Biomedical subjects
H M Katz
Publications and source records attributed to H M Katz.
A new agenda for psychotherapy of schizophrenia: response to Coursey.
A new agenda for the practice and study of psychotherapy of schizophrenia should focus not on the longstanding debate as to whether psychotherapy is effective, but on how it may be effective for particular groups of patients, and on combining psychotherapy with other interventions over the course of illness. Empirical studies have failed to substantiate claims for broadly superior outcome when patients are treated with psychotherapy, and practitioners of psychotherapy may need to have a narrower focus and more modest expectations for change. Research efforts should work toward developing guidelines for selective use of psychotherapy that are consistent with our recognition that schizophrenic patients show heterogeneity in their etiology, presenting symptoms, and clinical course. Intrapsychic, experiential, and interpersonal aspects of schizophrenia that are most resistant to other treatment approaches may be sensitive to psychotherapeutic intervention, and a psychodynamic approach to therapy offers the most direct help with a disordered inner world to the person struggling with schizophrenia.
Psychotherapy of schizophrenia: an empirical investigation of the relationship of process to outcome.
The Boston Psychotherapy Study found no major differences in the effects of insight-oriented and supportive psychotherapies in the treatment of schizophrenia. The authors of the current study looked beyond the assignments to those treatment designations and used blindly rated transcripts of tape-recorded sessions to examine the relationship of therapist interventions and patient outcomes at 2 years. They found significant relationships between skillfully conducted psychodynamic exploration and greater improvements in negative symptom areas of schizophrenia. The authors note the limitations and implications of these findings for clinical practice and research.
Effects of psychotherapy in schizophrenia: II. Comparative outcome of two forms of treatment.
This study compares the effects of exploratory, insight-oriented (EIO) and reality-adaptive, supportive (RAS) forms of psychotherapy on a sample of 95 schizophrenic patients. Analyses of 2-year outcomes revealed a complex interaction between the type of psychotherapy provided and the domain of psychopathology affected. RAS psychotherapy exerted clear preferential effects in the areas of recidivism and role performance. The EIO psychotherapy exerted preferential, albeit more modest, action in the areas of ego functioning and cognition. Overall, however, the magnitude of the differences was low. The results highlighted the need for more focused studies of subgroups, and of process and contextual influences on outcome.
Psychotherapy of schizophrenia. What happens to treatment dropouts.
Sixty-nine nonchronic schizophrenic patients who had dropped out of psychotherapy were studied with regard both to reasons for dropping out and their subsequent clinical course, assessed by means of a retrospective, semistructured interview. Their 2-year outcomes were compared with those of a group of similar patients who remained in psychotherapy. It was found that the patients who dropped out were markedly heterogeneous in terms of their reasons for dropping out, and their subsequent outcomes. As a group, they received an unexpectedly substantial amount of subsequent psychiatric treatment, and after 2 years did not generally differ from those remaining in psychotherapy on measures of social or occupational functioning.
Investor-owned and not-for-profit hospitals. A comparison based on California data.
The growth of investor-owned hospital-management companies represents the most dramatic change in the hospital industry in recent years. Whereas supporters of investor-owned chains suggest that their growth is attributable to operating efficiencies, critics suggest that it has resulted from pricing and marketing strategies. Using data supplied by the California Health Facilities Commission, we compared the economic performance of investor-owned and not-for-profit hospitals in California. There were three principal findings. First, during the study period both costs and charges were higher in for-profit than in not-for-profit hospitals, measured on the basis of either patient-days or admissions. Second, the for-profit chains have used aggressive marketing and pricing strategies to generate high rates of profitability and growth. Finally, the payer class of patients did not differ specifically according to the hospital-ownership category. We conclude that the recent dramatic growth of investor-owned hospital chains is attributable to the employment of managerial strategies that were well suited to the reimbursement system in effect during the period studied. As a result of recent changes in federal and state reimbursement, many of these reimbursement-maximization strategies have become obsolete. Whether the investor-owned chains will be able to adapt rapidly to this new reimbursement environment remains to be seen.
Pulmonary edema in a 52-year-old woman ingesting large amounts of aspirin.
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Physiologic responses to intravenous serotonin in the awake squirrel monkey.
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Olfactory learning-set formation in rats.
Rats trained on 16 two-odor discrimination problems showed rapid acquisition of a learning set and one-trial learning by the end of the problem series. Learning to sample odor cues before responding and adoption of a "win-stay, lose-shift" strategy probably accounts for the virtually errorless learning. Learning-set performance of rats trained with odor stimulus comparable to that reported for primates trained on visual cues.
Probucol in the long-term treatment of hypercholesterolaemia.
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Blood sugar lowering effects of chlorpropamide and tolbutamide. A double blind cooperative study.
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