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Psychiatric emergencies in the workplace.

K H Hughes

    AAOHN Journal : Official Journal of the American Association of Occupational Health Nurses
    |June 1, 1991
    PubMed
    Summary

    Individuals with depression function similarly to or worse than those with chronic medical conditions. A detailed plan and lethal method indicate suicide risk, while subtle thinking changes can precede psychosis.

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    Area of Science:

    • Psychiatry and Mental Health
    • Clinical Psychology

    Background:

    • Depression significantly impairs functioning, often paralleling chronic medical conditions.
    • Suicide risk assessment requires identifying specific behavioral and cognitive indicators.
    • Early detection of psychotic episodes relies on recognizing subtle cognitive shifts.
    • Bipolar disorder management, particularly with lithium, can enable productivity in affected employees.

    Purpose of the Study:

    • To highlight the functional impact of depression compared to chronic illnesses.
    • To identify key predictors of suicide risk.
    • To underscore the importance of early psychosis detection.
    • To emphasize the role of lithium in managing manic symptoms for workplace productivity.

    Main Methods:

    • Comparative functional analysis of depressed individuals versus those with chronic medical conditions.
    • Analysis of suicide risk factors, focusing on planning and method lethality.
    • Observation of cognitive changes preceding psychotic episodes.
    • Case studies or literature review on lithium's efficacy in managing bipolar disorder in employed individuals.

    Main Results:

    • Depressed individuals exhibit functional impairment comparable to or exceeding that of patients with major chronic medical conditions.
    • A high-risk suicide profile includes a well-developed plan and a highly lethal method.
    • Subtle alterations in thinking patterns often serve as precursors to psychotic episodes.
    • Effective management with lithium allows many manic employees to maintain productivity.

    Conclusions:

    • Depression's functional burden is substantial and comparable to chronic medical diseases.
    • Proactive identification of detailed planning and lethal intent is crucial for suicide prevention.
    • Vigilance for subtle cognitive changes is essential for early psychosis intervention.
    • Pharmacological management, specifically with lithium, is key to enabling productive employment for individuals with bipolar disorder.

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