Re- Establishment Of A Satellite Outpatient Psychiatric Clinic

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ACKNOWLEDGEMENT

I would take this opportunity to thank my research supervisor, family and friends for their support and guidance without which this research would not have been possible.

DECLARATION

I, [type your full first names and surname here], declare that the contents of this dissertation/thesis represent my own unaided work, and that the dissertation/thesis has not previously been submitted for academic examination towards any qualification. Furthermore, it represents my own opinions and not necessarily those of the University.

Signed __________________ Date _________________

ABSTRACT

There have been no previous studies about consultation of the bereaved who have lost a loved one to cancer and ask for medical help. The aim of this study was to investigate their basic characteristics and their psychiatric disorders. A retrospective study using clinical and background data obtained over 30 months (from April 2007 to September 2009) was conducted at outpatient services for bereaved families at the Department of Psycho-Oncology at Northwick Park Mental Health, UK. During the period of investigation, 51 patients underwent consultation. The patients were frequently female (P < 0.0001) and the spouse of the deceased. Regarding the psychiatric diagnoses, major depression was the most common (39%), followed by adjustment disorders (28%). This study revealed basic characteristics and psychiatric disorders of the bereaved who asked for medical help. Most of the patients were women (86.3%) and 86.3% of them received a psychiatric diagnosis. This information is important for both physicians and psychologists since the bereaved who have lost a loved one to cancer often ask for medical help in clinical settings.

TABLE OF CONTENT

ACKNOWLEDGEMENTii

DECLARATIONiii

ABSTRACTiv

CHAPTER 1: INTRODUCTION1

1.1 Introduction1

1.2 Rationale for carryinh out the change2

1.3 Summary2

CHAPTER 2: LITERATURE REVIEW4

2.1 Introduction4

2.2 Levels of Outpatient Treatment4

2.2.1 Types of Outpatient Treatment6

2.2.2 Services Overlapping Outpatient Treatment10

2.2.3 Patient Placement Guidelines11

2.3.1 Barriers to Service Use13

2.3.2 Best Practice in Family Mental Health14

2.4.1 Outpatient Family Interventions in the Preschool Years15

2.4.2 Outpatient Services for Families and Adolescents16

2.4.3 Dissemination of Family-Centered Interventions in Service Settings18

2.5.1 Physicians' Offices and Mental Health Clinics19

2.5.2 Medical Detoxification20

2.5.3 Long-Term and Short-Term Residential Treatment21

2.5.4 John Kotter's Steps22

2.6. Summary23

REFERENCES26

CHAPTER 1: INTRODUCTION

1.1 Introduction

Cancer is a disease that is increasing the awareness of mortality among the Britons. This is due to the fact that one out of three Britain dies of cancer, which has been the most common cause of death since 1981, and that there has been an increase in the number of fatalities. Not only patients but also their family members are affected by cancer. There have been several studies about the psychiatric consultation of cancer patients and relatives of cancer patients from the view of psycho-oncology. These studies suggest that cancer patients and their families suffer from physical and psychiatric disorders.

If a patient dies, the 'family of the patient' becomes a 'bereaved family'. The death of a person (spouse or close relative, in particular) is a stressful event in life. Bereavement, defined as 'other conditions that may be a focus of clinical attention' by the Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV-TR), of the American Psychiatric Association, from ...