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Biomedical subjects

R M Berlin

Publications and source records attributed to R M Berlin.

30 records · Page 2Linked to original sources
PubMed1984

Management of insomnia in hospitalized patients.

In hospitalized patients, the commonest causes of acute insomnia are the effects of illness, environmental sleep disruption, medication, anxiety, and depression. Treatment should correct underlying medical disorders; reduce environmental sleep disruptions; and lower anxiety with psychological interventions, sedative or hypnotic medication, and relaxation training. Special clinical problems include chronic pain, delirium, and insomnia in the elderly.

Age Factors↗
PubMed1983

Withdrawal after substitution of a short-acting for a long-acting benzodiazepine.

A withdrawal syndrome occurred in two patients after substitution of a short-acting benzodiazepine for a long-acting benzodiazepine. Both patients had used long-acting benzodiazepines on a daily basis for many years. In one case, oxazepam was substituted for diazepam, and in the other, temazepam was substituted for flurazepam hydrochloride. In both cases the short-acting benzodiazepine was substituted in a once-daily dosage. Withdrawal symptoms followed and persisted for at least one month. Relative advantages and disadvantages of short-acting and long-acting benzodiazepines are discussed.

Anti-Anxiety Agents↗
PubMed1983

The role of psychiatrists in family medicine training.

The authors surveyed 356 family medicine residency training directors to determine the role of psychiatrists in family medicine training. Two hundred five responses were received, covering the training experiences of 3696 residents. Psychiatrists were actively involved in the training programs, but their role was circumscribed to areas of traditional, demonstrated expertise. Most of the program directors rated psychiatrists as highly useful. Programs rating psychiatrists highly useful differed from low usefulness raters only in having both general psychiatry and consultation-liaison rotations available. This lends support to the hypothesis that consultation-liaison activities provide the most useful method of integrating psychiatrists into family medicine training programs.

Behavioral Medicine↗
PubMed1983

Psychiatric symptomatology in an outpatient neurology clinic.

The self-report Symptom Checklist-90 (SCL-90) was used to screen 105 consecutive first-visit patients in an outpatient neurology clinic. Neurologists diagnosed a primary psychiatric disorder in 35 patients (33%) and a secondary psychiatric disorder in 5. The SCL-90 uncovered previously unidentified emotional distress in 14 patients, for an overall incidence of psychiatric symptoms of 51%. Pain was the most common chief complaint (N = 49), and pain patients accounted for 86% of the primary psychiatric diagnoses. Tricyclic antidepressants were the most often prescribed medications; 81% of these prescriptions were given to pain patients, usually in low doses. Depression was the most common diagnosis (N = 15). Despite the high incidence of psychiatric symptoms, only 3 patients received a psychiatric referral. Neurologists and consulting psychiatrists should maintain a high index of suspicion for psychiatric symptoms when examining patients complaining of pain and, after assessing the presence and severity of depression, prescribe tricyclics judiciously.

Adolescent↗
PubMed1981

The patient care crisis in community mental health centers: a need for more psychiatric involvement.

The authors examine the role of psychiatrists in community mental health centers and suggest that extensive psychiatric involvement is needed to ensure proper patient care. Within the context of four basic clinical models--social, psychological, behavioral, and biomedical--they describe the psychiatrist's unique clinical skills in history taking, differential diagnosis, case formulation, use of psychopharmacologic agents, and provision of leadership in patient care. Five case reports illustrate instances in which psychiatric intervention corrected serious problems in diagnosis and treatment that otherwise would have resulted in inadequate care or harm to the patient.

Adolescent↗
PubMed1980

Severe vomiting in a diabetic woman. Psychological considerations.

A 50-year-old diabetic woman experiencing 20 episodes of vomiting each day was admitted to the hospital. When vigorous medical management failed to control the vomiting, psychiatric consultation indicated that psychological factors, especially displaced anger and an early childhood history of gastrointestinal sensitivity, combined with autonomic neuropathy and uremia to produce the symptom. A multimodal treatment regimen including continued medical management, supportive psychotherapy, relaxation training and mental imagery exercises effected a dramatic improvement.

Anger↗