ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Despite the growing interest in the process of informed consent, little research has actually examined what information clinicians give to patients concerning psychiatric treatment. In this paper, the neuroleptic drug disclosure practices of 60 North Carolina psychiatrists are examined, utilizing survey data collected in 1979. Although the vast majority of psychiatrists surveyed reported that they routinely provided information to their patients regarding the reason for the chemotherapy, signs of drug toxicity, and minor side effects, information on major side effects and tardive dyskinesia was reported to be far less routinely supplied. Physician and patient/treatment context characteristics influencing the scope of physicians' drug information disclosure were examined through the use of bivariate correlation and multiple regression techniques. Patient racial and diagnostic characteristics, as well as physician medical and psychiatric journal use, were found to be significant predictors of drug disclosure in the multivariate analyses. Patient social class, patient legal status, and treatment setting were significant predictors of drug disclosure in the bivariate, but not in the multivariate analyses. Study limitations and implications are discussed.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

This paper presents findings from a comparison between patterns of use of substances of abuse among a psychiatric population and among a similarly studied medical and surgical patient population. A self-assessment survey was carried out in an urban, university medical center population that included 300 psychiatric patients and close to 3000 medical and surgical patients. The psychiatric population was significantly higher than the demographically similar general medical and surgical population in quantity and frequency of use problems associated with use, and composite categories of use of alcohol and other drugs of abuse. This was true in spite of the fact that the psychiatric service did not readily accept known substance-abusing patients at the time the study was conducted.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To estimate the annual treated incidence and prevalence of chronic and nonchronic mental disorders, data from the Monroe County Psychiatric Register were analyzed. Patients were classified as either chronic or nonchronic based upon their utilization of inpatient psychiatric treatment. A chronic illness was defined as one requiring at least three psychiatric hospitalizations or at least 365 inpatient days during a 5-year follow-up period. Based upon this definition, the annual treated incidence of chronic mental disorders did not change significantly between 1964–65 (.47/1000) and 1969–70 (.41/1000), unlike the annual treated incidence of nonchronic disorders, which rose by 37 per cent (p < .001). The annual treated prevalence of chronic mental disorders also remained unchanged at approximately .6 per cent between 1965 and 1970, but the treated prevalence of nonchronic mental disorders rose by 43 per cent from 1.4 per cent in 1965 to 1.9 per cent in 1970 (p < .01). These increases in treatment for nonchronic disorders coincided with the development of community mental health centers. The rates of chronicity and peak ages of treatment varied considerably across diagnostic groups. Approximately one fifth of new cases of organic brain disorders, schizophrenia, and alcohol disorders became chronic according to our definition during the first 5 years after illness onset, compared to only 9 to 11 per cent of cases of major affective disorders and less than 2 per cent of all other disorders. However, in a given year, approximately 50 to 60 per cent of persons treated for organic brain syndromes or schizophrenia had chronic illnesses, compared to 35 to 45 per cent of persons treated for alcohol or affective disorders and 7 per cent of patients treated for other mental disorders. The treated prevalence of chronic illnesses increased progressively with age for organic brain syndromes, affective disorders, and schizophrenia. In contrast, the treated prevalence for chronic alcoholism and other chronic disorders peaked earlier in life, probably reflecting differences in the mortality and natural course of these various disorders.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The authors have completed a large descriptive study of the system of psychiatric aftercare in Metropolitan Toronto. This article describes the relevant 6-month and 2-year postdischarge outcome in each of five aftercare components for 505 subjects in a traditional system of service delivery. Provincial hospital, research institute, and general hospital subgroups are compared.For the total group, recidivism and employment rates are similar to those found in previous studies. Symptoms and distress levels are high. Considerable numbers of subjects live in inadequate and unsatisfactory housing. Social isolation, inadequate income, and difficulties with instrumental role functioning are persistent problems with little improvement between 6 months and 2 years postdischarge. Differences among the subgroups vary according to type of outcome and, for the most part, can be explained by differences in the characteristics of the patients served by the three types of inpatient treatment settings.These findings provide additional information about serious deficiencies in discharge planning and aftercare service delivery that is focused primarily upon the treatment of illness. The authors conclude that a more balanced system of aftercare requires a shift in resources to rehabilitation programs in the community.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The authors assessed the reliability and validity of the DSM-III criteria for schizotypal personality disorder (SPD) and their measurement by the Schedule for Schizotypal Personalities (SSP) developed by Baron. Additional criteria not in DSM-III were also explored. Consensual clinical ratings of videotaped interviews of subjects were used to validate item content of the SSP and the schizotypal diagnosis.The SSP assessments, with the exception of odd speech, were found to be reliable and valid. Higher cutoff scores than those recommended by Baron may be helpful in discriminating schizotypal from other psychiatric patients. Six of eight DSM-III criteria and all experimental criteria were highly specific for SPD cases but varied widely in their sensitivities.Based on these pilot data, the authors recommend combining all of the criteria into four conceptual categories: 1) self-report cognitive-perceptual disturbances, 2) observable disorders of thought and communication, 3) deficits in drive or affect, and 4) interpersonal difficulties. When three of these were required to make the SPD diagnosis, all of the subjects in the present data set were correctly identified.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A 51-item true-false Impulsive Nonconformity Scale was constructed to measure impulsive antisocial behavior of the sort often reported in the premorbid adjustment of some psychotics. Schizophrenics and schizoaffective patients (N= 46) scored higher on the scale than control (N= 76). An experimental group of 120 aberrantly high-scoring (2 SDs above the mean) college students and 176 control subjects were interviewed using modified versions of Weissman and Paykel's Social Adjustment Scale interview and Spitzer and Endicott's Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SADS-L). The experimental subjects reported more antisocial and nonconforming behaviors than control subjects, supporting the construct validity of the scale as a measure of impulsive nonconformity, and reported more psychotic or psychotic-like experiences, more schizotypal experiences, and more depressive and manic or hypomanic symptoms, suggesting that a portion of the experimental subjects may be at elevated risk for psychosis and/or major affective disorder. Subjects who score aberrantly high on both the Impulsive Nonconformity Scale and our earlier Perceptual Aberration-Magical Ideation Scale are more aberrant on several other measures of schizophrenic-like cognitive slippage than are subjects who score high on only one of the two scales.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Two typical recurrent episodes of neuroleptic malignant syndrome (NMS) in the same patient are described. The first episode was caused by a sulpiride derivative, tiapride. This is the first case in which a drug of the benzamide group has been reported to have caused such adverse drug reaction. In the second episode, NMS occurred due to haloperidol in the lowest dose ever reported and was accompanied by highly excessive levels of various muscle enzymes. Involvement of hypothalamic and striatal dopamine system, and particularly of D-2 subtype receptors, is suggested by this case.

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0022-3018    

出版商:OVID    

年代:1984

数据来源: OVID