Opinion paper: the role of work in the management of medically unexplained physical symptoms.

Objectives: Patients with medically unexplained physical symptoms suffer from chronic fatigue and/or pain in combination with a variety of other symptoms. A flexible, biopsychosocial approach is needed for diagnostic screening and global management. It is crucial to involve the direct patient environment, including family, friends, colleagues as well as health providers, evaluation, and reintegration sector.

A multidisciplinary network for the care of abnormal fatigue and chronic fatigue syndrome in the provinces of East and West Flanders in Belgium.

The organization of care for patients with the chronic fatigue syndrome (CFS) in tertiary care referral centres from 2002 onwards, was negatively evaluated by the Belgian Health Care Knowledge Centre on the endpoint of socio-professional reintegration. Subsequently, the federal health authorities asked for the elaboration of a new and innovative model of stepped care, aiming at improved integration of diagnosis and treatment into primary care and between levels of health care for patients with CFS. The reference centre of the University Hospital Ghent took the initiative of recruiting partners in the Belgian provinces of East and West Flanders to guarantee the care for patients with medically unexplained symptoms, in particular abnormal fatigue and CFS.

Perceptions, needs and mourning reactions of bereaved relatives confronted with a sudden unexpected death.

Many individuals die suddenly and unexpectedly outside the hospital or in the emergency department (ED). The aim of this study was to determine the perceptions, needs and mourning reactions of their bereaved relatives and to assess the relationship with the cause of death. Data were collected prospectively in the emergency department of a university hospital by means of an interview and a standardised questionnaire.

Strategies to increase compliance with out-patient aftercare among patients referred to a psychiatric emergency department: a multi-centre controlled intervention study.

Background: Compliance with referral for out-patient aftercare of psychiatric emergency patients is limited. This study investigated the efficacy of a combination of several referral strategies (fixed appointment, involvement of the family, presence of the aftercare person, motivational counselling) in increasing referral and treatment compliance of patients referred to the psychiatric emergency department of three general hospitals.

Methods: A randomized controlled design was used to assess the effect of this experimental condition on referral compliance and on continuation of aftercare treatment.

Repeated psychiatric referrals to Belgian emergency departments: a survival analysis of the time interval between first and second episodes.

Repetition of psychiatric emergency department use by a relatively small number of patients constitutes a major problem for clinicians and service providers. This study aimed at the identification of risk factors for repetition by addressing the time interval between the first and second visits to the emergency department. The purpose was to investigate what patient characteristics and referral circumstances determine this interval.

Short-term outcome following referral to a psychiatric emergency service.

The study described here is part of an evaluation of a pilot project concerning the implementation of three psychiatric crisis units in general hospitals in Belgium. The purpose was to evaluate the short-term outcome of a multidisciplinary crisis intervention for psychiatric patients referred to the emergency department. Patients were assessed with the General Health Questionnaire (GHQ-28) at the time of referral to the emergency department and again 1 month later.

Patients with psychiatric emergencies transported by an ambulance in an urban region.

This paper studies the use of an ambulance service in the case of psychiatric emergency referrals. A cross-sectional design was used to compare the patients brought in by an ambulance with all other psychiatric emergency referrals. The sociodemographic and clinical characteristics as well as the referral pattern of both groups of patients are compared.

Epidemiology of psychiatric emergency referrals in four regions of Belgium.

Over a period of two years, all psychiatric emergency referrals at the emergency department of four public hospitals were monitored using a standardized form. The results showed that the hospitals share a typical profile of the psychiatric emergency department user. The profile is consistent with earlier descriptive studies, in Belgium as well as in other countries.