Biomedical subjects
Publications and source records attributed to M Swartzburg.
To examine the possibility that pathological gambling is related to the deficits in impulse control associated with attention deficit disorder, 14 pathological gamblers and 16 controls were administered questionnaires concerning their childhood behaviors. These self-reports indicated a strong correlation between pathological gambling and childhood behaviors related to attention deficit disorder.
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Levels of plasma glucose, nonesterified fatty acids and total amino acids at various times after insulin administration were determined in patients with either major depressive disorder or dysthymic disorder and in normal control subjects. For the first 30 min following insulin administration, the rate of change in glucose levels was significantly less among the patients with major depressive disorder than among either the patients with dysthymic disorder or the normal control subjects. However, during the same time period, the rates of decline in nonesterified fatty acids and total amino acids were indistinguishable among the three subject groups. Therefore, the insulin resistance in terms of glucose levels that is observed in patients with major depressive disorder is not generalized to other substances affected by insulin.
Levels of free plasma tryptophan, total plasma tryptophan, and total amino acids were determined at various times after insulin administration in patients with either major depressive disorder or dysthymic disorder and normal control subjects. Prior to insulin administration, there were no significant differences among the three groups in any of the parameters. However, following insulin, free plasma tryptophan levels fell significantly among the patients with major depressive disorder for the first 30 min, but not among normal controls. The rate of decline among the patients with dysthymic disorder was intermediate between those of the patients with major depressive disorder and normal controls. The levels of total tryptophan and amino acids following insulin did not differ significantly among the three groups.
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This study is concerned with an attempt to determine whether meaningful utilization review criteria could be productively generated by viewing a patient population from a developmental perspecitve. During a 2-year period, a multidisciplinary panel at Yale University sought to identify the sociodemographic, clinical, and administrative issues posed by late adolescents seeking treatment at the Connecticut Mental Health Center, New Haven. We sought to address the following questions: a) From what segment of the population were we drawing our adolescent patients? b) Who referred them for help? c) What kinds of problems led to referral? d) What were the diagnostic characteristics of the adolescent's evaluation? e) Under what conditions do adolescents terminate treatment? The charts of over 1222 adolescent patients were studied to help us answer these questions. Our investigation revealed that the adolescent patients seen at the Mental Health Center were sociodemographically and diagnostically heterogeneous. An increasingly large number of adolescents are referring themselves for evaluation and treatment, rather than being sent by schools, physicians, or social welfare agencies. The majority of patients seeking help come from blue collar or working class backgrounds mainly because of intrapsychic complaints of anxiety and depression. Upwardly mobile, they constitute a group who have completed their high school education, often live away from home, and are struggling with problems of defining an identity different from that of their family. Review of their charts indicated that significant sholastic, medical, and developmental information was frequently lacking or vaguely recorded. Our chart review also indicated that many clinicians did not ask their patients about symptoms relating to body functioning such as difficulties with sleeping, eating, or psychosomatic complaints. The study also discovered that it was difficult in the great majority of the charts reviewed to specify the adolescent's own perception of the difficulties which led them to seek help. Suggestions are then outlined for developing review criteria dealing with the emancipated adolescent, parental involvement in the treatment of the adolescent, treatment plans, and the termination of treatment. The comparative advantages of combining utilization review criteria from both a traditional "disease model" and a "developmental model" are discussed. The panel concluded that input from both perspectives is necessary in understanding the impact of a mental health delivery system upon adolescent patients, their family, and the community.
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The authors compare their experience with 4 years on a brief hospitalization unit based on crisis theory with a fifth year on the same unit based on a traditional psychiatric approach. In terms of demographic and diagnostic variables and rehospitalization rates, they found that the change in approach had no significant effect on the type of patient admitted or the treatment outcome. The fact that certain tasks necessary for rapid discharge were effectively performed accounted for the success of the unit.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.