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Biomedical subjects

M K Popkin

Publications and source records attributed to M K Popkin.

At least 55 records · Page 3Linked to original sources
PubMed1983

Consultation-Liaison outcome evaluation system. I. Consultant-consultee interaction.

The Consultation-Liaison Outcome Evaluation System characterizes the effectiveness of consultative activities. The initial phase of the system identifies consultees' responses to psychiatric consultants' recommendations and diagnoses and the variables critical to concordance with the use of quantitative measures. The observed incidence and concordance rates of the consultant-consultee interaction were integrated (1) to establish a concordance hierarchy clarifying consultees' priorities in seeking psychiatric consultation, (2) to provide reference points to guide psychiatric consultants' clinical actions, (3) to establish tentative standards with which to evaluate the effectiveness of psychiatric consultation, and (4) to signal the need for further outcome studies and the development of data-based consultation practices.

Clinical Competence↗
PubMed1983

Consultation outcomes. The psychiatrist as consultee.

The frequent coexistence of psychiatric and medical illness supports the need for excellent medical care on inpatient psychiatric services. Effective use of consultation is an important element in ensuring this care. In our study of medical-surgical consultation to an inpatient psychiatric service during a two-year period, outcome variables, such as frequency of and concordance with drug and diagnostic action recommendations, were determined and compared with similar data for psychiatric consultations to medical-surgical services. Thirty-eight percent of cases received a consultation. Patients seen by a consultant had a longer hospital stay. Twenty-seven and forty-six percent of consultantions contained a drug or a diagnostic action recommendation, respectively. The concordance of psychiatric consultees was 79% for drugs and 75% for diagnostic action recommendations. Comparison with medical-surgical consultations done by psychiatric consultants revealed important important differences and similarities.

Adult↗
PubMed1983

Organic anxiety syndrome.

DSM-III defines and offers diagnostic criteria for organic affective, organic delusional, and organic personality syndromes but provides no organic personality syndromes but provides no organic equivalent for anxiety disorders. Nevertheless, symptoms of anxiety characterize such conditions as hyperthyroidism and pheochromocytoma. The authors define and formulate diagnostic criteria for an organic anxiety syndrome and discuss the theoretical and therapeutic implications.

Adrenal Gland Neoplasms↗
PubMed1983

Clinical applications of DSM-III in consultation-liaison psychiatry.

The authors examine the clinical application of DSM-III from the perspective of the consultation-liaison psychiatrist. They discuss contributions of DSM-III that have refined psychiatric diagnosis in medical-surgical settings, including the multiaxial system, a broader approach to the organic mental disorders, introduction of the category of psychological factors affecting physical condition, and an improved classification of disorders that present with physical symptoms. However, some areas of continuing ambiguity remain, such as how much discretion a clinician has to discount somatic symptoms related to physical illness in the diagnosis of depression, the implications of exempting bereavement from diagnostic status, and uncertainty about what constitutes evidence of an etiological relationship.

Diagnosis, Differential↗
PubMed1983

Antidepressant drug therapy and sexual dysfunction in men: a review.

Medical literature concerning sexual dysfunction associated with antidepressant drug therapy in men is reviewed. Available information consists mainly of individual case reports or small series of cases. A complicating factor in understanding this area is the lack of sufficient information concerning sexual dysfunction associated with depression. Both erectile dysfunction and ejaculatory problems have been reported with the use of the clinically available antidepressants. No single agent seems to be implicated more frequently than the other drugs. Changes in libido have also been reported. The authors found no reported cases of priapism, which has been reported as a side effect of antipsychotic therapy.

Antidepressive Agents↗
PubMed1982

Yield of psychiatric consultants' recommendations for diagnostic action.

The results of diagnostic measures proposed by psychiatric consultants were examined in a retrospective study of 793 medical records. Of 302 recommendations implemented by consultees, 137 yielded abnormal findings. Abnormalities were widely distributed among laboratory determinations, diagnostic procedures, and psychological tests. Highest yields were associated with EEGs, thyroid function studies, vitamin B12 and folate levels, and the Minnesota Multiphasic Personality Inventory. Two thirds of cases with one or more implemented recommendation were found to have an abnormal result. These findings suggest that consultees may curtail medical examinations of patients with psychiatric symptomatology. The outcomes demonstrate the merits of the diagnostic recommendations offered by psychiatric consultants and underscore the advantages conferred on patient and consultee by a consultant with a firm base on medical knowledge.

Electroencephalography↗
PubMed1982

Antipsychotic drug therapy and sexual dysfunction in men.

The authors review the literature on male sexual dysfunction associated with antipsychotic drug treatment. Erectile and ejaculatory disturbances have been most frequently reported. Changes in libido have also been reported, but the effects of these drugs on sexual drive have apparently not been systematically studied. Fortunately, most types of sexual dysfunction associated with antipsychotic drugs appear to be medically benign and reversible with drug discontinuation. An exception is priapism, which necessitates prompt urological consultation and may require surgical intervention.

Antipsychotic Agents↗
PubMed1982

The medical care of psychiatric patients.

Longitudinal and cross-sectional data have demonstrated a high incidence of physical illness among psychiatric patient populations. Problems involved in the treatment of medically ill psychiatric patients include the nonspecificity of psychiatric symptoms, the inadequacy of previous examinations by a nonpsychiatric physician to rule out the possibility of physical disease causing psychiatric symptoms, and the patient's lack of awareness of current or pre-existing physical disease when consulting the psychiatrist. The following review examines nine categories of medical disorders that are known to produce psychiatric symptoms, with discussion of the psychiatric manifestations. Implications for current practice and training are briefly considered.

Brain Neoplasms↗
PubMed1981

An interdisciplinary comparison of consultation outcomes. Psychiatry vs cardiology.

Responses to cardiologists' and psychiatrists' recommendations for drugs and diagnostic actions were compared in a retrospective study of 788 consultations. Variables significantly related to outcome achieved by cardiologists and psychiatrists were identified; similarities among these variables were evident only for the drug recommendations. Cardiologists' recommendations achieved a higher rate of concordance than psychiatrists' for both drugs and diagnostic actions. For drug recommendations, the interservice discrepancy in concordance was directly related to differences in timing of the consultations and incidence of recommendations to start a drug. For diagnostic recommendations, however, the difference was directly related to the consultants' service. The following factors may explain the less favorable outcome for psychiatrists' diagnostic recommendations: (1) the reasons for seeking psychiatric consultation, (2) the consultees' expectations, and (3) the skill of the psychiatrists in offering these recommendations.

Cardiology↗