Deaths of patients in state psychiatric hospitals in the New York City area during heat waves and control periods from 1950 to 1984 were compared with those in the overall New York City population during the same periods. Psychiatric patients had twice the risk of dying during a heat wave ...

OBJECTIVE: To study the sociocultural transformation of neurasthenia (shenjing shuairuo, SJSR), as both disease and illness, in Chinese society. METHOD: This is based on a critical review of evidence drawn from the psychiatric and anthropological literature, and the use of a single case study. RESULTS: SJSR remains a ubiquitous illness ...

OBJECTIVE: The study examined functional impairment associated with psychological distress and severity of medical illness in a rural primary care population and explored how functional impairment varied with psychological distress and chronic medical illness. METHODS: Fifty-eight patients recruited from three rural primary care clinics completed the 36-item Short Form Health ...

In order to define the contributions of cognitive impairment, medical burden, and psychopathology to the functional status of geriatric psychiatric patients, a forward-looking, retrospective study of 106 consecutive admissions to a geriatric psychiatric unit at the Houston Veterans Affairs Medical Center Hospital was done. It was found that psychopathology and ...

This paper describes an epidemic of uncommon psychiatric symptoms among nine criminal defendants charged under California's new "Three Strikes and You're Out" law. The defendants were facing a minimum sentence of 25 years to life in prison. The defendants exhibited the following uncommon psychiatric symptoms: coprophagia (eating feces), eating cockroaches ...

BACKGROUND: General practice is characterised by its person-centred approach. It crosses the boundaries of all the medical disciplines as well as the boundary between medical and social problems. Family physicians are committed to dealing with whatever problem the patient presents. This is particularly relevant when women present with premenstrual complaints, ...

The research objective was to measure the variation in the size of a facility's market areas across different diagnostic categories. Specifically, the market area radii for outpatient psychiatric services are compared to the radii for outpatient medical services. Data were collected from the outpatient clinics of the Little Rock Veterans ...

Delirium, a transient organic psychiatric syndrome, is a common psychiatric diagnosis. It is associated with increased rates of morbidity and mortality in medical-surgical inpatients. There have been few reports describing the risk factors and prevalence of delirium among psychiatric inpatients. The purpose of the present study was to investigate the ...

This article attempts to summarize some of the pertinent literature in the context of the authors' clinical experience and suggests that a comprehensive psychiatric and medical evaluation, as well as a combined behavioral/environmental approach together with appropriate pharmacotherapy, are important tools in the management of this complicated clinical challenge.

Eating disorders (ED) in the medically ill population have seldom been studied. The objective of this study is to review a series of medical and surgical patients referred for psychiatric evaluation for a presumed ED. Between 1982 and 1990, a series of 65 patients were referred for psychiatric consultation to ...

OBJECTIVE: Denial of physical illness and/or refusal of treatment are critical issues in the practice of medicine. A previous article proposed DSM-IV consider a new diagnosis for a subgroup of patients who refuse treatment, i.e., maladaptive denial of physical illness [1]. It is necessary to be able to use this ...

Chronic pelvic pain in the absence of organic pathology identifiable in medical terms is considered one of the most perplexing conditions that gynecologists confront. A critical analysis of the medical, psychiatric, and psychological literature on chronic pelvic pain without organic pathology reveals that the dichotomous construct of mind and body ...

Lymphopenia is a common finding in old people admitted to medical and psychiatric wards. We describe a pilot study of the clinical associations, and prognostic significance of lymphopenia in elderly persons admitted to acute medical and psychiatric wards. Consecutive patients admitted to acute medical and psychiatric wards were prospectively selected ...

A 60-year-old black female with chronic paranoid schizophrenia was admitted to the Medical Service for a workup because of severe iron deficiency anemia; she refused the workup. She was found to be acutely psychotic and incapable of informed medical decision making. The management of her medical workup by her medical/C-L ...

The prevalence and patterns of use of psychiatric and anticonvulsant medications were studied in 83 seriously emotionally disturbed children and adolescents at the time of their admission to a residential treatment facility. Youths (aged 5-19, mean = 13.6 years), consecutively admitted over 17 months, were assessed for the prevalence and ...

Through a critical examination of the psychiatric profession's heavy reliance on the Diagnostic and Statistical Manual of Mental Disorders, the authors explore the central role of diagnosis in the theory and practice of psychiatry. The set of beliefs that have guided the psychiatric profession since the creation of DSM-III are ...

OBJECTIVE: To identify variables that predict length of stay (LOS) in an acute psychogeriatric ward; quantify psychiatric, medical and social factors that contribute to LOS; and identify factors that prolong LOS. DESIGN: Prospective audit of admissions over 12 months. SETTING: Acute psychogeriatric ward in teaching hospital. PATIENTS: 73 consecutive patients ...

Failure in medication compliance in adult psychiatric patients is often found to be due to side effects or associated with unawareness of illness. Little research has been conducted on medication compliance in adolescent psychiatric patients. In this study, 97 adolescent psychiatric patients, including 46 with substance abuse, were followed up ...

The problem of dependence on benzodiazepines has been aggravated by iatrogenic physiologic dependence on these medications and by polysubstance abusing patients using them in addition to other agents. A safe, rapid, and effective way to detoxify patients from benzodiazepines is of prime importance to facilitate further treatment of their psychiatric ...

In the past, a pre-electroconvulsive therapy (ECT) psychiatric evaluation focused on the question, "Does the patient have an ECT-responsive condition?" Technological advances, a broadening experience base with psychiatric patients with concomitant severe medical illness, and advances in ECT technique have led to the need for a more extensive pre-ECT assessment ...

OBJECTIVE: To review the most common psychiatric disorders in women and to address gender-related pharmacokinetic and pharmacodynamic differences in psychotropic medications. DATA SOURCES: Recent clinical literature selected by the author. DATA SYNTHESIS: Women have higher prevalence rates of anxiety, mood, and eating disorders than do men, and they are prescribed ...

OBJECTIVE: To examine (1) the 1-year and lifetime prevalence of suicidal thoughts and behavior among adolescents with insulin-dependent diabetes mellitus (IDDM), (2) the relationship between suicidal thoughts and serious noncompliance with the medical regimen, and (3) factors including psychiatric disorder, self-efficacy expectations, and hopelessness that might mediate the relationship between ...

Antibiotics are the second most commonly prescribed class of medication in the United States. An awareness and understanding of their potential effects on the central nervous system and their interactions with psychotropic agents is important in the evaluation of neuropsychiatric signs and symptoms in patients. Since the introduction of antibiotic ...

There has been little research in Britain into the experiences of doctors who are ill. We conducted in-depth interviews with 64 doctors of all grades with a recent illness lasting one month or more. Whether the illness was physical or psychiatric, many expressed the idea that illness is inappropriate for ...

1. Many patients with chronic mental illness who improve with medical therapy are left with debilitating psychosocial deficits and residual symptoms. 2. A predischarge group based on psychoeducational and process objectives can facilitate psychosocial rehabilitation. 3. The psychiatric clinical nurse specialist can be instrumental in coordinating and facilitating psychosocial rehabilitation.

Violence in medical institutions is escalating and is not limited to emergency departments and psychiatric units. Employers, administrators, and supervisors share responsibility for controlling these assaults. Preventive measures are expensive, but not as expensive as the lack of safety control. Nor can safety be measured only in terms of dollars. ...

Outliers may be of interest in their own right or they may merely be distractions from the point in question, and a hindrance to generalisation. In the medical field, including psychiatry, concise summary statistics and parsimonious models have tended to be the main aim of many studies. However, partly motivated ...

This article describes the problems involved in the global medical assessment of persons with developmental disabilities who present with behavioral changes. Solutions offered include anticipating the difficulties in treating this group and taking steps to insure adequate information is provided. Community providers are cautioned against assuming behavioral changes in this ...

The Structured Interview for Competency and Incompetency Assessment Testing and Ranking Inventory (SICIATRI) is a structured interview guide to assess the competency for giving informed consent to treatment among psychiatric and medical patients. The competency levels of 48 psychiatric and medical inpatients were assessed by SICIATRI. A relatively high- inter-rater ...

People experiencing the Capgras delusion claim that others, usually those quite close emotionally, have been replaced by near-identical impostors. Ellis & Young suggested in 1990 that the Capgras delusion results from damage to a neurological system involved in orienting responses to seen faces based on their personal significance. This hypothesis ...

Many people with developmental disabilities and "challenging behaviors" present to primary care physicians, internists, or general psychiatrists for assessment and treatment. These clinicians seek to provide the comprehensive biopsychosocial assessment necessary for successful treatment, but may encounter interference from funding agencies. Epidemiologic data on medical comorbidity in persons with developmental ...

In 1995, a statewide project to improve the practice of electroconvulsive therapy (ECT) in the Medicare population was started in Louisiana. A retrospective baseline study found high concurrent utilization of lithium and benzodiazepines, medications considered detrimental to ECT by the second American Psychiatric Association Task Force on ECT. Resistance to ...

BACKGROUND: The aim of this study was to determine the effect of physical morbidity on the outcome of patients with psychiatric disorder, and to compare the effects on non-medically and medically explained symptoms. METHOD: One hundred and fifty psychiatric cases were recruited using a two-stage design from 1620 consecutive patients ...

Workplace violence has become an increasing problem in the United States. This paper reviews 40 such incidents of non-patient violence occurring in medical facilities. Areas of study include categories of violence, weapons used, number of persons killed or wounded, precipitant for the violent act, and the presence of psychopathology. Additional ...

The authors evaluated the accuracy of clinical impressions and Mini-Mental State Exam scores for assessing patient capacity to consent to major medical treatment, relative to expert psychiatric assessment. Consecutive medical inpatients (N = 63) facing a decision about major medical treatment received a clinical impression of capacity from their treating ...

A multidisciplinary diagnostic evaluation was performed for 868 older psychiatric inpatients during a 46-month interval. A total of 402 (46%) met DSM-III-R criteria for organic mental disorders, 329 (38%) had mood disorders, 90 (10%) had psychotic disorders, and 47 (5%) had other mental disorders or conditions. Concurrent medical problems were ...

Geriatric patients are subject to mental disorders that are due to the physiologic effects of medical illness or are substance induced. Elders are at increased risk for such syndromes because of the higher rates of physical illnesses and resultant polypharmacy as well as aging-related susceptibility to disruption of brain functioning. ...

Although adolescents suffer from a variety of complaints, they do not often consult a doctor. Following a high rate of medical consultation during infancy and childhood, the rate dramatically decreases at the age of 10 and increases again around the age of 16. In this study we investigated factors that ...

OBJECTIVE: To investigate characteristics of children and adolescents with a history of combined pharmacotherapy (CPT) and compare them with a group with no history of CPT. METHOD: Eighty-three consecutive admissions to a residential treatment center were divided into a CPT and a no-CPT group based on treatment history and compared ...

The use of PRN or 'as required' medication by mental health nurses is an important, yet little explored aspect of psychiatric inpatient care. In a survey of 100 inpatients in Canada (Craven et al. 1987), it was reported that 88% had been prescribed PRN medication. The most frequently administered drugs ...

The ability to understand medication and consistently follow a prescribed medical regimen varies among the general population. The Department of Nursing at Mohawk Valley Psychiatric Center developed a medication self-administration program to help consumers gain knowledge and/or improve their ability to participate in medication and symptoms management. Results have demonstrated ...

The object of this study was to compare the diagnoses and characteristics of self-reported domestic violence victims with a random sample of nonvictim controls who were selected from attendees at the Emergency Department (ED) of a major public hospital in Australia. Comparisons were made at index presentation and for the ...

The authors retrospectively reviewed the charts of 29 inpatients with AIDS and 24 medically ill inpatients, all of whom were exposed to neuroleptics. Results adjusted for age, gender, type and dosage of neuroleptic, and extrapyramidal prophylaxis indicated that inpatients with AIDS were 7 times more likely to develop extrapyramidal syndromes ...

The study of consultation time at the Psychiatric Emergency Service (PES) can be a valuable guide to allocation of resources in a time of scarcity. Most reports have dealt with the duration of evaluations in the medical emergency room, but more comprehensive PES services use separate space, staff, and 'holding ...

When confronted by the threat of illness, general medical and psychiatric patients may turn to treatments that have a spiritual orientation but lack empirical validation. This article examines the nature of contemporary movements that offer these treatments and their impact on medical care. A typology of spiritually oriented recovery movements ...

The Changes in Sexual Functioning Questionnaire (CSFQ), a structured interview/questionnaire designed to measure illness- and medication-related effects on sexual functioning, is presented with initial evidence of its clinical usefulness in differentiating between those who have sexual dysfunction and those who have no dysfunction. Individuals from clinical and nonclinical samples completed ...

This column will discuss the legal liability of health care professionals and hospitals in the case of a psychiatric patient who suffered side effects to his medications, side effects that contributed to his death. Although the circumstances occurred in the psychiatric milieu, issues related to side effects can arise in ...

Among ten bipolar depressed patients admitted to our psychiatric ward, five patients were treated with fluoxetine alone and five subjects were treated with fluoxetine in association with total sleep deprivation (TSD) in order to evaluate the effect of the interaction between the administration of the serotonergic antidepressant compound fluoxetine and ...

Acute treatment records of all medical and surgical patients evacuated to Walter Reed Army Medical Center in Washington, D.C., from the Persian Gulf theater (N = 161) were examined to better understand the relationship of injury to psychiatric symptoms. A total of 110 (68 percent) sustained a traumatic injury. They ...

The first Medical Psychiatry Unit (MPU) in Japan was established in 1990. The clinical experience during the first 4 years of this unit is presented, and the characteristics of the Unit between its first 2 years and its latter 2 years are compared. The number of patients, the average length ...