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Biomedical subjects

L Grinspoon

Publications and source records attributed to L Grinspoon.

At least 19 recordsLinked to original sources
PubMed1986

Can drugs be used to enhance the psychotherapeutic process?

Many preindustrial cultures traditionally use certain psychedelic plants to enhance a procedure that resembles psychotherapy--an idea that was also tested in Western psychiatry in the 1950s and 1960s. LSD and related drugs were used to facilitate the production of memories, fantasies and insights and to enhance the therapeutic alliance. The results were inconclusive, and research was largely abandoned after the drugs became difficult to obtain. It may now be possible to revive this research, using new drugs that do not have some of the disadvantages of the old ones. The drug now of most interest is MDMA (3,4-methylenedioxymethamphetamine) a relatively mild and short-acting substance that is said to give a heightened capacity for introspection and intimacy without the perceptual changes, emotional unpredictability, and occasional adverse reactions associated with LSD. Therapists who have used the drug claim that it can enhance the therapeutic alliance by inviting self-disclosure and promoting trust. Whether MDMA fulfills this promise or not, other drugs may eventually prove useful in psychotherapy. Research on their potential should not be curtailed because of fear that they will be subject to illicit abuse.

3,4-Methylenedioxyamphetamine↗
PubMed1983

Mental patients' knowledge of in-hospital rights.

The authors questioned 52 recently admitted patients about formally receiving information regarding patients' rights and about their knowledge of that information. Of the 13 day hospital patients, 12 recalled being given the information, but only 20 of 39 inpatients recalled receiving the information. Most patients, irrespective of their diagnosis or legal status, knew their rights. Surprisingly, comparison with a group of patients who did not receive information on their rights revealed no relationship between receiving this information and knowledge of patients' rights. On the basis of these and other findings, the authors discuss some difficulties with presentation of patients' rights and offer recommendations.

Adolescent↗
PubMed1981

A follow-up of deinstitutionalized chronic patients four years after discharge.

Twenty-seven chronically ill mental patients were followed up four years after their discharge from a state hospital to the Massachusetts Mental Health Center. In interviews with the patients and their caregivers, data were gathered on the patients' current places of residence, mental status, time spent in the hospital since discharge, levels of functioning, and quality of life. The authors found that patients tended to move from hospital to community, with rehospitalization dropping dramatically once patients were placed in the community; that the group of patients living in the community had a better average mental status; that all but two patients preferred their current living situations to life at the state hospital; and that the best predictor of community residence was age at first admission (over 20). Two policy issues are discussed: the relationship (or lack of one) between restrictiveness and type of residence, and the importance to the findings of changes in psychiatric practice over the lifetime of the sample.

Adult↗
PubMed1981

Alternative to the back ward: the quarterway house.

The Quarterway House was founded in December 1978 to deinstitutionalize and provide rehabilitation services to a small group of long-term, seriously ill inpatients of the Massachusetts Mental Health Center. The purposes of the residential program are to provide a less institutional therapeutic environment and to develop a psychosocial treatment program that might enable some patients to move toward more independent settings in the community. In a randomized experimental study, with center inpatients as the control group, the effectiveness of the program was assessed by multiple outcome measures before the program began and at one year. Although neither group moved rapidly to more independent community living, Quarterway House patients showed improvement in general functioning and socialization-survival skills and decreased medication and seclusion. They did not show a decline in psychotic symptoms, obstreperousness, or antisocial behavior. Over-all, the findings suggest the program may prove useful for the long-term rehabilitation of severely ill patients.

Activities of Daily Living↗
PubMed1980

Immunologic studies in schizophrenic and control subjects.

Heath and coworkers proposed that schizophrenia may be an autoimmune disorder in which antibodies are built up against specific substances in certain brain cells. Heath reports that schizophrenic patients exhibit abnormal brain waves in recordings from the caudate nucleus and septal area. These abnormal waves can also be recorded from similar sites in monkey brains after injections into the lateral ventricle cerebrospinal fluid of gamma-G-immunoglobulins (IgG) isolated from the blood of acutely ill schizophrenic patients. We prepared IgG fractions from control subjects and acutely ill schizophrenic patients and tested them in rhesus monkeys under double-blind conditions. Of 107 sera tested from 24 schizophrenic patients, 29 produced positive electroencephalographic recordings in the monkeys. From 30 control subjects we tested 80 samples and found 6 to be positive according to Heath's criteria. This amounts to more than 1 positive reaction for every 4 schizophrenic patients' fractions tested and approximately 1 positive in 13 from control subjects' serum fractions. The difference between control and patient groups is highly significant (p less than 0.001). Although our results confirm the experimental findings of the Heath group concerning abnormal EEG activity associated with an IgG fraction from schizophrenic patients, they differ from Heath's results for fractions from control persons. We found positive effects from a small number of control fractions whereas Heath claims never to have observed positive biological activity in control fractions. The autoimmune hypothesis has numerous drawbacks, the greatest of which is the inability to demonstrate the presence of circulating antibody in schizophrenic patients with the use of standard immunologic techniques.

Acute Disease↗
PubMed1979

A surfeit of surveys: escalating data demands on community mental health centers.

In a recent six-month period, a state-operated community mental health center was required to gather data for nine major surveys, reviews, and budget requests. Such surveys cover much the same ground, yet without any attempt to standardize formats so that the data a center compiles for one survey can be used in the next. The surveys frequently are not designed for the programs required to complete them; they are a drain on increasingly scarce staff time and deplete staff morale. A two-part solution to the problem would involve coordiantion and control of the demands for data, perhaps through the development of a model mental health data set and format by the National Institute of Mental Health, and the development of locally based, smaller-scale information systems. The latter step would generate more complete and reliable data for local clinicians and administrators and yield a limited amount of basic information to be used by outside agencies.

Community Mental Health Centers↗