摘要:

Informed consent allows patients to make treatment decisions based on the best possible information. The current study examines the long-term impact of the informed consent process on schizophrenic patients. Patients were administered a baseline questionnaire and were given an information form, which was read aloud to them by the investigator. Patients were re-administered the questionnaire at 4 weeks and were randomly assigned to no review (single-session group) or a review of the information (educational review group). All patients were administered the questionnaire at 2-year follow-up. Both the single session and the educational review process significantly increase the schizophrenic patient's knowledge about the benefits and risks of neuroleptic medication. No previous study has examined the impact of informed consent for anti-psychotic medication at 2-year follow-up.

ISSN:0022-3018    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Proponents of psychiatric rehabilitation believe that active patient participation in rehabilitation planning is essential. Participation assumes, however, that severely mentally ill patients can reliably report their needs. Unfortunately, reliably responding to a needs assessment may be diminished by cognitive deficits that are associated with psychosis and low intelligence. To address this issue, 35 severely mentally ill outpatients completed the Needs and Resources Assessment twice, with 1 week intervening. Their reliability on this task was compared with that of 16 control subjects. Results showed that subjects in both groups performed more reliably (measured as raw agreement) on the more highly structured, standardized items. Patients were less reliable than controls on individualized and standardized items. Further analyses suggested that the patients' raw agreement was found to be significantly associated with thought disturbance. Assessment methods must be sufficiently structured to help cognitively disordered patients provide reliable information for rehabilitation planning.

ISSN:0022-3018    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The seasonality of depressed mood was examined in 70 men and women who spent the 1991 austral winter at three American research stations in Antarctica. Seasonal Pattern Assessment Questionnaire global seasonality scores increased significantly from late summer (February/March) to midwinter (July/August; p <.001). Only one case of seasonal affective disorder (SAD) was found during midwinter, but the prevalence of subsyndromal SAD increased significantly, from 10.5 to 28.4 per 100, during this period. Station latitude was significantly associated with SAD-specific symptoms and global Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorders Version scores in midwinter and in early spring (October). The results suggest that even clinically normal individuals are likely to experience symptoms of subsyndromal SAD in high latitude environments, that these variations become more pronounced with increasing latitude, and that they can be detected through repeated administrations of instruments such as the Seasonal Pattern Assessment Questionnaire and Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorders Version.

ISSN:0022-3018    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Evidence from naturalistic and laboratory studies indicates that schizophrenic symptoms are exacerbated by stress or arousal of negative affect in some patients and not in others. Affective reactivity of symptoms may reflect a pathophysiological process or set of processes present only in a subset of cases of schizophrenia and, therefore, may constitute a dimension potentially relevant to subtyping efforts aimed at discriminating separate processes within the disorder. This paper reviews the evidence a) that affective reactivity of symptoms exists in some but not all schizophrenic patients, b) that this dimension corresponds with other variables that also are putative process discriminators, and c) that it is associated with a more global pathological reactivity to sensory and affective stimuli. Hypotheses as to its biological substrata, relevance to treatment, and importance to larger diagnostic issues are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

A number of studies have shown that schizophrenics have increased obstetric complications compared with controls, but conflicting negative results have also been reported. Similarly, some studies found that obstetric complications were more frequently observed among male or nonfamilial schizophrenics than their female or familial schizophrenic counterparts, but others reported negative or inverse results. Since 1948 in Japan, every pregnant woman has been assigned aMaternal and Child Health Handbookin which obstetricians have been obliged to fill in obstetric data. In the current study, perinatal complications assessed using the scale of Parnas et al. (1982), based on information from the maternal and child health handbook were compared between DSM-III-R—diagnosed schizophrenics (N= 59), their healthy siblings (N= 31), and controls (N= 108). We found that female schizophrenics had experienced significantly more perinatal complications than siblings and controls. We could not detect any significant association between perinatal complications and family history.

ISSN:0022-3018    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

This study uses Stroop methodology to investigate cognitive biases in the processing of five different forms of threat in bulimic and comparison women. The processing of different forms of threat was found to be relatively independent, which suggests that the measures do not tap a unitary threat construct. As predicted, the bulimic women showed a greater general attentional bias (interference effect) than the comparison women in color-naming threatening words. In the bulimic women, an attentional bias for specific forms of threat was positively correlated with bulimic psychopathology. A strong association was found between bulimic characteristics and sensitivity to self-directed ego-threats and a less robust association with sensitivity to autonomy threats (threats to personal control). The clinical implications of these findings are discussed in light of recent formulations of bulimia, which suggest that a function of bingeing and vomiting is to reduce the individual's awareness of threat (e.g., aversive emotional states).

ISSN:0022-3018    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

Using data from 61 bulimic patients, we evaluated associations among axis II disturbances, psychopathological traits, eating symptoms, and adverse developmental experiences (e.g., childhood sexual and physical abuse). Findings showed likelihood of childhood abuse to increase markedly in function of comorbid personality pathology. In addition, comorbid borderline personality disorder was found to be a better predictor of object-relations disturbances, primitive defenses, and hostility than developmental adversity was. Although marked trait disturbances were strongly associated with borderline personality disorder (more than with severity of childhood adversity), the converse seemed true of severity of bulimic symptoms (i. e., comorbid personality disorder had no predictive effects, whereas developmental variables had inconsistent effects). Bulimic and general psychopathological symptoms, thus, seemed to have intriguingly independent determinants. We interpret these findings as showing that the observed association between developmental adversity and bulimic syndromes may, in large part, be attributable to comorbid personality pathology.

ISSN:0022-3018    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The relationship between nonverbal behavior and emotional awareness, as measured by the Toronto Alexithymia Scale, was studied in 24 young volunteers free of medical and psychiatric disorders. Multiple regression analysis revealed that nonverbal behavior during psychiatric interview was a significant predictor of the Toronto Alexithymia Scale total score independent of situational depression and anxiety. Subjects who had difficulty identifying and describing their feelings showed a combination of poor nonverbal expressivity and frequent self-directed behavior patterns indicative of tension and anxiety. In addition, subjects with a tendency toward externally oriented thinking showed more avoidance behavior during the interview. The ethological data of this study support clinical observations, which suggest that alexithymic traits interfere with both processing of emotion and interpersonal behavior.

ISSN:0022-3018    

出版商:OVID    

年代:1996

数据来源: OVID

摘要:

The present investigation examined patterns of change in basic features of panic and anxiety during cognitive behavioral treatment for panic disorder. Data were collected in the context of a study comparing the efficacy of cognitive therapy (CT) and relaxation training, both administered without exposure-based treatments of any kind. Thirty-six panic disorder patients completed 10 weeks of either CT or relaxation training. Weekly measures of panic frequency, state and trait anxiety, and associated fears were obtained. Data were examined using both multivariate techniques (which conceptualize change as incremental) and analysis of response slopes (wherein change is conceptualized as continuous). Results indicated that during the first half of treatment, relaxation training led to greater reductions in state and trait anxiety and agoraphobic fear, whereas CT demonstrated a slight advantage on change in panic frequency. During the second half of treatment, CT produced faster reductions in state anxiety and agoraphobic fears. Over the entire treatment course, CT conferred an advantage in rate of change in social fears. The data provide support for the utility of a more process-oriented approach to the examination of treatment effects.

ISSN:0022-3018    

出版商:OVID    

年代:1996

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1996

数据来源: OVID