The International Journal of Psychiatry in Medicine最新文献_第10页

Lessons Learned: Outcomes and Methodology of a Coping Skills Intervention Trial Comparing Individual and Group Formats for Patients with Cancer 经验教训:应对技能干预试验的结果和方法，比较癌症患者的个人和团体形式

The International Journal of Psychiatry in Medicine Pub Date : 2001-09-01 DOI: 10.2190/U0P3-5VPV-YXKF-GRG1

L. Edgar, Z. Rosberger, J. Collet

{"title":"Lessons Learned: Outcomes and Methodology of a Coping Skills Intervention Trial Comparing Individual and Group Formats for Patients with Cancer","authors":"L. Edgar, Z. Rosberger, J. Collet","doi":"10.2190/U0P3-5VPV-YXKF-GRG1","DOIUrl":"https://doi.org/10.2190/U0P3-5VPV-YXKF-GRG1","url":null,"abstract":"Objective: Nucare, a short-term psychoeducational coping skills training intervention was evaluated in a randomized controlled clinical trial (RCT) of 225 newly diagnosed breast and colon cancer patients. Method: Measures of psychosocial distress, well being and optimism were evaluated every four months during a one-year period. Patients were randomized to one of four arms: Nucare presented in an individual basis; Nucare presented in a group format; a non-directive supportive group; and a no-intervention control. The interventions were provided in five sessions of ninety minutes each. Results: Patients with breast cancer who received Nucare presented in an individual format showed more significant improvements in well-being over time compared to those in the control and group arms. Conclusions: We were unable to develop functioning groups within the RCT. Partial explanations for the latter finding include the structural limitations of the RCT: the groups were small, difficult to schedule and patients indicated that they would have preferred to choose whether or not to participate in a group. The positive changes in women with breast cancer who received Nucare persisted at 12 months.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"81 1","pages":"289 - 304"},"PeriodicalIF":0.0,"publicationDate":"2001-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78144834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 64

Religion and Medicine III: Developing a Theoretical Model 宗教与医学III:发展一个理论模型

The International Journal of Psychiatry in Medicine Pub Date : 2001-06-01 DOI: 10.2190/2YBG-NL9T-EK7Y-F6A3

H. Koenig

引用次数: 67

How Well Informed are Australian General Practitioners about Adolescent Suicide? Implications for Primary Prevention 澳大利亚全科医生对青少年自杀的了解程度如何?对初级预防的影响

The International Journal of Psychiatry in Medicine Pub Date : 2001-06-01 DOI: 10.2190/3NB2-VVUY-P8N3-7XKQ

David I. Smith, K. Scoullar

{"title":"How Well Informed are Australian General Practitioners about Adolescent Suicide? Implications for Primary Prevention","authors":"David I. Smith, K. Scoullar","doi":"10.2190/3NB2-VVUY-P8N3-7XKQ","DOIUrl":"https://doi.org/10.2190/3NB2-VVUY-P8N3-7XKQ","url":null,"abstract":"Objective: To investigate the extent of knowledge of Australian general practitioners (GPs) in terms of critical information about adolescent suicide. Method: GPs knowledge about adolescent suicide was assessed using the 39-item Adolescent Suicide Behaviour Questionnaire (ASBQ), distributed to all GPs listed on the Medical Practitioners Board register of the Australian state of Victoria. Forty-three percent of GPs (n = 1694) completed and returned the survey. Results: GPs scored, on average, 71 percent of the questionnaire items correct. The mean level of incorrect and uncertain responses was 14 percent and 15 percent, respectively. However, there were wide differences in the number of correct scores between individual GPs, with some respondents scoring as few as four items correct and others as many as 38 items correct. Analysis of knowledge rates within ABSQ content domains showed that GPs were generally well informed about adolescent suicide in relation to precipitating factors, and less well informed about the remaining content domains. Conclusions: Australian GPs are, in general, moderately well informed, and are in a unique position to identify those at risk and to provide appropriate intervention (or referral). However, there is considerable variability in the accuracy of beliefs about adolescent suicide, with some GPs demonstrating excellent knowledge levels but others holding little accurate information. The extent of this variability in knowledge is a cause for concern. Findings highlight the need for ongoing education of GPs as an essential component of prevention strategies for youth suicide.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"31 1","pages":"169 - 182"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91382755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

Complicated Dual Diagnosis: A Case for Physician Involvement in Addictions Treatment 复杂的双重诊断:一个病例的医生参与成瘾治疗

The International Journal of Psychiatry in Medicine Pub Date : 2001-06-01 DOI: 10.2190/8YRG-3WCB-RYDX-GD5H

W. Bobo, Shannon C Miller

引用次数: 0

Anxiety and Depression in an Internal Medicine Resident Continuity Clinic: Difficult Diagnoses 内科住院医师连续性门诊的焦虑和抑郁:难以诊断

The International Journal of Psychiatry in Medicine Pub Date : 2001-06-01 DOI: 10.2190/C7WY-RELT-3U1N-JX9C

David G. Didden, J. Philbrick, J. Schorling

{"title":"Anxiety and Depression in an Internal Medicine Resident Continuity Clinic: Difficult Diagnoses","authors":"David G. Didden, J. Philbrick, J. Schorling","doi":"10.2190/C7WY-RELT-3U1N-JX9C","DOIUrl":"https://doi.org/10.2190/C7WY-RELT-3U1N-JX9C","url":null,"abstract":"Objective: To determine the prevalence of anxiety and depression in a residents' clinic and if these diagnoses are associated with patients being perceived as difficult, as well as how often these diagnoses are documented in the patients' charts. Methods: This was a cross-sectional study conducted in a general internal medicine residents' clinic. A total of 135 patients were given the Primary Care Evaluation of Mental Disorders questionnaire (DSM-IIIR version) and their physicians filled out the Difficult Doctor-Patient Relationship Questionnaire after the visit. Charts were reviewed for documentation of a diagnosis of anxiety or depression. Results: Major depression was present in 26 percent, dysthymia 16 percent, major depression in partial remission 9 percent, generalized anxiety disorder 13 percent, and panic disorder 7 percent. Overall, 38 percent had at least one and 21 percent had more than one diagnosis. Of patients with one psychiatric diagnosis, 9 percent were classified as difficult versus 100 percent of patients with four diagnoses. Documentation of depression was noted for 43 percent of patients with major depression but only 9 percent with an anxiety disorder. Conclusions: Anxiety and depression were very common among the patients in this clinic, and increasing numbers of diagnoses were associated with patients being classified as difficult. Residents diagnosed depressive disorders as often as practicing physicians in other studies, but anxiety less well. The high prevalence of mental disorders has implications for resident education in that they need to be prepared to care for these patients, but residents also may benefit from exposure to sites with more typical prevalences of these illnesses.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"10 1","pages":"155 - 167"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89614623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 20

Restricted Emotional Processing and Somatic Attribution in Fibromyalgia 纤维肌痛的限制性情绪加工与躯体归因

The International Journal of Psychiatry in Medicine Pub Date : 2001-06-01 DOI: 10.2190/K7AU-9UX9-W8BW-TETL

J. Brosschot, H. R. Aarsse

{"title":"Restricted Emotional Processing and Somatic Attribution in Fibromyalgia","authors":"J. Brosschot, H. R. Aarsse","doi":"10.2190/K7AU-9UX9-W8BW-TETL","DOIUrl":"https://doi.org/10.2190/K7AU-9UX9-W8BW-TETL","url":null,"abstract":"Objective: Medically unexplained symptoms or syndromes, such as fibromyalgia (FM), might be partly caused or sustained by a mechanism involving restricted emotional processing (REP) and the subsequent attribution of emotional arousal to somatic or syndrome-consistent causes. In this study, it was hypothesized that FM patients, compared to healthy individuals, would be higher on trait measures of REP (defensiveness and alexithymia), and would show affective-autonomic response dissociation, that is, higher standardized scores of heart rate responses than affective responses, during negative emotional stimulation. Additionally, FM patients were expected to attribute their bodily symptoms more to somatic than to psychological causes. Method: Emotional movie excerpts were shown to 16 female FM patients and 17 healthy women. Affective response and heart rate were monitored continuously, while symptoms and their causal attributions were measured before and after the excerpts. Repressor coping style and alexithymia were measured, along with negative affectivity and habitual attributions of somatic complaints. Results: FM patients nearly all showed the relatively uncommon combination of high defensiveness and high anxiousness. Compared with healthy women FM patients were more alexithymic, showed a higher level of affective-autonomic response dissociation, and lower within-subject emotional variability. The groups showed opposite attributional patterns, with FM patients attributing symptoms less to psychological causes and more to somatic causes. There was no evidence of a shift in these attributions caused by the emotional stimuli. Conclusions: The results provide preliminary support for the hypotheses. Both at trait and at state level, FM showed restricted emotional processing on most of the parameters measured, and a high ratio of somatic to psychological symptom attribution, coupled with high negative affectivity.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"14 1","pages":"127 - 146"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75553761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 79

A Case of Bilateral Ptosis with Unsteady Gait: Suggestibility and Culture in Conversion Disorder 双侧上睑下垂伴步态不稳1例:转换障碍的暗示与培养

The International Journal of Psychiatry in Medicine Pub Date : 2001-06-01 DOI: 10.2190/YCND-9Y51-KG8T-61E5

M. Al-Sharbati, Noona Viernes, Ala'adin Al-Hussaini, Z. Zaidan, P. Chand, S. Al-Adawi

引用次数: 7

National Institute of Mental Health—Abstracts 美国国家心理健康研究所

The International Journal of Psychiatry in Medicine Pub Date : 2001-06-01 DOI: 10.2190/22q3-eu8l-rpgq-mqhy

引用次数: 0

Utilization of Medical Services and Quality of Life among Low-Income Patients with Generalized Anxiety Disorder Attending Primary Care Clinics 在初级保健诊所就诊的低收入广泛性焦虑障碍患者的医疗服务利用与生活质量

The International Journal of Psychiatry in Medicine Pub Date : 2001-06-01 DOI: 10.2190/2X44-CR14-YHJC-9EQ3

G. Jones, S. Ames, S. Jeffries, I. Scarinci, P. Brantley

{"title":"Utilization of Medical Services and Quality of Life among Low-Income Patients with Generalized Anxiety Disorder Attending Primary Care Clinics","authors":"G. Jones, S. Ames, S. Jeffries, I. Scarinci, P. Brantley","doi":"10.2190/2X44-CR14-YHJC-9EQ3","DOIUrl":"https://doi.org/10.2190/2X44-CR14-YHJC-9EQ3","url":null,"abstract":"Objective: Anxiety disorders appear to influence morbidity and medical utilization. However, little is known about the relationship between Generalized Anxiety Disorder, quality of life, and medical utilization, especially among low-income patients. The goals of this investigation were to 1) determine if low-income patients with GAD utilize medical services more than patients with other Axis I diagnoses, or no psychopathology, and 2) compare the health-related quality of life of these three groups. Method: Participants were randomly recruited from public primary care clinics and administered intake assessments of demographics, stress, and health-related self-report questionnaires. At the end of the first year a structured psychiatric interview was administered (N = 431). Over the second year, patients (n = 360) were administered a health-related quality of life measure every three months for four assessments. Medical charts were abstracted to collect information about chronic illnesses and visits to outpatient clinics and the emergency department during the two years. Results: Patients were predominantly middle-aged, low-income, uninsured African-American females. In this low-income sample, patients with GAD utilized the emergency department more and reported poorer quality of life than patients with other Axis I disorders and patients without any psychopathology. Conclusion: Low-income patients with GAD utilize the emergency department more and report poorer quality of life than patients with other Axis I disorders and patients without any psychopathology. Programs to identify and treat patients with GAD may yield improvements in quality of life, as well as reduce emergency department utilization.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"42 1","pages":"183 - 198"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79961925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 50

An Explanatory Model for Munchausen by Proxy Abuse 代理滥用对Munchausen的解释模型

The International Journal of Psychiatry in Medicine Pub Date : 2001-06-01 DOI: 10.2190/GBNF-4XD7-EKVC-226P

D. C. Rand, M. Feldman

{"title":"An Explanatory Model for Munchausen by Proxy Abuse","authors":"D. C. Rand, M. Feldman","doi":"10.2190/GBNF-4XD7-EKVC-226P","DOIUrl":"https://doi.org/10.2190/GBNF-4XD7-EKVC-226P","url":null,"abstract":"Objective: In Munchausen by proxy (MBP) abuse, a caretaker fabricates or induces illness in another person to obtain emotional gratification. In representative cases, a mother is the perpetrator and her child is the victim. In view of the limits of current explanatory models, we use personal accounts of MBP perpetrators, physicians, and family members as a window into understanding this counterintuitive behavior. Method: As subspecialty clinicians and consultants, we supplemented our extensive direct experience with MBP with a review of published reports of MBP located via MEDLINE and PsycINFO (1980 onward). We also examined the books devoted to the subject and incorporated personal accounts of MBP perpetrators and of family members and professionals involved with them. Results: Factors contributing to the onset and continuation of MBP are the perpetrator's experiencing a particular drive (e.g., intense anger or frustration); lacking or overcoming internal inhibitions against abusive actions; and overcoming external inhibitions, such as the potential intercession of a spouse or pediatrician. As a result, the MBP parent experiences release from unpleasant emotions and a sense of renewed control. MBP behavior gains “habit strength” each time it occurs. Conclusions: Psychodynamic explanations of MBP, while favored by some authors, are inherently speculative and tend to be low in predictive value. We suggest broadening these traditional explanations by emphasizing observable behaviors and verifiable background factors. The behavioral perspective we outline helps explain how MBP behavior is learned, why it is more prevalent among mothers, and why it is so difficult for perpetrators to stop.","PeriodicalId":22510,"journal":{"name":"The International Journal of Psychiatry in Medicine","volume":"28 1","pages":"113 - 126"},"PeriodicalIF":0.0,"publicationDate":"2001-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80259166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21