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Biomedical subjects

H Leigh

Publications and source records attributed to H Leigh.

At least 37 records · Page 2Linked to original sources
PubMed1980

Psychiatric consultation: compliance and level of satisfaction with recommendations.

As a measure of the effectiveness of psychiatric consultation, we assessed the level of compliance and consultee satisfaction with our recommendations in 55 consecutive cases. Overall compliance with the consultants' recommendations was 90% and did not vary significantly for the different types of recommendations. The medical staff felt that 60-70% of the recommendations had a positive effect on patient care and that only 1-2% had a negative effect. The remaining recommendations either had no effect or could not be evaluated by the medical staff. These favorable results have implications both for the care of patients, and the training of psychiatric residents.

Adolescent↗
PubMed1979

The current status of placebo in hospital practice.

Despite a voluminous literature on the topic of placebo, there has been little documentation of either actual clinical practice of prescribing placebo or the attitudes that surround it. Through a questionnaire survey of all head nurses of clinical units in one health services area of Connecticut, data were obtained on current practices regarding placebo use in the natural hospital setting. Multiple reasons for placebo use in the natural hospital setting. Multiple reasons for placebo use were given, and it was noted that patients receiving placebo tended to be viewed in certain ways. The effectiveness of placebo in symptom relief was reported as nearly double that reported in the experimental literature. Methodologic issues of the study and of placebo investigation, in general, are discussed. Because common clinical problems appear to generate most instances of placebo use, several issues pertinent to medical education are raised. Some future directions for placebo research are proposed.

Adolescent↗
PubMed1979

Goals of education in psychosomatic medicine.

The modern concept of psychosomatic medicine is based on a multifactorial, interactional systems model for all diseases in which the behavioral and social dimensions play important roles in the pathogenesis, manifestation, course, and outcome. This psychosomatic approach forms the philosophical underpinning of a modern educational program. A general goal of education for all physicians is understanding the behavioral and psychosocial factors in all illness. Specific goals for the primary physician and the psychiatrist are the instillation of a holistic attitude in patient care through systematic training, and the attainment of skills and knowledge to integrate behavioral and biomedical sciences, respectively. This includes specific diagnostic, treatment, and educational skills. Yale's multilevel educational program in psychosomatic medicine is described.

Connecticut↗
PubMed1978

Good outcome in a catatonic patient with enlarged ventricles.

In the differential diagnosis of the catatonic syndrome, the demonstration of an intracranial anomaly is often taken as evidence of irreversibility. We present the case of a 27-year-old white female with catatonia who was found to have enlarged ventricles on automatic computerized tomographic axial scan. She had a complete resolution of the catatonia and psychotic symptoms without any change in the size of the ventricles. This resolution occurred when the patient was treated for her ulcerative colitis with colectomy and the steroids she received for the colitis were gradually withdrawn. The discovery of a structural anomaly of the brain per se should not discourage the clinician from identifying and treating all other factors that might contribute to the catatonic syndrome.

Adult↗
PubMed1978

Self-control, biofeedback, and change in 'psychosomatic' approach.

The new psychosomatic treatment modalities of biofeedback and relaxation techniques have in common an emphasis on self-control or self-regulation. The surging popularity of the self-control techniques at present may reflect a change in the self-image of medicine, which emphasizes its role as a collaborator of the patient in his self-control of disease processes. The modern concept of psychosomatic medicine emphasizes a systems or field approach to evaluation and treatment rather than 'psychogenic' causes of physical illness. The self-control treatment modalities form an important part of the armamentaria of a modern 'psychosomaticist'. We present preliminary data suggesting that 'potentiation' of biofeedback treatment may be useful. In borderline hypertensives, using pharmacologic means to reduce blood pressure during a biofeedback session may help subjects identify and re-create the 'low blood pressure states' without further aid of drugs. Hypertensives seeking biofeedback treatment are extremely internal in locus of control and tend to generalize their self-control to other areas of life to foster health and to prevent illness.

Adult↗
PubMed1978

Self-control, biofeedback, and change in 'psychosomatic' approach.

The new psychosomatic treatment modalities of biofeedback and relaxation techniques have in common an emphasis on self-control or self-regulation. The surging populatiry of the self-control techniques at present may reflect a change in the self-image of medicine, which emphasizes its role as a collaborator of the patient in his self-control of disease processes. Modern concept of psychosomatic medicine emphasizes a systems or field approach to evaluation and treatment rather than on 'psychogenic' causes of physical illness. The self-control treatment modalities form an important part of the armamentaria of a modern 'psychosomaticist'. We present preliminary data suggesting that 'potentiation' of biofeedback treatment may be useful. In borderline hypertensives, using pharmacologic means to reduce blood pressure during a biofeedback session may help subjects identify and re-create the 'low blood pressure states' without further aid by drugs. Hypertensives seeking biofeedback treatment are extremely internal in locus of control and tend to generalize their self-control to other areas of life to foster health and to prevent illness.

Adult↗
PubMed1977

Major trends in psychosomatic medicine. The psychiatrist's evolving role in medicine.

Three developmental lines are identifiable in psychosomatic medicine: (1) psychodynamic investigations, (2) psychophysiologic and psychosocial research, and (3) consultation-liaison psychiatry. Although psychodynamic understanding of medical patients remains important, "psychogenesis" is no longer the principal concern of psychosomatic medicine, which has shifted emphasis to a holistic understanding that includes the biologic, psychologic, and social systems of medical and psychiatric patients. Recent investigations along the second line indicate that all medical and psychiatric illnesses can be regarded as "psychosomatic," in that comprehensive understanding and care cannot be achieved without considering the three interrelated systems. Consultation-liaison psychiatry is the practice of this holistic approach in the general hospital. The essential role of the consultation-liaison psychiatrist as a bridge between the biologic and behavioral disciplines may become a major part of the role of the general psychiatrist in the future.

Biofeedback, Psychology↗
PubMedDate not supplied

The relationship between repressive and defensive coping styles and monocyte, eosinophile, and serum glucose levels: support for the opioid peptide hypothesis of repression.

The opioid peptide hypothesis of repression (1) predicts that repressive coping is associated with increased functional endorphin levels in the brain, which can result in decreased immunocompetence and hyperglycemia. In a random sample of 312 patients seen at a Yale Medical School outpatient clinic, significant main effects of coping style were found for monocyte and eosinophile counts, serum glucose levels, and self-reports of medication allergies. Specifically, repressive and defensive high-anxious patients demonstrated significantly decreased monocyte counts. In addition, repressive coping was associated with elevated eosinophile counts, serum glucose levels, and self-reported reactions to medications. This behavioral, immunologic, and endocrine profile is consistent with the opioid peptide hypothesis, which provides an integrative framework for relating the attenuated emotional experience of pain and distress characteristic of repressive coping with reduced resistance to infectious and neoplastic disease.

Adaptation, Psychological↗