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Biomedical subjects

A Frances

Publications and source records attributed to A Frances.

At least 145 records · Page 8Linked to original sources
PubMed1982

Psychotic vs. nonpsychotic depression: comparison of treatment response.

This retrospective study compared the treatment responses of 34 primary, unipolar depressives without psychotic features and 30 with psychotic features. Patients were diagnosed by Research Diagnostic Criteria and received trials of tricyclic antidepressants, antipsychotics, the combination of the two, electroconvulsive therapy, or placebo and psychotherapy. Only three of 18 psychotic patients vs. 17 of 23 nonpsychotic patients responded to antidepressants alone. Electroconvulsive therapy and the combination of antipsychotic and antidepressant medication gave better responses. These data suggest that major depressive disorder with psychotic features is best considered as a distinct subtype rather than a severe variant of major depression.

Adult↗
PubMed1982

A controlled study of satisfaction among psychobiology research patients.

Because of the controversy regarding research involving human subjects, the authors designed an 18-item questionnaire to measure research patients' satisfaction with hospital treatment. They compared the questionnaire scores of 25 hospitalized depressed patients treated on a psychobiology study unit with those of 18 comparable patients treated on standard inpatient psychiatric units. Satisfaction was equally high in both groups. Satisfaction and improvement in depression scores were significantly correlated in study unit patients but not among patients on standard units. The authors believe that these data provide valuable information for institutional review boards, potential research subjects and referral sources, researchers, and the public at large.

Adult↗
PubMed1982

Delusions: when to confront the facts of life.

Research indicates that patients do not hold delusions with as fixed a certainty as has been believed. Confrontation with reality may have an important role in the evaluation and treatment of delusional patients. The authors suggest four factors that may help predict the value of reality confrontation in a given clinical situation: 1) how understandable the delusion is in the context of the patient's life, 2) the degree of conviction with which the patient holds the delusion, 3) the phase in development of the delusional beliefs, and 4) the diagnosis of the patient.

Adaptation, Psychological↗
PubMed1982

Selection criteria for the brief psychotherapies.

Selection criteria are outlined for five forms of brief psychotherapy--crisis intervention, psychodynamic, problem-solving, marital/family, and behavior. Indications, patient enabling factors, and contraindications are suggested for each. This is organized along a three-step decision tree intended to guide, in turn, the selection of (1) crisis intervention, (2) brief vs. long-term therapy, (3) one particular type of brief psychotherapy from among the various models. The value and limitations of a differential therapeutic approach are discussed.

Adult↗
PubMed1982

Selection criteria for partial hospitalization.

During the early 1960s partial hospitalization emerged as an important component of community-based psychiatric treatment. Initially partial hospitals offered all types of treatment to all types of patients. To help mental health professionals make informed decisions when matching specific treatments to specific patient characteristics, the authors define three kinds of partial hospitals--intensive care, chronic care, and rehabilitation partial hospitals--and propose selection criteria for referral to each model. Factors to be considered in making differential therapeutic decisions between a specific type of partial hospital program and alternative methods of treatment, such as inpatient treatment, are discussed.

Ambulatory Care↗
PubMed1982

A suicide attempt by a seductive patient: what's the treatment plan?

For the past ten columns, we have been exploring questions of differential diagnosis and the ways to apply the Diagnostic and Statistical Manual of Mental Disorders, third edition, to the complexity of the clinical situation. We are now embarking on an even more uncharted and certainly more controversial area: differential therapeutics. In this column, to appear in alternate issues, we will learn how our guest experts would select treatment modalities for various clinical situations. We have the good fortune to lead off this new series with Toksoz B. Karasu, M.D., professor of psychiatry at Albert Einstein College of Medicine in the Bronx and director of psychiatry at the Bronx Municipal Medical Center, Dr. Karasu is the chairman of the American Psychiatric Association's commission on psychiatric therapies and has been deeply involved in studying how best to determine which treatments are most effective for which psychiatric disorders in which patients and circumstances.

Adult↗
PubMed1981

The effect of psychobiological research on treatment outcome. A controlled study.

Recent advances in psychiatric research methodology promise major progress. Simultaneously, however, mounting concerns about ethnics of human experimentation have resulted in increased scrutiny and regulation that threaten scientific productivity. Virtually no systematic data have been gathered about the effects of research participation on treatment outcome or patient satisfaction. In this study 56 hospitalized depressed patients, who had agreed to participate in psychobiological research protocols, were then randomly assigned to treatment on a research unit or on standard adult inpatient (nonresearch) units. Research participants received more diagnosis-related somatic treatments, had a longer mean length of stay, and experienced trends toward greater symptom reduction and better consumer satisfaction. We conclude that research participation may be helpful to patients but that more systematic study is needed to help to resolve ethical questions and to assist risk-benefit evaluations.

Adult↗
PubMed1981

No treatment as the prescription of choice.

As part of each evaluation, the clinician must decide whether or not a psychiatric treatment is indicated. It is unfortunate that there is little available research to aid in this decision, and it has not received much attention in the clinical literature. In actual practice, therapists tend to recommend treatment almost automatically and without a careful consideration of its necessity or possible harmful effects. The research methodology and problems is defining those patients who are better off without psychiatric treatment is discussed. This group is categorized into negative responders and nonresponders and spontaneous improvers. A set of preliminary criteria for no treatment and clinical examples are provided.

Adult↗