General hospital psychiatry
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Gen Hosp Psychiatry · Sep 1992
Letter Review Case ReportsFactitious disorder resulting in bilateral mastectomies.
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Gen Hosp Psychiatry · Mar 1992
Clock drawing in the screening assessment of cognitive impairment in an ambulatory care setting: a preliminary report.
In an exploratory study to assess the utility of clock drawing as a screening test for cognitive impairment in medical/surgical outpatients, clock drawing and the 6-item Orientation-Memory-Concentration Test (OMCT) were administered to over 400 randomly selected ambulatory patients over the age of 55 in a busy inner-city hospital. The clock drawing test was completed by 431 patients, and 471 completed the OMCT. Clock drawing errors suggestive of moderate-to-severe cognitive impairment were found in 42.7% of patients; OMCT errors suggestive of moderate-to-severe cognitive impairment were found in 35.4% of the population tested. The clock drawing test might represent a quick-screen for cognitive impairment in an older general medical/surgical outpatient population, and might help identify patients not otherwise recognized as potentially unable to fully understand treatment recommendations.
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In order to examine the relationship of dyspnea to anxiety and depression, the authors rated dyspnea using several methods in 50 patients with chronic respiratory impairment. Anxiety and depression were measured by the Symptom Checklist-90 and the Symptom Questionnaire. Results varied with the method of assessing dyspnea. ⋯ When the sample was limited to patients with chronic obstructive pulmonary disease, the results remained the same. The patients were significantly more depressed and anxious than matched family practice patients. In the study of the complex relationship of dyspnea to physical and emotional factors, it is desirable to use more than one measure of dyspnea because the results depend in part on the method of assessment.
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Gen Hosp Psychiatry · Sep 1990
Factors affecting length of stay in a psychiatric intensive care unit.
As a response to the challenge posed by an increasing number of agitated and violent patients, there is in Canada a growing number of psychiatric intensive care units (PICUs), in both general and psychiatric hospital settings. In this article, the functioning of such a unit in a general hospital context is reviewed. ⋯ The factors influencing the functioning and LOS of this PICU are analyzed. A possible "deskilling" of the staff in other wards is discussed, and alternative explanations are hypothesized in an attempt to shed light on the interaction between this unit and its environment.