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Biomedical subjects

T Trauer

Publications and source records attributed to T Trauer.

At least 37 records · Page 2Linked to original sources
PubMed1995

Ethnic differences in the utilisation of public psychiatric services in an area of suburban Melbourne.

OBJECTIVE: The main aim of this study was to compare levels of service use by English and non-English speaking background people. METHOD: A comparison of service use in 1991/1992 between clients of English speaking (ESB) and non English-speaking (NESB) background was undertaken using hospital inpatient statistics, community mental health centre contact data, interpreter usage figures, and the 1991 Australian census. RESULTS: The main findings indicated: (a) longer median lengths of stay of NESB than ESB inpatients; (b) roughly equal involuntary hospitalisation rates between ESB and NESB residents, but significantly lower rates of voluntary hospitalisation for NESB residents; (c) NESB face-to-face clinic contacts significantly shorter (by between five to ten minutes) than ESB; and (d) variable and generally low use of interpreters. No significant associations between ethnicity, legal status and gender were found. There were limitations in the available data and conclusions could be drawn only with caution. CONCLUSIONS: Recommendations include better routine collection of ethnically relevant information, and measures designed to improve the acceptability and accessibility of inpatient services.

Adolescent↗
PubMed1985

Cystic fibrosis in adult life: a study of coping patterns.

Despite comparable degrees of physical disability, some patients with cystic fibrosis (CF) cope more successfully than others with the difficulties of competitive adult life. This study found substantial differences between a coping and non-coping sample of adult CF patients. Non-copers had twice as many hospital admissions as copers over a year, even though their ventilatory function was better. The non-coping sample compared unfavourably with the copers in four main spheres of psychosocial functioning--their vocational records; level of family support; awareness of anomalies in sexual function; and knowledge about CF.

Adolescent↗
PubMed1983

A study of collective disturbed behaviour among psychiatric patients.

An investigation was conducted over a 40-week period in which staff completed weekly a list of 34 items representing aspects of disturbance for all patients in a modified therapeutic community comprising male and female wards. Four principal components accounted for about half the variance in both the men's and women's disturbance data. The first components in both groups represented general disturbance. Subsequent components in the men concerned rejection and withdrawal, nocturnal disturbance, and physical aggression, whilst among the women the later components reflected hysterical acting-out, withdrawal and 'opting out', and self-directed and indirect forms of aggression. There was only an insignificant relationship between the general disturbance levels in the two wards. A number of variables, including the level of disturbance predicted from the diagnostic composition of the ward, average length of stay, and numbers of patients in the wards were found to correlate with the weekly levels of disturbance. In the men's ward, a 12-week cycle of general disturbance was found. An occasion of disruption to the routine of the unit (Christmas) was implicated in an episode of high disturbance.

Adult↗
PubMed1983

A comparison of purposeless movements in psychiatric patients treated with antipsychotic drugs, and normal individuals.

Oro-facial dyskinesia and purposeless trunk and limb movements were assessed, using a standard videotape rating technique, in 182 psychiatric patients receiving antipsychotic medication, in a second sample of 43 elderly psychiatric patients also receiving antipsychotic drugs, and 85 normal, drug-naive subjects. In both the first patient sample and the group of normal subjects, oro-facial dyskinesia was more common over 50 years of age. Statistical analysis of the data suggested that drug-induced oro-facial dyskinesia has a characteristic pattern of movement distribution significantly different from that of idiopathic oro-facial dyskinesia. The videotapes of the first patient sample and the normal subjects were viewed by a neurologist who assessed and categorised all movements. Purposeless trunk and limb movements were classified as either normal or abnormal. Normal purposeless movements were significantly more common in the drug-naive subjects. The presence of abnormal movements such as choreiform movements, dystonias and stereotypies and mannerisms was limited, almost exclusively, to the patients.

Adolescent↗
PubMed1983

Assessment of outcome after psychosurgery using the Present State Examination.

The aim of the study was to explore the way psychiatric symptoms might influence independent psychiatric assessment of outcome one year after stereotactic subcaudate tractotomy. In a sample of 34 patients consecutively accepted for psychosurgery the results showed that both 'good' and 'poor' outcome groups improved overall. No patients were significantly worse and the symptoms which improved most were nervous tension, depressed mood and somatic anxiety. It was not possible to identify symptomatic predictors of outcome because the preoperative symptom profiles of both groups were so similar. The reason why symptomatic outcome is so variable despite a basically identical psychosurgical technique is discussed.

Caudate Nucleus↗
PubMed1982

Ward environment and disturbed behaviour.

Disturbed behaviour and dissatisfaction were studied in relation to two contrasting ward environments, one representing the 'medical model' of psychiatry and the other being a modified form of 'therapeutic community'. Specially designed forms were used for 18 months to obtain daily and weekly measures of behavioural disturbance from the nurses and of dissatisfaction with various aspects of the ward environment fom the patients. The results suggested that the 'therapeutic community' ward was significantly more disturbed, and that disturbance on that ward varied according to the day of the week, something which did not happen on the 'medical model' ward. Differences in disturbance between diagnoses were also found. Disturbance was significantly correlated with, and tended to precede, dissatisfaction only in the 'therapeutic community' ward.

Adult↗
PubMed1982

Effects of staff changes on psychiatric patients.

The disturbed behavior and dissatisfaction of patients were studied in relation to nurse and junior and senior doctor changes in two different psychiatric wards. One ward represented the medical model of psychiatry and the other a modified form of therapeutic community. The results showed no statistically significant relationship between the weekly level of disturbed behavior and staff changes in either ward. There was a tendency for patients to become more dissatisfied when the nurses left the ward and less dissatisfied with the arrival of senior doctors in the medical model ward only.

Adult↗
PubMed1982

Reliability and validity of a tardive dyskinesia videotape rating technique.

Ninety-four psychiatric in-patients, receiving regular antipsychotic medication, were videotaped using a standard procedure. The tapes were rated by blind observers using a simple scoring system for the duration of abnormal movements. Using this combined videotape and rating scale assessment technique the re-rating reliability, inter-rater reliability and test-retest reliability were high. In order to demonstrate the validity of the technique the rating scale scores in a sub-sample of 30 patients, were compared with the assessment of three experienced clinicians on the same patients, and AIMs scores. Central (lip, tongue, jaw and neck movements) scores showed close agreement with the clinicians' assessment, suggesting that clinical diagnosis is based principally on the presence and severity of oro-facial dyskinesia. Total rating scale scores were in close accord with total AIMs scores. When the two scales were carried out on the same patients on the same occasion a diagnostic criterion level of 2 or more on the central score produced a tardive dyskinesia prevalence rate identical to that produced by an AIMS criterion level of 2 or more on the global severity rating. The tardive dyskinesia prevalence rate based on the central score criterion level showed an increase with age.

Aged↗
PubMed1980

Sub-syndromes of tardive dyskinesia.

A reliable method for recording the site and duration of purposeless movements was devised. With this method 267 subjects were studied, 182 of whom had been exposed to neuroleptics. The results were submitted to a principal components analysis and 3 movement dimensions emerged. One group of movements resembled a parkinsonian syndrome. The other 2 groups of movements both conformed to the generally accepted criteria for tardive dyskinesia. These groups were: (1) head and neck movements and (2) trunk and limb movements. The possibility of the second and third groups representing clinically relevant sub-syndromes of tardive dyskinesia is discussed.

Dyskinesia, Drug-Induced↗
PubMed1980

Psychiatric patients' opinions of nurses ceasing to wear uniform.

Psychiatric patients at two general hospitals were asked whether they felt that nurses on their ward should wear uniforms or mufti. In one of the hospitals the procedure was repeated immediately after the nurses changed from uniforms to mufti and again at 5 and 7 month intervals. The results showed a general preference among patients for nurses to wear uniforms and there was no clear trend over time for increased acceptance of mufti on the wards which changed. There is a clear tendency for older patients to prefer uniforms, and it was only in the patients aged 29 or less that a preference for mufti could be discerned.

Adult↗
PubMed1980

Correlates of patient participation in the large group meetings of a therapeutic community.

In view of the importance of verbal communication in community meetings, an attempt was made to identify the characteristics of patients with differing average levels of communication. Paper-and-pencil recordings of 117 consecutive community meetings in a psychiatric unit run along therapeutic community lines yielded average communication scores on 237 patients. Scores were unrelated to sex, age, social class, length of stay, in-patient or day-patient status and questionnaire measures of total hostility and attitude towards psychiatric treatment. Patients who talked much were characterized by manic and personality disorder diagnoses and were hysteroid and extrapunitive on questionnaire measures. They attended a high proportion of meetings held during their admission and contributed verbally to almost all meetings they attended. They frequently became the subject of discussion in meetings, and they tended to be high on objective and consensual measures of rule-breaking. Patients with low level of verbal communication were likely to have anorexic, organic or psychotic depressive disorders. The results are discussed in terms of Berne's distinction between 'performers' and 'audience' and the presumed functions of community meetings.

Adolescent↗
PubMed1978

Size of cerebral ventricles in 66 psychiatric patients.

The routine air ventriculograms of 66 psychiatric patients, aged from 22 to 73 years, taken during the psychosurgical operation of stereotactic subcaudate tractotomy, were studied. Ventricular size was unrelated to progressive ageing, but a minority of patients over 60 years had abnormally large ventricles, not invariably associated with cognitive impairment on testing. Enlargement was associated with a clinical diagnosis of schizoaffective illness but not with past ECT.

Adult↗