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Biomedical subjects

L R Marcos

Publications and source records attributed to L R Marcos.

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

Psychiatric catchment areas in an urban center: a policy in disarray.

This study of the catchment area policy in New York City's 10 municipal psychiatric inpatient units and emergency rooms showed that of a total of 52,170 emergency room visits and 18,558 admissions in 1982, 35% and 24%, respectively, were of patients from outside the hospitals' catchment areas. The authors discuss the factors associated with the relative ineffectiveness of the policy and the implications for municipal hospitals' funding and patient care. They suggest that policy makers consider a different model for acute-care hospitals and propose a network approach as a plausible alternative. The need for further research is also emphasized.

Catchment Area, Health↗
PubMed1983

Muddling through mental health policies.

This study reports the process and outcome of a mental health policy change designed to relieve overcrowding in the 10 municipal adult psychiatric inpatient units in New York City. The authors describe the strategies used to achieve a limited change in admission policies and analyze the effect of this change on the municipal hospitals. Comparison of conditions before and after the policy change suggests its positive impact. Results are discussed in reference to the model of incrementalism in policy making, emphasizing the need for comprehensive rational planning, the training of mental health professionals in policy making, and further research on this important area of psychiatry.

Bed Occupancy↗
PubMed1982

Adults' recollection of their language deprivation as immigrant children.

For this retrospective study, six adult patients in psychoanalytic psychotherapy participated in 45-min audiotaped individual sessions that focused on their reaction to the language deprivation they experienced following their immigration to the United States during their later childhood years. The content analysis of these sessions showed that all six patients experienced the impact of language deprivation in a strikingly similar way. Four consecutive stages were identified: withdrawal, despondency, adaptation, and integration. On the basis of these preliminary observations, the author makes tentative recommendations aimed at ameliorating the consequences of language deprivation in immigrant children and suggests systematic research on these children.

Acculturation↗
PubMed1982

Pharmacotherapy of Hispanic depressed patients: clinical observations.

Based on the observation that Hispanic depressed patients appear to receive lower dosages of antidepressants, the clinical records of 41 Hispanic and 21 Anglo, female outpatients receiving antidepressants were compared. All the patients had been diagnosed by two psychiatrists as suffering from a major depressive episode according to the DSM III criteria. The records showed that the Anglo patients received about double the dosage of antidepressants given to the Hispanic patients. The Hispanic patients complained more about side effects, but the treatment outcome was comparable in both groups. Apart from pharmacokinetic factors, the authors suggest that these clinical observations may be due to the fact that Hispanic depressed patients express depression in terms of somatic symptoms which are often similar to the side effects produced by antidepressants. Clinicians ought to familiarize themselves with the psychological, sociocultural, and biologic characteristics of the patient, and should approach the chemotherapy in a differential manner. Controlled prospective studies should be designed to test the hypotheses generated by this study.

Adult↗
PubMed1980

Impact of the outpatient clerkship on medical students.

Using an anonymous questionnaire, the authors assessed the professional relevance of outpatient and inpatient curricula and the didactic value of different parts of the clerkship for 80 junior medical students randomly assigned to a pilot clerkship. Significantly more medical students preferred outpatient to inpatient psychiatry; they supported the view that working with outpatients is more useful, rewarding, and educational for the nonpsychiatrist physician. The implications of this study include the need to increase the outpatient psychiatric experience in medical school, the importance of surveying the impact of learning settings on students, and the reasonableness of adapting the curriculum to the didactic needs of students.

Adult↗
PubMed1980

Factors in medical students' choice of psychiatry.

The authors review the literature on and systematize the factors influencing medical students' choice of psychiatry as a specialty. The results indicate that students who are single, from large metropolitan areas, uninterested in religion, politically liberal, interested in humanitarian ideas, who score low in authoritarianism, have a high capacity to tolerate ambiguity, have a high level of anxiety and fear of death, and have low self-esteem are likely to choose psychiatry. In medical school, the students likely to choose psychiatry have a lower class rank and express positive attitudes toward psychiatry and psychiatrists. Exposure to and taking responsiblity for patients, especially patients with good prognoses, are crucial factors encouraging students to be psychiatrists.

Achievement↗
PubMed1979

Nonverbal behavior and thought processing.

Generally, clinicians assessing mental status interpret patients' nonverbal behavior in terms of its discharge, expressive, interactional, or neurological properties. The present study addresses the conceptualization of hand movement behavior as related to central cognitive processes, and attempts to identify encoding-related motor behavior by comparing the hand movements of subordinate bilingual subjects in situations of dominant- and nondominant-language and low- and high-imagery verbalization. Compared to the parallel dominant-language situation, subjects verbalizing in their nondominant language produced more speech-primacy and groping hand movements. Also, in comparison with the verbalization about a high-imagery topic, when the subjects encoded a low-imagery topic they displayed more pointing movements. Unless they are aware of these movements, clinicians evaluating bilingual patients may interpret an increase in encoding-related motor activity as reflecting psychopathology. Apart from this psychodiagnostic significance, hypothetical implications of these findings for the study of aphasia and information processing mechanisms are discussed.

Adult↗
PubMed1979

Effects of interpreters on the evaluation of psychopathology in non-English-speaking patients.

Non-English-speaking patients in need of psychiatric services are usually evaluated with the help of an interpreter. Discussions with psychiatrists and lay hospital interpreters who had experience in these interviews and content analysis of eight audiotaped interpreter-mediated psychiatric interviews suggested that clinically relevant interpreter-related distortions could lead to misevaluation of the patient's mental status. The author notes that pre- and post-interview meetings of clinicians and interpreters have been found useful in minimizing these distortions.

Adjustment Disorders↗
PubMed1979

Dynamic psychotherapy with the bilingual patient.

Bilingualism is known to affect the communicative behavior of the individual. This paper describes the implications of the bilingual experience for the process of dynamic psychotherapy, and presents recommendations to psychotherapists treating the bilingual population.

Communication Barriers↗
PubMed1979

Hand movements and nondominant fluency in bilinguals.

16 subordinate bilingual subjects produced 5-min. monologues in their nondominant languages, i.e., English or Spanish. Hand-movement activity manifested during the videotape monologues was scored and related to measures of fluency in the nondominant language. The hand-movement behavior categorized as Groping Movement was significantly related to all of the nondominant-language fluency measures. These correlations support the assumption that Groping Movement may have a function in the process of verbal encoding. The results are discussed in terms of the possibility of monitoring central cognitive processes through the study of "visible" motor behavior.

Adult↗
PubMed1978

Paradoxical reaction to L-dopa in schizophrenic patients.

The authors administered 6 g of L-dopa to 8 schizophrenic patients and 750 mg of chlorpromazine to 7 schizophrenic patients. Chlorpromazine showed only a modest advantage over L-dopa and only on some Brief Psychiatric Rating Scale factor scores, and at maximum dosage the thought disturbance factor score in the L-dopa-treated group was not worse than at baseline. The results suggest that L-dopa is associated more with toxic than with schizophreniform symptoms and that there is adaptation to its effects. The authors discuss implications of these findings for the dopamine hypothesis of schizophrenia.

Adult↗