Malnutrition and Psychosis

What is the problem that needs to be addressed? Please describe how it is related to mental health.
7-Day and 30-Day readmission statistics for Psychosis are abysmal (https://www.hcup-us.ahrq.gov/reports/statbriefs/sb230-7-Day-Versus-30-Day-Readmissions.jsputm_source=ahrq&utm_medium=en1&utm_term=&utm_content=1&utm_campaign=ahrq_en11_7_2017). Thus a valid hypothesis is that the diagnosis of the underlying cause and treatment of the underlying cause for psychosis in the in-patient setting is abysmal. Some clues for the cause of psychosis may be in the initial complete blood count or comprehensive metabolic panel in conjunction with pre-albumen (not a test commonly offered in a medical clearance for psychiatric hospitalization). However, malnutrition can be a cause of psychosis.

Why is this a concern for Orange County? What can Orange County and other counties learn from this project?
Addressing the number one cause of 7-day hospital readmission is probably a concern for Orange County residents that foot the bill for insuring the costs of 7-day hospital readmission.

What is currently being done to resolve this problem in our county and throughout the United States? If applicable: Is it working; why or why not?
Unknown. What is being done may be looked up by the reader in the numerous references that are available.

What is new or different about this project idea? Please describe how this differs from what is already being done (Question 6). Please list any research that was done on this topic.
Treating psychosis with an antipsychotic is the typical process. Understanding the underlying reason for psychosis and treating the underlying reason is not. Thus, antipsychotic treatment in a hospital setting may succeed because the malnutrition is concurrently treated. The antipsychotic may be irrelevant.

What is the project idea? Please describe how this project will operate.
Randomize patients with unknown psych history who show CBC/CMB/Prealbumin signs of malnutrition to a “control” inpatient setting where housing/nutrition/talk therapy/circadian rhythm is provided or an “experimental” inpatient setting where housing/nutrition//talk therapy/circadian rhythm/antipsychotics are provided. See which group does better, which has implications for medical decision making and discharge planning.

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November 5, 2019

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