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1.
The country/region of origin of all original papers appearing in the International Journal of Psychiatry (IJGP) during the first 9 years of its publication was recorded. A more detailed analysis of citation patterns was carried out on the 105 original articles published during 1992. The results indicated that 50–60% of the articles emanated from the United Kingdom but that in general authors cited a broad range of specialities from journals published around the world. North American authors tended to cite North American sources more frequently than did their counterparts from other countries. There was evidence that the impact of the IJGP is increasing despite its omission from some scientific reference databases.  相似文献   
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This study is a predictor analysis of the screening procedure followed by a psychiatric service for a period of 1 year preceding and a period of 1 year following the introduction of community psychiatry. Throughout this period, the psychiatric service consisted of a local service within the catchment area and a central service at a psychiatric hospital outside the area. At the time of the reorganization, the responsibility for the psychiatric service was transferred from the public health authorities to the social services. Before the reorganization, screenings were conducted on the basis of referral papers or simply as a result of telephone communication. After the reorganization, the screening procedure was intensified by means of a pre-examination. One aim of the reorganization was to ensure that the severely mentally ill take priority over patients characterized predominantly by social strain. Patients with manic-depressive psychosis and other psychoses showed a significantly increased probability of being accepted for treatment, whereas those with schizophrenia showed no significant increase, irrespective of the service reorganization. Similarly, manic-depressive psychosis and other psychoses (not schizophrenia) were significant predictors of hospitalization at the mental hospital outside the catchment area as well as hospitalization in the local facilities, irrespective of the service reorganization. Indicators of social strain were not given higher priority following the service reorganization.  相似文献   
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Approximately 30–40% of elderly patients with major depression have inadequate response to an initial therapeutic trial of antidepressant medication. In these cases augmentation of the antidepressant has been recommended as one way of improving the rate of response. This article reviews the literature on augmentation strategies in treatment-resistant geriatric depression. Successful augmentation with lithium, triiodothyronine, stimulants, carbamazepine, valproate and a tricyclic–serotonin reuptake inhibitor combination have been described. However, there have been no controlled trials and, with the exception of two open prospective studies of lithium potentiation, the literature consists entirely of case reports and retrospective case series. As a result, it is difficult to draw conclusions about the efficacy of these strategies in late life, especially since treatment failures seldom get reported. Side-effects may limit the usefulness of some augmentation regimens in old age—up to 25% of patients treated with lithium or carbamazepine discontinued these medications because of adverse events. There is a need for controlled studies to better determine the clinical utility of augmentation strategies in physically well depressed elderly, as well as those with depression complicating medical illness, dementia and other neurological disorders.  相似文献   
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Interventions are needed to improve the quality of care for schizophrenia. However, in designing these interventions it would be helpful to understand better which patients are at highest risk for poor-quality care and why care for this disorder is often of poor quality. We study the extent to which patient and treatment factors are associated with poor-quality care in 224 patients randomly sampled from two mental health clinics. Quality of medication management is evaluated using an established method based on national treatment recommendations. Multivariate regression is used to study the effect of patient and treatment factors on treatment quality, controlling for provider. Risk for poor-quality care was greater for patients who were more severely ill, older, and less compliant with treatment recommendations. There were trends toward poor management of symptoms in men and substance abusers, and poor management of side effects in Black patients. Provision of poor-quality care was associated with failure to document symptoms and side effects in the medical record. Interventions to improve care for schizophrenia should attend to the need for accurate clinical assessment and strategies for managing challenging clinical situations.  相似文献   
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Abnormal illness behavior, such as hypochondriacal attitude and inappropriate treatment-seeking, has been associated with various psychiatric disorders in which patients tend to abuse medical services and seek inappropriate treatment in general practice clinics rather than psychiatric clinics. However, the relationship between illness behavior and psychiatric disorders in Japan is yet to be elucidated. We examined the abnormal illness behavior of 243 patients who visited the outpatient department of psychiatry at Saga Medical School Hospital, Saga, Japan, using a Japanese version of the Illness Behavior Questionnaire (IBQ). Multivariate analysis indicated significant association between some of the IBQ scale scores and age, sex and employment status. Patients with anxiety disorder scored higher on five of the seven IBQ scales compared with patients with another major disorder (mood disorder, schizophrenia or somatoform disorder). When compared with the IBQ scale scores reported in Australian patients in a psychiatric hospital, most of the IBQ scale scores differed significantly in our patients; a higher score among Japanese patients on the general hypochondriasis scale was most prominent. A similar trend in IBQ scale scores was also noted among Japanese patients visiting the hospital's general medicine clinic in comparison with Australian patients visiting a general practice clinic. Japanese patients with anxiety disorder may display the most salient abnormal illness behaviors among patients with psychiatric disorders. Sociocultural background may contribute to the characteristic abnormal illness behaviors of Japanese patients.  相似文献   
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OBJECTIVE: This paper aims to study the detection of individuals malingering posttraumatic stress disorder (PTSD) in criminal and civil situations. METHOD: A brief history of PTSD and its rise to prominence in legal circles are discussed. The characteristics of individuals who malinger and particularly those who fake PTSD are discussed. Diagnostic dilemmas inherent to the condition, such as the definition of a traumatic exposure, what constitutes a PTSD flashback and the potential for normal symptom exaggeration, are explored. RESULTS: The typical presentation of malingered symptoms is presented to help clinicians detect commonly seen malingering patterns. Suggestions for interview techniques, Minnesota Multiphasic Personality Inventory test values and sources of collateral information to help detect malingering are reviewed. CONCLUSION: The paper concludes with a review of the typical presentations of malingered PTSD symptoms and a reminder that physicians need to distinguish legitimate symptoms from faked or embellished presentations.  相似文献   
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精品课程建设应当以优异的教学质量为标准,立足于自身的基础,保持传统的优势,针对时代的需求,建设出自己的特色。本文着重介绍中南大学精神医学系在长期的实践及对教学模式的积极探索中,通过创建精品课程,努力营造出自己的特色。  相似文献   
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不同时期在押罪犯司法精神病学鉴定案例的对比分析   总被引:4,自引:0,他引:4  
目的 探讨近年来在押犯罪司法精神病学鉴定的特点和发展趋势。方法 对1994年后经该院鉴定的87例与1993年前鉴定的33例在押罪犯案例进行对比分析。结果 1994年后组在押罪犯鉴定的案例明显增加(P<0.01)。服刑能力的鉴定,1994年后组较多(P<0.01),服教能力的鉴定,1993年前组较多(P<0.05)。1994年后组经济类案件有上升趋势(P<0.05),诊断为精神分裂症的有明显下降(P<0.01),诊断为拘禁性精神障碍的有明显上升(P<0.05)。结论 在押罪犯司法精神病学鉴定已成为司法精神病学鉴定的重要组成部分,对其法定能力的评定需进一步入研究。  相似文献   
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