up period, 9 persons had died by suicide. Borderline personality disorder and affective psychosis, no employment, 2 or more previous attempts, violent method and potential lethal attempt proved to be predictors of suicide later on. Alcohol and drug abuse, lack of social support and loneliness did not influence the risk.

Adolescent↗
PubMed1993

Admission of self-poisoned patients during one year at the Poisoning Treatment Centre, Copenhagen, Denmark.

The study comprises 541 patients admitted to the Poisoning Treatment Centre at Bispebjerg Hospital, Copenhagen; 440 of the patients were psychiatrically evaluated prospectively. The sex distribution was almost equal. In comparison with the normal population there was an overrepresentation of the age groups of 30-49 years old and of 18-19 years old. Only 20% were employed. Sixty-nine percent of the males and 40% of the females were living alone. Forty-six percent of the patients had some sort of abuse. Twenty-one percent suffered from psychotic disorder. Forty-eight percent had at least once before attempted suicide. The group was found to be at high risk of repeating suicide attempt according to a scale developed in the poisoning treatment centre in Edinburgh. The treatment of suicidal patients is discussed.

Adolescent↗
PubMed1992

[Changes in social conditions and drinking patterns in male and female clients attending an outpatient clinic for alcoholics in Copenhagen].

The proportion of new female clients in the ALKO outpatient clinic in Copenhagen increased from 22% in 1975 to 37% in 1985. The first 100 new male and female clients in the ALKO outpatient clinic in 1975 and 1985 were investigated. The new female clients in 1985 were educated better as regards scholastic and occupational training than were the new female clients in 1975. Fewer of the clients of the ALKO outpatient clinic were married than was the case in the normal population in 1975 and also 1985. In 1975, fewer of the new female clients were registered in the occupational market than among the new female clients in 1985. Attention is drawn to a tendency to evening out of the differences between male and female alcohol addicts as regards social conditions and drinking patterns. The therapeutic consequences of these observations are discussed.

Adult↗
PubMed1992

[Suicide among psychiatric patients].

Investigation of the development in the incidence of suicide among psychiatric patients is reviewed and it is concluded that the majority of investigations have demonstrated an increasing suicide rate even when the increasing numbers of admissions and discharges are taken into consideration. It is concluded that altered circumstances for psychiatric patients have played a part in relation to the increase in the suicide rate. Investigation of the suicide rates related to diagnoses suggest that manic-depressive patients, alcoholics and schizophrenics have the highest suicide rates. In investigations of patients who died from suicide as compared with patients who did not die from suicide but who were otherwise comparable, it appears that unmarried status, male sex and previous attempted suicide and suicidal thoughts are more frequently correlated with subsequent suicide. Medical audit in connection with suicide among psychiatric patients is discussed as a possible method of improving the training and competence of psychiatric staff in relation to suicidal behaviour.

Humans↗
PubMed1992

Patients in the care of private psychiatric practitioners. Comparison with public hospital patients and the background districts' population.

In Western societies, the number of psychiatric hospital beds has decreased markedly in the past decades. The reduction in hospital beds has resulted in a relatively large number of mentally ill individuals residing in the community. They experience varying degrees of success. One form of treatment available to such patients is private psychiatric consultation. In Denmark and England (two countries with public supported health care systems) the number of psychiatrists in private practice (PPPs) has increased in recent years. These private practioners may offer a mode of treatment which may meet the needs of a subgroup of the psychiatric patients in the community. The fees of the PPPs are paid by the National Health Service. In this study we report on the characteristics of the patients attending the consultation of private psychiatrists and the treatment which they are offered. We compare the patients of the PPPs with 1. psychiatric patients residing in the same districts who are cared for by the public hospital system and 2. the background populations of these same districts. The results suggest that the patients in private psychiatric practice are distinct in a number of ways. Neurosis is the dominant diagnosis. Of the patients, 71% are women; the patients tend to be younger than the background districts population; after controlling for age, the marital status of the patients in PPPs' care does not differ significantly from that of the background population, and they are comparable to the background population in level of employment. These patients are more able to care for themselves than the psychiatric patients treated in the public hospital system. The results suggest that PPP is a means of caring for a subgroup of the psychiatric patients in urban settings.

Adult↗
PubMed1992

Housing conditions and residential needs of psychiatric patients in Copenhagen.

A study of the extent of homelessness among 1581 psychiatric patients in Copenhagen found that 342 patients (22%) in contact with the psychiatric services had serious housing problems. A total of 112 (7%) were long-stay patients without a home address, 134 (8%) were in an unstable housing situation and 96 (6%) were actually homeless. The homeless among the psychiatric patients were characteristically single, on disability pension or general public assistance, most often under 45 years of age, often schizophrenic and, among the men, almost one third were alcohol abusers. The majority of the homeless preferred separate apartments, and the psychiatrists also considered this form of housing to be the most appropriate for them. Approximately one fifth were estimated to need staff-supported housing, and the number of places in psychiatric group homes or halfway houses should therefore be increased.

Activities of Daily Living↗
PubMed1991

[Psychosocial aspects of women applying for abortion after 12 weeks of pregnancy].

In 1986, 595 women applied for termination of pregnancy after the twelfth week of pregnancy in Denmark. Permission for termination was given in 519 cases. The late terminations of pregnancy constituted 2.6% of the total number. Women who apply for termination of pregnancy after the twelfth week of pregnancy are younger and socially more stressed than the remainder of the women who obtain termination of pregnancy. Young age in the women and medical errors are important factors in connection with exceeding of the twelve week limit. If the number of late abortions is to be reduced, particular attention must be focussed on these factors.

Abortion Applicants↗
PubMed1991

[Working and living conditions of Danish medical assistant].

In spring 1988 almost 6,000 members of the Danish Association of Young Doctors answered a questionnaire containing 132 questions about their working and living conditions. The Danish study shows that many young doctors are worried by uncertain conditions of employment, lack of opportunities for further training, and demanding emergency duty. Traditional sex role patterns in the families afflict the women doctors who have difficulty in holding their own in the keen competition. Stress in different forms is regarded as a problem by about 25 per cent. Almost half of the respondents had wholly or partially regretted their choice of a career and one fifth had considered changing their profession. The physicians own occupational injuries are substantially (24 per cent) underreported. Swedish and Finnish studies indicate that the problems in the medical profession are similar in the Nordic countries.

Alcohol Drinking↗
PubMed1989

[Patient transfer to and from psychiatric departments].

The most recent Danish literature which illustrates movements of patients into and out of psychiatric departments and outpatient clinics is reviewed. It is demonstrated that psychotic conditions play an increasing part in psychiatry and that a few quite well-defined patient groups are responsible for the greater part of employment of the psychiatric service and that there are frequently factors in the immediate environments of the patients on which the psychiatric departments and outpatient clinics have very little influence and which contribute to the extent to which a patient will conclude or continue the psychiatric treatment. It is emphasized that many aspects of the knowledge about patient movements in psychiatry are incompletely investigated.

Denmark↗