Psychiatric services : a journal of the American Psychiatric Association
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The state of Iowa mandates services for persons with mental retardation but not for those with mental illness, resulting in widely divergent spending for the two populations. Members of 98 of the 99 county boards of supervisors were interviewed to determine differences in attitudes about services and funding priorities. ⋯ Respondents tended to disagree not about whether services should be funded but about who should fund them. Three-fourths believed that the state should fund such services.
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The clinical practice guidelines for substance use disorders from the American Psychiatric Association (APA) recommend referral of some patients to self-help groups. The purpose of this study was to determine current patterns of referral to self-help groups in substance abuse treatment programs in the United States and compare them with referral recommendations in APA guidelines. ⋯ Clinicians make extensive use of self-help groups for their patients, as recommended in APA practice guidelines. However, some differences between current practice and recommended practice warrant further investigation.
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To make clinically relevant recommendations for electrocardiogram (ECG) testing among psychiatric patients, the study examined the practice of ordering ECGs for this population. ⋯ Routine ECG is not an effective treatment or screening tool in this population, and substantial cost savings could result from more selective testing, particularly among young patients, those at low risk, and those with repeat admissions.
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Standard scales for measuring anxiety and depression did not distinguish between these two psychological constructs in a sample of 295 inpatients with major depressive disorder. Items from these scales were used to form new measures, based on the results of a factor analysis. ⋯ When the factorial procedure was repeated with a subsample of patients with only mild to moderate symptoms, there was no discrimination between depression and anxiety. This finding suggests that when measured in a sample with a restricted range of symptom severity, anxiety and depression have poor discriminant validity.