Search PubMed⌕ Search

Biomedical subjects

M Galanter

Publications and source records attributed to M Galanter.

121 records · Page 7Linked to original sources
PubMed1972

Behavioral changes of chronic schizophrenic patients given L-5-hydroxytryptophan.

Oral administration of the serotonin precursor L-5-hydroxytryptophan with a peripheral decarboxylase inhibitor produced Mild to moderate improvement in six of seven chronic undifferentiated schizophrenic patients who were resistant to phenothiazine treatment, as compared to an oral administration of a placebo. Two of four chronic paranoid schizophrenic patients who were resistant to phenothiazine treatment became worse with 5-hydroxytryptophan, one improved. It is presumed that these psychological changes were directly or indirectly produced from increases in brain serotonin. Indirect data from animals and humans indicate that there may be an abnormality in serotonin metabolism in some schizophrenics. While our data are consistent with this hypothesis, other explanations for our data must be entertained.

5-Hydroxytryptophan↗
PubMed1972

Effects on humans of 9 -tetrahydrocannabinol administered by smoking.

Twelve chronic marijuana users received triangle up(9)-tetrahydrocannabinol by smoking. The magnitude of their pulse increment was highly correlated with their subjective experiences. Three of the 12 subjects subsequently received triangle up(9)-tetrahydrocannabinol labeled with carbon-14; the time course of its concentration in plasma was highly correlated with the pulse increment. Subjective symptoms, however, appeared later and dissipated more slowly.

Adult↗
PubMedDate not supplied

Self-medication among addicts with primary psychiatric disorders.

Thirty-two dually diagnosed inpatients described drug-induced changes in their psychiatric symptoms. All heroin addicts and most alcoholics reported drug-induced improvement of their primary psychiatric symptoms; all cocaine addicts reported symptom worsening. These findings suggest that chronic cocaine abuse may not necessarily be related to attempts at self-medication of psychiatric symptoms.

Adult↗
PubMedDate not supplied

Empirical assessment of the self-medication hypothesis among dually diagnosed inpatients.

The aim of this study was to empirically determine the expected effects of drugs of abuse on the psychiatric symptoms of individuals dependent on alcohol and other drugs to assess the validity of the self-medication hypothesis, defined as motivation of patients to seek a specific drug for relief of a particular set of symptoms. Eight-three inpatients in a large metropolitan hospital with an axis I diagnosis of one drug dependence and an axis II diagnosis of personality disorder completed the Hopkins Symptom Checklist-Revised (HSCL-90-R) and the Neuropsychological Impairment Scale (NIS). They also reported the effect of their drug of choice on each of the symptoms included in both tests. Heroin addicts reported that heroin improved some of their psychiatric symptoms and all of their cognitive dysfunctions. Both cocaine and alcohol users reported that their drug of choice worsened their psychiatric and cognitive symptoms. No relationship was found between frequency or severity of symptoms and drug choice. We concluded that attempts at self-medication may have occurred among heroin addicts, but were unlikely among alcoholics and cocaine addicts. We found no evidence in support of the self-medication hypothesis as a necessary reinforcer of continued drug use.

Adaptation, Psychological↗
PubMedDate not supplied

Combining behavioral and self-help approaches in the inpatient management of dually diagnosed patients.

The combination of a token economy and a self-help model made it feasible to organize and maintain an intensive dual-diagnosis treatment program in a public municipal hospital acute psychiatric ward. The program described here, which integrates the token economy and 12-step approaches, fosters voluntary and active patient participation in the process of simultaneous recovery from mental illness and addiction; it also networks the patient with community resources. Implementation of the clinical program involved addressing multiple clinical and organizational obstacles, including a multihandicapped and often nonmotivated patient population, a lack of psychiatric staff trained in managing substance abuse, and the need to integrate mental health with substance abuse clinical interventions. The program has been operating more than 5 years and has treated more than 1,000 patients. As the token economy became an integral part of the ward routine, violence on the ward declined substantially, and patient participation in group activities increased significantly.

Activities of Daily Living↗
PubMedDate not supplied

Shelter-based treatment of the homeless alcoholic.

We describe a model for integrating municipal shelter and hospital-based alcoholism outpatient treatment services for the homeless alcoholic, and report on its outcome at 12 months. The experimental program was designed to increase homeless patient's length of stay in treatment and was based on integrating clinic services for homeless men at Bellevue Hospital in New York with an abstinence oriented dormitory, the "Clean and Sober" Unit in a municipal shelter. The study sample consists of 189 consecutive male admissions to an intensive outpatient alcoholism treatment program in the Bellevue hospital. The patients' outcome was assessed in relation to their place of residence divided in three groups: the experimental group counts 100 men housed in the Clean and Sober Unit. The two contrast groups counted 34 residents of various unaffiliated shelters and 55 domiciled men with independent living arrangements. The three subject groups did not differ significantly on demographic or clinical characteristics. After 12 months, residents in unaffiliated shelters were significantly less likely to be retained than the domiciled patients and showed a trend towards less retention than the experimental group.

Adult↗
PubMedDate not supplied

Concurrent cocaine withdrawal is associated with reduced severity of alcohol withdrawal.

The purpose of this study was to implement an empirical assessment of the clinical response to standard alcohol detoxification during withdrawal from both alcohol and cocaine. One hundred forty-nine males consecutively admitted in acute alcohol withdrawal to a hospital-based detoxification unit were studied. All subjects completed a 4-day chlordiazepoxide detoxification. Patients who used drugs other than cocaine were excluded. Fifty-five subjects withdrawing only from alcohol and 94 subjects withdrawing from both alcohol and cocaine, as evidenced by positive urinalysis and history, were studied. Both groups reported similar amounts of daily alcohol intake and had a similar age of onset of alcohol dependence. Parental alcoholism was equally frequent in both groups. Statistically, several variables were directly related to severity of alcohol withdrawal, including associated cocaine abuse, age, abnormal laboratory values, and duration of homelessness. As measured by the Alcohol Withdrawal Scale (AWS), alcohol withdrawal was less severe among cocaine users, not only at intake but throughout the 4-day detoxification. Singly addicted alcoholics were older and had longer drinking histories, more prior detoxifications, and more abnormal laboratory values than cocaine users. A multiple regression analysis demonstrated a significant relationship between cocaine and severity of alcohol withdrawal. Cocaine users more frequently requested reductions in chlordiazepoxide dosages than singly addicted alcoholics, complaining of dysphoria, sedation, and weakness. The severity of alcohol withdrawal was associated with recent cocaine use, age, laboratory abnormalities, and duration of homelessness. Concurrent cocaine withdrawal in the sample was associated with reduced severity of alcohol withdrawal. Possible neurobiological mechanisms, as well as study limitations affecting interpretation of the findings, are discussed. Tailored detoxification as opposed to standard detoxification regimens may be more appropriate for the clinical management of combined alcohol-cocaine withdrawal.

Adult↗
PubMedDate not supplied

A modified therapeutic community for the dually diagnosed. Greenhouse Program at Bellevue Hospital.

Techniques used in therapeutic communities may be applicable to patients dually diagnosed with mental illness and a psychoactive substance use disorder (PSUD). This study was designed to evaluate the demographics, course, and outcome for 100 patients treated in one such residential program. One hundred indigent male patients admitted to a drug-free therapeutic community for the dually diagnosed were studied on admission and over the course of their treatment, and subjects were monitored throughout their stays on the basis of observed urine toxicology tests and a clinical assessment of drug or alcohol use. The mean age of the patients was 33.8 years, and the average length of stay was 121.0 days. Thirty-three of the patients completed the full 6-month program and moved on to another stable living environment. Only 12 patients had urine toxicologies positive for illicit drugs or alcohol while in the program. These findings support the possibility of applying the residential drug-free therapeutic community to dually diagnosed patients.

Adult↗
PubMedDate not supplied

Modified therapeutic community treatment for homeless dually diagnosed men. Who completes treatment?

We studied a modified therapeutic community designed for the treatment of patients with combined substance abuse and psychiatric disorders. This model has been ap117117plied on a limited basis in clinical practice, and little is known about the characteristics of patients who are likely to complete the prescribed stay in such a program. In this report, we present characteristics of 189 homeless dually diagnosed men who entered a shelter-based, modified therapeutic community with a prescribed 6-month stay. Thirty-four percent of admissions completed the prescribed stay. These patients were more likely to have fewer inpatient psychiatric admissions and more job experience than those who did not complete their stay. Findings are discussed in terms of their similarities and differences to findings from traditional therapeutic communities for the singly diagnosed.

Adult↗
PubMedDate not supplied

Evaluation of a multisystems model for treating perinatal cocaine addiction.

Two stages of a gender-specific treatment program for perinatal cocaine-addicted women were introduced into a coed peer-led day treatment program and evaluated for outcomes. Stage I (N = 21) targeted gender-specific needs, but did not expressly promote family reintegration. Stage II (N = 27) augmented the gender-specific program with a multisystems model for family reintegration. As a control for historical effects, nonperinatal clients whose treatment remained the same during the periods corresponding to the two stages, were evaluated for outcomes (N = 66 for Stage I, N = 75 for Stage II). As hypothesized, urine toxicology and retention data were significantly improved for perinatal clients treated in Stage II, as compared with those treated in Stage I; no such improvements were noted for non-perinatal clients. The data support a conclusion that introducing a multisystems framework into a gender-specific program selectively improves clinical outcomes for inner-city perinatal cocaine-addicted women.

Adolescent↗
PubMedDate not supplied

Self-help large-group therapy for alcoholism: a controlled study.

An innovative approach to ambulatory alcoholism treatment is proposed, based on adapting a self-help modality to the institutional clinic setting, for more cost-effective care. It draws on the principles of social influence in large groups, and diffuses the therapist's perogatives among more advanced patients. The program thereby operates with half the usual counseling staff. In this study (n = 235), a controlled comparison of this approach was made with more conventional clinic treatment, based on small-group therapy. Retention and visit rates of the experimental patients over 1 year of care were no different from the control patients, and engagement of inpatients into ambulatory care was more effective.

Alcoholism↗