Biomedical subjects
T B MacKenzie
Publications and source records attributed to T B MacKenzie.
Difficulties in the physician-patient dyad: invoking the psychiatric consultant.
Drawing upon their studies of physicians' responses to the recommendations and diagnosis of psychiatric consultants, the authors propose that the psychiatric consultant is most often invoked when the primary physician experiences an inappropriate interpersonal distance in the relationship with the patient. Sensing the threat or the reality of the patient as too close or too distant, the physician seeks the presence of the consultant. In the subsequent triadic constellation, the psychiatric consultant is suggested to function principally as buffer between the physician and the patient, restoring, or effecting a more optimal interpersonal distance in the original dyad. This construct helps to explain the consultees' "selectivity" in requesting consultation and the marked disparity between reported prevalence of psychiatric disorders in the medically ill and referral rates. It also calls attention to the role of the psychiatric consultant in assuring that the medical care of the patient with psychiatric features is not compromised or abbreviated.
Adult men and women with trichotillomania. A comparison of male and female characteristics.
Trichotillomania (hair pulling) has been considered a disorder that primarily affects women. It is rarely reported in men. Such rarity may reflect distinct clinical features in men that call for different treatment strategies. To investigate potential gender differences in trichotillomania, the authors systematically assessed the descriptive and phenomenological characteristics as well as psychiatric comorbidity of 14 male hair pullers and compared them to 128 female hair pullers who had been similarly assessed. Although a few gender differences existed, male trichotillomania was very similar to that seen in women. These results suggest that gender-specific treatment is not justified at this time; however, a more thorough psychiatric screening should be done with men because they may have additional psychiatric comorbidity.