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At least 73 records · Page 4Linked to original sources
PubMed1978

Concurrent diagnostic validity of a structured psychiatric interview.

In order to estimate the concurrent validity of a structured psychiatric interview, we compared interview diagnoses obtained for 101 psychiatric inpatients to those recorded in the same patients' hospital charts. For most diagnoses considered, concordance was found to be high. For those in which concordance was low, we examined the reasons for the diagnostic discrepancy. Diagnostic errors that were judged to have occurred on the basis of the structural interview often seemed to have resulted from a lack of longitudinal clinical observation. However, more errors were judged to have occurred in the hospital charts, apparently because of physician oversight. We conclude that the concurrent validity of this structured interview is high and that such examinations might be useful not only for research but also for the routine initial evaluation of psychiatric patients.

Alcoholism↗
PubMed1980

Structure: the neglected ingredient of community treatment.

Eighty patients in a locked, skilled-nursing facility that serves only psychiatric patients were studied. Of these, 78 were diagnosed as psychotic, 48 had overt major psychopathologic characteristics, and 33 had been physically assaultive within the past 12 months. A third had diagnoses both of psychosis and severe drug and/or alcohol problems. Fifty-eight were unmanageable in previous placements in open settlings. Four of five were resistant to taking psychotropic medications. Six were judged dangerous to themselves. Such patients are extremely difficult to manage in community settings where the need for structure is often overlooked; therefore, this facility, serves as an alternative to the state hospital. Structure is provided not only by security features but also by an intensive treatment and rehabilitation program. This type of facility is contrasted with the state hospital.

Adolescent↗
PubMed1982

Interictal behavior abnormality in temporal lobe epilepsy. A specific syndrome or nonspecific psychopathology?

Two studies examine the degree to which the traits measured by the Bear and Fedio personality inventory are specific to temporal lobe epilepsy. In the first study, none of the 18 traits discriminated among a group of temporal lobe epileptics with behavioral-psychiatric disorders, a group of patients with concomitant neurological and behavioral-psychiatric disorders, and a group of patients with psychiatric but not neurological illness. The second study demonstrated that a very large percentage of variance in the traits can be accounted for by presence or absence of psychiatric illness. The results of these two studies suggest that previously reported differences between temporal lobe epileptics and normals on these trait variables reflect underlying differences in degree of nonspecific psychopathology and do not necessarily indicate the presence of a specific behavioral syndrome in temporal lobe epilepsy.

Dominance, Cerebral↗
PubMed1982

Random number generation, psychopathology and therapeutic change.

In two studies, 145 psychiatric inpatients were each asked to say 100 numbers in random order, using the numbers 1 through 10. Compared with normative data, patients with personality disorders and neuroses were not impaired on the random number generation (RNG) task and patients with chronic alcoholism and primary affective disorder, depression, were significantly imparied, but not as much as those with schizophrenia and organic brain syndrome. The relationship between RNG performance and psychiatric diagnosis may reflect severity of disturbed cognitive functioning. The Randomization Index was sensitive to changes in symptoms during hospitalization. The RNG task provides a brief objective measure of those components of attention, cognitive capacity, and short-term memory that are affected by severity of psychopathology.

Attention↗
PubMed1985

Mortality in a follow-up of 500 psychiatric outpatients. I. Total mortality.

Total or all-cause mortality data were determined from a prospective study of 500 randomly selected psychiatric outpatients during a mean follow-up period of seven years. With the use of age-, sex-, and race-adjusted methods, a mortality nearly twice that expected from reference population rates was observed. Mortality was excessive among younger, but not older, patients; and among white men and women and black men, but not among black women. Certain psychiatric diagnoses (based on structured personal interviews performed at index and using explicit criteria) were associated with excess mortality: alcoholism, antisocial personality, drug addiction, homosexuality, organic brain syndrome, and schizophrenia. Excess mortality was not observed among patients with primary affective disorders, ie, disorders not antedated by nonaffective psychiatric illness.

Adolescent↗
PubMed1998

Legal and ethical duties of the clinician treating a patient who is liable to be impulsively violent.

This paper reviews published tort cases that arose after a patient impulsively hurt or killed someone. Plaintiffs alleged breach of the duty to protect (Tarasoff) or negligent release from hospital. There are sixteen cases involving a variety of facts and diagnoses. As a matter of law courts typically hold that impulsive violence is not foreseeable. One jury found a defendant negligent but that verdict was ultimately overturned. Statutes on duty to protect do not imply a duty to act on the fact patterns of impulsive violence in this sample. The author concludes that the ethical duty to do careful clinical work is essentially identical to the legal duty to use due care in these cases. The law imposes no additional burden on the clinician in these cases.

Disruptive, Impulse Control, and Conduct Disorders↗
PubMed1997

Mortality in elderly patients with organic brain disorder enrolled on the Salford Psychiatric Case Register.

The observed mortality of 397 elderly patients with organic brain disorder, recruited to the Salford Psychiatric Case Register between 1 January 1968 and 31 December 1975 and followed up by record linkage to 31 December 1985, was compared with expected mortality. The overall SMR was 1.91. SMRs were significantly raised for all age groups beyond 65 years, being highest in the younger age-bands and declining almost linearly with age. SMRs were elevated for both men and women, during all calendar periods, for incident and prevalent cases, and throughout the whole follow-up period, being highest in the first year. While social class variations may account for up to 9% of the excess deaths, marital status and ethnic differences had little effect.

Age Factors↗
PubMed1975

The dependence of psychiatric diagnosis on psychological assessment.

This study examined the dependence of 500 inpatient psychiatric diagnoses on the results of standard psychological assessment procedures. A 43% agreement was found between psychological test findings and psychiatric discharge diagnoses. While this level of agreeement is greater than chance, it suggests that psychological test results are not of value in more than one-half of the cases investigated. Specific diagnostic discrepancies between clinical and psychological diagnostic results were noted, and several explanations for these differences were offered.

Alcoholism↗
PubMed1975

Time factor as a prognostic indicator on the Bender-Gestalt test.

Z-scores from Bender-Gestalt records of 62 psychiatric in- and outpatients were computed. The patients were put on active treatment, and a psychiatric rating was done to evaluate therapeutic recovery after a period of 19 to 24 months. These patients were grouped into three categories, i.e., patients with low Z-scores and good therapeutic recovery; patients with high Z-scores and poor therapeutic recovery; patients with low Z-scores who still showed poor response to treatment. Total time taken by each patient to reprduce the BG designs was noted as well. Results indicate that Z-score was a significant prognostic indicator for schizophrenics, affective psychotics, organic psychotics and patients who were suffering from anxiety and conversion reactions, but not for obsessive compulsive neurotics. Time taken for BG reproductions proved to be an important prognostic indicator, as patients who did not respond satisfactorily to the treatment took significantly more time than those who responded well to treatment. Hence, time taken by the patients for BG reproductions also needs to be considered when any predictions are made with regard to therapeutic outcome.

Adolescent↗
PubMed1978

Factors in the rotation of reproduced figures.

Investigated the effectiveness of presenting some of the MPD designs on rotated backgrounds; examination was made of the incidence of a particular rotational error in the records of 246 psychiatric patients. This error, the reproduction of the square of the circle-square design in "square" instead of the correct "diamond" orientation, occurred very much more often when the background was rotated than when it was normal, which confirmed that the orientation of the background had a strong effect on the reproductions. The error was made significantly more often by Ss with brain damage than by those with functional disorders. The findings were discussed in relation to the concept of field-dependence.

Affective Symptoms↗
PubMed1978

Wechsler Memory Scale: a selective review of the literature.

Research on the Wechsler Memory Scale (WMS) is reviewed with respect to questions of its reliability, factor structure, construct validity, and utility. The relationship of Memory Quotient to Full Scale IQ is explored and the conditions under which disparity between the two scores may be clinically useful indicated. Despite its numerous limitations, the WMS has been a sensitive test of short-term verbal memory. As such, it may be helpful in identifying impairment of the dominant (left) temporal lobe and its medial hippocampal connections. The test is badly in need of re-standardization, however, and suggestions for improving the instrument are made.

Adult↗
PubMed1981

Separation of brain-damaged from psychiatric patients with ability and personality measures.

Previous research indicates that many brain-damage screening tests lack the ability to separate organic from functional patients at a satisfactory level. However, the Smith Symbol-Digit Modalities Test, the Benton Visual Retention Test, the Background Interference Procedure variation of the Minnesota Percepto-Diagnostic Test, and the MMPI Psychiatric-Organic Scale have shown some promise in earlier studies. Their abilities to separate brain-damaged patients from five functional samples in a psychiatric setting were compared here. The Smith proved capable of discriminating organics from all functional samples both before and after demographic matching. The Benton and the Minnesota Percepto-Diagnostic Test separated our organics from our functional groups before matching, but results with them after matching were unencouraging. The P-O scale separated the organics from four of the five functional samples before matching and two afterward. The combined use of the P-O and Smith provided a higher level of discrimination than that attained with either alone, correctly identifying 90% of the organics and 79% of the functional Ss.

Adult↗
PubMed1983

Neuropsychological impairment scale (NIS): initial validation study using trailmaking test (A & B) and WAIS digit symbol (scaled score) in a mixed grouping of psychiatric, neurological, and normal patients.

Described a 50-item, self-administered neuropsychological screening test with test results correlating with three reference measures for three participant groupings--Normals (N = 22), Psychiatric patients (N = 21) and Neurological patients (N = 14). Results suggest that neuropsychological self-description can correlate with performance measures that are known to be sensitive to cognitive impairment.

Adult↗
PubMed1984

PPVT IQ validity in adults: a measure of vocabulary, not of intelligence.

Used partial correlation and multiple regression procedures to test the hypothesis that the PPVT IQ assesses more than vocabulary in adults. Ss were 84 inpatients from psychiatry and neurology wards. The relationships between the PPVT IQ and other measures of vocabulary, intelligence, memory, visual-motor speed and education were examined in the statistical analyses. Although these variables have significant simple correlations with the PPVT IQ, the multivariate analyses show that the Vocabulary Subtest of the WAIS-R is the only important variable. No other variable or variable combinations are able to account for further PPVT IQ variance after the effect of the Vocabulary Subtest is removed. The results support the use of the PPVT as a test of adult vocabulary, but not adult intelligence, and suggest that the PPVT may be useful as part of language assessment in patients with expressive language disorders.

Adult↗