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Biomedical subjects

R O Pasnau

Publications and source records attributed to R O Pasnau.

At least 19 recordsLinked to original sources
PubMed1991

Low dose desipramine treatment of cocaine-related panic attacks.

Thirteen patients meeting DSM-III-R criteria for panic disorder with or without agoraphobia that started during or shortly after cocaine exposure were treated in the UCLA Anxiety Disorders Program (Los Angeles, CA). Low starting doses (ranging from 2.5 to 10 mg/day) of desipramine were used. Doses were then slowly increased to an average daily dose of 25 mg. Eleven patients who were able to tolerate an initial increase in panic anxiety responded to this treatment strategy with almost full resolution of panic attacks. The authors discuss the possible value and mechanisms of low dose treatment of cocaine-related panic attacks.

Adult↗
PubMed1991

Bereavement in AIDS.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Psychological reaction to hospitalization and illness in the emergency department.

Each personality type presents with different methods of coping. Physicians should be aware of the impact on a patient's psychological functioning and ability to cope with illness and hospitalization, to understand and more effectively manage the patient. The physician must try to assess the patient's baseline personality from their past and present behavior. Establishing a good physician-patient relationship is important as a source of information about behavior of patients and how they will respond to their illness. Depending on the specific personality type, each patient will respond differently to the stress of illness. The effort of the emergency physician to identify personality types will aid in medical management of the patient and enable the physician to help each patient cope effectively with the illness and the hospitalization. The specific issues that seem to be threatening to traumatized patients include the following: helplessness, humiliation, blurring of body image, and gaps in memory filled with distortions. The traumatized patient experiences an altered state of consciousness which is either due to a physiologic cause or an emotional cause. Emotional causes are usually based on defensive dissociation. People who have been in an auto accident characteristically report loss of memory of the intense pain that the accident produces initially. Oftentimes, the core experience for the traumatic patient is not somatic, it is unconscious. The interesting feature is that so many patients do not remember the accident. The mind seems to be filled with all kinds of distortions and irrelevant and perhaps totally inconsistent fantasies, such as imprisonment, confinement, or deathlike experiences. Some report that they are being incarcerated, others recall being in a featureless cubicle with no contact with the normal world in which there are no windows, no pictures, no flowers. Others remember only being surrounded by masked, hatted, uniformed wardens who are standing over them with nasogastric tubes, intravenous lines, Foley catheters, arterial blood gases, subclavians, and dermal cut-downs. This is an overwhelming nightmare that can be relieved only by the empathic and caring physician and emergency department staff. The stress of medical illness and/or hospitalization can be overwhelming for some patients and is usually followed by some form of psychological response. Current understanding of the psychological impact of illness is based upon psychological defenses, coping mechanisms, and individual personality. It is the ability of the emergency physician to identify defenses, coping skills and personality types that will aid him or her in the medical management of the patients in their time of illness and hospitalization.

Disease↗
PubMed1990

Darwin's illness: a biopsychosocial perspective.

Throughout an illustrious scientific career, Charles Robert Darwin (1809-1882) suffered from a mysterious and disabling malady. The illness, which was characterized by depressed feelings and violent and uncomfortable cardiac palpitations, gastric upsets, and headaches, began shortly after Darwin returned from a five-year voyage to South America as the naturalist of the Beagle. One explanation for Darwin's symptoms is he suffered from Chagas' disease as a result of being bitten by an insect common to South America. More psychodynamically oriented theorists speculate that Darwin's illness was an expression of repressed anger toward his father. Others have noted a familial vulnerability to the symptoms Darwin described. The author examines these theories and suggests that they all may have validity in explaining the mysterious illness of Charles Darwin.

Chagas Cardiomyopathy↗
PubMed1990

An overview of anxiety disorders.

Anxiety disorders are more prevalent than any other mental health problem in the United States. Afflicted persons are often untreated or are treated only by a primary care physician without psychiatric consultation. However, based on current knowledge of the biological and psychological factors involved in these disorders, psychiatry has defined effective treatment that integrates education, psychotherapy, and psychopharmacology. After reviewing current research on possible mechanisms of anxiety, the authors discuss therapeutic interventions and recommend ways to choose appropriate treatment modalities for anxiety-disordered patients.

Agoraphobia↗
PubMed1989

Psychiatric syndromes linked to reproductive function in women: a review of current knowledge.

Four psychiatric syndromes related to reproductive function in women have been identified: postpartum depression, premenstrual syndrome (PMS), post-hysterectomy depression, and involutional melancholia. The authors review what is known about these syndromes and conclude, first, that postpartum depression comprises three separate syndromes, the most severe of which is most likely a variant of primary affective disorder. Second, research into the syndromal nature, biology, and treatment of PMS is still in its infancy due to a variety of methodological difficulties. Third, the rate of depression among women during the involutional period or following hysterectomy for benign pathology is not higher than it is at other times.

Depressive Disorder↗
PubMed1985

Acquired immune deficiency syndrome (AIDS) and consultation-liaison psychiatry.

Acquired Immune Deficiency Syndrome (AIDS) is a new highly lethal transmissible syndrome that occurs primarily in identified high-risk groups. The number of AIDS cases has been doubling approximately every 6 months in the United States since 1981. A large number of healthy HTLV-III seropositive individuals, and a significant number of individuals with AIDS-related complex (ARC), who are at increased risk for eventual development of AIDS, have been identified. At least one third of AIDS patients develop neurologic disease prior to death. Organic mental disorders are frequent in AIDS and can have devastating consequences. Severe psychologic distress and functional psychiatric syndromes are also common. The psychosocial effects of AIDS for patients, family and friends, and health-care professionals are discussed in relationship to the psychosocial consequences of other serious medical illnesses including cancer. An ideal comprehensive program to meet the needs of "AIDS affected" individuals is presented, as are the authors' views on the tasks of C-L psychiatrists in participating in the comprehensive care of these individuals.

Acquired Immunodeficiency Syndrome↗
PubMed1979

Phantom breast syndrome.

In this study of 41 women who underwent mastectomy, over half (54%) experienced phantom breast syndrome (PBS). Of these, 80% had phantom breast pain. The majority of women (58%) did not report their symptoms to their physicians, despite the considerable interference in their lives from these symptoms. Six variables were found to differentiate the women who had phantom breast syndrome from those who did not. All of these factors were closely related to the psychological aspects of mastectomy. Significant among these was that women who experienced PBS perceived both that they did not receive much emotional support from their surgeons, and that most of their emotional problems were secondary to the mastectomy. In these respects, they differed from women not reporting PBS. By early evaluation of each patient who is to undergo mastectomy, it should be possible to identify those at risk, to develop means to prevent the development of the syndrome, and to treat those women in whom the preventive attempts are unsuccessful.

Adult↗
PubMed1979

Psychology interns on a consultation-liaison service.

This paper develops a rationale for training psychology interns on a consultation-liaison service to deal with the psychologic problems of medically ill patients and to work with their health care providers. General and specific goals are delineated to summarize training objectives for these interns at the end of three and six months on the service. The overall objective of the service in offering such a program is to train psychologists to feel competent and comfortable in meeting the psychologic needs of the medically ill. The service seeks to train psychologists primarily as clinicians and secondarily as researchers in the health care area.

Curriculum↗
PubMed1978

Psychosocial aspects of mastectomy: I. the women's perspective.

The authors administered a questionnaire to 41 women who had had mastectomies to investigate aspects of the procedure itself, pre- and postmastectomy adjustment, effects on sexual relationships, and the influence of age. Although most women reported good overall adjustment, there were strong indications of psychological suffering (suicidal ideation, increased use of alcohol and tranquilizers, etc.). Psychological intervention may be called for in many cases, and age, support systems, and premorbid functioning may be indicators of the amount and type of intervention needed. Counseling is particularly important before surgery, since this was viewed as the period of maximum stress by most women. Further research with larger, more random samples and postsurgical control groups is indicated to determine more precisely the factors related to adjustment to mastectomy.

Adaptation, Psychological↗
PubMed1978

Psychosocial aspects of mastectomy: II. the man's perspective.

In order to assess factors related to men's adjustment to mastectomy and its aftermath the authors administered a questionnaire to 31 men whose wives or partners had had mastectomies. Most men reported a good overall adjustment, but a subgroup remained distressed and reported adverse effects on their relationships with wives or lovers. The data indicate that the nodal points in the process are the involvement of partners in the decision-making process, the frequency of hospital visits, resumption of the sexual relationship, and the man looking at his partner's body after surgery. These findings have implications for counseling couples who face this emotionally stressful procedure.

Adaptation, Psychological↗
PubMed1977

The emotionally disturbed psychiatric resident.

The authors compared data on 2,860 residents gathered by means of questionnaire responses by residency directors with data on 288 residents found in an earlier similar survey to have emotional difficulties. They found that age, marital status, previous psychiatric treatment, substance abuse, and previous nonpsychiatric medical practice differentiated the "problem" residents from the total residency population surveyed. However, sex, ethnicity, foreigh medical graduation, and transfer from other residency programs did not differentiate the two groups.

Adult↗