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Biomedical subjects

J L Houpt

Publications and source records attributed to J L Houpt.

At least 37 records · Page 2Linked to original sources
PubMed1984

Differentiation of depression from chronic pain with the dexamethasone suppression test and DSM-III.

The concept of chronic pain has become enmeshed with depression. In an attempt to unravel this complex relationship, the authors studied a uniform group of 42 patients with chronic pain, i.e., patients who had chronic low back pain with defined organic pathology, in relation to the dexamethasone suppression test (DST). The results were analyzed in relation to the presence or absence of major depression and cortisol suppression. Forty-one percent of the patients with major depression had abnormal cortisol responses to dexamethasone administration; all patients without major depression had normal responses. These results suggest that chronic pain patients differ from patients with major depression and a positive DST.

Adolescent↗
PubMed1984

Propranolol and depression: a reevaluation based on a pilot clinical trial.

A wide range of neuropsychiatric side effects are attributed to propranolol including visual hallucinations, somnulence, memory impairment, decrease in response time, dizziness, confusional states, insomnia, nightmares, fatigue, sedation and depression. Benson et al., in a summary review of several clinical studies of 5,846 patients being treated with a variety of beta adrenergic blocking agents, listed depression as a rare side effect of propranolol that was usually reported only after long term treatment at high doses. Despite the widely circulated attribution that depression is a side effect of propranolol, there is a paucity of evidence to directly link this drug with clinically significant mood disturbance. For example, the most widely quoted reference attributing propranolol as a depressogenic agent was a "letter to the editor" which was a retrospective, uncontrolled, unblinded study that did not use a standardized depression rating scale. Most of the evidence linking propranolol to depressive symptoms have derived from scattered case reports in which the onset of depressive symptoms were attributed to this agent. Given the well known cyclic onset and remissions of affective disorders, and the prevalence of depression in the general medical population as a whole, the role of propranolol in these cases is debatable.

Aged↗
PubMed1983

Central nervous system sarcoidosis.

Sarcoidosis may involve the central nervous system (CNS) in approximately 5% of cases. Three levels of neurological involvement are possible and include cranial nerve abnormalities, peripheral neuropathies, and lesions of the brain, spinal cord, and meninges. In addition to abnormal neurological findings, psychiatric presentations of CNS sarcoidosis include symptoms of delirium, dementia, depression, personality changes, and psychosis. The diagnosis usually rests on neurological, psychiatry, and cerebrospinal fluid (CSF) abnormalities with a history of sarcoidosis in other organ systems. The CSF, however, may be normal in as many as 30% of cases. The complexities of the illness and the difficulties that may be encountered in making the diagnosis are illustrated with a case of suspected CNS sarcoidosis that presented with delirium and choreoathetosis. The use of steroids as the mainstay of treatment is also discussed.

Central Nervous System Diseases↗
PubMed1980

Evaluating a clinical psychiatry course using process and outcome measures.

An empirical approach was taken in evaluating training in experiences and outcomes in a second-year psychiatry clerkship. A biweekly activity summary provided a detailed record of actual training experiences, didactic and clinical, and is presented as a model for use in other program evaluations. Statistically significant preclerkship changes occurred on most attitude and all perceived skill measures. Scores on the examination of the National Board of Medical Examiners were well above average. Satisfaction measures were favorable and correlated significantly with the overall attitudinal and perceived skill changes. Comparisons among outcome measures showed that attitudinal and skill dimensions correlated with each other and with satisfaction ratings, but they did not correlate with scores on an objective examination.

Attitude↗
PubMed1980

The role of psychiatric and behavioral factors in the practice of medicine.

The authors review the role of psychiatric and behavioral factors in the practice of medicine in three areas: 1) prevalence of psychiatric morbidity, 2) the role of behavioral or lifestyle factors in illness onset, and 3) the overlapping of psychiatric and behavioral factors with medical illness. Within each areas they review behavioral factors to the practice of medicine, the limits of current treatment approaches, and future research needs. In their final section they draw implications for health care delivery and manpower development.

Alcoholism↗
PubMed1980

Interpersonal factors in the psychiatry clerkship: new findings.

The authors took an empirical approach to determining ingredients of a successful psychiatry clerkship. They collected measures of clinical, didactic, and interpersonal experiences throughout the clerkship and correlated these with a range of outcomes. Correlations showed that positive relationships with supervisors, fellow students, and patients were strongly related to favorable attitudes and opinions at the end of the clerkship and to improvements in self-rated clinical skills. Only outcomes related to formal knowledge were independent of these factors. These findings highlight the importance of structuring a positive interpersonal environment for the psychiatry clerkship.

Attitude of Health Personnel↗
PubMed1979

Models for evaluating teaching in consultation-liaison psychiatry: III. Conclusion-oriented research.

This paper reviews the purposes and methodologic requirements of conclusion-oriented research for evaluating outcomes of consultation-liaison (C-L) teaching in psychiatry. Requirements for replicating educational methods and outcomes, and for demonstrating cause-effect relationships between program inputs and program outcomes include: careful definition of educational methods; selection of valid and reliable outcome measures; and use of sound experimental designs. Barriers to meeting these methodologic criteria in C-L settings are identified, and methods for overcoming them are suggested. In addition, useful guidelines are provided for the educator wishing to conduct conclusion-oriented C-L research to determine teaching effectiveness.

Attitude of Health Personnel↗
PubMed1979

Models for evaluating teaching in consultation-liaison psychiatry: II. Decision-oriented research.

The authors present a Program Audit Form (PAF), which can be used to evaluate liaison programs. Use of PAF illustrates the decision-oriented approach to evaluative research defined in Part I of this paper. The PAF includes three categories of information about the liaison program: (a) administrative arrangements, (b) program description, and (c) program feed-back. The information will provide the user with an overall picture of a Program's weaknesses and strengths, and a basis for making decisions about program change. The form is short and represents the minimal data program directors should have readily available without requiring technician time or research expense. Finally, it can be used to compare programs across institutions, because it includes descriptors of administrative arrangements.

Feedback↗
PubMed1979

Models for evaluating teaching in consultation-liaison psychiatry: I. An overview.

In this paper two useful models are introduced for evaluation of teaching in consultation-liaison psychiatry: decision-oriented and conclusion-oriented research. These models, based on previous studies of educational evaluation, are defined here in terms of their purpose for liaison psychiatry. To clarify the models' usefulness, the methodologic requirements for each model are presented while the unique characteristics of the liaison environment are described in terms of their effect on conclusion-oriented evaluation.

Attitude of Health Personnel↗
PubMed1979

Perception of poor health in the healthy older adult.

A survey of 977 community subjects aged 65 or older identified 719 of them as not impaired in physical health. Of these, 104 (14 percent) perceived their physical status to be poor, whereas 615 (86 percent) accurately perceived it to be unimpaired. There were no significant differences between the two groups with regard to age, sex, race, social class, living arrangements and number of drugs used. The physically healthy elderly who perceived their physical status to be poor were more depressed, more hypochondriacal, and more dissatisfied with life. They tended to complain of multiple symptoms; activities of daily living were decreased, and they were more likely to visit their doctor frequently during the year (analysis controlled for physical health in each case). Mental health was slightly but significantly more impaired in these subjects; nevertheless, they were more likely to seek the help of a trained counselor. The findings suggest that a self-perception of poor health among the physically healthy elderly may represent a generalized request for attention from trained personnel in the social environment.

Aged↗
PubMed1978

Referral of patients from primary care physicians to a community mental health center.

The referral process between primary care physicians and a community mental health center was examined in a community which lacks a geographically based psychiatrist. The method included inspection of referral completion rate and evaluation or patients' characteristics and attitudes concerning mental health care. The findings indicated that only 10 per cent of referred patients who have had no prior contact with the community mental health center completed the referral. Reasons for this low referral completion rate are discussed.

Attitude↗