Biomedical subjects

E L Perez

Publications and source records attributed to E L Perez.

6 recordsLinked to original sources

PubMed2001

Healthcare quality in an international setting.

This report discusses the process used by the Healthcare Quality Certification Board to internationalize its certification program. With some modifications this methodology can be utilized to define the role of any healthcare professional and to legitimize, create or restructure a certification program that assesses competency in a particular healthcare field. This process and the importance of quality management are related to today's cataclysmic healthcare environment which challenges efforts to confront cost and access.

Certification↗

PubMed1988

Computerized administration of the Diagnostic Interview Schedule.

The National Institute of Mental Health (NIMH) Diagnostic Interview Schedule (DIS) is a highly structured interview designed to be administered by lay interviewers and to yield psychiatric diagnoses. While the DIS has been used widely in large research centers, its use has been limited due to its complexity and need for extensive training to administer. In the present study 100 volunteers consisting of 80 psychiatric patients and 20 normal controls completed a self-administering computerized version of the DIS on two occasions. A standardized Computer Attitude Scale (CAS) was administered to each volunteer before the first and after the second computerized DIS (C-DIS). The C-DIS yielded acceptable test-retest reliability. Certain diagnoses were found to yield high test-retest reliability while reliability was lower for others. This general pattern was similar to the results of previous procedural validity studies. Patients found the C-DIS generally easy to use and operate, and after using the C-DIS, felt that their level of expertise in using computers had improved. Generally, the results support the use of computerized administration of the DIS.

Adult↗

PubMed1988

Treatment of bulimia with fenfluramine and desipramine.

Desipramine and fenfluramine were administered to bulimic patients in a 15-week study of double-blind, placebo-controlled, crossover design. The 22 patients in the study met DSM-III criteria for bulimia and were of normal weight. Twelve subjects were randomly allocated to the fenfluramine group, and 10 subjects received desipramine. Half the subjects in each group received the active drug in the first 6 weeks and half received placebo. There was a 3-week washout period, after which subjects were crossed over for the remaining 6 weeks. The Eating Disorder Inventory, profile of Mood States, bulimia symptom checklists, and Hopkins Symptom Checklist were administered at weeks 0, 2, 4, 6, 9, 11, 13, and 15. Subjects maintained a daily record of bingeing, vomiting, and laxative/diuretic abuse. Results indicated that both drugs had beneficial effects on bingeing and vomiting frequency, although a greater proportion of patients were identified who responded to fenfluramine than to desipramine. Fenfluramine and desipramine were also effective in reducing the psychological symptoms of bulimia, such as the urge to binge, and feelings of depression. Results suggest that direct alteration of central food intake regulatory centers can effectively control bulimia.

Adolescent↗

PubMed1988

The dexamethasone suppression test in bulimia: nonsuppression associated with depression and suboptimal weight.

This study was designed to assess the extent to which DST nonsuppression in bulimic women could be predicted by the incidence of major depression in the patient and her family and by other factors known to affect DST results, such as suboptimal weight. The DST was administered to 33 women who met DSM-III criteria for bulimia. Subjects were given a complete psychiatric and psychological assessment, including the National Institute of Mental Health Diagnostic Interview Schedule, a personal and family medical history questionnaire, the Hopkins SCL-90, and the Eating Disorders Inventory. Ideal weight was determined with Metropolitan Life tables. The rate of DST nonsuppression was 58%. Nonsuppression was more frequent among women who suffered from major depression and those who maintained a suboptimal weight. Depression and suboptimal weight were unrelated and thus appear to contribute independently to the high rate of DST abnormalities commonly seen in bulimia.

Adolescent↗

PubMed1987

The need for aftercare services in a Canadian urban region: day-hospital patients' perspectives.

Day hospitals serve an important function in the rehabilitation of psychiatric patients. Community aftercare services are especially important to patients in this type of care. In order to determine the aftercare needs of day-hospital psychiatric patients in the Ottawa-Carleton region, a survey was conducted. A semistructured interview with a standardized questionnaire was administered by trained interviewers. Questions were asked regarding service use, problems encountered, and patient satisfaction. Information on housing, educational-vocational, financial, social-recreational, and medical services was gathered. The application of the study results to the planning of community psychiatric aftercare services for day-hospital patients is discussed.

Aftercare↗

PubMed1986

The impact of a geriatric assessment unit on a psychiatric consultation service in a general hospital.

The opening of a geriatric assessment unit (GAU) in a large general hospital has affected the number of elderly patients referred for psychiatric consultation, the type of psychopathology seen, and the training provided for psychiatric residents and interns on the consultation-liaison service. To examine these changes, the six months prior to the opening of the GAU are compared to the six months immediately following its opening. The number of patients age 65 or older referred and diagnoses made by the consulting psychiatrists were studied. The opening of the GAU significantly increased the number of elderly patients referred for psychiatric consultation. It was found that the GAU offered unique advantages in the assessment and treatment of elderly patients with certain psychiatric problems, and the advantages and limitations of different facilities within the general hospital for the psychiatric assessment and treatment of elderly patients are discussed. A case is presented which illustrates the interplay between the consultation-liaison psychiatrist and the geriatric service in the management of an elderly patient referred for consultation. The experience of this hospital in providing psychogeriatric training for residents and interns on the psychiatric consultation service is reviewed.

Aged↗