Physical impairment and emotional problems among chronically disabled patients.
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Biomedical subjects
Publications and source records attributed to P Hesbacher.
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Emotional sympomatology data on 78 obese females treated for 3 weeks with fenfluramine, dextroamphetamine, or placebo were evaluated. These obese females were shown to be considerably less emotionally disturbed than neurotic females, and similar in emotional symptomatology to other females seeing physicians for nonpsychiatric complaints. Even within these marginally sympatomatic patients, fenfluramine and dextroamphetamine were significantly more effective than placebo in reducing anxious, depressive, and anxious-depressive symptomatology. Fenfluramine was particularly effective in alleviating anxiety in patients who were initially higher in anxiety. Most important, fenfluramine produced significantly greater weight loss than dextroamphetamine in patients with higher levels of anxiety and depression, while dextroamphetamine was an especially effective anorexic in low anxious patients. Differences in initial anxiety and depression, even within relatively normal patients, may well affect results obtained with fenfluramine and dextroamphetamine in the short-term treatment of obesity.
In an attempt to assess the precision of an illness-treatment "fit" between dispensing and actual need for psychotropic medications, the present study examined the dispensing patterns to consecutive attenders of private general practice. "Conservative" use of psychotropic drugs was indicated insofar as patients were seldom dispensed medication in the absence of emotional problems, and the presence of emotional problems frequently was not accompanied by the dispensing of medication. In addition, specific social and illness factors were located which could differentially predict either the presence of emotional problems, the use of psychotropic drugs, or both of these variables. The potential for constructing a more precise illness-treatment fit was considered.
A comparison is made between the General Health Questionnaire (GHQ) and the Symptom Checklist (SCL) as psychiatric screening tests in community-based research projects. Both are shown to correlate equally well with independent clinical assessment, and the differences between them mainly reside in the form of their response scales. The GHQ works best as a screening test, since it has fewer false positives associated with its use, but it may miss those with long-standing disorders. The SCL tends not to miss long-standing disorders and furnishes diagnostic sub-scales if these are required. Both tests function better with men than with women and with whites than with blacks, but neither is affected by social class or age of the respondent. The study revealed high correlations between the symptoms of anxiety and depression, and indicated some possible differences between the symptom clusters seen in whites and in blacks.
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