摘要:

This study explored the relationship of public support payments, intensive psychiatric community care (IPCC), and fidelity of implementation to 1-year employment outcomes for 520 veterans with severe mental illness (SMI) in a clinical trial of IPCC. At study entry, 455 (87.5%) participants received public support. At 1 year, 46 (8.8%) participants met criteria to be classified as workers. A multivariate analysis indicated that baseline public support was significantly associated with a lower likelihood of employment, and baseline work was positively associated with employment at 1 year. IPCC patients were three times more likely to be working than control subjects, and a significant interaction favored well-implemented IPCC programs over others. This study points out not only the inhibiting effect of public support payment on employment but also the value of IPCC and the special importance of fidelity to program models for employment for people with SMI.

ISSN:0022-3018    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Assessing substance use of homeless persons is a critical task. This study examines the test-retest reliability, concurrent validity, and sensitivity to change of the Time-Line Follow-Back interview, a calendar instrument used to assess days and quantities of alcohol use and days of illicit drug use, in the multisite Collaborative Program to Prevent Homelessness (CPPH). The Time-Line Follow-Back was reliable for assessing use during the past month and the recent 6 months. Results from the Time-Line Follow-Back were correlated with other self-reports of use, with research diagnoses of substance use disorder, and with clinician ratings of severity of substance abuse. The Time-Line Follow-Back detected changes in clients with severe mental illness and in those with less severe psychiatric problems.

ISSN:0022-3018    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This study examined the incidence of posttraumatic stress disorder (PTSD) and depression in 586 earthquake survivors living in prefabricated housing sites a mean of 20 months after the 1999 earthquake in Turkey. The estimated rates of PTSD and major depression were 39% and 18%, respectively. More severe PTSD symptoms related to greater fear during the earthquake, female gender, older age, participation in rescue work, having been trapped under rubble, and personal history of psychiatric illness. More severe depression symptoms related to older age, loss of close ones, single marital status, past psychiatric illness, previous trauma experience, female gender, and family history of psychiatric illness. These findings suggest that catastrophic earthquakes have long-term psychological consequences, particularly for survivors with high levels of trauma exposure. These findings lend further support to the need for long-term mental health care policies for earthquake survivors. Outreach service delivery programs are needed to access non-treatment-seeking survivors with chronic PTSD.

ISSN:0022-3018    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

To determine the treatment preferences (i.e., medication, counseling, or both) for victims of recent trauma at risk for posttraumatic stress disorder and the determinants of those choices, preferences were elicited from 466 consecutive victims of physical or sexual assault at an urban emergency department as part of the routine clinical evaluation by emergency department social workers. Demographics, assault characteristics, and clinical history were used to predict preference. More than 80% of victims expressed an interest in treatment, with more interested in counseling (76%) than medication (62%). Female gender and assaults of a sexual nature were most highly predictive of preference for medication, whereas female gender, sexual assault, a history of psychiatric treatment, and perceived life threat from the trauma were most predictive of preference for counseling and preference for any treatment. Because treatment preferences were easily obtained from assault victims seeking emergency care, the elicitation of these treatment preferences and the consideration of them in the treatment planning process could facilitate engagement in treatment and overcome the avoidance of treatment by some victims.

ISSN:0022-3018    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Despite recent advances in treatment, many Americans decline to take prescribed psychiatric medication. This study explores the role of attitudes regarding the effectiveness of and potential problems associated with psychiatric medications on Americans’ willingness to use them. Face-to-face interviews of a US household population sample were done with 1387 volunteers. The 1998 General Social Survey’sPressing Issues in Health and Medical Care Module(response rate, 76.4%) included questions about efficacy, problems, and potential use. Most Americans agree that psychiatric medications are effective, and fewer than half had concerns regarding potential problems. However, the majority of respondents would not be willing to take them. Willingness to use is influenced by these attitudes and other factors, including health status and past use of mental health treatments. Although Americans perceive psychiatric medications to be effective, and this influences their willingness to take them, many still are not willing to take them.

ISSN:0022-3018    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Eleven subjects with acute major depressive episodes and 9 subjects with partially remitted major depressive episodes were compared with 24 healthy control subjects on an emotional priming task. Positive and negative emotional facial expressions were presented as subthreshold primes, followed by a neutral pattern mask, and an emotionally neutral face as suprathreshold target. Subjects had to judge if they had seen a pleasant or an unpleasant facial expression. Healthy subjects and subjects with partially remitted depression judged the neutral target as significantly more unpleasant when negative emotional facial expressions were presented as primes as compared with when positive facial expressions were presented as primes. In contrast, subjects with acute depression did not show a significant judgment shift. It is concluded that subjects with acute depression are not able to preactivate emotional concepts by subthreshold-presented emotional facial expressions.

ISSN:0022-3018    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

In this first prevalence study of dissociative symptoms and different forms of childhood experiences among transsexuals, 41 transsexuals and 115 psychiatric inpatients were compared by means of the Interview for Dissociative Disorders (SCID-D-R), the Dissociative Experiences Scale (DES), and the Childhood Trauma Questionnaire (CTQ).The total score for the dissociative symptoms revealed no significant differences between the transsexuals and the psychiatric inpatients. However, the higher DES score among transsexuals compared with a normal population was found to be due largely to one item. A surprisingly high prevalence of emotional maltreatment was recorded. The results suggest that both the DES and the SCID-D-R have limited validity as instruments for screening and diagnosing dissociative disorders in transsexuals.Psychiatrists should be mindful of the possible existence of dissociative disorders in transsexual patients. Further investigations are needed to clarify the effects of traumatic childhood experiences on sexual identity in transsexuals and to throw more light on the phenomenological correlation between transsexualism and dissociative identity, using taxometric analyses.

ISSN:0022-3018    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:2003

数据来源: OVID