Biomedical subjects
N S Kaye
Publications and source records attributed to N S Kaye.
The psychiatrist's role, responses, and responsibilities when a patient commits suicide.
The suicide of a patient is not an infrequent event in a psychiatrist's practice, and it has a major impact on the clinician as well as on the patient's family and the hospital staff. Dealing with a patient's suicide is a neglected topic in residency training, and many psychiatrists are never taught how to cope with such a situation. The authors review the relevant literature and draw on this as well as on their own clinical experience to recommend specific interventions. They point out that the psychiatrist has a leadership role and a number of responsibilities in the aftermath of a suicide, including notifying the family, the hospital staff, hospital officials, and patients who knew the deceased patient; meeting with the family, the staff, and the patients to encourage discussion and venting of feelings; attending the funeral; and accurately documenting events in the medical record. The psychiatrist should also attend to his or her own needs by seeking support from a colleague and should ensure that a psychological autopsy is performed in order to facilitate learning, improve care of patients in the future, and help bring about closure for the psychiatrist so that the quality of his or her care of other patients is not compromised.
Effect of evaluations of competency to stand trial on the state hospital in an era of increased community services.
The authors studied court-ordered inpatient evaluations of competency to stand trial at two Massachusetts state hospitals for the period from 1972 to 1987, with particular attention to the effects of a 1978 federal court consent decree that created an extensive system of community-based services in the catchment area of one of the hospitals. The authors found that the broad array of community services developed under the consent decree did not reduce commitments to the state hospital for evaluation of competency to stand trial at the same rate as it reduced civil commitments, with the result that the composition of the patient population changed to include a significantly larger proportion of patients referred by the criminal justice system. This proportion was as high as 17.8 percent in 1985. These patients used a disproportionate share of the hospital's resources, staying in the hospital for a median of 28 days, compared with 12 days for all other patients.
Families, murder, and insanity: a psychiatric review of paternal neonaticide.
Neonaticide is the killing of a newborn within the first 24 h of life. Although relatively uncommon, numerous cases of maternal neonaticide have been reported. To date, only two cases of paternal neonaticide have appeared in the literature. The authors review neonaticide and present two new case reports of paternal neonaticide. A psychodynamic explanation of paternal neonaticide is formulated. A new definition for neonaticide, more consistent with biological and psychological determinants, is suggested.
The right to health care.
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Doxepin for treatment of mania.
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