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Biomedical subjects

E Corty

Publications and source records attributed to E Corty.

At least 19 recordsLinked to original sources
PubMed1994

Severity of substance use disorders among psychiatric inpatients.

This study compares the severity of DSM-III-R psychoactive substance use disorders (PSUDs) among dually diagnosed psychiatric inpatients with independent axis I mental disorders (IMDs) with the severity of PSUDs among: a) patients from the same hospitals with PSUD-related organic mental syndromes (PSUD-OMD) and b) patients from a residential drug-treatment program with PSUDs but no axis I mental disorders. The drug-use disorders among the group 1 (IMD+PSUD) patients were less severe on multiple indicators from the Structured Clinical Interview for DSM-III-R (SCID) and the Addiction Severity Index compared with the drug-use disorders among the other two groups. This did not hold for alcohol disorders. These findings carry potential implications for treatment strategies for the mentally ill with drug use.

Adolescent↗
PubMed1994

The impact of systemic lupus erythematosus on women's sexual functioning.

OBJECTIVE: We investigated the impact of systemic lupus erythematosus (SLE) and the mediating effects of psychosocial factors on women's sexual adjustment. METHODS: Data were obtained through structured interviews and psychometric scales administered to 100 female subjects with SLE and 71 disease-free controls. RESULTS: Compared with controls, patients with SLE had a significantly higher rate of abstention (26 vs 4%, p < 0.01), a lower frequency of sexual activity among the sexually active (p < 0.05), diminished vaginal lubrication (p < 0.01), and poorer general sexual adjustment (p < 0.01). Greater disease severity was associated with more impairment in sexual function (p < 0.01). Variables mediating the relationship between diagnostic status and sexual outcome included age (delta R2 = 0.04, p < 0.01), relationship status (delta R2 = 0.03, p < 0.05), weight concerns (delta R2 = 0.05, p < 0.01), premorbid sexual adjustment (delta R2 = 0.04, p < 0.01), and depression (delta R2 = 0.03, p < 0.05). Seventy-two percent of patients with SLE were receptive to physician inquiry about sexual functioning and 82% desired further education about the sexual impact of the disease. CONCLUSION: Our results suggest that sexual impairment is not inevitable among women with SLE. The role that providers can play in helping to prevent sexual difficulties is discussed.

Adult↗
PubMed1993

Influence of psychoactive substance use on the reliability of psychiatric diagnosis.

The interrater reliability of diagnoses made on the basis of a structured interview for psychiatric patients with and without psychoactive substance use disorders (PSUDs) was examined. Forty-seven pairs of ratings by 9 different clinical interviewers were used. Results supported 3 major findings: (a) The interrater reliability for non-PSUD psychiatric diagnoses is quite high when a subject has no diagnosable PSUD; it is lower, though still substantial, when a PSUD is present. (b) Interviewers are not aware of this and are just as certain of the accuracy of their diagnoses when a PSUD is present as when one is not. (c) Interrater reliability is moderate to substantial as to the judgment of whether, when a non-PSUD diagnosis is present, it is caused by the use of psychoactive substances. The implications of these findings for the appropriate selection of treatments for dually diagnosed patients are discussed.

Adult↗
PubMed1993

Implications of mental and substance use disorders. A comparison of single and dual diagnosis patients.

To understand better the implications of co-occurring mental and substance use disorders, we examined DSM-III-R diagnoses and life problems among a representative sample of 314 patients admitted to either a psychiatric hospital or a residential substance abuse treatment program from the same inner-city catchment area. Based upon the Structured Clinical Interview for DSM-III-R, the patients were divided into four groups. The first two groups had dual diagnoses, either: a) a primary axis I mental disorder (MD) and a comorbid psychoactive substance use disorder (PSUD); or b) a PSUD-related mental disorder and a PSUD, but no primary axis I MD. The third and fourth groups had a single diagnosis, either: c) a primary axis I MD, but no lifetime PSUD; or d) a PSUD, but no lifetime primary axis I MD. As expected, the two dual disorder groups had more cumulative problems than did either of the single disorder groups. Dually disordered patients with PSUD-related MD most resembled single-diagnosis PSUD patients in terms of substance use profile and life problems. Dually disordered patients with primary MD more resembled single-diagnosis MD patients, but had more severe life problems. Presence of a PSUD was associated with male gender, antisocial personality disorder, and more severe legal problems. Presence of a primary mental disorder was associated with more extensive prior hospitalizations and greater psychiatric severity.

Adolescent↗
PubMed1989

Assessment and classification of patients with psychiatric and substance abuse syndromes.

Patients with both mental illness and substance abuse pose a major clinical challenge to mental health and substance abuse clinicians. The literature seems to support the hypothesis that mental illness and substance abuse occur together more frequently than chance would predict. Assessment and classification of these patients should be guided by clinicians' needs to make meaningful therapeutic judgments and to communicate effectively with each other in coordinating treatment. Different phases of treatment require different approaches to assessment and classification. In initial classification, the clinician should recognize the problem of dual diagnosis and resist premature assumptions about which diagnosis is primary. Long-term treatment and rehabilitation may require systematic evaluation of alternative clinical hypotheses about why a patient exhibits both disorders. This approach eventually may lead to better ways to assess, classify, and treat these difficult patients.

Humans↗
PubMed1988

Reactivity to alcohol stimuli in alcoholics: is there a role for temptation?

Two studies investigated conditioned reactions to alcohol in alcoholics. In the first, alcoholic and control subjects were exposed to alcoholic and non-alcoholic stimuli and physiological parameters were measured. No significant differences were found to indicate that alcoholics reacted differentially to alcoholic stimuli. As this was contrary to other findings, procedural differences were examined. In the second study, a series of case studies, subjects were selected for extreme alcohol dependence and the procedure was varied by persuading the subjects that they might consume the stimuli. Under conditions in which the alcoholic stimulus was available and the subjects were able to consume it, two of the three subjects exhibited responses consonant with conditioned reactions to alcohol stimuli. We conclude that such conditioned reactions do exist but that their prevalence and the conditions under which they can be elicited are unknown. From these studies it appears to us that one of the most important parameters may be that of temptation.

Adult↗
PubMed1987

Admissions to methadone maintenance: comparisons between programs and implications for treatment.

Male admissions to six methadone maintenance programs in three cities were interviewed. The characteristics of these patients in the seven Addiction Severity Index (ASI) scales--medical, employment/support, alcohol, drug, legal, family/social and psychiatric--were described. The characterization of drug addicts was not found to be unidimensional. Though the admissions, as a group, had some positive characteristics (e.g., over 50% reported full time employment over the past three years), they also reported severe problems. For the 30 days prior to interview, heroin was the most commonly used drug, followed by cannabis, cocaine, and alcohol. Less than 10% had never been arrested and subjects reported engaging in crime on 6.4 of the past 30 days. The majority of these subjects had never married, but very few lived alone. The most common psychiatric symptoms reported were depression and anxiety. Characteristics were compared between programs and differences were found in race and age as well as two of the seven ASI areas. Thus, despite differences in demographics there was a great commonality in terms of the characteristics of admissions to these programs. The implications of this for the behavioral problems related to drug abuse and for the development of treatments aimed at specific areas (such as measured by the ASI) were discussed.

Adult↗
PubMed1986

Medical services provided to 2,394 patients at methadone programs in three states.

The type and amount of medical services provided to 2,394 patients in methadone maintenance programs in three states was studied. Data were obtained from on-site confidential interviews with the entire treatment staff at seven programs. It was found that there were marked differences in the number and type of medical staff. Thus, there was ten times more coverage by physicians at some programs than others. In general, there were notable differences in the treatment staff available. Comparable variations among the programs were found with respect to the actual provision of medical services. Thus, the number of patients seen by the medical staff on a weekly basis varied from a high of 185 patients to a low of 36 patients. Similarly, the proportion of each program's patients receiving medical treatment per week varied from 53 to 14 percent. Reasons for those variations in medical services are considered.

Ambulatory Care Facilities↗
PubMed1984

Response prevention in the treatment of cigarette smoking.

The present study developed and tested a response prevention treatment for cigarette smoking. Response prevention is based on the conditioning theory of addictions. Thirty-nine smokers were divided into two groups, one receiving response prevention and the other a rapid smoking comparison treatment. No significant differences were found between the two treatments in terms of their effectiveness in achieving abstinence or smoking reduction. The abstinence rate at the 6-month follow-up for response prevention was 7% and for rapid smoking was 23%.

Adult↗
PubMed1984

Predictors of adolescents' intentions to smoke: age, sex, race, and regional differences.

The present study investigated the predictors of smoking intentions among subgroups of adolescent nonsmokers, examining age, sex, ethnic, and regional differences. Both proximal factors specific to smoking and more general, distal factors were successful predictors of intentions to smoke. The similarities in prediction outweighed the differences between demographic subgroups. There were three demographic differences: (1) peer and family smoking levels were more important in predicting intentions for girls than boys; (2) smoking initiation was more of a way of adopting deviant or problem behavior for midwestern than for southwestern subjects; (3) familial smoking models were more related to the intentions of midwestern than southwestern subjects. The theoretical significance of these results and their practical implications for smoking prevention are discussed.

Adolescent↗