Ten questions about alcohol as identifier of addiction problems. Psychometric tests at an emergency psychiatric department

It is important to develop and evaluate methods of identifying alcohol dependent patients and patients at risk of alcohol problems. The World Health Organisation recommends a 10-item questionnaire, AUDIT (Alcohol Use Disorders Identification Test), which assesses hazardous alcohol use, dependence symptoms, and harmful alcohol use. The article describes a Swedish version of AUDIT that has been psychometrically tested on a sample of patients admitted to a psychiatric emergency ward. Both internal consistency, reliability and validity were found to be satisfactory in terms of sensitivity and specificity in predicting DSM alcoholism diagnoses.     

Use of alternative treatment among hospital staff in a psychiatric and a rheumatology department

Staff members of a psychiatry and a rheumatology department were given a questionnaire concerning their use of alternative treatment. The response rate was 59% (111 of 187). Of 111 replies it was found that 48% had used alternative treatment at least once, while 23% had used alternative treatment within the 3 months preceding the interview. There were no significant differences in the use of alternative treatment in relation to sex or age. Only 22 had paid more than 1000 Dkr. for alternative treatment during their lifetime. The personnel's total expenses for alternative treatment within the last 3 months were 10,400 Dkr. paid by 19 members of the personnel. Compared to investigations of the general population this investigation indicated that the hospital staff had used alternative treatment more widely. Staff use of alternative treatment was at a similar level to that found in different patient group. If the way in which the staff relates to illness and treatment serves as a model for others, it cannot be expected that they counteract the use of alternative treatment.     

Patients admitted to psychiatric hospital: Presenting problems and resolution at discharge.

Examined a cohort of admissions (N?=?280) to a 150-bed public psychiatric hospital to investigate homogeneity in patient problems and patient subtypes. The interrelationships of presenting problems, treatment provided, length of stay, resolution of presenting problems, and several other variables were also studied. Results indicated that many problems experienced by patients were not psychiatric symptoms. Most presenting problems were addressed but few resolved. The primary form of treatment was psychotropic medication. Many patients were discharged before treatment effectiveness was determined. Little association was found between diagnosis, patients' problems or patient subgroup, and psychotropic drugs prescribed. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Primary psychiatric illness in a neurological out-patient department in North-East England

A Gram-negative bacillus that defies identification was isolated from blood cultures of 17 patients with fever. Fifteen patients were male adults, and 14 patients had underlying diseases, including previous splenectomy in five, which impair host defenses against infection. Illnesses occurred in the summer and autumn in 14 cases and had been recently preceded by dog bites in 10 cases. Clincal syndromes included cellulitis in seven cases, primary bacteremia without localization in four, purulent meningitis in four, and endocarditis in three. Three patients died. The organism grows slowly on blood or chocolate agar in 10% CO, is oxidase- and catalase-positive, and is negative for nitrate reduction, indole production, and urease. It produces acid from glucose, lactose, and maltose. These features distinguish it from all previously described and classified bacteria. Furthermore, the epidemiologic features of the patients suggest that this organism is an opportunistic invader and may have an animal reservoir in nature.     

A proposal for a computerized clinical records file for a department of general surgery

The author suggest a computerized program for filing clinical records of surgical institution. The proposed file is written in DB III plus (Ashton-Tate) and consists of one file .dbf and 4 files .prg. The database file contains anagraphic and clinical data of the patients. The program files make it possible to attribute a personal code to patients, print records of single patients, calculate the time of operation and assist in codifying diagnostic related groups (DRGs). The author stresses the utility of a medical computerized records system containing only few but important clinical data. It makes it possible to perform the most analysis of surgical series without the aid of a professional programmer.     

Management of psychiatric problems in a Kenyan mission hospital

Many psychiatric conditions are found in the rural general hospital in Kenya and are recognisable and manageable along standard Western lines. An essential element in management is the training of the nursing staff. The psychiatric patient should be actively managed and can benefit from the unsophisticated treatment possible at the mission hospital.     

Comparing emergency department and psychiatric setting patients with panic disorder

A solid state magnetic resonance imaging technique is used to measure true three-dimensional mineral density of synthetic hydroxyapatite phantoms and specimens of bone ex vivo. The phosphorus-31 free induction decay at 2.0 T magnetic field strength is sampled following application of a short, hard radiofrequency excitation pulse in the presence of a fixed amplitude magnetic field gradient. Multiple gradient directions covering the unit sphere are used in an efficient spherical polar to Cartesian interpolation and Fourier transform projection reconstruction scheme to image the three-dimensional distribution of phosphorus within the specimen. Using 3-6 Gauss/cm magnetic field gradients, a spatial resolution of 0.2 cm over a field of view of 10 cm is achieved in an imaging time of 20-35 minutes. Comparison of solid state magnetic resonance imaging with dual energy X-ray absorptiometry (DXA), gravimetric analysis, and chemical analysis of calcium and phosphorus demonstrates good quantitative accuracy. Direct measurement of bone mineral by solid state magnetic resonance opens up the possibility of imaging variations in mineral composition as well as density. Advantages of the solid state magnetic resonance technique include avoidance of ionizing radiation; direct measurement of a constituent of the mineral without reliance on assumptions about, or models of, tissue composition; the absence of shielding, beam hardening, or multiple scattering artifacts; and its three-dimensional character. Disadvantages include longer measurement times and lower spatial resolution than DXA and computed tomography, and the inability to scan large areas of the body in a single measurement, although spatial resolution is sufficient to resolve cortical from trabecular bone for the purpose of measuring bone mineral density.     

Clinical consensus strategies for interpersonal problems between young adults and their parents.

Objective: Research that identifies areas of agreement among expert therapists can complement findings from clinical trials by highlighting common practices as well as innovations. The present study accessed consensus among expert therapists on the effectiveness of clinical strategies for treating young adults experiencing interpersonal problems with their parents. Method: This study drew on the behavioral–analytic model (Goldfried & D’Zurilla, 1969) and the methodology of the Expert Consensus Guideline Series (Frances, Kahn, Carpenter, Ross, & Docherty, 1996). In Phase I, 54 therapists (mean age = 60.32 years; 55.6% women, 44.4% men; 96.3% White/European American) provided clinical situations involving young adult clients and their parents. In Phase II, 171 therapists (mean age = 59.45 years; 47.4% women, 52.0% men; 91.8% White/European American) proposed responses to the situations, and more general clinical strategies underlying the responses were identified. In Phase III, 134 peer-nominated expert therapists (a mean of 22.33 therapists per situation; mean age = 55.46 years; 61.2% women, 34.3% men; 91.0% White/European American) rated the effectiveness of these clinical strategies. Results: Results indicated that the experts reached consensus on strategies rated as highly effective; in particular, they agreed on the value of exploring clients’ emotional experience and providing validation. Participants reached greater agreement on strategies for use in future sessions than strategies for immediate use. Exploratory analyses revealed correlations between experts’ theoretical orientations and their ratings. Conclusions: The findings provide converging evidence of the value of exploring emotions and validating clients and, further, demonstrate the feasibility of this method for accessing clinicians’ experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance abuse problems, psychiatric severity, and HIV risk in Millon Clinical Multiaxial Inventory-II personality subgroups.

This study identified clinically meaningful psychopathology subgroups of drug-dependent male veterans based on cluster analysis of Millon Clinical Multiaxial Inventory-II (MCMI-II) records completed shortly after inpatient admission. A high pathology cluster subgroup was defined by clinically significant elevations on multiple personality disorder and symptom scales. An antisocial cluster subgroup was identified by a highly significant mean elevation on the Antisocial scale and secondary clinical elevations on the Aggressive and Narcissistic scales. Finally, a subclinical cluster subgroup was defined by the absence of clinically significant elevations on any MCMI-II scales. In comparison with members of the other two groups, members of the high pathology subgroup exhibited more substance abuse and psychiatric problems and less favorable attitudes relevant to HIV-AIDS risk reduction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Current psychiatric problems at the Congress of the Società Freniatrica Italiana in Genoa (1904)

At the beginning of XX century the new nosographic concepts expressed by Kr?pelin were introduced in our country where, at an other side, the first asylum and psychiatric law was approved. At the XII Congress of the S.F.I. in Genoa many present problems in different fields of psychiatry (social psychiatry, psychiatric organization, neurology and psychiatry, somatic and mental etiology of psychiatric diseases, nosography, restraint, isolation, alcoholism) have been debated and original views have been expressed by some authors.     

Rooming-in at the maternity department. Results of a questionnaire-action

The authors report from the Univ.-Frauenklinik in Giessen, where rooming-in was first introduced in 1976; the newborn baby's bed is now put in the mother's room. When 171 outpatients, who had never heard of rooming-in, and 81 patients in the maternity ward were consulted, the women agreed to a trial period for rooming-in. It was shown that more than 70% of the women would have prefered a clinic where rooming-in was possible to a traditional type clinic. This tendency was particularly strongly felt among women with a higher level of secondary education and among women who held the view that the fathers should be more involved in the family and in the upbringing of small children. The results of individual questionnaires showed that support for rooming-in was significantly strong on the grounds of interhuman relations; also, the rejection of the traditional mother-image was apparent. Reasons for the introduction of rooming-in, as well as the difficulties involved in putting it into practice are outlined.     

Ambulatory psychotherapy at the medical department of a district policlinic

From the psychotherapeutic unit of the department of internal diseases of a district outpatient department some experiences and recognitions are reported. The autogenic training and the group psychotherapy are the methodical centre. 200 non-selected psychotherapeutic cases are analysed with regard to sex, age, profession and diagnostics of the neurotic symptomatology.