Biomedical subjects

J A Feinman

Publications and source records attributed to J A Feinman.

5 recordsLinked to original sources

PubMed2000

Development of a model for the detection and treatment of depression in primary care.

Development and implementation of a protocol for identifying and treating depressed patients in a busy, group model, HMO primary care practice is described. Initial results and barriers to implementation are reported. A simple depression screening tool was adapted and a protocol for using available primary care staff and resources was developed to efficiently integrate screening and treatment for depression into daily practice. Important components of the program included specification of the target population, adaptation of a patient self-report diagnostic and rating tool, a nurse-educator protocol for patient follow-up and telephone support, a database to track patient progress, training for primary care staff, and collaboration with specialty Behavioral Health Care. After piloting, plans were made for transferring the model to other practices. Although the protocol was seen as beneficial to the PCP, Nurses, and patients involved, the scarcity of resources in other primary care practices proved a major barrier to full implementation.

Behavioral Medicine↗

PubMed1996

The effect of alcohol and substance abuse on the course of bipolar affective disorder.

It has been found that > 60% of bipolar I and almost 50% of bipolar II patients have a history of substance abuse (Regier et al., 1990). While previous studies have examined comorbidity of bipolar disorder and substance abuse, little has been done to examine the effect of substance abuse on the course of bipolar disorder. There has also been little distinction made between bipolar disorder occurring prior to substance abuse and that occurring after the onset of substance abuse. Given the high prevalence of substance abuse in bipolar patients, it would be useful to determine more about the effect of substance abuse on demographic and clinical features and on the course of illness. We attempted to do this with a retrospective chart review of 188 bipolar patients seen by D.L. Dunner between January 1992 and December 1993. Demographic and clinical information as well as information about course of illness were systematically extracted from the charts. We compared the means and percentages of these variables and analysed them for significance. Preliminary results show differences in demographics, clinical features and course of illness between patient groups. These differences may illustrate the clinical effects of substance abuse on the course of bipolar disorder. Our results also indicate that there are differences between patients whose bipolar disorder began prior to and those whose disorder began after the onset of substance abuse.

Adult↗

PubMed1988

Intermittent brief psychotherapy in an HMO setting.

In this exploratory study the authors investigate the practice of intermittent brief psychotherapy in an HMO setting. It was found that returning patients represented 27 percent of the requests for treatment in a four-month period. The majority of these patients found previous treatment helpful, and the authors hypothesize that for many of these individuals the need for further treatment comes about as the result of changes related to problems of normal development or problems in coping with significant life transitions.

Consumer Behavior↗

PubMed1979

The question of hormonal influences on intellectual development: growth hormone.

Contrary to expectations based on findings of enhanced brain development and learning in rats after prenatal growth-hormone administration, a sample of patients with growth-hormone deficiency of early onset did not show impairment of mental abilities when tested with standard intelligence tests. We conclude from our findings, as well as from other clinical reports, that growth-hormone deficiency of onset does probably not interfere with normal human brain development.

Child, Preschool↗

PubMed1978

Growth hormone deficiency, brain development, and intelligence.

Twenty-nine patients with growth hormone (GH) deficiency were selected according to the following criteria: no evidence of reversible GH deficiency, onset of growth retardation in early childhood, and no evidence of pituitary tumors or other direct pituitary trauma. Fourteen patients had evidence of multiple hormone deficiencies, 14 had isolated GH deficiency, and one patient questionable isolated GH deficiency. Psychometric testing showed a normal IQ distribution. The GH deficiency was not associated with deficiencies in specific mental abilities. Likewise, GH treatment in later childhood and adolescence did not seem to influence intelligence. Patients with multiple hormone deficiencies had somewhat lower IQs than patients with isolated GH deficiency when socioeconomic status was controlled. We conclude that GH deficiency itself does not seem to affect human brain development and intelligence.

Adolescent↗