Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders.Biological Psychiatry: An interdisciplinary science concerned with studies of the biological bases of behavior - biochemical, genetic, physiological, and neurological - and applying these to the understanding and treatment of mental illness.Child Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in children.Forensic Psychiatry: Psychiatry in its legal aspects. This includes criminology, penology, commitment of mentally ill, the psychiatrist's role in compensation cases, the problems of releasing information to the court, and of expert testimony.Community Psychiatry: Branch of psychiatry concerned with the provision and delivery of a coordinated program of mental health care to a specified population. The foci included in this concept are: all social, psychological and physical factors related to etiology, prevention, and maintaining positive mental health in the community.Adolescent Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders in individuals 13-18 years.Geriatric Psychiatry: A subspecialty of psychiatry concerned with the mental health of the aged.Insanity Defense: A legal concept that an accused is not criminally responsible if, at the time of committing the act, the person was laboring under such a defect of reason from disease of the mind as not to know the nature and quality of the act done or if the act was known, to not have known that what was done was wrong. (From Black's Law Dictionary, 6th ed)Psychoanalysis: The separation or resolution of the psyche into its constituent elements. The term has two separate meanings: 1. a procedure devised by Sigmund Freud, for investigating mental processes by means of free association, dream interpretation and interpretation of resistance and transference manifestations; and 2. a theory of psychology developed by Freud from his clinical experience with hysterical patients. (From Campbell, Psychiatric Dictionary, 1996).Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.Preventive Psychiatry: A discipline concerned with the prevention of mental illness and the promotion of mental health.Psychopharmacology: The study of the effects of drugs on mental and behavioral activity.Psychiatric Department, Hospital: Hospital department responsible for the organization and administration of psychiatric services.Military Psychiatry: Branch of psychiatry concerned with problems related to the prevention, diagnosis, etiology, and treatment of mental or emotional disorders of Armed Forces personnel.Neurology: A medical specialty concerned with the study of the structures, functions, and diseases of the nervous system.Hospitals, Psychiatric: Special hospitals which provide care to the mentally ill patient.Serbia: A republic located south of HUNGARY, west of ROMANIA and BULGARIA, and part of the former YUGOSLAVIA. The capital is Belgrade.Neuropsychiatry: A subfield of psychiatry that emphasizes the somatic substructure on which mental operations and emotions are based, and the functional or organic disturbances of the central nervous system that give rise to, contribute to, or are associated with mental and emotional disorders. (From Campbell's Psychiatric Dictionary, 8th ed.)Commitment of Mentally Ill: Legal process required for the institutionalization of a patient with severe mental problems.Literature, ModernHistory, 19th Century: Time period from 1801 through 1900 of the common era.Dangerous Behavior: Actions which have a high risk of being harmful or injurious to oneself or others.Psychoanalytic Theory: Conceptual system developed by Freud and his followers in which unconscious motivations are considered to shape normal and abnormal personality development and behavior.Philosophy, MedicalMentally Ill Persons: Persons with psychiatric illnesses or diseases, particularly psychotic and severe mood disorders.Career Choice: Selection of a type of occupation or profession.History, 20th Century: Time period from 1901 through 2000 of the common era.Social Work, Psychiatric: Use of all social work processes in the treatment of patients in a psychiatric or mental health setting.Psychosomatic Medicine: A system of medicine which aims at discovering the exact nature of the relationship between the emotions and bodily function, affirming the principle that the mind and body are one.Neurosciences: The scientific disciplines concerned with the embryology, anatomy, physiology, biochemistry, pharmacology, etc., of the nervous system.Emergency Services, Psychiatric: Organized services to provide immediate psychiatric care to patients with acute psychological disturbances.Mental Health Services: Organized services to provide mental health care.Psychoanalytic Therapy: A form of psychiatric treatment, based on Freudian principles, which seeks to eliminate or diminish the undesirable effects of unconscious conflicts by making the patient aware of their existence, origin, and inappropriate expression in current emotions and behavior.Psychotropic Drugs: A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents).Mind-Body Relations, Metaphysical: The relation between the mind and the body in a religious, social, spiritual, behavioral, and metaphysical context. This concept is significant in the field of alternative medicine. It differs from the relationship between physiologic processes and behavior where the emphasis is on the body's physiology ( = PSYCHOPHYSIOLOGY).Coercion: The use of force or intimidation to obtain compliance.Students, Medical: Individuals enrolled in a school of medicine or a formal educational program in medicine.Hysteria: Historical term for a chronic, but fluctuating, disorder beginning in early life and characterized by recurrent and multiple somatic complaints not apparently due to physical illness. This diagnosis is not used in contemporary practice.Secularism: Indifference to, or rejection of, RELIGION or religious considerations. (From Merriam-Webster's Collegiate Dictionary, 10th ed)Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication.Internship and Residency: Programs of training in medicine and medical specialties offered by hospitals for graduates of medicine to meet the requirements established by accrediting authorities.Schizophrenia: A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, HALLUCINATIONS, emotional disharmony, and regressive behavior.Deinstitutionalization: The practice of caring for individuals in the community, rather than in an institutional environment with resultant effects on the individual, the individual's family, the community, and the health care system.Specialization: An occupation limited in scope to a subsection of a broader field.Education, Medical, Undergraduate: The period of medical education in a medical school. In the United States it follows the baccalaureate degree and precedes the granting of the M.D.Moral Development: The process by which individuals internalize standards of right and wrong conduct.Medicine: The art and science of studying, performing research on, preventing, diagnosing, and treating disease, as well as the maintenance of health.Psychophysiologic Disorders: A group of disorders characterized by physical symptoms that are affected by emotional factors and involve a single organ system, usually under AUTONOMIC NERVOUS SYSTEM control. (American Psychiatric Glossary, 1988)Mental Competency: The ability to understand the nature and effect of the act in which the individual is engaged. (From Black's Law Dictionary, 6th ed).Psychopathology: The study of significant causes and processes in the development of mental illness.Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Countertransference (Psychology): Conscious or unconscious emotional reaction of the therapist to the patient which may interfere with treatment. (APA, Thesaurus of Psychological Index Terms, 8th ed.)Referral and Consultation: The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.Behaviorism: A psychologic theory, developed by John Broadus Watson, concerned with studying and measuring behaviors that are observable.Medicine in Literature: Written or other literary works whose subject matter is medical or about the profession of medicine and related areas.Communism: A totalitarian system of government in which a single authoritarian party controls state-owned means of production with the professed aim of establishing a classless society.Community Mental Health Services: Diagnostic, therapeutic and preventive mental health services provided for individuals in the community.Psychology, Medical: A branch of psychology in which there is collaboration between psychologists and physicians in the management of medical problems. It differs from clinical psychology, which is concerned with the diagnosis and treatment of behavior disorders.Ethics, Medical: The principles of professional conduct concerning the rights and duties of the physician, relations with patients and fellow practitioners, as well as actions of the physician in patient care and interpersonal relations with patient families.Freudian Theory: Philosophic formulations which are basic to psychoanalysis. Some of the conceptual theories developed were of the libido, repression, regression, transference, id, ego, superego, Oedipus Complex, etc.Expert Testimony: Presentation of pertinent data by one with special skill or knowledge representing mastery of a particular subject.Biography as Topic: A written account of a person's life and the branch of literature concerned with the lives of people. (Harrod's Librarians' Glossary, 7th ed)Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Attitude: An enduring, learned predisposition to behave in a consistent way toward a given class of objects, or a persistent mental and/or neural state of readiness to react to a certain class of objects, not as they are but as they are conceived to be.Delirium, Dementia, Amnestic, Cognitive Disorders: Cognitive disorders including delirium, dementia, and other cognitive disorders. These may be the result of substance use, trauma, or other causes.Antipsychotic Agents: Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in SCHIZOPHRENIA; senile dementia; transient psychosis following surgery; or MYOCARDIAL INFARCTION; etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus.Freedom: The rights of individuals to act and make decisions without external constraints.Fantasy: An imagined sequence of events or mental images, e.g., daydreams.Transference (Psychology): The unconscious transfer to others (including psychotherapists) of feelings and attitudes which were originally associated with important figures (parents, siblings, etc.) in one's early life.Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.Crime: A violation of the criminal law, i.e., a breach of the conduct code specifically sanctioned by the state, which through its administrative agencies prosecutes offenders and imposes and administers punishments. The concept includes unacceptable actions whether prosecuted or going unpunished.Holocaust: A massive slaughter, especially the systematic mass extermination of European Jews in Nazi concentration camps prior to and during World War II.History, 18th Century: Time period from 1701 through 1800 of the common era.Humanism: An ethical system which emphasizes human values and the personal worth of each individual, as well as concern for the dignity and freedom of humankind.Eugenics: The attempt to improve the PHENOTYPES of future generations of the human population by fostering the reproduction of those with favorable phenotypes and GENOTYPES and hampering or preventing BREEDING by those with "undesirable" phenotypes and genotypes. The concept is largely discredited. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)History, 21st Century: Time period from 2001 through 2100 of the common era.Education, Medical, Graduate: Educational programs for medical graduates entering a specialty. They include formal specialty training as well as academic work in the clinical and basic medical sciences, and may lead to board certification or an advanced medical degree.Education, Medical: Use for general articles concerning medical education.Religion and Psychology: The interrelationship of psychology and religion.Curriculum: A course of study offered by an educational institution.Videoconferencing: Communications via an interactive conference between two or more participants at different sites, using computer networks (COMPUTER COMMUNICATION NETWORKS) or other telecommunication links to transmit audio, video, and data.Interprofessional Relations: The reciprocal interaction of two or more professional individuals.Personnel Selection: The process of choosing employees for specific types of employment. The concept includes recruitment.USSRPsychotic Disorders: Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994)Affective Disorders, Psychotic: Disorders in which the essential feature is a severe disturbance in mood (depression, anxiety, elation, and excitement) accompanied by psychotic symptoms such as delusions, hallucinations, gross impairment in reality testing, etc.HistoryCrisis Intervention: Brief therapeutic approach which is ameliorative rather than curative of acute psychiatric emergencies. Used in contexts such as emergency rooms of psychiatric or general hospitals, or in the home or place of crisis occurrence, this treatment approach focuses on interpersonal and intrapsychic factors and environmental modification. (APA Thesaurus of Psychological Index Terms, 7th ed)Psychoses, Substance-Induced: Psychotic organic mental disorders resulting from the toxic effect of drugs and chemicals or other harmful substance.Reactive Attachment Disorder: Markedly disturbed and developmentally inappropriate social relatedness that begins before age 5 and is associated with grossly pathological child care. The child may persistently fail to initiate and respond to social interactions in a developmentally appropriate way (inhibited type) or there may be a pattern of diffuse attachments with nondiscriminate sociability (disinhibited type). (From DSM-V)Great BritainFamous PersonsDiagnostic and Statistical Manual of Mental Disorders: Categorical classification of MENTAL DISORDERS based on criteria sets with defining features. It is produced by the American Psychiatric Association. (DSM-IV, page xxii)Educational Measurement: The assessing of academic or educational achievement. It includes all aspects of testing and test construction.Electroconvulsive Therapy: Electrically induced CONVULSIONS primarily used in the treatment of severe AFFECTIVE DISORDERS and SCHIZOPHRENIA.
Cross-cultural psychiatry: Cross-cultural psychiatry, transcultural psychiatry, or cultural psychiatry is a branch of psychiatry concerned with the cultural context of mental disorders and the challenges of addressing ethnic diversity in psychiatric services. It emerged as a coherent field from several strands of work, including surveys of the prevalence and form of disorders in different cultures or countries; the study of migrant populations and ethnic diversity within countries; and analysis of psychiatry itself as a cultural product.Peter Riederer: Peter Riederer (born 1942) is a German neuroscientist with several thousands of citations and around 950 scientific writings. He has published more than 620 scientific papers in peer-reviewed scientific journals that are indexed in the most referent biomedical scientific database Medline.Alejandro Rodriguez (psychiatrist): Alejandro Rodriguez (February 1918 – January 20, 2012) was a Venezuelan-American pediatrician and psychiatrist, known for his pioneering work in child psychiatry. He was the director of the division of child psychiatry at the Johns Hopkins University School of Medicine, and conducted pivotal studies on autism and other developmental disorders in children.Graham Young: Graham Fredrick Young (7 September 1947 – 1 August 1990) was an English serial killer who used poison to kill his victims. He was sent to Broadmoor Hospital in 1962 after poisoning several members of his family, killing his stepmother.Journal of the American Academy of Child and Adolescent Psychiatry: The Journal of the American Academy of Child and Adolescent Psychiatry is a peer-reviewed medical journal covering pediatric psychiatry. It is published by Elsevier and is the official journal of the American Academy of Child and Adolescent Psychiatry.Abbreviated mental test score: The abbreviated mental test score (AMTS) was introduced by Hodkinson in 1972 rapidly to assess elderly patients for the possibility of dementia. Its uses in medicine have become somewhat wider, e.InsanityKarl Abraham: Karl Abraham (; 3 May 1877 – 25 December 1925) was an early important and influential German psychoanalyst, and a collaborator of Sigmund Freud, who called him his 'best pupil'.Freud Museum at www.Mental disorderBernard Glueck, Jr.: Bernard Charles Glueck, Jr. (August 26, 1914 – July 24, 1999) was an American psychiatrist.International Psychopharmacology Algorithm Project: The International Psychopharmacology Algorithm Project (IPAP) is a non-profit corporation whose purpose is to "enable, enhance, and propagate" use of algorithms for the treatment of some Axis I psychiatric disorders.Amager HospitalUCL Institute of NeurologyTwo Rivers Psychiatric Hospital: Two Rivers Behavioral Health System is a psychiatric hospital located in Kansas City, Missouri.List of birds of Serbia: This is a list of the bird species recorded in Serbia. The avifauna of Serbia include a total of 381 species, one of which has been introduced by humans.Cognitive neuropsychiatry: Cognitive neuropsychiatry is a growing multidisciplinary field arising out of cognitive psychology and neuropsychiatry that aims to understand mental illness and psychopathology in terms of models of normal psychological function. A concern with the neural substrates ofInvoluntary commitment: Involuntary commitment or civil commitment is a legal process through which an individual with symptoms of severe mental illness is court-ordered into treatment in a psychiatric hospital (inpatient) or in the community (outpatient).Jonathan AllynNewington Green Unitarian ChurchThe Thrill Killers: The Thrill Killers is a horror/thriller film released in 1964 and directed by low-budget film-maker Ray Dennis Steckler. It stars Cash Flagg (Steckler under a nom de plume) and Liz Renay.Paul Ferdinand Schilder: Paul Ferdinand Schilder (February 15, 1886, Vienna – December 7, 1940, New York City) was an Austrian psychiatrist, psychoanalyst, researcher and author of numerous scientific publications. He was a pupil of Sigmund Freud.Becky JamesThe Flash ChroniclesSandra Sully (songwriter): Sandra Sully is a songwriter who co-wrote Bobby Womack's "If You Think You're Lonely Now". BMI Website, Songwriter Sandra Sully In 2006 she was credited as a co-writer of Mariah Carey's Grammy Award–winning song "We Belong Together" which incorporated part of "If You're Think You're Lonely Now".Zbigniew J. LipowskiNeurogeneticsEmergency psychiatryNational Collaborating Centre for Mental Health: The National Collaborating Centre for Mental Health (NCCMH) is one of several centres of the National Institute for Health and Care Excellence (NICE) tasked with developing guidance on the appropriate treatment and care of people with specific conditions within the National Health Service (NHS) in England and Wales. It was established in 2001.Richard Bromfield: Richard Bromfield, Ph.D.Narcotics and Psychotropics Control Law: The Narcotics and Psychotropics Control Law (麻薬及び向精神薬取締法 Mayaki oyobi kousei shin'yaku torishimari hou) is a law enacted in Japan in 1953 to control most narcotic and psychotropic drugs.Reproductive coercion: Reproductive coercion (also called coerced reproduction) are threats or acts of violence against a partner's reproductive health or reproductive decision-making and is a collection of behaviors intended to pressure or coerce a partner into becoming a parent or ending a pregnancy. Reproductive coercion is a form of domestic violence, also known as intimate partner violence, where behavior concerning reproductive health is used to maintain power, control, and domination within a relationship and over a partner through an unwanted pregnancy.Leiden International Medical Student ConferenceHysteria: Hysteria, in its colloquial use, describes unmanageable emotional excesses. Generally, modern medical professionals have given up the use of "hysteria" as a diagnostic category, replacing it with more precisely defined categories such as somatization disorder.Martin Weaver: Martin Weaver is a psychotherapist, author and media writerReligion and schizophrenia: == Background ==UNICEF Tap Project: The UNICEF Tap Project is a nationwide campaign that provides children in impoverished nations with access to safe, clean water. The campaign culminates during World Water Week, celebrating the United Nations’ World Water Day, March 22.Indignation (novel): Indignation is a novel by Philip Roth, released by Houghton Mifflin on September 16, 2008. It is his twenty-ninth book.Psychodermatology: Psychodermatology is the treatment of skin disorders using psychological and psychiatric techniques. It is a subspecialty of dermatology.Developmental psychopathology: Developmental psychopathology is the study of the development of psychological disorders, such as psychopathy, autism, schizophrenia and depression, with a lifecourse perspective.Cicchetti, D.Role suction: Role suction is a term introduced in the United States by Fritz Redl in the mid-20th century to describe the power of a social group to allocate roles willy-nilly to its members. W.Referral (medicine): In medicine, referral is the transfer of care for a patient from one clinician to another.García Olmos L, Gervas Camacho J, Otero A, Pérez Fernández M.Thirteen Steps To Mentalism: Thirteen Steps to Mentalism is a book on mentalism by Tony Corinda. It was originally published as thirteen smaller booklets as a course in mentalism, and was later, in 1961, republished as a book.Spanking Shakespeare: Spanking Shakespeare (2007) is the debut novel by Jake Wizner. It is a young adult novel that tells the story of the unfortunately named Shakespeare Shapiro and his struggles in high school, dating and friendship.Communism and homosexuality: The attitude of the communist movement and historical communist states regarding homosexuality has been varied. Views from various communists and communist states have ranged from acceptance to apathy, and even to condemnation.Community mental health service: Community mental health services (CMHS), also known as Community Mental Health Teams (CMHT) in the United Kingdom, support or treat people with mental disorders (mental illness or mental health difficulties) in a domiciliary setting, instead of a psychiatric hospital (asylum). The array of community mental health services vary depending on the country in which the services are provided.Nathan Raw: Lieutenant-Colonel Nathan Raw C.M.Mark Siegler: Mark Siegler (born June 20, 1941) is an American physician who specializes in internal medicine. He is the Lindy Bergman Distinguished Service Professor of Medicine and Surgery at the University of Chicago.Expert elicitation: In science, engineering, and research, expert elicitation is the synthesis of opinions of authorities of a subject where there is uncertainty due to insufficient data or when such data is unattainable because of physical constraints or lack of resources. Expert elicitation is essentially a scientific consensus methodology.Biography Work: Biography Work based on Anthroposophy views the human circle of life on one hand as being embedded in the rhythms of nature and the cosmos on the other hand shaped by the individual power of creativity in everyone’s Self.Closed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.Reduplicative paramnesia: Reduplicative paramnesia is the delusional belief that a place or location has been duplicated, existing in two or more places simultaneously, or that it has been 'relocated' to another site. It is one of the delusional misidentification syndromes and, although rare, is most commonly associated with acquired brain injury, particularly simultaneous damage to the right cerebral hemisphere and to both frontal lobes.Atypical antipsychotic: The atypical antipsychotics (AAP; also known as second generation antipsychotics (SGAs)) are a group of antipsychotic drugs (antipsychotic drugs in general are also known as major tranquilisers and neuroleptics, although the latter is usually reserved for the typical antipsychotics) used to treat psychiatric conditions. Some atypical antipsychotics have received regulatory approval (e.Libertarian perspectives on political alliances: Libertarian perspectives on political alliances vary greatly, with controversies among libertarians as to which alliances are acceptable or useful to the movement.Fantasy prone personality: Fantasy prone personality (FPP) is a disposition or personality trait in which a person experiences a lifelong extensive and deep involvement in fantasy. This disposition is an attempt, at least in part, to better describe "overactive imagination" or "living in a dream world".Bipolar disorderFelony murder rule (Florida): In the state of Florida, the common law felony murder rule has been codified in Florida Revised Statutes § 782.04.Bibliography of The Holocaust: This is a selected bibliography and other resources for The Holocaust.Enlightenment Intensive: An Enlightenment Intensive is a group retreat designed to enable a spiritual enlightenment experience within a relatively short time. Devised by Americans Charles (1929–2007) and Ava Berner in the 1960s,http://www.Joachim Kahl: Joachim Kahl (born 1941 in Cologne, Germany) is a German freelance philosopher whose work focuses on the criticism of religion, ethics and aesthetics. His central theme is ‘secular humanism’.Eugenics in the United States: Eugenics, the set of beliefs and practices which aims at improving the genetic quality of the human population played a significant role in the history and culture of the United States prior to its involvement in World War II.Syllabus: A syllabus (pl. syllabi) is an outline and summary of topics to be covered in an education or training course.Webcam: A webcam is a video camera that feeds or streams its image in real time to or through a computer to computer network. When "captured" by the computer, the video stream may be saved, viewed or sent on to other networks via systems such as the internet, and email as an attachment.Yevgeny Vesnik: Yevgeny Yakovlevich Vesnik (; January 15, 1923 — April 10, 2009) was a Russian and Soviet stage and a film actor. The son of Yakov Vesnik, the first director of the Kryvorizhstal plant, he fought the Germans in the Second World War.DSM-IV Codes (alphabetical): __FORCETOC__Psychotic depression: Psychotic depression, also known as depressive psychosis, is a major depressive episode that is accompanied by psychotic symptoms.Hales E and Yudofsky JA, eds, The American Psychiatric Press Textbook of Psychiatry, Washington, DC: American Psychiatric Publishing, Inc.List of asbestos disease medical articles: Thousands of scientific and medical articles have chronicled human understanding of the hazards of asbestos to human life.Environmental Working Group, List of References regarding asbestos hazards This understanding paralleled the growth of the industrial revolution, particularly in the textile factories and mines of Great Britain.Ontario Correctional ServicesSubstance-induced psychosisAttachment disorder: Attachment disorder is a broad term intended to describe disorders of mood, behavior, and social relationships arising from a failure to form normal attachments to primary care giving figures in early childhood. Such a failure would result from unusual early experiences of neglect, abuse, abrupt separation from caregivers between 6 months and three years of age, frequent change or excessive numbers of caregivers, or lack of caregiver responsiveness to child communicative efforts resulting in a lack of basic trust.National Cancer Research Institute: The National Cancer Research Institute (NCRI) is a UK-wide partnership between cancer research funders, which promotes collaboration in cancer research. Its member organizations work together to maximize the value and benefit of cancer research for the benefit of patients and the public.Nicholas II of WerleSchizophreniaList of people who have undergone electroconvulsive therapy: This is a list of notable cases of treatment with electroconvulsive therapy (ECT).
(1/743) Relationship between practice counselling and referral to outpatient psychiatry and clinical psychology.
BACKGROUND: Although reduction in the use of secondary care mental health services is a suggested benefit of counselling in general practice, there has been little empirical investigation of this relationship. AIM: To investigate the relationship between the provision of counselling in general practice and the use of outpatient psychiatry and clinical psychology services across a geographical area. METHOD: Information on referrals to outpatient psychiatry and clinical psychology from all general practices in the London Borough of Islington over one year (October 1993 to September 1994) was collected from the routine information systems of the main hospital departments serving this area. Referral rates per 1000 practice population were compared for practices with and without a practice-based counsellor. RESULTS: Fifteen (35%) of the 43 practices had a counsellor based in the practice. The median referral rate to clinical psychology was higher in practices with a counsellor (4.1 per 1000) than in practices without a counsellor (0.8 per 1000). There was no relationship between the provision of practice counselling and median referral rates to outpatient psychiatry (1.8 per 1000 with a counsellor, 1.7 per 1000 without a counsellor). CONCLUSION: Provision of practice counselling in the study was associated with higher referral rates to clinical psychology and no difference in referral rates to outpatient psychiatry. This is in contrast to the hypothesis that counselling reduces the use of secondary care mental health services. (+info)
(2/743) Early theory and research on hemispheric specialization.
This article provides an account of early theory and research on hemispheric specialization. It begins by tracing theory and research on localization of function that set the stage for the discovery of hemispheric specialization. After that, it describes the studies of Paul Broca, John Hughlings-Jackson, and others on hemisphere specialization and reviews some of the proposed explanations for the phenomenon. It then turns to the study of hemispheric specialization and mental illness, and it ends by identifying some of the linkages between theory and research from the past and the present. (+info)
(3/743) A new method of developing expert consensus practice guidelines.
To improve the quality of medical care while reducing costs, it is necessary to standardize best practice habits at the most crucial clinical decision points. Because many pertinent questions encountered in everyday practice are not well answered by the available research, expert consensus is a valuable bridge between clinical research and clinical practice. Previous methods of developing expert consensus have been limited by their relative lack of quantification, specificity, representativeness, and implementation. This article describes a new method of developing, documenting, and disseminating expert consensus guidelines that meets these concerns. This method has already been applied to four disorders in psychiatry and could be equally useful for other medical conditions. Leading clinical researchers studying a given disorder complete a survey soliciting their opinions on its most important disease management questions that are not covered well by definitive research. The survey response rates among the experts for the four different psychiatric disorders have each exceeded 85%. The views of the clinical researchers are validated by surveying separately a large group of practicing clinicians to ensure that the guideline recommendations are widely generalizable. All of the suggestions made in the guideline are derived from, and referenced to, the experts' survey responses using criteria that were established a priori for defining first-, second-, and third-line choices. Analysis of survey results suggests that this method of quantifying expert responses achieves a high level of reliability and reproducibility. This survey method is probably the best available means for standardizing practice for decisions points not well covered by research. (+info)
(4/743) Managing somatic preoccupation.
Somatically preoccupied patients are a heterogeneous group of persons who have no genuine physical disorder but manifest psychologic conflicts in a somatic fashion; who have a notable psychologic overlay that accompanies or complicates a genuine physical disorder; or who have psychophysiologic symptoms in which psychologic factors play a major role in physiologic symptoms. In the primary care setting, somatic preoccupation is far more prevalent among patients than are the psychiatric disorders collectively referred to as somatoform disorders (e.g., somatization disorder, hypochondriasis). Diagnostic clues include normal results from physical examination and diagnostic tests, multiple unexplained symptoms, high health care utilization patterns and specific factors in the family and the social history. Treatment may include a physician behavior management strategy, antidepressants, psychiatric consultation and cognitive-behavior therapy. (+info)
(5/743) Persistence of substance use-related hospital utilization among psychiatric consultation patients.
Among 86 consecutive consultation-liaison (C-L) patients with current substance use-related hospital attendance, the case records revealed an average history of 5.9 years in male patients and 5.3 years in female patients of repeated substance use-related hospital visits. A history of at least 1 year was found in 60% (52/86) of patients. The history had started at the age of early 30s with attempted suicide as the most common principal diagnosis. By the age of 40, there had been several hospital visits for various health problems. However, 48% (41/86) of the patients had never received substance use treatment. It appeared that opportunities to intervene with substance use were frequently missed on hospital encounters, a finding also observed in earlier studies. (+info)
(6/743) Differences between generalists and mental health specialists in the psychiatric treatment of Medicare beneficiaries.
OBJECTIVE: To examine differences between the general medical and mental health specialty sectors in the expenditure and treatment patterns of aged and disabled Medicare beneficiaries with a physician diagnosis of psychiatric disorder. DATA SOURCES: Based on 1991-1993 Medicare Current Beneficiary Survey data, linked to the beneficiary's claims and area-level data on provider supply from the Area Resources File and the American Psychological Association. STUDY DESIGN: Outcomes examined included the number of psychiatric services received, psychiatric and total Medicare expenditures, the type of services received, whether or not the patient was hospitalized for a psychiatric disorder, the length of the psychiatric care episode, the intensity of service use, and satisfaction with care. We compared these outcomes for beneficiaries who did and did not receive mental health specialty services during the episode, using multiple regression analyses to adjust for observable population differences. We also performed sensitivity analyses using instrumental variables techniques to reduce the potential bias arising from unmeasured differences in patient case mix across sectors. PRINCIPAL FINDINGS: Relative to beneficiaries treated only in the general medical sector, those seen by a mental health specialist had longer episodes of care, were more likely to receive services specific to psychiatry, and had greater psychiatric and total expenditures. Among the elderly persons, the higher costs were due to a combination of longer episodes and greater intensity; among the persons who were disabled, they were due primarily to longer episodes. Some evidence was also found of higher satisfaction with care among the disabled individuals treated in the specialty sector. However, evidence of differences in psychiatric hospitalization rates was weaker. CONCLUSIONS: Mental health care provided to Medicare beneficiaries in the general medical sector does not appear to substitute perfectly for care provided in the specialty sector. Our study suggests that the treatment patterns in the specialty sector may be preferred by some patients; further, earlier findings indicate geographic barriers to obtaining specialty care. Thus, the matching of service use to clinical need among this vulnerable population may be inappropriate. The need for further research on outcomes is indicated. (+info)
(7/743) Sexual harassment of psychiatric trainees: experiences and attitudes.
A survey was carried out of psychiatric trainees' work-related experiences of unwanted sexual contact. A structured postal questionnaire was administered to 100 psychiatric trainees from senior house officer to specialist registrar level in a large psychiatric rotation. There was an 85% response rate; 86% (73) of the sample had experienced unwanted sexual contact, with 47% (40) experiencing deliberate touching, leaning over or cornering, and 18% (15) receiving letters, telephone calls or material of a sexual nature. Three-quarters (64) of respondents had experienced unwanted sexual contact from patients and 64% (54) from staff. Experiences and attitudes did not generally differ by gender, grade or training experience. Four out of 48 female respondents described stalking by patients. Of the 39 respondents who had reported harassment by patients, 31 felt supported by colleagues, while of the 13 who had reported harassment by colleagues, eight felt supported. Two-thirds of the respondents considered sexual harassment 'some-times' or 'frequently' a problem for the profession. Diagnoses of confusional states, mania or schizophrenia made subjects less likely to consider unwanted sexual behaviour to be 'sexual harassment' (86%, 80%, and 67%, respectively), but not for other diagnoses. Levels of threatening and intrusive sexual harassment are unacceptably high in this study group. Health trusts should adopt policies of 'zero tolerance' and all incidents should be reported. Psychological impact on victims should be acknowledged even when the behaviour of the perpetrator can be explained by diagnosis. (+info)
(8/743) Characteristics of health plans that treat psychiatric patients.
Nationally representative data regarding the organizational, financial, and procedural features of health plans in which psychiatric patients receive treatment indicate that fewer privately insured, Medicaid, and Medicare managed care enrollees receive care from a psychiatrist than is true for "nonmanaged" enrollees. Financial considerations were reported to adversely affect treatment for one-third of all patients. Although utilization management techniques and financial/resource constraints commonly applied to patients in both managed and nonmanaged plans, performance-based incentives were rare in nonmanaged plans. The traditional health plan categories provide limited information to identify salient plan characteristics and guide policy decisions regarding the provision of care. (+info)