PubMed Health⌕ Search

Biomedical subjects

H M Pettinati

Publications and source records attributed to H M Pettinati.

At least 19 recordsLinked to original sources
PubMed1994

Patient attitudes toward electroconvulsive therapy.

Electroconvulsive therapy (ECT), a safe and effective treatment for major depression, has been more harshly criticized than any other psychiatric treatment. Despite widespread negative public opinion, clinical impressions that are supported by limited empirical data suggest that patients who benefit from ECT do not share these negative sentiments. This study surveyed attitudes toward ECT in 78 depressed inpatients, twice during hospitalization and at 6 months after discharge, using a semi-structured interview. Significantly more ECT-treated patients (n = 56) were favorable about ECT, compared to depressed patients (n = 22) never treated with ECT, both at pretreatment (chi square = 8.4, df = 1, p < .01) and at post-treatment (chi square = 12.5, df = 1, p < .01). Favorable attitudes were maintained after 6 months. ECT-treated patients, initially uncertain or negative about ECT, changed to a favorable attitude after completing treatment. Ninety-eight percent of ECT-treated patients said they would agree to ECT if they became depressed again.

Adult↗
PubMed1994

Speed of ECT?

Explore the source record for details and available documents.

Antidepressive Agents↗
PubMed1993

Inpatient vs outpatient treatment for substance dependence revisited.

Miller and Hester's 1986 review of inpatient versus outpatient alcohol treatment studies concluded with no "justification" for inpatient treatment. Further examination of these studies revealed shortcomings such as the use of random assignment designs which excluded psychiatrically-complicated patients. Carrier Foundation's inpatient/outpatient study of private psychiatric patients with alcohol and/or cocaine dependence includes a patient-treatment matching design to address weaknesses in the existing literature. Patients with high psychiatric severity and/or a poor social support system are predicted to have a better outcome in inpatient treatment, while patients with low psychiatric severity and/or a good social support system may do well as outpatients without incurring the higher costs of inpatient treatment. Preliminary results from 183 inpatients and 120 outpatients indicated outpatients, regardless of level of psychiatric severity, were 4 times more likely to be early treatment failures (chi-square = 41.2, df = 1, p < .01). While the determination of long-term follow-up status of early treatment failures is currently underway, this finding underscores the potential risk of early treatment failure in outpatient compared to inpatient substance abuse treatment programs and the importance of addressing the issue of early attrition in conducting outcome analyses.

Ambulatory Care↗
PubMed1991

Choosing an electroconvulsive therapy device.

The selection of an electroconvulsive therapy (ECT) device from the more than 10 American-made models can be a difficult endeavor. This article is meant to be a single source of basic descriptions of these ECT devices. The information provided will allow the ECT clinician to be aware of the important issues involved in the selection of an ECT device and to become familiar with the basic features of each model.

Electroconvulsive Therapy↗
PubMed1990

A placebo-controlled evaluation of vasopressin for ECT-induced memory impairment.

Vasopressin may be involved in normal memory functions and may alleviate certain memory impairments. In this study, the usefulness of vasopressin to relieve electroconvulsive therapy (ECT)-induced memory impairment was evaluated using a placebo-controlled, random assignment, double-blind design. Patients were 33 depressives receiving bilateral ECT. Vasopressin, in a nasal spray, was administered q.i.d. from the first through the fifth ECT. Extensive memory testing evaluated both retrograde and anterograde amnesia; ratings of depression and patient ratings of subjective memory complaints were also obtained. Results did not show statistically significant evidence of benefit from vasopressin, though a number of comparisons were in the predicted direction. The role of vasopressin in reducing memory impairment of various types remains to be elucidated.

Administration, Intranasal↗
PubMed1990

Hypnotizability of psychiatric inpatients according to two different scales.

Data on the hypnotizability of 113 psychiatric inpatients and 58 normal control subjects were compared. The patients' mean score on the Hypnotic Induction Profile was significantly lower than that of the control subjects, but on the Stanford Hypnotic Susceptibility Scale: Form C, these patients and control subjects did not differ significantly. On both scales rank-ordered scores of different diagnostic groups of the patients supported the theory that hypnotizability varies according to type of psychopathology. Some results, such as the hypnotizability of the schizophrenic patients, depended on which scale was used. This finding may explain the conflicting literature on the hypnotic potential of schizophrenic patients.

Adolescent↗
PubMed1990

Evidence for less improvement in depression in patients taking benzodiazepines during unilateral ECT.

Among 48 patients with diagnoses of depression according to DSM-III, there was a significant relation between therapeutic failure of unilateral ECT, as measured by scores on the Hamilton Rating Scale for Depression, and the concomitant use of a benzodiazepine. Of the 34 patients who showed a good therapeutic response to unilateral ECT, those taking benzodiazepines had smaller changes in their Hamilton depression ratings from before treatment to after treatment and were more symptomatic at the end of the course of ECT. Thus, when patients take benzodiazepines during a course of unilateral ECT, the maximum therapeutic response may be compromised.

Adult↗
PubMed1989

The role of female occupation in severity of alcohol-related problems.

This study investigated whether occupational class is related to the severity of problems associated with alcohol abuse in females. Sixty-six female alcoholic inpatients at a private psychiatric hospital were studied. Of these women, 31 were workers (working at the time of admission), 18 were unemployed workers (unemployed at admission but had worked most of their adult lives), and the remaining 17 were homemakers. Problem severity was assessed for 66 alcoholic women using the Addiction Severity Index (ASI), a standardized clinical interview. A questionnaire assessing the degree of occupational stress experienced was also administered. Employment problem severity ratings from the ASI differed significantly across the three occupation subgroups [F(2,63) = 10.99, p less than .05]; the unemployed workers reported more severe employment problems than did either the workers [t(63) = 3.07, p less than .05] or homemakers [t(63) = 4.77, p less than .05]. There were no significant differences between the three groups on the other five ASI dimensions. A cluster analysis on ASI severity ratings revealed a trend for workers to have family and psychological problems in addition to alcoholism. This seems not to have had an impact on wanting a job change; significantly more homemakers (z = 4.77, p less than .05) and unemployed workers (z = 4.56, p less than .05) than workers wanted a job change.

Adult↗
PubMed1988

An application of an MMPI classification system for predicting outcome in a small clinical sample of alcoholics.

The purpose of this study was to apply Conley and Prioleau's MMPI classification system to predict drinking and adjustment outcome for a sample of 113 inpatient alcoholics. Although a dual grouping (termed "reactive" and "essential") of the original six MMPI subtypes was found to be more useful for this sample size, the findings, nevertheless, supported the predictive value of this MMPI classification system. The "essential" group, derived from a triad of Psychopathic and Schizoform MMPI types was rated as drinking significantly more often during 4 years after treatment than the "reactive" group, derived from a triad of Neurotic and Classic MMPI types (Fisher's p = .02). Females classified as the "essential" MMPI group were rated as having significantly poorer adjustment (Fisher's p = .007) than females classified as the "reactive" MMPI group.

Adolescent↗
PubMed1985

Hypnotizability in patients with anorexia nervosa and bulimia.

Hypnotizability was assessed with the use of three standardized hypnosis scales in 86 patients with eating disorders. All diagnoses were made according to DSM-III criteria. Sixty-five patients had anorexia nervosa and 21 had bulimia. The anorectic patients were divided into subgroups of 19 abstainers and 46 vomiters and purgers. Bulimic patients were highly hypnotizable, significantly more so than the patients with anorexia nervosa and age-matched populations. There was also a trend for the purging subgroup of anorectics to have higher hypnotic capacity than abstaining anorectics.

Anorexia Nervosa↗
PubMed1985

Comparing bilateral to unilateral electroconvulsive therapy in a randomized study with EEG monitoring.

In a double-blind study, 48 DSM-III depressed patients were randomly assigned to either the bilateral or nondominant unilateral electroconvulsive therapy (ECT) group. Seizure length was monitored by electroencephalography (EEG). When seizures were less than 25 s, ECT was immediately readministered. When length of seizure and pretreatment depression scores were controlled between the two groups, there were no differences in treatment effectiveness, as measured by the Hamilton Rating Scale for Depression and the Beck Depression Inventory, or in the number of treatments required. This was true after five ECT treatments as well as after completing all ECT treatments. Thus, when ECT is monitored via EEG to assure the presence of an adequate seizure, bilateral and nondominant unilateral placement yield equivalent responses. If ECT had not been readministered immediately following a missed seizure, unilateral patients would have had significantly more missed seizures. Significant difficulties in both short- and long-term memory were found 24 hours after the fifth ECT in bilateral but not in nondominant unilateral patients. No apparent memory loss could be documented in nondominant unilateral ECT.

Adult↗
PubMed1985

Missed and brief seizures during ECT: differential response between unilateral and bilateral electrode placement.

The number of electroconvulsive therapy (ECT) stimulations over a course of treatment that resulted in brief or no seizure activity was evaluated for depressed patients (N = 58, treated for DSM-III diagnosed major depressive disorder) who had been randomly assigned to either bilateral or unilateral nondominant ECT in a double-blind study. Comparable treatment efficacy between both groups was found. Although there were no group differences in brief seizures, unilateral nondominant ECT resulted in more missed seizures (p less than 0.01) and required more restimulations than bilateral ECT. Of 27 unilateral ECT patients, 63% had at least one missed seizure over the course of treatment, compared to 29% of 31 bilateral ECT patients (p less than 0.02). Although more missed seizures occurred early in treatment, brief seizures occurred later in treatment. As missed seizures are not always detected clinically, it is possible that without seizure monitoring, patients with unilateral nondominant ECT will not improve at the same rate as patients with bilateral ECT. Lack of seizure monitoring in the clinic is one likely explanation for the discrepancy between a number of research studies reporting equivalent efficacy for bilateral and unilateral ECT and the clinical impression that bilateral ECT is more effective.

Depressive Disorder↗