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Biomedical subjects

T J Craig

Publications and source records attributed to T J Craig.

At least 91 records · Page 5Linked to original sources
PubMed1985

Clinical correlates of readmission in a schizophrenic cohort.

A study of a cohort of 223 schizophrenic patients from a single catchment area followed up for two years after discharge from inpatient status revealed a significant association between the presence of two of 38 clinical problem categories (social withdrawal and drug abuse) and subsequent readmission. In addition, patients without social withdrawal who were readmitted showed a significantly greater use of aftercare services than those not readmitted, while, among those with social withdrawal, male patients were significantly more likely to be readmitted than female patients. Neither prior hospitalization nor the presence of affective symptoms were significantly associated with readmission. Clinical and research implications of these findings are discussed.

Follow-Up Studies↗
PubMed1985

Measurement of mood and affect in schizophrenic inpatients.

Ratings of mood and affect using the Brief Psychiatric Rating Scale (BPRS), the Hamilton Rating Scale for Depression, the Center for Epidemiologic Studies Depression Scale (CES-D), and an affective flattening scale in 32 male schizophrenic inpatients revealed high total scale reliability but lower intra-item reliability, especially for specific depression items. Interscale correlations suggested several dimensions of mood and affect: anxiety-depression (psychological dysphoria, motor activation, and somatic symptoms), retardation-affective blunting, thought disturbance, and hostility-suspiciousness. Correlation with a rating of extrapyramidal symptoms suggested an association with the presence of depressive symptoms. These results suggest that although adequate total scale reliability was obtained, these indexes of depression may measure different dimensions in schizophrenic patients than they do in patients with affective disorders.

Adolescent↗
PubMed1985

Informed consent as a form of volunteer bias.

Two nontreatment studies of tardive dyskinesia were examined to see if giving or refusing informed consent might bias results. Three prominent psychiatric journals were also reviewed to determine whether the outcome of informed consent procedures was sufficiently well described to permit evaluation of potential bias. The nontreatment studies suggested that the bias created by requiring informed consent may cause both false-positive and false-negative findings. The literature review showed that treatment studies have generally ignored the potential impact of these biases on results. Accurate interpretation of research reports, particularly clinical trials, demands that more attention be given to the process of obtaining and reporting informed consent.

Adolescent↗
PubMed1984

The current systems assessment and the clinical care process. A tool for clinical supervision and the design of clinical information systems.

A side benefit of a current systems assessment carried out prior to automation was the development of a systematic picture of the clinical care system as captured in the system flow chart. The results of this assessment provided clinical administrators with a blueprint identifying the current system's strengths and weaknesses, which could be used both to introduce improvements and to measure the effect of such changes totally apart from the initial question of automation.

Delivery of Health Care↗
PubMed1984

Clinician-computer interaction: automated review of psychotropic drugs.

Five years after its introduction at a state mental hospital, an automated drug exception review system continues to show a long-term impact on the prescribing practices of hospital physicians. Although the overall rate of exceptions has remained low, approximately 25% of all new exceptions pointed out by the computer result in a change in the order by the physician. The fact that 60% of new exceptions are justified suggests that some forms of polypharmacy may be appropriate. The integration of the exception-reporting system into the clinical review process has avoided the danger of the computer's being seen as an adversary to the clinician or as exerting undue control over psychopharmacologic prescription practices.

Attitude of Health Personnel↗
PubMed1984

The dynamics of hospitalization in a defined population during deinstitutionalization.

In a sample of 1,032 psychiatric inpatients studied for 1 year, chronic patients (more than 6 months' inpatient stay) represented 17.4%, almost half of whom were discharged during a 2-year follow-up; an additional 19.4% died. The incidence of "new" long-stay patients was 8.6/100,000 population, which, if constant over time, would result in a net increase of long-stay patients. Most chronic long-stay patients had a diagnosis of schizophrenia or organic brain syndrome. The two diagnostic groups had strikingly different patterns of deinstitutionalization. Alcoholic patients and those with "other" diagnoses demonstrated chronic dependence on the hospital, characterized by short inpatient stays and high readmission rates.

Alcoholism↗
PubMed1983

The relationship between socioeconomic class and prevalence of schizophrenia, alcoholism, and affective disorders treated by inpatient care in a suburban area.

This study relates inpatient-treated prevalence of the three mental illnesses most often requiring inpatient treatment--schizophrenia, alcoholism, and affective disorders--to social class in a suburban area. Rates were developed for the total population, including those living in domiciliary care, for those living in households only, and for first-admission patients living in households. Log-linear models supported the finding that low socioeconomic status was related to a high prevalence of alcoholism and affective disorders. In contrast, socioeconomic status was not related to the prevalence of schizophrenia among those living in households or among first-admission patients living in households.

Adolescent↗
PubMed1983

Disability and depressive symptoms in two communities.

A community survey conducted in Kansas City, Mo., and Washington County, Md., revealed a significant association between symptoms of depression and self-reported disability. No demographic variables showed any consistent relationship to disability. The findings underscore the need for programs designed to identify and treat depression. In addition, any study using disability as an outcome measure must control for level of depressive symptoms.

Alcoholism↗
PubMed1983

Mortality in the era of deinstitutionalization.

The authors examined the 3 1/2-year mortality rate of 1,033 psychiatric patients who had received inpatient treatment during a 1-year period, using standardized mortality ratios to identify heightened risk. Deaths due to accidents or suicides and pneumonia occurred more frequently than expected. Deaths due to cancer occurred primarily among alcoholics; nonalcoholic patients had a significantly lower cancer mortality risk. The risk associated with age was greatest for young patients in general, but male schizophrenic patients and female alcoholics died at particularly young ages. The highest mortality risk associated with diagnosis was for male patients with affective disorders. The authors discuss the implications of these findings.

Accidents↗
PubMed1983

Deinstitutionalization and the survival of the state hospital.

Despite vigorous efforts at deinstitutionalization, the state mental hospital continues to be the locus of care for a wide variety of patient populations. The authors examined the changes in one state hospital's clientele between 1972 and 1980 and discovered a 50 percent reduction in long-stay patients, a 27 percent increase in admissions, and the emergence of a new long-stay population. The authors say that the modern state hospital can be conceptualized as several different facilities under a single administrative roof rather than as a monolithic structure. They conclude that mental health planners must acknowledge the continued existence of a group of patients whose needs are perhaps best served by the state hospital. Strategies must be developed to use the existing hospital resources in the most efficient and effective manner.

Adolescent↗
PubMed1982

Intra-patient variability in the measurement of tardive dyskinesia.

Intra-patient variability in the movements of tardive dyskinesia was examined through the analyses of 8-min frequency counts collected over a period of 11 weeks for six chronic schizophrenic patients. Weekly observation segments of 8 min, 4 min, 2 min, 1 min and 30 s showed considerable variation both across weeks and within sessions. Variations were of sufficient magnitude to contribute to the possibility of false negative tardive dyskinesia assessments and false positive treatment outcome designations. Measurement procedures taking this variability into account are urged for the study of tardive dyskinesia. Additionally, independently obtained rating scale scores showed no association to the collected frequency count data, suggesting fundamental differences between these two assessment procedures.

Dyskinesia, Drug-Induced↗
PubMed1982

An epidemiologic study of a psychiatric liaison service.

An epidemiologic study of 308 consultations revealed substantial differences in referral rates related to the demographic, clinical, and programmatic characteristics of patients and services. Actual liaison was associated with substantially increased referral rates across all age groups. Female patients appeared to have differentially benefited by liaison activities in terms of obtaining appropriate psychiatric intervention. Across all services studied (medicine, neurology, surgery, and obstetrics/gynecology), consultation appeared mainly directed at establishing a specific psychiatric diagnosis and treatment. Markedly different patterns of emotional disturbance were noted across different medical disease categories (e.g., cancer, chronic renal disease).

Adolescent↗