[The basis of psychiatric treatment--from belief to science].
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Biomedical subjects
Publications and source records attributed to S Lorentzen.
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OBJECTIVE: The reorganization in 1981 of a general hospital psychiatric ward in Oslo, Norway, to achieve a more suitable treatment milieu for patients with schizophrenia resulted in a change in patients' perceptions of the ward atmosphere. Reduced group participation and increased individualized support from staff led patients to perceive of the ward as having a low level of anger and aggression and a high level of order and organization. This study examined whether the reorganization was associated with improved treatment outcome. METHODS: Psychiatrists retrospectively examined the charts of all patients with a DSM-III-R diagnosis of schizophrenia or schizophreniform disorder who were admitted to the ward the year before and the second year after the reorganization. Multiple regression analyses were used to examine treatment outcomes for both groups. Outcome was measured indirectly by length of stay, level of functioning at discharge, and whether the patient was rehospitalized during the following seven years. RESULTS: Patients treated after the reorganization had significantly shorter stays with no reductions in either level of functioning at discharge or length of community tenure after discharge. Differences in demographic characteristics, illness history, or psychopharmacological treatment could not account for differences in outcome. CONCLUSIONS: The results supported the hypothesis that the organization and milieu of brief-stay wards influence the short-term outcome of inpatient treatment of patients with schizophrenia.
Block training in group psychotherapy makes it possible to train professionals living far apart and to import conductors to an area or country lacking sufficient expertise. This article reports experience with such a training program in Norway. Training is given in blocks of 5 weekends a year, each weekend containing small group therapy, supervision, theory courses, lectures, and large group experiences. The participants were questioned about their personal and professional gains from the training. These findings and the effect of the program in relation to stated goals are discussed.
Investigations in the BB rat and the non-obese diabetic (NOD) mouse have provided substantial evidence for the involvement of the monocyte/macrophage system in the development of type 1 diabetes mellitus. However, it is not known whether monocytes play the same role in the pathogenesis of human type 1 diabetes. We investigated this problem in a longitudinal study of 29 recent-onset type 1 diabetes mellitus patients. Monocyte chemotaxis, phagocytosis and superoxide production as well as metabolic and haematological parameters were studied immediately after diagnosis and 6 months later. At diagnosis the patients had activated casein and C5a chemotaxis (casein 70 +/- 9 versus 150 +/- 5 (mean +/- s.e.m.), P < 0.001; C5a 137 +/- 10 versus 158 +/- 5, P < 0.05 (activation immobilizes monocytes, reducing the measured values)), and activated superoxide production (3.6 +/- 0.3 versus 3.0 +/- 0.3, P < 0.05). After 6 months casein chemotaxis (115 +/- 16 versus 150 +/- 5, P < 0.05) and Candida phagocytosis (3.3 +/- 0.1 versus 2.8 +/- 0.2, P < 0.001) were still activated. There was no correlation with other clinical or paraclinical parameters. We conclude that the circulating monocytes in newly diagnosed type 1 diabetes patients are activated. It is reasonable to expect that monocytes at the local site of inflammation in pancreas are even further activated. This could play a pathogenic role in beta cell destruction.
Eighty-eight patients were admitted to the acute ward of a catchment area suffering from the following functional psychoses: schizophrenia (S; n = 41), affective disorder (AD; n = 22), other disorders (OD; n = 25). Follow-up data were obtained for 97%. Ten patients were dead at follow-up, 8 due to suicide. Sixty-five were personally interviewed. While nearly all the patients had only brief periods of rehospitalization, most had used neuroleptics during the follow-up period. Compared to other samples, functioning at follow-up was fairly good for the AD and OD patients, but rather poor for the S patients.
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Explore the source record for details and available documents.