The American journal of psychiatry
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Comparative Study
Reliability of a Standardized Mini-Mental State Examination compared with the traditional Mini-Mental State Examination.
The objective of this study was to compare the reliability of the Mini-Mental State Examination with that of a new Standardized Mini-Mental State Examination, which has expanded guidelines for administration and scoring. ⋯ The Standardized Mini-Mental State had better reliability than the Mini-Mental State in this study group. Although the improved reliability of the Standardized Mini-Mental State was achieved by reducing measurement noise, this advantage would likely occur in a broad spectrum of patients.
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The authors evaluated 558 patients for tardive dyskinesia. They found that the prevalence of tardive dyskinesia was 34%. ⋯ Patients with mild tardive dyskinesia received more neuroleptics than did patients with moderate and severe forms. However, patients with moderate tardive dyskinesia had significantly more drug-free periods in their drug histories than did patients with mild tardive dyskinesia.
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Rapid changes in health care financing and delivery systems will adversely affect child psychiatry training. Reductions in teaching hospitals' patient revenues and in federal support for graduate medical education have made the development of strong academic and research programs more difficult. Training programs must search for innovative ways to fund clinical training if they are to survive and grow. The authors review major sources for funding, such as state governments, future employers of trainees, endowments, faculty practice plans, and residents paying for training, and discuss opportunities for increasing their contributions.
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The authors describe suicide rates in Toronto and Ontario and methods used for suicide in Toronto for 5 years before and after enactment of Canadian gun control legislation in 1978. They also present data from San Diego, Calif., where state laws attempt to limit access to guns by certain psychiatric patients. Both sets of data indicate that gun control legislation may have led to decreased use of guns by suicidal men, but the difference was apparently offset by an increase in suicide by leaping. In the case of men using guns for suicide, these data support a hypothesis of substitution of suicide method.