Search PubMed⌕ Search

Biomedical subjects

L Citrome

Publications and source records attributed to L Citrome.

7 recordsLinked to original sources
PubMed1995

Clinical and administrative consequences of a reduced census on a psychiatric intensive care unit.

The Psychiatric Intensive Care Unit at the FDR VA Hospital is a specialized ward designed to assess and treat suicidal and assaultive patients. Since its creation in 1983, over 1600 admissions have taken place. The authors have previously reported that patients referred for aggressive behavior had a statistically significant higher recidivism rate, as well as a statistically significant longer length of stay. The unit went through several changes in response to externally perceived needs and available resources. When the census cap was decreased, the referral pattern changed and the patients were even more likely to be aggressive. Length of stay decreased dramatically leading to a unit with a significantly higher turnover rate. Clinical and administrative concerns are also discussed.

Aggression↗
PubMed1994

Management of depression. Current options for this highly treatable disorder.

Depression is a common disorder that leads to substantial functional impairment and even death if untreated. Suicide rates in persons with untreated major depression can be as high as 30%. However, the disorder is treatable; pharmacotherapy in combination with psychotherapy is effective in up to 90% of patients. Established diagnostic criteria enable physicians to differentiate major depression from other psychiatric disorders and from somatic conditions that may mimic depression. Current treatment options include traditional antidepressant medications as well as the newer serotonin-reuptake inhibitors. Successful treatment depends on administration of an appropriate dose for an adequate duration.

Antidepressive Agents↗
PubMed1990

The dangerous agitated patient. What to do right now.

Short-term management of the agitated patient involves the use of psychological, behavioral, diagnostic, and pharmacologic options. Knowledge of verbal interventions may help physicians prevent personal injury and destruction of property. Accurate diagnosis allows safe and effective pharmacologic intervention. Involuntary treatment in emergency situations is legal; however, clearly documenting all clinical events is essential.

Adult↗
PubMed1990

A double-blind, placebo-controlled study of adjunctive nadolol in the management of violent psychiatric patients.

We report a controlled 3-week study (n = 30) of adjunctive use of nadolol, 80 to 120 mg per day, vs. placebo for the management of violent psychiatric patients. There were no remarkable adverse cardiac effects at this dose. The active treatment group showed lower total Brief Psychiatric Rating Scale (BPRS) scores after the first week of treatment (analysis of covariance [ANCOVA], p less than .08) and similar trends for the activation factor and the hostility scale. There were parallel findings for measures of extrapyramidal symptoms (EPS) (Simpson-Angus Neurological Rating Scale), which were reliable after the second week (ANCOVA, p less than .02). A significant association between changes in EPS and BPRS scores was found by regression analysis, after the effects of baseline measures were removed. Given that nadolol does not penetrate the central nervous system well, the antiaggressive effects may be associated with sympathetic nervous system feedback mechanisms.

Adult↗
PubMed1989

Differential diagnosis of psychosis. A brief guide for the primary care physician.

By keeping in mind that not a psychosis is schizophrenia, the primary care physician can often avoid misdiagnosis in behaviorally disturbed patients. Abnormal behavior may result from mood disorders, drug-induced psychosis and other organic disorders, personality disorders, delusional disorders, autism, or mental retardation. A long-term history is essential for correct diagnosis and treatment.

Affective Disorders, Psychotic↗