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Biomedical subjects

M K Popkin

Publications and source records attributed to M K Popkin.

At least 91 records · Page 5Linked to original sources
PubMed1978

Covert outpatient drug abuse. Incidence and therapist recognition.

One hundred ninety-five consecutive psychiatric outpatients were surveyed for covert drug abuse by a standardized technique for determining opiates, cocaine, barbiturates, and amphetamines in urine samples. On the basis of demographic variables, diagnostic information, and treatment course, patterns of abuse were defined for the 13.3 per cent with positive test results. Covert abusers demonstrated a higher incidence of adverse drug reactions and a less favorable therapy course than controls. Covert abuse was meaningfuly related to misdiagnosis, management problems, and therapist's response. Demographic variables and patient reports of previous abuse were not found to be reliable predicators of covert drug abuse. Urine screening for drug use is recommended as an aid to proper diagnosis of psychiatric outpatients that present diagnostic questions.

Adolescent↗
PubMed1977

Angel's Trumpet psychosis: a central nervous system anticholinergic syndrome.

The authors warn physicians that intoxication by Angel's Trumpet (Datura sauveolens) is becoming more frequent due to its use by adolescents and young adults as a legal, readily available hallucinogen. Ingestion of Angel's Trumpet flowers or a tea brewed from them results in an alkaloid-induced central nervous system anticholinergic syndrome characterized by symptoms such as fever, delirium, hallucinations, agitation, and persistent memory disturbances. Severe intoxication may cause flaccid paralysis, convulsions, and death. Treatment with intravenous physostigmine reverses the toxic effects of Angel's Trumpet.

Acetylcholine↗
PubMed1977

The effect of unrecognized drug abuse on diagnosis and therapeutic outcome.

One-hundred and ninety-five consecutive psychiatric outpatients had urine sampled for the presence of opiates, cocaine, barbiturates, and amphetamines. All patients had demographic variables, diagnostic information, and treatment course analyzed in a blind fashion using preselected criteria. Patterns of abuse were defined for the 13.3% of the total sample who were covert abusers. An analysis of diagnostic accuracy for abusing and nonabusing populations indicated that covert abuse markedly distorted diagnosis and management. The study indicates that demographic variables and previous history were not reliable predicators of covert abuse. Drug abuse was a major factor in distorting the accuracy of diagnosis. Drug abusers were significantly less likely to improve with therapy than were nonabusers. Barbiturate abusers were most likely to suffer from adverse drug reactions. Urine screening for drugs was the single most valuable diagnostic tool and was felt to be indicated in all cases where diagnostic confusion was present. Therapists saw the covert abuser as sick out of proportion to their social behavior, were perplexed and frightened by these patients' dependency, and perceived them as too brittle for therapy. Therapists behaved very differently with these patients than with diagnostically matched controls. They misdiagnosed them four times more often, missed appointments with them seven times more often, and were ten times more likely to refer them to another therapist or agency. Therapist anxiety and "flight from therapy" with covertly abusing patients are discussed.

Adolescent↗
PubMed1976

Recent life changes and outcome of prolonged competitive stress.

To test the predictive utility of subjects' recent life changes with regard to outcome of prolonged competitive stress, the authors studied racers (N = 25) in a long distance Alaskan sled race, the Iditarod. Rank order correlations between subjects' 1-year life change units (LCU) total and adjusted place of finish proved significant by both Kendall's and Spearman's Test. Thus, lowe LCU scores correlated with better performance and higher scores with poorer performance. Differences between subgroupings of the racers are considered. The work suggests that the usefulness of recent life changes assessment may be extended beyong physical illness, particularly in the study of response and adaptation to prolonged stress.

Age Factors↗
PubMedDate not supplied

Mummification and folie à deux.

Mummification is the preservation of the effects and/or corpse of a loved one. Psychiatric literature regarding this condition is reviewed and a case is presented in which a mother's paranoid psychosis is discovered following her apparent mummification of her son's corpse. In retrospect, it appears that a diagnosis of folie à deux pertained to this pair. The authors contend that mummification may represent the outcome of a shared delusional system and that failure to establish psychiatric diagnoses in those who practice mummification has been the result of inherent difficulties in diagnosing paranoid disorders.

Aged↗
PubMedDate not supplied

Lifetime prevalence of psychiatric disorders in patients with alopecia areata.

Thirty-one patients with alopecia areata were administered a structured psychiatric interview (the Diagnostic Interview Schedule; DIS). Overall, 74% had one or more lifetime psychiatric diagnoses. Particularly noteworthy were the high lifetime prevalence rates of major depression (39%) and generalized anxiety disorder (39%). In addition, patients reported increased rates of psychiatric disorders in first-degree relatives: anxiety disorders (58%), affective disorders (35%), and substance use disorders (35%). Patients with patchy alopecia areata were more likely to have a diagnosis of generalized anxiety disorder. No relationships were found between major depression and any variable characterizing alopecia areata history. Possible interrelationships between psychiatric disorders and alopecia areata are discussed. The study suggests that patients with alopecia areata are at increased risk for psychiatric disorders, and calls attention to the need for psychiatric assessment in this population.

Adolescent↗
PubMedDate not supplied

Psychiatric diagnosis and the surgical outcome of pancreas transplantation in patients with type I diabetes mellitus.

To examine the role of psychiatric diagnosis in the surgical outcome of pancreas transplantation, we studied candidates with type I diabetes mellitus. Eighty of 140 candidates underwent transplantation. Survival analysis found the extent of human leukocyte antigen-DR (HLA-DR) matching, two diagnoses, and patients' perceived support from first-degree relatives to be related to duration of full-graft function. Lifetime diagnoses of tobacco use disorder (P = 0.029) and alcohol abuse/dependence (P = 0.006) were associated with less favorable outcomes; perceived support was associated with positive outcomes (P = 0.048). Subsequent analysis suggested that the four variables independently and directly affect outcome.

Adaptation, Psychological↗