Canadian journal of psychiatry. Revue canadienne de psychiatrie
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An open clinical study with 20 consecutive outpatients suffering from major depression with melancholia (DSM-III) was carried out. All patients were resistant to desipramine after at least six weeks of treatment. ⋯ The mechanism of action of the lithium augmentation effect in tricyclic-resistant depressed patients is discussed in view of our findings. We suggest that the unified 5-HT/NE hypothesis used in affective disorder could be applied in drug refractory depression.
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The conclusions drawn by study are susceptible to two types of errors. The more familiar one occurs when it is believed that there was a true difference between the groups or an association between two variables, when in fact this observation was due to chance (a Type I error). The second potential error consists of falsely concluding that there was no difference or association when indeed there was one (a Type II error). ⋯ This paper discusses techniques researchers can use to calculate the sample sizes required for studies, and the effects of sample sizes which are too small or too large. If it is too small, there is an increased risk of a Type II error, whereas if it is too large, there may be a needless waste of time, money, and effort. The paper also discusses how readers of research articles can determine whether or not negative findings reported by a study are a true reflection of the lack of any difference between groups, or a result of insufficient sample size.
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This article briefly examines the ethical and legal foundations for the doctrine of informed consent in medical research and practice. The doctrine is based upon the importance of respecting the individual's autonomy and his right to self-determination. The article also reviews the development of the doctrine of informed consent based on its recent application. ⋯ The effects of informed consent in psychiatry are examined specifically, as well as the consequences for psychiatric research, on subjects who are able to give their consent, as well as those who are unable to do so. As for its effects on clinical practice, the paper discusses the right of the hospitalized patient to refuse treatment, and informed consent and the risks for patients treated with neuroleptics of developing tardive dyskinesia. The authors conclude that in psychotherapy the concept of informed consent cannot be taken for granted.
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This paper describes the operation of a psychiatric intensive care unit in a provincial psychiatric hospital. Its introduction led to a decrease in staff and patient accidents, a decrease in constant observation and seclusion hours, and a decrease in the number of nursing hours lost to injuries at work. ⋯ In addition, it was also felt that the ward environment in other parts of the hospital became more therapeutic. We therefore conclude that psychiatric ICU's are useful additions to psychiatric settings with important cost and patient care implications.