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Biomedical subjects

T B Karasu

Publications and source records attributed to T B Karasu.

At least 73 records · Page 4Linked to original sources
PubMed1978

Toward a rationale for the seclusion process.

The present paper summarizes three studies focusing on different aspects of seclusion room practices. The first study involved chart review to collect empirical data on reasons for seclusion, length of seclusion, and characteristics of secluded patients. The second study focused on staff attitudes toward seclusion; the third dealt with the attitudes of both secluded and nonsecluded patients. The average time of seclusion was approximately 4 hours and in most cases aggressive behaviors of various types were cited as the precipitating event. In addition, patient and staff attitudes implied that a major function of the seclusion process was to isolate patients from disturbing interactions and to maintain the smooth functioning of the ward minisociety. Two models of seclusion, an ethological model and a behavioristic "time out" model, were developed in order to integrate the results of these studies. Implications of the findings and models are presented for changes in seclusion room procedures.

Adult↗
PubMed1978

Clinical utility of a rapid diagnostic test series for elderly psychiatric outpatients.

Psychiatric evaluation of the elderly is especially difficult for several reasons, e.g., the presence of organic impairment, the effects of multiple drug therapy, and the tendency to confuse the normal concomitants of aging with neurotic symptoms. The authors have developed and evaluated a brief series of self-report assessment tests (GRDB) designed to assist the psychiatrist in the process of diagnosis. Coefficients of the internal consistency of the seven scales are presented. A comparison was make between 28 psychiatric patients attending a geriatric clinic and 48 well-functioning elderly persons matched for age and sex, and living in the same community. Results showed that the geriatric outpatients functioned at a lower level of adaptation than did the control group, on all seven scales - depression, daily living skills, social interaction, cognitive skills, number of illnesses, number of life problems, and the use of drugs and alcohol. These findings provide a measure of discriminant validity. The advantages of this brief assessment instrument are discussed.

Aged↗
PubMed1978

"No-commitment week": a feasibility study.

To determine the extent to which involuntary hospitalization is overused, a "No-Commitment Week" was set aside, during which emergency room psychiatrists committed only patients in absolute need of hospitalization. Compared with the week before and the week after, there was no significant difference in the number of patients committed during No-Commitment Week. The authors propose replication of the study on a larger scale but suggest that decisions about involuntary hospitalization in public mental hospitals are the result of societal attitudes, which will be subject to change as long as society itself continues to change.

Commitment of Persons with Psychiatric Disorders↗
PubMed1978

Emergency psychiatry and the assaultive patient.

The authors studied 62 emergency room patients with violent ideation or action to assess the feasibility of predicting assaultive behavior. Although the likelihood of future violent acts could not be predicted accurately, they discovered that a significant majority of violent patients were potentially treatable within the setting of emergency psychiatry practice.

Acting Out↗
PubMed1978

Mid-adult development and psychopathology.

The authors studied a group of 193 psychiatric outpatients with varying diagnoses and a comparison group of 136 nonpatients across nine measures: sense of self; feelings about marriage, sex, career, and leisure time; relationship to parents, friends, and children; and sense of time passing. They found significant differences between the groups at specific ages in the areas of sense of self, feelings about career and sex, and relationship to parents, children, and friends. They discuss these results with a view toward identifying and elucidating normal and pathological factors in the adult life cycle.

Adolescent↗
PubMed1977

Psychotherapies: an overview.

The author schematically describes the three predominating themes in the development of the psychotherapies: dynamic, behavioral, and experiential. These themes represent different conceptualizations of the fundamental nature of man and his ills, therapeutic processes or change agents, the basic nature of the physician-patient relationship, and the primary techniques and methods used. Although there appears to be some unifying thread connecting the four different areas within each theme, a comparable bond does not exist across the three themes. The author questions the potential unification of the psychotherapies and poses specific dimensions for further exploration.

Autogenic Training↗
PubMed1977

Medical and nonmedical models in clinical practice and training.

Dealing with the range of events encountered by mental health professionals requires both anatomic/physiologic and psychologic/behavioral viewpoints. These viewpoints belong to two different universes of discourse, and their languages are not mutually translatable. For responsible clinical practice, both medical and nonmedical models are necessary and neither model is sufficient.

Humans↗
PubMed1977

Psychotherapy with the dying patient.

This paper develops and describes encounters with dying patients and their families and looks for consesus of patterns and responses of possible help in confronting this situation. It offers positive suggestions for those providing care for dying patients but also acknowledges that only an intellectual grasp of the situation is not sufficient qualification for caring for the dying.

Adult↗
PubMed1977

Patterns of psychiatric consultation in a general hospital.

The authors conducted a study of the rate of utilization of psychiatric consultation by various services at two general hospitals. The study found that the rehabilitation and plastic surgery services had the highest ratio of consultations to admissions. Depression was the most frequent reason cited in staff requests for psychiatric consultation. Male patients were overrepresented among the consultees in proportion to their number in the total general hospital census. The authors conclude that appropriate psychiatric consultation can enable the majority of patients with psychiatric problems to be maintained on the wards to which they were admitted, and that psychiatric liaison staff should be trained in a variety of consulting roles.

Adolescent↗
PubMed1977

The therapeutic community in theory and practice.

To obtain an operational description of the therapeutic community, the authors reviewed recent literature and composed a 40-item questionnaire describing aspects of the therapeutic community. The questionnaire was mailed to authors of recently published articles or books on the subject, 27 of whom responded with ratings of the degree to which each item was characteristic of a therapeutic community. The validated questionnaire was then completed by 22 staff members on four psychiatric wards of a university-affiliated municipal hospital, who rated the items in terms of real and ideal conditions on the ward. Comparisons of the real and ideal ratings are discussed.

Attitude of Health Personnel↗
PubMed1977

[Formation of new American psychiatrist and the future of psychiatry in the U. S.--A reference for France?].

A Ballad on the future of american psychiatry. Since the publication of Johann Reil's, Rhapsodies About the Application of Psychotherapy to Mental Disturbances (1803), variations upon this theme of extravagant discourse have received enthusiastic welcomes from the ever enlarging psychiatric audience for whom they are performed... Although the soloists change, the basic orchestration continues creating an uncanny sense of déjà entendu. While there as been longstanding recognition of the contributions of biological, psychological and social forces to the etiology of mental illness, actual efforts at a synthesis of their roles have been infrequent. Rather, we have experienced ideological clustering around each with the formation of schools and movements which have tended to over-value their own viewpoint at the expense of the others and to the detriment of progress in psychiatry. The authors describe a periodicity of one to two decades in which one of the schools achieves preeminence over the others, consolidates its position in medical education and with the community at large, comes under fire for failing to provide solutions to the problems of the mentally ill, and finally experiences a decline of its influence and prestige. Since World War II, both psychoanalytic and social and community psychiatry have experienced these vicissitudes, and, as the influence of the latter diminishes, voices are already raised promoting the succession of biological psychiatry of the seat of power. We believe another cycle of hopeful expectance in the quest for psychiatric omniscience and the following period of disillusionment can be avoided. The stunning advances in biological research in the past, and the prospect of even more exciting revelations to come should not lead us to devalue those techniques and institutions which have proved effective, while in pursuit of new approaches. Experience informs us that no one discipline in psychiatry can answer all the questions confronting us, and the time is ripe for a reassessment of the appropriate contributions of each subspecialty to the field as a whole. The authors propose the establishment of fellowships in biological psychiatry to promote this subspecialty, just as fellowships have been created to train child psychiatrists, administrative psychiatrists, etc. We believe such action could insure a more active role for biological psychiatry without repeating the cycle of disruption already described. The outlines of such a fellowship are sketched.

France↗
PubMed1977

[Ideas and theories in the new psychotherapies in the U.S.A].

A primary concern with man's fragmentation and alienation from himself and others. A concept of pathology which reflects the loss of self or congruence with one's experiences and the resultant blocking and diminution of one's potentialities. A concept of cure which means authenticity, spontaneity and self-actualization. A primary mode of change via immediate experiencing i.e. intense feeling of one's sensory, bodily and/or spiritual dimensions. A primary therapeutic task of providing an authentic and permissive atmosphere for mutual interaction or dialogue. A primary focus upon the phenomenological moment. A treatment model of therapist to client within the egalitarian framework of a "human alliance". A doctor/patient relationship which is a real, here-and-now encounter. A primary therapist role of mutual interactor and acceptor. A primary therapist stance which is involved and real. A primary tool or technique of encounter (and/or intensification of feelings via methods of emotional flooding for intense abreaction, or methods of meditation for profound rest). A primary treatment length which is shortterm and intense.

Humanism↗
PubMed1975

Supervision of the initial interview. A study of two methods.

Two methods of supervision of the initial evaluation of outpatients by psychiatric residents were compared. In condition 1, residents evaluated patients and then presented the case material to a supervisor in the traditional manner. In condition 2, the supervisor observed the interview directly. Supervisor and residents then independently completed ratings of psychopathology, motivation, insight, and prognosis of the patients. Significant differences in several variables between the two conditions were noted. Resident and supervisor ratings of patients were in clear agreement when both observed the interview.

Brief Psychiatric Rating Scale↗