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Biomedical subjects

H F Schalken

Publications and source records attributed to H F Schalken.

9 recordsLinked to original sources

Dissociative identity disorder: diagnosis and treatment in the Netherlands.

Dissociative Identity Disorder (DID) is a controversial diagnosis and empirical data on the efficacy of treatment modalities are scanty. The objective of this study was to explore the frequency of the diagnosis, the types and efficacy of prevailing treatment practices, and to examine demographic data on patients in the Netherlands. A questionnaire, including questions on one selected DID patient, was mailed to 1,452 Dutch psychiatrists. The response rate was 46.7%. A total of 273 psychiatrists reported having made the diagnosis at least once. The diagnosis was made in a statistically significant manner more frequently by female psychiatrists, by psychiatrists aged 50 years or younger, and by those certified after 1982. No correlation was observed with primary theoretical orientation or the type or topography of work facility. The mean age of the selected patients was 33.2 and the male:female (M:F) ratio 1:9. The majority of patients were seen once a week in an outpatient setting. Individual psychotherapy and adjunctive anxiolytic or antidepressant medications were the most widely endorsed treatment modalities. Hypnosis was rarely used. We conclude that the diagnosis of DID is not to be dismissed as a local eccentricity. It is warranted as an explanatory framework in the context of a psychotherapeutic treatment.

Adult↗

The inventory for déjà vu experiences assessment. Development, utility, reliability, and validity.

In this article the development, utility, reliability, and validity of the Inventory for Déjà vu Experiences Assessment (IDEA) are described. The IDEA is a 23-item self-administered questionnaire consisting of a general section of nine questions and qualitative section of 14 questions. The latter questions comprise 48 topics. The questionnaire appeared to be a user-friendly instrument with satisfactory to good reliability and validity. The IDEA permits the study of quantitative and qualitative characteristics of déjà vu experiences.

Adolescent↗

Attitudes of health-care workers towards AIDS at three Dutch hospitals.

A questionnaire survey was held among 938 doctors and 2304 nurses to assess their attitudes toward AIDS and the influence of their concern about the occupational risks involved. The response was 65 and 72%, respectively. The results suggest that in treating patients with actual or possible HIV infection, in non-invasive procedures many doctors and nurses often take too many precautions, whereas in invasive procedures doctors often take too few. A minority of the respondents were in favour of testing all patients. The majority felt that patients in the high-risk groups should be tested. The percentage in favour of anonymous testing was considerably higher among the doctors than among the nurses. Most of the doctors and nurses were concerned about contagion by patients. This concern had a negative influence on their attitudes toward AIDS. Factual information alone does not suffice to dispel excessive concern. In training and educating medical personnel, attention should be devoted to cognitive as well as emotional aspects.

Acquired Immunodeficiency Syndrome↗

Comparison between saliva and serum lithium concentrations in patients treated with lithium carbonate.

The relation between serum and saliva lithium concentration was studied in patients treated with lithium carbonate. In 23 patients a highly variable saliva/serum ratio was found in simultaneous saliva and serum samples. In five patients studied during a period of 4-8 weeks three patients showed a high fluctuation in saliva/serum lithium ratio. In 20 patients saliva lithium concentrations varied unexpectedly in a second sample produced after 15 min. Although some authors report a high and stable relation between saliva and serum lithium concentration, we consider the saliva lithium level unreliable as a prediction of the serum lithium level in patients treated with lithium carbonate.

Carbonates↗

Thioridazine in the treatment of depressive patients.

In a double-blind study of 44 depressive in-patients, treatment with placebo appeared to give equally good results as did treatment with thioridazine. Both treatment procedures permitted the additional prescription of chlordiazepoxide when the patient's condition indicated the need for anxiety reduction. The use of chlordiazepoxide was more frequently necessary with treatment with placebo than with treatment with thioridazine.

Adult↗

The principle of separate responsibility and the therapeutic community.

Within a psychiatric hospital it has been attempted to realize a maximum number of the elements of the therapeutic community. Problems here are the short median stays of patients and the rapid turnover of both patients and staff. What is more, a basic problem of the therapeutic community was encountered, namely that the interests of the individual patient and of the patients as a group are considered as identical. Thus there came about the development of the principle of separate responsibility, whereby a division of responsibility is made between the individual patient and the unit. Work is carried out by multidsiciplinary and largely democratized teams.

Comprehensive Health Care↗