Biomedical subjects
Publications and source records attributed to C Cullen.
Anger is a poorly understood but very common emotion. When it is misdirected or uncontrolled it becomes dangerous. An analysis of anger and a treatment paradigm is presented, and we outline a research project in which we are using the approach with a group of mentally handicapped adults.
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This brief paper is intended to amplify three points which are contained in Slade (1982) and Owens & Ashcroft (1982). They are that (i) functional relationships must be demonstrated, not merely claimed; (ii) functional relationships are likely to be complex, and clinicians should be wary of superficial analysis; and (iii) there is a distinction between discriminative stimuli and setting conditions which has important implications for clinical practice.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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The advent of community psychiatry has tended to blur the interface between primary and secondary psychiatric care. We used a postal questionnaire to investigate each new referral from general practice to the public outpatient clinics of three West Dublin Psychiatric Sectors. 70 referrals, from 35 general practitioners, over a four month period in 1991 were analysed, regarding reason for referral and prior management in general practice. On average patients had seen their GP six times over a period of ten months. Mixed anxiety/depression was the most common diagnosis (23%). Medication had been prescribed for 61% of patients and 67% had counselling before referral. Common reasons for referral were: Access to therapies not available directly to the GP (30%); Failure of treatment (20%); To share the burden of chronic care (14%). In only 13% of referrals did the GP wish the psychiatrist to take over care. We conclude that the GPs surveyed undertake extensive pre-referral management of patients with psychological illness. They have well defined expectations of referral and are keen to follow up patients themselves. Future plans for community psychiatric services should take account of this pattern of care.