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Biomedical subjects

H R Conte

Publications and source records attributed to H R Conte.

At least 19 recordsLinked to original sources
PubMed1992

A review of treatment studies of minor depression: 1980-1991.

This article provides a brief overview of the changing nature of the concept of minor depression. It then discusses treatment studies conducted from 1980 to 1991 of patients diagnosed as neurotic depression, depressive neurosis or dysthymia, characterologic depression, "double depression" and minor depression or dysthymia, if there has been a full remission of a major depressive episode lasting at least six months prior to the development of dysthymia. Long-term treatment of chronic depression is also reviewed. Cognitive-behavioral intervention and marital therapy have been reported beneficial for patients diagnosed as having neurotic depression, characterological depression, or dysthymia. All studies of antidepressant drug treatment showed drugs to be efficacious and superior to placebo, with few differences found between drugs. In addition, they all showed the importance of analyzing the interactions between treatment and severity or diagnosis. Patients diagnosed as "double depression" also appear responsive to both psychosocial intervention and drug treatment; in general, however, these patients tend to have a poor long-term outcome and continued treatment is indicated. The most obvious finding to emerge from this review is that the diagnosis of minor depression is ambiguous, in large part because of the lack of defining criteria related to severity and course. The review also revealed that in addition to poorly defined subgroups, many studies lacked controls, had small sample sizes, inadequate and/or inconsistent measures of outcome, and limited follow-up. For these reasons, their findings cannot be considered conclusive. Finally, the literature revealed a dearth of controlled studies of psychosocial treatment for well defined subgroups of neurotic depression.

Antidepressive Agents, Tricyclic↗
PubMed1991

Interrelations between ego functions and personality traits: their relation to psychotherapy outcome.

Ninety consecutive admissions to a large outpatient clinic of a municipal hospital completed two self-report questionnaires: the Self-Evaluation Questionnaire (SEQ) which consists of four 10-item scales that assessed four areas of ego functioning; and the 89-item Personality Profile Index (PPI) that provided measures of eight dimensions of personality traits and also a measure of conflict. Results indicated that the four measures of ego functioning had good internal consistency, and three of the four ego functions had a highly similar pattern of relations to the personality trait dimensions and to the conflict measure. It thus appears that each set of constructs amplifies and sheds light on the other. Two of the ego function measures were significant predictors of psychotherapy outcome. They correlated highly with one another and also with a third measure of ego functioning. This fact, together with the similarity of their correlations with the personality traits, suggests that these ego functions represent different aspects of an underlying construct that could be called Ego Strength. Therefore, combining the three ego functions into a 30-item Ego Strength measure could provide an even more sensitive predictor of therapy outcome and a useful new instrument for psychotherapy research.

Adult↗
PubMed1991

Sex differences in personality traits and coping styles of hospitalized alcoholics.

Forty inpatients on an alcohol detoxication unit of a large municipal hospital were administered a battery of tests consisting of a Coping Styles scale, a Personality Profile scale, a Depression scale and the Brief MAST. A demographically comparable comparison group of 40 outpatients attending the medical screening clinic at the same hospital also completed the battery. The two groups did not differ in terms of age, education or the ratio of men to women. There were significant differences in coping styles and personality characteristics between alcoholics and nonalcoholics and, to a large extent, between men and women within the alcoholic group. Practically no significant differences were found between the men in the two groups, but female alcoholics differed greatly from nonalcoholic women in terms of coping styles, personality variables and also in terms of conflict. These findings indicate that the differences between alcoholic and nonalcoholics in the sample were due largely to patterns uniquely characterizing the female alcoholic group. Results are discussed in terms of cultural expectations.

Adaptation, Psychological↗
PubMed1990

Malpractice in psychotherapy: an overview.

This paper gives a capsule review of the major issues on the subject of malpractice for individual practitioners of psychotherapy. It examines the elements necessary to support a malpractice claim and presents examples of cases in specific areas of liability. Historically, the field of psychotherapeutic malpractice was largely inactive. However, recent court rulings reveal that psychotherapists are no longer immune to malpractice suits. In decreasing order of the likelihood of the plantiffs being successful in their suits are cases involving the misuse of the therapeutic relationship, breach of confidentiality, and cases that involve prevention of harm to third parties and to patients themselves. Malpractice suits based on negligence in providing appropriate treatment are beginning to emerge and will probably increase in frequency as the efficacy of biological treatment is demonstrated. Available solutions to the problems of malpractice are discussed. It is suggested that in addition to the existing external sanctions, there is a need for consultation plus educational programs to enhance our ability to practice within the boundaries that the courts have set for us.

Confidentiality↗
PubMed1989

Is there a relation between the seriousness of suicidal intent and the lethality of the suicide attempt?

The relation between the strength of an individual's intent to commit suicide and the nature and seriousness (lethality) of any suicide attempt has been a controversial one. Some studies suggest a positive correlation, while others report no connection. The present investigation included 60 patients, who were studied shortly after they had been admitted to a medical service after a suicide attempt. Measures of depression, impulsivity, suicidal intent, seriousness of the attempt, and efforts to prevent intervention were obtained. Results reveal that both depression and impulsivity correlate positively with the strength of the intent to commit suicide, but there appears to be almost no correlation in this population between measures of intent and seriousness of the attempt.

Adolescent↗
PubMed1989

Correlates of suicide and violence risk: III. A two-stage model of countervailing forces.

Questionnaires and self-report scales were administered to 100 psychiatric inpatients. The scales measured such variables as depression, hopelessness, impulsivity, mental and life problems, family violence, personality characteristics, and dyscontrol tendencies. These were correlated with indices of suicide risk and violence risk. Most variables were found to correlate significantly with both suicide and violence risk. Partial correlation analyses revealed that 10 variables correlated significantly with suicide risk but not violence risk, while four variables correlated significantly with violence risk but not suicide risk. A two-stage model of countervailing forces, incorporating concepts from both psychoanalysis and ethology, is presented as a way of interpreting the results.

Adult↗
PubMed1989

Ethics in the practice of psychotherapy: a survey.

One hundred and one psychotherapists responded to a survey designed to obtain data concerning beliefs about various ethical issues encountered in psychotherapy. Opinions about ethical standards in many areas were quite varied for the entire sample. Differences also emerged when therapists were compared in terms of orientation and years of experience.

Confidentiality↗
PubMed1979

Measurement of thinking dysfunction. An empirical study.

This investigation is concerned with the development of a practical method for assessment of thought disorders. A review of eight major textbooks and four review articles revealed 37 different terms used to describe the components of thought disorders. Because of overlap of meanings or ambiguous usage, these terms were reduced to 17 discrete terms that could be operationally defined. Twenty-five psychiatrist were surveyed on the appropriateness of the definitions and their relevance to the concept of thought disorder. An average of 83 per cent agreement was obtained, and some of the definitions were modified as a result of the survey. Eight psychiatrists then applied this scale, titled the Thinking Dysfunction Rating Scale, to the evaluation of five videotaped patient interviews. Based on observation of all five patients, interjudge agreement was over 90 per cent for all items of the scale. Analysis of variance showed that the scale significantly discriminated among schizophrenics, patients with organic brain syndromes, psychotic depressives, geriatric depressives, and outpatients. The patterns of scores were found to vary among these five groups. The scale should be helpful for teaching purposes and as a checklist for routine clinical diagnosis.

Adult↗
PubMed1979

Thought disorder in alcoholics.

Research on cognitive impairment in chronic alcoholics has generally focused on pathology associated with organic brain damage. On the other hand, deficits more typical of the functional psychoses have been less explored, due to the absence of appropriate tests. By using the Thought Disorder Rating Scale (TDRS) recently developed at our Center, however, we have tested chronic alcoholics for the presence of classical symptoms of thought disorder. This test is based on the assessment of the patient's verbal behavior by an experienced clinician. Twenty subjects free of psychosis, severe withdrawal symptoms, and medical illness were, after detoxification, administered a test battery which included the TDRS, the Bender-Gestalt Test, and the Zung Self-rating Depression Scale (SDS). Five scored pathologically for thought disorder and of them four had abnormal Benders; whereas only two of 15 of those without thought disorder had abnormal Benders (t = 2.84, p < .01). Although SDS scores for both groups were in the depressed range, there was no significant difference between SDS means for the two groups. TDRS scores for these alcoholics are compared with those for other diagnosed groups, and implications for future investigation are discussed.

Adult↗
PubMed1978

Studies of body image. IV. Figure drawings in normal and abnormal geriatric and nongeriatric groups.

Figure drawings were obtained from 72 normal adults, 48 adult psychiatric inpatients, 30 senior citizens, and 33 elderly inpatients in a mental hospital. Blind analyses were carried out for "emotional indicators" and other characteristics such as body image disturbance and intellectual impairment. Significant differences were found on almost all measures between the normal elderly and the normal adult. They were also found to discriminate between the normal adult group and the adult psychiatric patients. Very few differences were found between the normal elderly and elderly psychiatric patients, or between normal elderly and adult psychiatric patients. These results imply that norms based upon figure drawings of children or adults may not apply to the elderly and that, therefore, figure drawings may be a less useful diagnostic tool for elderly people than they are for children or adults.

Aged↗
PubMed1978

Toward a rationale for the seclusion process.

The present paper summarizes three studies focusing on different aspects of seclusion room practices. The first study involved chart review to collect empirical data on reasons for seclusion, length of seclusion, and characteristics of secluded patients. The second study focused on staff attitudes toward seclusion; the third dealt with the attitudes of both secluded and nonsecluded patients. The average time of seclusion was approximately 4 hours and in most cases aggressive behaviors of various types were cited as the precipitating event. In addition, patient and staff attitudes implied that a major function of the seclusion process was to isolate patients from disturbing interactions and to maintain the smooth functioning of the ward minisociety. Two models of seclusion, an ethological model and a behavioristic "time out" model, were developed in order to integrate the results of these studies. Implications of the findings and models are presented for changes in seclusion room procedures.

Adult↗
PubMed1978

Clinical utility of a rapid diagnostic test series for elderly psychiatric outpatients.

Psychiatric evaluation of the elderly is especially difficult for several reasons, e.g., the presence of organic impairment, the effects of multiple drug therapy, and the tendency to confuse the normal concomitants of aging with neurotic symptoms. The authors have developed and evaluated a brief series of self-report assessment tests (GRDB) designed to assist the psychiatrist in the process of diagnosis. Coefficients of the internal consistency of the seven scales are presented. A comparison was make between 28 psychiatric patients attending a geriatric clinic and 48 well-functioning elderly persons matched for age and sex, and living in the same community. Results showed that the geriatric outpatients functioned at a lower level of adaptation than did the control group, on all seven scales - depression, daily living skills, social interaction, cognitive skills, number of illnesses, number of life problems, and the use of drugs and alcohol. These findings provide a measure of discriminant validity. The advantages of this brief assessment instrument are discussed.

Aged↗
PubMed1978

"No-commitment week": a feasibility study.

To determine the extent to which involuntary hospitalization is overused, a "No-Commitment Week" was set aside, during which emergency room psychiatrists committed only patients in absolute need of hospitalization. Compared with the week before and the week after, there was no significant difference in the number of patients committed during No-Commitment Week. The authors propose replication of the study on a larger scale but suggest that decisions about involuntary hospitalization in public mental hospitals are the result of societal attitudes, which will be subject to change as long as society itself continues to change.

Commitment of Persons with Psychiatric Disorders↗
PubMed1977

Compliance with psychiatric emergency room referrals.

An attempt was made to identify some of the major variables, such as age, sex, ethnicity, and diagnosis, that might be determinants of compliance with psychiatrists' recommendations to enter outpatient treatment after emergency room visits. In general, it was found that older Puerto Rican and white women, usually those diagnosed as having some kind of depression, had the highest rate of compliance. Black patients, as well as all patients diagnosed as schizophrenic, had the lowest probability of outpatient follow-up. A telephone survey of those patients who did not go for outpatient treatment within six months after referral was conducted to elicit their reasons for not going. Several hypotheses were developed concerning reasons for lack of compliance with recommendations for outpatient follow-up, and a number of suggestions were made about possible methods for increasing the compliance rate.

Adjustment Disorders↗
PubMed1977

The therapeutic community in theory and practice.

To obtain an operational description of the therapeutic community, the authors reviewed recent literature and composed a 40-item questionnaire describing aspects of the therapeutic community. The questionnaire was mailed to authors of recently published articles or books on the subject, 27 of whom responded with ratings of the degree to which each item was characteristic of a therapeutic community. The validated questionnaire was then completed by 22 staff members on four psychiatric wards of a university-affiliated municipal hospital, who rated the items in terms of real and ideal conditions on the ward. Comparisons of the real and ideal ratings are discussed.

Attitude of Health Personnel↗
PubMed1976

The role of the chief resident: expectations and reality.

The job expectations of 35 incoming chief residents were tested by questionnaire when they attended a weekend workshop on leadership and were reexamined after they has had six months' experience on their jobs. Such personal qualities as a sense of humor and persistence and such administrative skills as the ability to exercise authority and set objectives significantly increased in importance six months after these residents began work. The authors recommend educational programs in administration for chief residents.

Humans↗