PubMed Health⌕ Search

Biomedical subjects

J L Houpt

Publications and source records attributed to J L Houpt.

At least 19 recordsLinked to original sources
PubMed1990

Sexual dimorphism, brain morphology, and schizophrenia.

The study of sexual dimorphism in brain morphology may help delineate subtypes of schizophrenia based, in part, on sex; yield insight into the relationship between brain structure and behavior; and provide a neurodevelopmental context for studying the ontogenesis of schizophrenia. Preliminary findings from an ongoing study of sex differences in brain morphology and neuropsychological performance in schizophrenia suggest that schizophrenic males are characterized by multiple morphological deviations; this may represent an extreme form of normal sexual dimorphism in brain morphology. The role of brain morphology deviation in the ontogenesis of schizophrenia is discussed.

Adult↗
PubMed1988

Subtypes of depression in patients with chronic pain.

Recent studies have shown that depression can be assessed in patients who have chronic pain. This study shows that various subtypes of depression can be differentiated in such patients using a standardized diagnostic schema for psychiatric disorders and a self-rating instrument for assessing the level of psychologic distress. In addition, when examining the onset of pain and subtypes of depression, there was no correlation between the onset of major depression and pain, whereas there was a strong positive correlation between the onset of chronic depression and pain. The recognition of the subtypes of depression has clinical implications in the management of the patient with chronic pain and depression.

Adult↗
PubMed1987

Products of consultation-liaison psychiatry.

The products of consultation and liaison activities differ considerably and require distinct marketing strategies. Whereas consultation results directly in improved patient care, the products of psychiatric liaison typically consist of less easily measured changes in nonpsychiatric physicians' attitudes and skills. The difficulty of demonstrating the benefits of liaison psychiatry as presently conceived suggest that its future course lies in the active collaboration of liaison psychiatrists in specialized treatment programs.

Forecasting↗
PubMed1987

A research development workshop to stimulate outcome research in consultation-liaison psychiatry.

With shrinking federal resources, innovative approaches involving both professional organizations and federal program staff are needed to stimulate research in new or undeveloped clinical areas. National Institute of Mental Health staff and members of the American Psychiatric Association's task force on cost-effectiveness in consultation-liaison psychiatry applied a collaborative model, the research development workshop, to stimulate outcome research in consultation-liaison psychiatry, a field with little previous such research. As a result 12 grant proposals have been submitted to NIMH for review in the last three years, and six are now funded. In contrast, in the previous ten fiscal years none of the nearly 700 services research proposals focused on the consultation-liaison area. The model could be applied to other mental health fields in which research should be stimulated.

Follow-Up Studies↗
PubMed1986

Depression as a psychopathological disorder in chronic low back pain patients.

An association between chronic pain and depression has been recognised for a long time. However, the exact nature of this association remains unclear. The authors studied 80 consecutive patients with chronic low back pain. Different types of depression were diagnosed using Research Diagnostic Criteria. The relationship between different types of depression and clinical and demographic variables are presented. Beck Depression Inventory and the Montgomery-Asberg Depression Rating Scale were used in an attempt to discriminate between the different types of depression.

Adjustment Disorders↗
PubMed1986

Recent research developments in consultation-liaison psychiatry.

With the major changes in health care and general hospital practice in the last decade, practice and research in consultation and liaison psychiatry have also changed dramatically. The authors present a selected review of recent advances and implications for five important topics in consultation-liaison research: diagnosis, disease mechanisms, biologic treatments, health services, and psychosocial treatments for medical disorders.

Disease↗
PubMed1986

The role of psychiatry in the training of primary care physicians.

The question of psychiatry's role in medicine, and in particular its role in the training of primary care physicians (PCPs), is heightened by the knowledge that 60% of the 15% of patients who have DSM-III diagnosable alcohol, drug abuse, and mental health (ADM) disorders are seen exclusively in the general health sector. In addition, although PCPs have a low recognition rate of ADM disorders and are pessimistic about their outcome even with treatment, they prescribe the majority of tricyclic and anxiolytic medications. Models of mental health training for PC residents in training are examined, with particular emphasis on competencies taught, pedagogic vehicles, disciplines of the mental health teacher, and the relationship to departments of psychiatry. A computerized approach to assist the mental health training of primary care physicians developed at the Mount Sinai School of Medicine and Northwestern is presented. Finally, critical policy issues with regard to psychiatry's future role in training is described.

Computers↗
PubMed1985

Health promotion in primary care: a survey of U.S. family practitioners.

A national sample of family practice physicians reported on the treatments and referrals they provide for each of three behavioral health risks--cigarette smoking, obesity, and insufficient exercise--and on obstacles to effective office-based health promotion. Most respondents reported regular health education and advice, but infrequent systematic treatment or referral for the substantial proportions of their patients who smoke cigarettes (40%), are obese (40%), or get too little exercise (70%). Results confirm past impressions that primary-care physicians (a) are somewhat reluctant to treat such problems, (b) overutilize relatively ineffective risk education strategies, and (c) underutilize potentially more effective behavioral or psychological treatments, either in their practices or via referral to outside programs and specialists. Physicians' pessimism about their patients' abilities to change health lifestyles, a lack of confidence in their own and outside treatments, and perceived patient rejection of referral for lifestyle change treatment, appear the major contributors to this underutilization along with the known financial and organizational obstacles to office-based health promotion and a lack of time and training for these activities. Suggestions for improving primary-care training and supports for health-promotion services are offered.

Attitude to Health↗
PubMed1985

How primary care physicians treat psychiatric disorders: a national survey of family practitioners.

A survey of 350 family practice physicians nationwide showed that 22.6% of their patients had significant psychiatric disorders. Physicians reported treating most psychiatric problems themselves, usually through a combination of psychotropic drugs, advice, and reassurance. The results suggest that anxiolytics are more conservatively used and referrals for mental health care more often made than past studies indicate. Physicians cited patient resistance and time limitations as the most important barriers to primary care mental health treatment, followed by limited third-party payment for mental health services, poor coordination between the primary care and mental health care sectors, and insufficient training to treat psychiatric disorders.

Adult↗
PubMed1985

Contrasting models for combined medical and psychiatric inpatient treatment.

The authors contrast the clinical, administrative, and reimbursement aspects of two units offering combined medical and psychiatric inpatient treatment, one under medical auspices (the medical/psychiatric model), the other under psychiatric auspices (the psychiatric/medical model). The typical patient on both units suffered from depression with prominent somatic symptoms. The psychiatric/medical model was clinically advantageous because of its greater capacity for containing agitated, psychotic, and suicidal behavior and because of its potentially longer lengths of stay for refractory patients. Furthermore, the psychiatric/medical model offers more predictable payment for psychotherapy under fee-for-service insurance and is less likely to be adversely affected by the current prospective payment system based on diagnosis-related groups.

Depressive Disorder↗
PubMed1984

The clinical concept of chronic pain.

In this article, the authors present a rationale for considering pain to be a major health problem in the United States, based on epidemiologic data. They then define the nature of pain disorders in terms of their acute and chronic forms. By extending the definition of pain into a psychogenic/organic dichotomy, the authors introduce the concept of personality variables and psychodynamic considerations that have been attributed to patients with chronic pain. Finally, the overlap and evidence for depression as a coexisting variable with chronic pain is considered. Throughout the article, the authors are arguing implicitly for a multimodal approach to therapy.

Back Pain↗
PubMed1984

Therapeutic effects of antidepressants in chronic pain.

Depression and chronic pain syndromes are often associated. Over the last twenty years there has been a number of controlled and uncontrolled studies evaluating the efficacy of antidepressants in various pain problems. The administration of antidepressant medications in the management of chronic pain has become a commonly prescribed therapeutic modality in the treatment of this complex syndrome. This paper reviews the clinical studies in which antidepressants have been used to control chronic pain, summarizes the results of the clinical studies, and comments on the mechanism of action of antidepressants in chronic pain.

Antidepressive Agents↗
PubMed1984

The Clinical Specialty Unit: the use of the psychiatry inpatient unit to treat chronic pain syndromes.

The authors describe a 15-bed psychiatry inpatient unit, the Clinical Specialty Unit (CSU), designed to treat patients with chronic pain syndromes. They argue that the use of psychiatry beds for this purpose is appropriate, given the nature of the chronic pain disorder, but is not without its liabilities. The administrative structure and roles of the multidisciplinary team are described.

Chronic Disease↗
PubMed1984

Differentiation of depression from chronic pain with the dexamethasone suppression test and DSM-III.

The concept of chronic pain has become enmeshed with depression. In an attempt to unravel this complex relationship, the authors studied a uniform group of 42 patients with chronic pain, i.e., patients who had chronic low back pain with defined organic pathology, in relation to the dexamethasone suppression test (DST). The results were analyzed in relation to the presence or absence of major depression and cortisol suppression. Forty-one percent of the patients with major depression had abnormal cortisol responses to dexamethasone administration; all patients without major depression had normal responses. These results suggest that chronic pain patients differ from patients with major depression and a positive DST.

Adolescent↗
PubMed1984

Propranolol and depression: a reevaluation based on a pilot clinical trial.

A wide range of neuropsychiatric side effects are attributed to propranolol including visual hallucinations, somnulence, memory impairment, decrease in response time, dizziness, confusional states, insomnia, nightmares, fatigue, sedation and depression. Benson et al., in a summary review of several clinical studies of 5,846 patients being treated with a variety of beta adrenergic blocking agents, listed depression as a rare side effect of propranolol that was usually reported only after long term treatment at high doses. Despite the widely circulated attribution that depression is a side effect of propranolol, there is a paucity of evidence to directly link this drug with clinically significant mood disturbance. For example, the most widely quoted reference attributing propranolol as a depressogenic agent was a "letter to the editor" which was a retrospective, uncontrolled, unblinded study that did not use a standardized depression rating scale. Most of the evidence linking propranolol to depressive symptoms have derived from scattered case reports in which the onset of depressive symptoms were attributed to this agent. Given the well known cyclic onset and remissions of affective disorders, and the prevalence of depression in the general medical population as a whole, the role of propranolol in these cases is debatable.

Aged↗