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Biomedical subjects

M H Sacks

Publications and source records attributed to M H Sacks.

15 recordsLinked to original sources

Applicants' choice of a residency training program.

The authors present results from a survey of senior medical students in the class of 1981 concerning their selection of residency training programs in psychiatry. Generally, students were more influenced by clinical training opportunities and quality of life factors and not much influenced by the philosophy of the program. The implications of the findings are discussed from the perspectives of both advising and recruiting medical students.

Adult

Seclusion: uses and complications.

A total of 7.2% of the patients in a private psychiatric hospital were placed in seclusion during a one-year study. These 63 patients had a more frequent diagnosis of schizophrenia and manic-depressive illness, manic type, than a comparison group. Significant intergroup differences in age and length of hospitalization became insignificant when the seclusion patients under 20 were excluded. Although seclusion was often used to protect patients, others, and property, the most frequent reason was to maintain a therapeutic environment. This study pointed toward a staff tendency to see the "problem" of the patient's behavior as being solved by seclusion rather than viewing seclusion as an intensive care environment in which the patient's behavior and treatment could be morec arefully monitored.

Adolescent

Evaluating signs and symptoms: comparison of structured interview ans clinical approaches.

Are research interview techniques adequate in assessing signs and symptoms? This question is investigated by obtaining two sets of interview schedule ratings on 49 patients, one by a research psychiatrist applying the interview and one by the patient's psychiatrist using all available information. The latter was considered a clinical standard with which a cross-sectional research interview could be contrasted. These two data sets were subjected to several types of analysis commonly undertaken with research interview ratings. Results indicated that the research interview adequately represents symptom data, but is seriously lacking in the assessment of observed behaviour. The effect of this difference depends on the goals of the study and the nature of the data analysis. If overall group findings are desired, or if analysis relies primarily on symptom data, results with a research interview may be similar to results based on a far more extensive evaluation. On the other hand, if conclusions are to be drawn on individual patients, or if data analysis relies heavily on observed behaviour, then data derived from research interviews are questionable.

Behavior

Folie à deux.

A review of folie à deux or induced psychotic disorder (DSM-III-R) is provided. The author believes it to be a more frequent phenomenon than usually thought, especially when hospitalized patients are evaluated with their families. An argument is made for viewing it as a description of a relationship and possible influence between individuals who may have very different disease processes. This includes, in the secondary partner, a continuum from being very "impressionable" to having an autonomous and independent delusional disorder. A case report and suggestions for treatment are given.

Adult