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Biomedical subjects

E M Caffey

Publications and source records attributed to E M Caffey.

At least 19 recordsLinked to original sources
PubMed1982

Relapse of psychiatric patients in foster care.

The authors examined factors related to relapse of psychiatric patients within 1 year of placement in a foster home. They collected data on 210 male patients who had been hospitalized in VA medical centers who were discharged to foster homes in five states. Slightly fewer schizophrenic than nonschizophrenic patients relapsed, but age, length of hospitalization, number of previous hospitalizations, marital status, education, and income did not predict relapse. There was a suggestion that relapsed schizophrenic patients may be characterized before hospital discharge by hyperactivity, undermedication or drug noncompliance, and fewer social skills.

Adult↗
PubMed1979

Day treatment and psychotropic drugs in the aftercare of schizophrenic patients. A Veterans Administration cooperative study.

Schizophrenic patients referred for day treatment at the time of discharge from ten hospitals were randomly assigned to receive day treatment plus drugs or to receive drugs alone. They were tested before assignment and at 6, 12, 18, and 24 months on social functioning, symptoms, and attitudes. Community tenure and costs were also measured. The ten day centers were described on process variables every six months for the four years of the study. Some centers were found to be effective in treating chronic schizophrenic patients and others were not. All centers improved the patients' social functioning. Six of the centers were found to significantly delay relapse, reduce sumptoms, and change some attitudes. Costs for patients in these centers were not significantly different from the group receiving only drugs. More professional staff hours, group therapy, and a high patient turnover treatment philosophy were associated with poor-result centers. More occupational therapy and a sustained nonthreatening environment were more characteristic of successful outcome centers.

Adult↗
PubMed1979

Antipsychotic drugs: can education change prescribing practices?

Forty-two VA Hospitals participated in an evaluation of educational techniques for physicians on the use of psychotherapeutic drugs. The purpose of the study was to determine whether educational techniques, such as articles and videotapes can be instrumental in changing physician prescribing practices so that they are more in conformity with current recommendations. The 2 major findings of the study were that there was less polypharmacy--less use of antiparkinson drugs and less use of antiparkinson drugs for longer than 6 months--and that there were no statistically significant differences among educational groups.

Antiparkinson Agents↗
PubMed1978

Hospital surveys of prescribing practices with psychotherapeutic drugs. A critical examination.

Hospital surveys of psychotherapeutic drug prescribing in the United States have been generally critical of the treatment practices of physicians and have been used to support claims that psychotherapeutic drugs are overprescribed and misused. This report examined several recent multihospital surveys of psychotherapeutic drug use and concludes that the surveys have failed to provide sufficient information to determine the appropriateness of treatment practices. The limitations of these surveys and the need to develop more adequate information about physician prescribing patterns are discussed.

Drug Prescriptions↗
PubMed1978

An evaluation of the Veterans Administration day hospital program.

A study of the day hospital program of the Veterans Administration was aimed at determining how well patients functioned three months after admission in relation to nine treatment goals, and how much they improved between admission and follow-up. The study group consisted of 1410 patients admitted to 34 VA day hospital programs; follow-up interviews were conducted with 70 per cent of them. At follow-up less than 10 per cent of the patients showed significant problems related to delusions, hallucinations, irrelevant speech, suicidal preoccupation, antisocial behavior, drinking, poor hygiene and eating habits, and assaultiveness. However, almost a fourth were significantly withdrawn, about a third were anxious, and three-fifths were not self-supporting. From the perspective of improvement during the three months, the study showed that treatment was helpful in all areas except promoting economic independence; it was most effective in reducing perceptual-cognitive dysfunctioning, emotional distress, and interpersonal difficulties.

Adult↗
PubMed1977

Hospital vs community (foster) care for psychiatric patients.

The aim of this study was to determine the effectiveness of foster care preparation and placement. Five hundred seventy-two patients from five hospitals were randomly assigned to foster care preparation (experimentals) or continued hospitalization (controls). They were studied before assignment, at placement of experimental subjects, and four months later regarding social functioning, mood, activity, and overall adjustment. Hospitals averaged two months preparing experimental subjects, resulting in 73% placed in foster care. Little change was observed between referral and placement. However, four months after placement, experimental subjects were significantly improved over controls, particularly in social functioning and adjustment. After four months, 88% of the foster care subjects were in the community. Findings suggest that attention should be given to selection criteria, that lengthy preparation may be unnecessary, and that foster care is superior to hospitalization for patients who cannot return to their own homes.

Emotions↗
PubMed1977

Foster placement for the older psychiatric patient.

The effect of age on foster care outcome was examined for 572 male psychiatric patients referred for foster care from five VA hospitals. Subjects were assigned randomly to preparation (experimentals) or continued inpatient care (controls.) Research staff collected data on social functioning, mood, activity, and adjustment. Only 79 (14%) were 60 years or older. Compared with younger patients, those 60 and over were more likely to be diagnosed as having chronic brain disease and less likely to be diagnosed as have schizophrenia. About 70% of the younger and older experimentals were placed into foster care. Alcoholics and persons with more hospitalizations were significantly less likely to be placed. Patients in foster care changed significantly compared with hospitalized controls by having less social dysfunction and better adjustment. Older subjects improved as a result of being seen in the hospital prior to placement but were not different from younger subjects in how they responded to the foster home. The study suggests that foster care is an appropriate and underutilized resource for elderly psychiatric patients.

Adaptation, Psychological↗
PubMed1977

Antipsychotic drug use: physician prescribing practices in relation to current recommendations.

Forty-two Veterans Administration hospitals contributed data on all the psychotherapeutic drugs being prescribed for a sample of their patients. These prescriptions were compared with the recommendations in "Guidelines for Antipsychotic Drug Use" by Drs. Prien and Caffey (1975). Generally, the results showed moderate differences between the actual physician practices and those recommended in the guidelines. The most significant differences were in polypharmacy, use of antiparkinson drugs, dosage levels and "drug holidays". The use of once- or twice-a-day schedules and the administration of major portion of the dose at night were much closer to the recommendation.

Antiparkinson Agents↗
PubMed1976

Relationship between dosage and response to lithium prophylaxis in recurrent depression.

The authors analyzed the results of a multihospital collaborative study on the effectiveness of lithium prophylaxis in recurrent depression in terms of dosage and found that serum lithium levels between 0.5 and 0.7 mEq/liter and doses below 1000 mg/day were relatively ineffective in preventing recurrences. Serum lithium levels between 0.8 and 1.0 mEq/liter and doses above 1000 mg/day were associated with a relatively low failure rate. The authors discuss the relevance of these findings to current prescription guidelines for lithium carbonate.

Bipolar Disorder↗
PubMed1976

Polypharmacy in the psychiatric treatment of elderly hospitalized patients: a survey of 12 Veterans Administration Hospitals.

Polypharmacy with psychoactive drugs was surveyed in 1276 elderly psychiatric patients from 12 Veterans Administration hospitals. One out of every six patients received two or more psychoactive agents. No specific combination of drugs was overly popular. The most frequently administered combinations, thioridazine plus phenobarbital and chlorpromazine plus phenobarbital, were administered to only 13 patients each (1% of the sample). The large majority of the combinations involved antipsychotic agents. One antipsychotic drug, thioridazine, was a component of nearly one-third of the combinations. The most frequent pairings were an antipsychotic drug plus and antidepressant, two antipsychotic drugs, and an antipsychotic drug plus an antianxiety agent or sedative-hypnotic. The use of polypharmacy was significantly related to patient age. One out of every four patients 60 to 65 years of age received two or more psychoactive drugs compared to only one out of eight over 75 years of age. The implications of these findings for treatment and research are discussed.

Age Factors↗
PubMed1975

The use of psychoactive drugs in elderly patients with psychiatric disorders: survey conducted in twelve Veterans Administration hospitals.

A survey conducted at 12 VA hospitals included the collection of detailed information on the use of psychoactive drugs in 1,276 elderly psychiatric patients. On the day of the survey, 61 per cent of the patients were receiving psychoactive drugs. Prescription practices relating to the choice of drugs, prevalence of drug use, dosage, combination drug preparations, and antiparkinson agents are discussed in terms of such factors as the patient's age and the diagnosis. Also discussed is the literature on psychoactive drugs, particularly as it pertains to elderly populations.

Aged↗
PubMed1975

[Practical considerations on treatment with antipsychotic preparations].

On the basis of a study of several hundred patients using the method of a double blind control the author showed the possibility of a successful maintenance treatment using intermittent dosage schedules with a marked reduction in the administration of antiparkinsonic agents. It is also demonstrated that patients under the age of 40 currently hospitalized less than 10 years on high doses of chlorpromazine in addition to showing generalized symptom reduction showed significant improvement in areas of social adjustment.

Adult↗