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Biomedical subjects

A B Goodman

Publications and source records attributed to A B Goodman.

At least 37 records · Page 2Linked to original sources
PubMed1984

The reliability of psychiatric diagnosis in Israel's Psychiatric Case Register.

To determine the reliability of psychiatric diagnoses in the Israel Psychiatric Case Register, DSM-III criteria were applied to case record abstracts of first admissions to a large psychiatric hospital in Jerusalem. The DSM-III diagnoses were compared with ICD-8 records diagnoses. Between 40 and 50% of those originally diagnosed as schizophrenia were re-diagnosed into less severe categories. The proportion diagnosed as affective disorder doubled from 21% for ICD-8 diagnoses to 40% for DSM-III diagnoses. The unreliability concerned the diagnoses of schizophrenia and affective disorder. Findings suggest that the introduction of standardized diagnostic criteria in Israel will lead to a substantial increase in the number of cases diagnosed as affective disorder, although difficulties involved in differentiating schizophrenia from the major affective disorders remain. The DSM-III findings suggest a high prevalence of affective disorders among Jews.

Adolescent↗
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↗
PubMed1984

Severe alcoholism in the mental health sector: I. A cost analysis of treatment.

In a country in which the public mental health sector provides services to alcoholics, the costs of direct care to alcoholics were compared with those of other mental health patients. Costs were developed for a 1-yr cohort of patients who had received inpatient care but who had recently come from the community and returned to the community. The costs were based on inpatient and outpatient utilization within 2 yr of follow-up, commencing at discharge from inpatient care. Alcoholics represented the largest single diagnostic group in the cohort (39%), although their cost of care was only 22% of total costs. This is so despite the facts that similar percentages of alcoholics and nonalcoholics required rehospitalization in the 2 yr of follow-up and both groups exhibited similar patterns in the number of readmissions. Alcoholics have lower costs than other patients because they use cumulatively fewer inpatient days and receive fewer days of the most expensive outpatient service of full-day treatment. On the average, the cost to serve alcoholic patients is less than half the cost to serve nonalcoholic patients.

Adolescent↗
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

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↗
PubMed1982

A needs assessment strategy for an era of limited resources.

Among the several methods of assessing need for health services, the social indicator and the rates under treatment approaches utilize routinely available data. A well designed community survey, considered by many as the criterion of need within an area, is costly, difficult to mount, and requires considerable expertise. Therefore, it would seem reasonable to attempt to limit the need to utilize this approach. Presented here is a schema which utilizes the social indicator and rates under treatment approaches for an entire catchment area, reserving the survey approach only for those areas in which the two readily available need assessments are at variance, suggesting questionable validity for one or both approaches. Within a suburban middle-class county containing pockets of small town poverty, a social area analysis was undertaken to characterize need for mental health services. Inpatient rates under treatment were developed to measure demand. Key informant and survey approaches were undertaken to study selectively those census tracts which were discordant as to need and demand. This resulted in reducing the size of the population to be surveyed to 25 per cent of the total county, thus more efficiently using the limited resources available for needs assessment purposes.

Cross-Sectional Studies↗
PubMed1982

Impact of DSM-III on clinical practice.

The authors compared criterion-based diagnoses (DSM-III) with clinical diagnoses (DSM-II) for 102 psychiatric inpatients. The introduction of specified diagnostic criteria represented a refinement of existing diagnostic practices rather than a qualitatively different approach to diagnoses; however, in the schizophrenia and affective disorder categories, nonwhites and women were more often assigned to worse prognostic category by the DSM-II system than were white men with similar symptoms. The authors suggest that the introduction of DSM-III criteria may ensure more appropriate diagnosis and treatment for nonwhites and women.

Alcoholism↗
PubMed1976

An evaluative paradigm for community mental health centers using an automated data system.

A methodology is presented for the evaluation of community mental health centers using data routinely collected by an automated patient management system (Multistate Information System). Four community mental health centers whose catchment areas were widely diverse in composition participated in the study. A generalized evaluation paradigm was developed with measures and objectives formulated to analyze various stages of care as patients progressed through the community mental health center system. The stages covered were admission, initial modality of service, service delivery in terms of types and amounts of services rendered and termination. Each other was analyzed independently of the others and it was ascertained that the methodology produced useful and informative evaluative data across all four centers.

Community Mental Health Services↗
PubMed1969

Fissioning in planarians: control by the brain.

Reduced population densities lead to increased rates of fissioning in planarians whereas higher population densities suppress fissioning. This effect is not primarily due to mucus deposition or substances secreted into the water. Experiments are presented which show a system of population feedback control. In the presence of other planarians, the brain exerts an influence (probably neurohormonal) to suppress fissioning. This influence becomes attenuated with axial distance from the brain.

Animals↗