research on effects of repeated exacerbations?

[greenbeanio]

When I was on clinical rotation in a mental health hospital, I was talking with the doc about the very short-term "bandaid" care offered, and the lack of longer-term inpatient therapeutic programs in our area, and he told me that (at least in the case of bipolar) every time there is a an acute exacerbation of a patient's illness and they need to be rehospitalized, they become harder and harder to treat effectively and their prognosis worsens. In other words, if it were effectively managed, they would do better in the long run, and this rapid-turnaround type of treatment was contributing to their progressive deterioration.

I just made this point in a paper I am writing for school, but realized I have no way of backing this assertion up. (Obviously I can't reference a conversation with a doctor who's name I have forgotten!) Does anyone have any research information that I could cite, on this. I have tried looking on CINAHL which we have access to through school, but I must not be using the right search terms. Any leads would be appreciated! Thanks!

[Davey Do]

You've got an interesting concept you're exploring there, greenbeanio!

I use the word concept because this school of thought, "every time there is an acute exacerbation of a patient's mental illness and they have to be rehospitalized, they become harder and harder to treat and their prognosis worsens", can be applied across the board. All chronic illnesses are progessive, and if treatment compliance is not maintained, the prognosis worsens.

Once again, a chronic illness is progressive. The best modern medicine can do in most cases is to slow that natural progression. My statement may be over zealous, but I mean to apply its concept in connection with your basic premise.

I would like to go into great detail about my observations in working with people over the past 35 plus years and give you my interpretation. But I won't pontificate. Shucks! I'll try to keep the focus on your most interesting enquiry and direct you to a site filled with a lot of studies and information. That site is: focus.psychiatryonline.org

But I tell you what, greenbeanio- If ya ever want to discuss premises such as the one you're currently pursuing, look me up. I love this stuff!

The best to you.

Dave

[Whispera, MSN, RN]

The term you're looking for is "kindling," as in kindling-wood for building a fire. I don't have any specific references to give you, but it was referred-to in a textbook I used a few years ago when I taught psych nursing.