Biomedical subjects
Publications and source records attributed to A Winston.
Proton T1 relaxation times of red blood cells were significantly higher in six bipolar depressed patients than in matched normal control subjects before lithium treatment. Times decreased in five of the six patients following 1 week of lithium therapy.
Although supportive psychotherapy techniques are more widely used than expressive or insight-oriented techniques, particularly with hospitalized or chronically ill patients, supportive treatment strategies have been underrepresented in the literature and not adequately taught to therapists in training. The authors review the diverse definitions and goals of supportive therapy as related to two major types of objectives. They stress the distinction between the supportive relationship, which is present to some extent in all psychotherapy, and supportive treatment, and they examine the inverse relationship between expressive and supportive therapy. Finally, selected elements and techniques of the conduct of supportive therapy, such as style of communication, respect, praise, advice, self-disclosure, and interpretation, are discussed.
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A study was made of the relationship of proton T1 relaxation times and stage of the menstrual cycle. Preliminary data show that these indicators of red blood cell hydration status may be useful as objective markers of premenstrual tension.
Three patients receiving alprazolam developed, within days after beginning treatment, acute excitatory states with features more suggestive of mania than of disinhibition syndrome. The authors suggest a neurochemical link between mania and disinhibitory states.
A series of polymers bearing hydroxamic acid-terminated side chains were prepared for the purpose of developing new iron chelators for treating iron overload in beta-thalassemia (Cooley's anemia) and other iron diseases. The polymers are for the most part amino acid amide derivatives of acrylic and methacrylic acid with the terminal carboxyl group converted to the hydroxamic acid. The polymers are generally water soluble and sequester iron(III) avidly. The polymeric iron chelators were assayed via a mouse screen for activity in removing iron. Iron overloaded mice were administered i.p. the iron chelator over a 7-day period. Urine and feces were collected and the iron content measured by atomic absorption. At the end of the treatment period the mice were sacrificed and the livers and spleens were homogenized and examined for iron content. The results were compared with similar data obtained for the iron chelator drug desferrioxamine as a standard. Four of the polymers prepared exhibited strong activity, as good or better than desferrioxamine in iron removal capability. The four polymers are the polyacroloyl and polymethacryloyl derivatives of beta-alanine with the side chain carboxyls converted to the N'--H or N'--CH3 hydroxamic acids. Of these four the polyacryloyl N'--CH3 derivative exhibited superior behavior, being 3 to 5 times as effective as desferrioxamine at the lower dose level. None of the four polymers produced toxic signs and the administration was accompanied by little or no pain response.
In response to pressure to assume more responsibility for chronic patients, many general hospitals have asserted that they should limit care to those suitable for voluntary treatment on an open ward. This assertion appears to be based primarily on political and symbolic arguments. The limitation of admission to voluntary patients would serve to exclude many acutely psychotic patients with excellent prognosis best treated in a general hospital. The locked ward appears to offer the maximum flexibility in dealing with illnesses which in varying degrees affect the individual's judgment and impulsivity. The limitation of psychiatric units to voluntary patients in open wards would preclude psychiatry from joining in the mission of the general hospital - the best possible care for the community it serves.
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A psychiatric center in Brooklyn provided a socialization program in a community residence for adults discharged from state hospitals and made a study of the program's outcome. Residents on two floors of the home, the experimental group, received an enriched treatment program; those on the other four floors, the control group, received a minimum of therapeutic intervention. A comparison of residents' ratings on assessment scales made early in the program and after seven months of operation showed that residents on all floors improved on measures of socialization, men improved more than women, and residents over 65 years of age improved the least. Residents in the experimental group did not improve much more than those in the control group. Costs for the experimental group, including room and board, were $16.59 a day per resident. Costs for the control group were $15.61 a day per resident.
In their study of the effects of posthospital treatment on psychiatric patients the authors found that those who entered aftercare were rehospitalized less often than those who did not. They found the rehospitalization rate was higher for schizophrenic patients than for patients in other diagnostic groups, and that schizophrenic patients who did not enter aftercare were rehospitalized at a higher rate than those who did. They found no difference between rehospitalization rates of patients who continued with their hospital therapist after discharge and those patients who worked with a new therapist.
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Twenty-one paranoid schizophrenics who were being treated in a therapeutic community were divided into groups with grandiose and nongrandiose symptomatology, based on ratings on the Inpatient Multidimensional Psychiatric Scale. The nine nongrandiose patients showed significantly greater improvement during hospitalization. A follow-up of five nongrandiose and nine grandiose patients one year after discharge revealed a trend toward greater improvement by the nongrandiose group. The authors feel that a patient's grandiosity creates a barrier that keeps the therapist and the members of the therapeutic community at a distance and makes him less accessible to therapeutic intervention. The field dependence of patients was also rated, but was of no prognostic significance.
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Explore the source record for details and available documents.