-Caveat Lector-

"At least one-third of the patients in these diagnostic groups had been
psychotic 'for a long time.' ... They were not brought to the emergency
department until they exhibited overtly dangerous or socially unacceptable
behavior, such as attacking others, talking to voices, removing their clothes
in public, or claiming to be possessed by aliens."
===============================================
Signs of Impending Psychiatric Crisis Often Missed
Mary Ann Moon, Contributing Writer
[Clinical Psychiatry News 27(4):28, 1999. � 1999 International Medical News
Group.]



--------------------------------------------------------------------------

Washington -- Many of the adolescents and young adults admitted for
psychiatric emergencies in one large study showed symptoms for months or even
years preceding the crisis but were never treated.

"More attention must be paid to those [adolescents] who exhibit subtle signs
of mental illness," Janet Lavelle said at the annual meeting of the American
Public Health Association.

"Earlier identification and treatment of adolescents and young adults will
reduce hospital admissions and will make the initial treatment contact less
traumatic an event than hospital admission," said Ms. Lavelle, a research
social worker at the State University of New York in Stony Brook.

She and her associates studied a countywide sample of 675 adolescent and adult
subjects admitted to hospitals for psychosis. Diagnoses included
schizophrenia, bipolar disorder, major depression, and drug-induced psychosis.

Only the patients with bipolar disorder had an acute symptom onset, typically
1 week to 1 month in duration, Ms. Lavelle said.

Most others had significant symptoms for months and sometimes for years before
their crisis, and 60% of them had never received treatment for their
condition.

At least one-third of the patients in these diagnostic groups had been
psychotic "for a long time."

They were not brought to the emergency department until they exhibited overtly
dangerous or socially unacceptable behavior, such as attacking others, talking
to voices, removing their clothes in public, or claiming to be possessed by
aliens.

"Our next step is to look closely at why these people aren't getting mental
health services when their symptoms are more manageable.

Is their behavior so subtle that teachers, doctors, and parents are all
missing it? That's doubtful," she said in an interview with Clinical
Psychiatry News.


=================================
Robert F. Tatman
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