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Biomedical subjects

J E Mezzich

Publications and source records attributed to J E Mezzich.

61 records · Page 4Linked to original sources
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Nonparametric mixture logistic regression models for clinical disposition.

Psychiatric hospitalization is one of the most important decisions in the care of patients. This is attributed to the complexity and intensity of treatment and isolation of patients from the family and community into a typically highly controlled and supervised setting. Logistic regression models are fitted to assess the relationship between DSM-III axes and psychiatric hospitalization decisions. Since the apparent error rate tends to underestimate the true error rate, the estimate for the downward bias of the apparent error was computed. A generalization of the logistic regression model is fitted where the intercept is assumed to be a random parameter.

Adolescent↗
PubMedDate not supplied

Clinical profile of comorbid major depression and alcohol use disorders in an initial psychiatric evaluation.

This study evaluated the clinical profile of patients who presented with both DSM-III major depression (MD) and alcohol use disorder (AUD) as compared with that of patients with either diagnosis alone. Comparison of these three groups (MD without AUD, AUD without MD, and comorbid AUD-MD) selected from a large sample (8,139) of general adult psychiatric patients showed that the historical, cross-sectional, and dispositional profile of AUD-MD patients occupied an intermediate position between that of the other two groups. The symptomatology of AUD-MD patients was somewhat closer to that of MD patients, whereas the premorbid personal and social history and dispositional status were more similar to those of AUD patients. AUD-MD patients had a strikingly higher rate of suicidal indicators as compared with AUD or MD patients.

Adult↗
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Gender effects on the clinical presentation of alcoholics at a psychiatric hospital.

Despite the clinical importance of gender effects on symptom patterns and comorbidity patterns in alcoholics, little is known about such effects in treatment facilities other than alcoholism treatment centers. This study evaluated the effect of gender on the clinical profile of 604 alcoholics who presented for initial evaluation and treatment at a psychiatric hospital. It demonstrated that major depression and accompanying depressive and anxiety-related symptoms are more prominent in female alcoholics than in male alcoholics, whereas antisocial personality disorder and antisocial symptoms are more prominent in male alcoholics presenting to a psychiatric hospital. The study also demonstrated that reversed neurovegetative symptoms are more severe in female than in male alcoholics.

Adult↗
PubMedDate not supplied

Age effects on the clinical presentation of alcoholics at a psychiatric hospital.

Little is known about the effects of age on the clinical presentation of alcoholism in various treatment settings, despite the clinical importance of this factor. This study evaluates the effects of age on the clinical profile of 604 alcoholics who presented for initial evaluation and treatment at a psychiatric hospital. Young alcoholics displayed the most prominent substance use, antisocial behavior, depressive symptoms (including suicidality), and impulsivity. Early middle-aged alcoholics displayed the highest levels of drinking. Elderly alcoholics displayed the highest levels of cognitive dysfunction, although some level of cognitive dysfunction was present among even the youngest alcoholics. These findings confirm and clarify the effects of age on the clinical profile of alcoholics presenting for initial evaluation at a psychiatric hospital.

Adult↗
PubMedDate not supplied

Characterizing female bipolar alcoholic patients presenting for initial evaluation.

This study examined gender differences of age and race-matched group of bipolar disorder (BPO) patients with comorbid alcohol dependence (AD; n = 65; males = 35, females = 30) to a group of BPO patients without comorbid AD (n = 61; males = 22, females = 39). The two groups were also similar on marital status and frequency of BPO subtypes. The results revealed that female bipolar alcoholic patients were more likely to report depressive symptoms as compared to either male bipolar alcoholics or both male and female non-alcoholic bipolar patients. When compared to male bipolar alcoholics, they had higher frequency of depressed mood, slow motor behavior, low self-esteem, decreased libido, decreased appetite, and higher general anxiety symptoms. On the other hand, female bipolar alcoholics differed from female non-alcoholic bipolar patients on reports of mood lability, depressed mood, low self-esteem, suicidal indicators, decreased libido, and general anxiety symptoms. These results raise the question of whether alcohol increases the frequency of depressive symptoms among female bipolar patients.

Adult↗
PubMedDate not supplied

Ethics and comprehensive diagnosis.

This paper briefly reviews basic concepts of ethics, including its meanings and dimensions and its relationship to culture. It then examines the ethical bases of medicine and psychiatry. Of particular relevance here is the connection between ethics as concern for totality and the fundamentals of health and healing. Next, the ethical bases and implications of clinical diagnosis are considered. Finally, the paper outlines the features of a comprehensive diagnostic model and explicates how ethics is linked to the integrative nature of comprehensive diagnosis and its therapeutic purpose.

Ethics, Medical↗