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P Castelnuovo-Tedesco

Publications and source records attributed to P Castelnuovo-Tedesco.

At least 19 recordsLinked to original sources
PubMed1999

A symposium on psychotherapy in the age of managed care.

This article is based upon a symposium presented at Vanderbilt University Medical Center on the Department of Psychiatry's 50th anniversary (September 20, 1997). The panel of psychotherapy scholar-clinicians discusses issues including: whether or not managed care and psychotherapy are compatible; the relevance of the Consumer Reports' psychotherapy study to MCOs' emphasis on brief therapy; how MCOs impact upon the therapist-patient relationship; the effects of MCOs on the psychotherapist's personal and professional identity; and training psychotherapists in the era of managed care. The paper is dedicated to Pietro Castelnuovo-Tedesco, M.D., Vanderbilt's Blakemore Professor of Psychiatry, who died on January 24, 1998.

Humans↗
PubMed1997

The psychological consequences of physical illness or defect and their relationship to the concept of deficit.

This paper describes the psychological consequences of physical illness or defect and examines their relationship to the concept of deficit which, in turn, has often been contrasted with psychological conflict. The psychological consequences of physical illness or defect differ in response to various parameters, particularly whether the defect is small, moderate, or severe. Typically, each has its special characteristics, which are considered here in detail. The author underscores that the concept of deficit, which refers to deficiencies in the structuralization of the personality, remains of uncertain scope and definition, despite its frequent use in recent years, mainly in the context of self psychology. Most important is to clarify the relationship between deficit and conflict. The paper explores the terms "defect," "deficiency," "deficit," and "sense of defectiveness"--all of which have similar but different meanings. A further complication arises because these terms have been used sometimes descriptively and atheoretically or as metapsychological concepts embedded in various aspects of psychoanalytic theory.

Body Image↗
PubMed1994

The "widening scope" reconsidered. Where do psychoanalysis and psychoanalytic psychotherapy meet?

This paper reviews the current status of the relationship between psychoanalysis and psychoanalytic psychotherapy and notes that, since the 1950s, the scope of indications for psychoanalysis has widened so that it has absorbed some of the clinical territory previously assigned to psychoanalytic psychotherapy. Simultaneously, these developments have brought changes in therapeutic technique and more blurring of the boundaries between these two approaches. By examining the manifestations of transference and their management both in psychoanalysis and in psychoanalytic psychotherapy, the author offers the view that these modalities of treatment, though linked in multiple ways, are basically different and that each has its preferential indications.

Humans↗
PubMed1990

Heterogeneity of personality traits in massive obesity and outcome prediction of bariatric surgery.

The search for heterogeneity of personality characteristics amongst the massively obese is extended to a larger sample (n = 215) of both males (n = 83) and females (n = 132). The Minnesota Multiphasic Personality Inventory standard scales serve as the data base for a cluster analysis which has yielded four clusters: cluster 1 (n = 36) where all scales fell well within normal limits; cluster 2 (n = 112) was coded as 3-1 and was also within normal limits; cluster 3 (n = 44) was coded as spike 4; and cluster 4 (n = 23) was coded as 2-1-7-3-8-4. Cluster membership was not related to surgeons' four-year follow-up overall outcome rating. Discriminant function analysis yielded two variables (patient age and MMPI scale 1 T-score) which were significant predictors of subsequent outcome. The results suggest that there is heterogeneity of personality traits among the massively obese and offer encouragement to the search for variables that are even more effective predictors of the outcome of bariatric surgery.

Cluster Analysis↗
PubMed1982

Long-term outcome of jejuno-ileal bypass surgery for superobesity: a psychiatric assessment.

In this study of the long-term psychosocial consequences of jejuno-ileal bypass, 24 patients were assessed with psychiatric interviews and psychological tests 4-12 years after the procedure. Twenty patients had had a good overall response to the surgery, and 4 had had a poor response. Most complications, physical and psychiatric, occurred during the first 3 years. Most patients with a good postoperative result maintained it for many years, gained occupationally and vocationally, were pleased with the results of the operation, and were willing to recommend it to others. Even those who had experienced complications tended to underrate their seriousness and to express satisfaction.

Adult↗
PubMed1980

Jaw-wiring for obesity.

Fourteen of nineteen-self referred obese women were treated for weight reduction by jaw-wiring. Most were immature, passive-dependent or passive-aggressive personalities. Only one-third of the group completed the study, which was six months in length. All lost weight initially, but about two-thirds later regained some weight. At first all responded with enthusiasm, but later most felt discouraged and found jaw-wiring difficult to accept. Only two patients derived significant benefit. There were no dental complications. Jaw-wiring appears to be a safe but ineffective means of controlling weight, especially if applied to patients with poor motivation and immature personalities.

Adult↗
PubMed1978

Ego vicissitudes in response to replacement or loss of body parts. Certain analogies to events during psychoanalytic treatment.

A comparison is made between the analytic experience and two distinct kinds of surgery, i.e., organ transplant operations and more traditional surgical procedures. Basically, the first add new parts, while the latter remove old parts. This fundamental difference influences patients' response to the surgical intervention. Similarly, in analysis one can identify phases when the patient is troubled over the possibility of acquiring new parts of the self, and other phases, usually later in treatment, when he mourns the loss of old and familiar parts. These generalizations bear on the problem of resistance to change during analysis and patients' fears about permitting themselves to be influenced by analytic treatment.

Adult↗
PubMed1976

Intestinal bypass surgery for obesity decreases food intake and taste preferences.

Food intake was measured in 22 obese patients before and after jejunioleostomy for obesity. Most of the weight loss could be accounted for by the observed reduction of caloric intake. Malabsorption was also present as indicated by increased loss of fat in the stools, and decreased absorption of D-xylose and vitamin B12. A dislike for sweet tastes developed after surgery in most patients. Preferences for concentrated solutions of sucrose and glucose were reduced after patients showed a depression of food intake by a 440-calorie preload which had not been detected before surgery. These studies show a decrease in food intake after intestinal bypass surgery and suggest a role for taste or other gastrointestinal factors in regulating food intake.

Adult↗
PubMed1976

Studies of superobesity: II. Psychiatric appraisal of jejuno-ileal bypass surgery.

The authors studied 12 superobese women for 10 months to 3 years following jejuno-ileal bypass surgery. All patients had significant weight loss to near normal levels and were pleased with their newfound capabilities in the areas of physical, social, and sexual activities. Enhanced self-esteem, initiative, and assertiveness were noted. Although there were no serious postoperative psychiatric complications, patients experienced more mood lability and greater awareness of anxiety, depression, and irritability; their necessary adjustments in lifestyle strained relationships with spouses and parents in some cases. The principal drawback of the procedure was the occurrence in 7 patients of major somatic complications, with concomitant discouragement and apprehension.

Adaptation, Psychological↗
PubMed1975

Studies of superobesity: I. Psychological characteristics of superobese patients.

Close study of twelve superobese women revealed the following principal characteristics. None had a serious psychiatric illness, but most showed moderate personality disturbances with predominant passive-aggressive traits. Depressive features, though common, were not severe. Food typically had been used to allay feelings of emotional deprivation present since early childhood and historically associated with the unstable marriages of these patients' parents. The label "oral character" is not sufficient to provide even a capsule description; stubbornness, defiance, needs for autonomy and wariness of entangling relationships as well as conflicts over exhibitionism also were prominent. These characteristics contribute to the traditional reputation of the obese as "difficult" patients and deserve greater attention to help improve the effectiveness both of standard medical management and of psychotherapy.

Adult↗