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Læknablaðið - 01.10.1973, Side 36

Læknablaðið - 01.10.1973, Side 36
204 LÆKNABLAÐIÐ nægilegur fyrir 60-70 þús. manns. Ein- angrun spítalans veldur því hins vegar, að hann getur ekki veitt fullkomna þjón- ustu, eins og geðdeildir tengdar öðrum spítölum eiga að gera. Eigi að veita full- komna geðlæknisþjónustu, verða geðdeild- irnar að vera landfræðilega og rekstrar- lega nátengdar öðrum spítaladeildum. Þar verða að vera göngudeildir, sem, auk eftir- meðferðar, eiga að geta sinnt geðsjúkl- ingum, sem ekki hafa dvalizt á spítala eoa eiga eftir að dveljast þar um stundar- sakir. Einnig þarf að auka möguleikana á því að fara í vitjanir heim til geðsjúkl- inga, þannig að unnt sé að fylgjast betur með þeim á heimilum þeirra. Síðast en ekki sízt þarf að sjálfsögðu stórauknar rannsóknir og þrotlausa leit að nýjum leið- um til að flýta fyrir bata og útskrift sjúklinganna. SUMMARY The annual number of first admissions to the psychiatric hospital in Reykjavík, Klepps- spítalinn, during the 20 year period 1951-1970 has greatly increased. The purpose of the in- vestigation was to analyse and explain the alterations which have taken place during this period. Progress in psychiatric treatment dur- ing this twenty year period is discussed, for instance introduction of rnodern psycho- pharmacotherapy and various forms of group therapy, family therapy and therapeutic community. The most remarkable changes and reforms which have been established in thera- peutic activities and organization of Klepps- spítalinn are briefly mentioned. In November 1963 the hospital took over a separate clinic for alcoholics with 24 beds. In 1964 an am- bulatory after-care service was started which is in steady expansion. The number of doctors is approximately three times as great at the end of the period as at the beginning. Social workers, psychologists and psychiatric nurses have been appointed to the hospital. By look- ing at the number of admissions it was ob- vious that the twenty year period could be divided into two parts. Therefore it was de- cided to compare the average annual number of first admissions during the two periods ’51- ’62 and ’63-’70, as well as the length of stay. Graphs and tables on the average annual number of first admissions during the periods ’51-’62 and ’63-’70 according to diagnoses are demonstrated, together with a table showing the average length of stay for patients ad- mitted for the first time during these two periods. The number of admissions has greatly increased and the length of stay for all dia- gnostic groups has decreased except for alco- holics and drug addicts. The duration of stay for these patient groups has somewhat in- creased during the later period (’63-’70). Possible explanation of these facts is dis- cussed. The length of stay for schizophrenic patients has shown the greatest decrease, the average duration of stay during the later period is only one tenth of the average length of stay during the former period. The average annual number of first ad- missions was 69,1 in the former period but 234,6 in the later period. The average length of stay for patients admitted for the first time was 305 days in the former period but only 58 days in the later period. The results seem to reveal that improved working conditions, increased staff resources together with ambulatory after care service has resulted in shorter duration of stay and thereby in better utilization of the hospital beds. HEIMILDIR 1. Achté, K. A. On prognosis and rehabilitat- ion in sehizophrenic and paranoid psych- osis. Acta Psychiat. Scand., supplementum 196, Vol. 43. 1967. 2. Harris, A., Linker, I., Norris, V. and Shep- herd, M. Schizophrenia, a prognostic and social study. Brit. J. soc. prev. Med. 10:107- 114. 1956. 3. Hastings, D. W. Follow-up results in psychiatric illness. Amer. J. Psychiat. 114: 1057-1066. 1958. 4. Henisz, Jerzy. A Follow-up Study of schizophrenic patients. J. Compreliens. Psychiat. 7:524-528. 1966. 5. Marstal, H. B. og Svendsen, B. B. An analysis of the doubling of admissions to Danish psychiatric institutions between 1948-1966. Acta Jutlandica XL:5. 1968. 6. Moon, L. E. and Patton, R. E. First admissions and readmissions to New York state mental hospitals. Psycliiat. Quart. 39: 476-486. 1965. 7. Páll Sigurðsson. Landspitalinn - Geðdeild. Vistunarrýmisþörf á heilbrigðisstofnunum. MorgunblaðiÖ 20. des. 1972. 8. Punell, G. Det psykiatriska artefakt- syndromet och dess behandling. Lakar- tidningen, 67:3560-3566. 1970. 9. Pöldinger, W. Kompendium i psyko- farmakoterapi. F. Hoffman - La Roche, Basel 1968. 10. Shepherd, M., Goodman, Nancy and Watt, D. C. J. comprehens. Psycliiatry 2:11-19. 1961. 11. Sherman, L. J., Moseley, E. C., Ging, R., Bookbinder, L. J. Prognosis in Schizo- phrenia. Arch. Gen. Psychiat. 10:123-130. 1964. 12. Ödegárd, ö. Utskrivningsmönstret fra norske psykiatriske sykehus för og etter den moderne medikamentbehandling. Nord- isk Medicin, 70:961-965. 1963.

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