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1.
Community Ment Health J. 2015 Feb;51(2):185-9. doi: 10.1007/s10597-014-9735-6. Epub 2014 May 11.

Intervention to reduce inpatient psychiatric admission in a metropolitan city.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 3901 Chrysler Drive, Detroit, MI, 48201, USA.

Abstract

When psychiatric hospitalization is over-used, it represents a financial drain and failure of care. We evaluated implementation and cessation of transporting people medically certified for psychiatric hospitalization to a central psychiatric emergency service for management and re-evaluation of hospitalization need. After implementation, the hospitalization rate declined 89% for 346 transported patients; only four of the nonhospitalized patients presented in crisis again in the next 30 days. Following cessation, the hospitalization rate jumped 59% compared to the preceding year. Costs declined 78.7% per diverted patient. The findings indicate that it is possible to reduce hospitalization and costs, and maintain quality care.

PMID:
24817259
DOI:
10.1007/s10597-014-9735-6
[Indexed for MEDLINE]
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2.
Prog Neuropsychopharmacol Biol Psychiatry. 2014 Jan 3;48:229-35. doi: 10.1016/j.pnpbp.2013.09.021. Epub 2013 Oct 10.

Behavioral and neurochemical effects of repeated MDMA administration during late adolescence in the rat.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.

Abstract

Adolescents and young adults disproportionately abuse 3,4-methylenedioxymethamphetamine (MDMA; 'Ecstasy'); however, since most MDMA research has concentrated on adults, the effects of MDMA on the developing brain remain obscure. Therefore, we evaluated place conditioning to MDMA (or saline) during late adolescence and assessed anxiety-like behavior and monoamine levels during abstinence. Rats were conditioned to associate 5 or 10mg/kg MDMA or saline with contextual cues over 4 twice-daily sessions. Five days after conditioning, anxiety-like behavior was examined with the open field test and brain tissue was collected to assess serotonin (5-hydroxytryptamine, 5-HT) and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) in the dorsal raphe, amygdala, and hippocampus by high-pressure liquid chromatography (HPLC). In a separate group of rats, anxiety-like and avoidant behaviors were measured using the light-dark box test under similar experimental conditions. MDMA conditioning caused a place aversion at 10, but not at 5, mg/kg, as well as increased anxiety-like behavior in the open field and avoidant behavior in light-dark box test at the same dose. Additionally, 10mg/kg MDMA decreased 5-HT in the dorsal raphe, increased 5-HT and 5-HIAA in the amygdala, and did not alter levels in the hippocampus. Overall, we show that repeated high (10mg/kg), but not low (5mg/kg), dose MDMA during late adolescence in rats increases anxiety-like and avoidant behaviors, accompanied by region-specific alterations in 5-HT levels during abstinence. These results suggest that MDMA causes a region-specific dysregulation of the serotonin system during adolescence that may contribute to maladaptive behavior.

KEYWORDS:

3,4-methylenedioxymethamphetamine; 5-HIAA; 5-HT serotonin; 5-hydroxyindoleacetic acid; 5-hydroxytryptamine; ANOVA; Amygdala; Anxiety; Conditioned place preference; Dorsal raphe; HPLC; High Pressure Liquid Chromatography; IP; Intraperitoneal; MDMA; PND; SEM; SERT; Serotonin; analysis of variance; postnatal date; serotonin transporter; standard error of the mean

PMID:
24121061
PMCID:
PMC4348097
DOI:
10.1016/j.pnpbp.2013.09.021
[Indexed for MEDLINE]
Free PMC Article
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3.
J Psychiatr Res. 2013 Oct;47(10):1492-8. doi: 10.1016/j.jpsychires.2013.06.007. Epub 2013 Jul 6.

Evoked potential correlates of post-traumatic stress disorder in refugees with history of exposure to torture.

Author information

1
Department of Psychiatry and Behavioral Neurosciences, Wayne State University, School of Medicine, Clinical Electrophysiology Lab, Detroit, MI 48201, USA. kgjini@med.wayne.edu

Abstract

The presence and magnitude of information processing deviations associated with Post-Traumatic Stress Disorder (PTSD) are far from being well-characterized. In this study we assessed the auditory and visually evoked cerebral responses in a group of Iraqi refugees who were exposed to torture and developed PTSD (N = 20), Iraqi refugees who had been exposed to similar trauma but did not develop PTSD (N = 20), and non-traumatized controls matched for age, gender, and ethnicity (N = 20). We utilized two paired-stimulus paradigms in auditory and visual sensory modalities, respectively. We found significantly smaller amplitudes of both the auditory P50 and the visual N75 responses in PTSD patients compared to controls, reflecting decreased response to simple sensory input during a relatively early phase of information processing (interval 50-75 ms post stimulus). In addition, deficient suppression of the P50/N75 response to repeating stimuli at this early stage in both modalities is indicative of difficulty in filtering out irrelevant sensory input. Among associations between electrophysiological and clinical measures, a significant positive correlation was found between dissociation score and P50 S1 amplitudes (p = 0.024), as well as stronger auditory P50 gating correlated with higher quality-of-life index scores (p = 0.013). In addition, smaller amplitudes of N150 visual evoked response to S1 showed a significant association with higher avoidance scores (p = 0.015). The results of this study highlight the importance of early automatic auditory and visual evoked responses in probing the information processing and neural mechanisms underlying symptomatology in PTSD.

KEYWORDS:

Auditory; Evoked potentials; PTSD; Post-Traumatic Stress Disorder; Sensory gating; Visual

[Indexed for MEDLINE]
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