Showing papers on "Psychiatric interview published in 1996"
TL;DR: The cross-sectional association between regular smoking and psychiatric morbidity was consistent with the use of smoking by teenage girls as self-medication for depression and anxiety and future health promotional campaigns might consider strategies that attend to perceived psychological benefits of smoking.
Abstract: OBJECTIVES. An association of smoking with depression and anxiety has been documented in adult smokers. This study examines this association in a representative group of teenage smokers. METHODS. A two-stage cluster sample of secondary school students in Victoria, Australia, were surveyed by using a computerized questionnaire, which included a 7-day retrospective diary for tobacco use and a structured psychiatric interview. RESULTS. Subjects reporting high levels of depression and anxiety were twice as likely to be smokers after the potential confounders of year level, sex, alcohol use, and parental smoking were controlled for. Regular smokers were almost twice as likely as occasional smokers to report high levels of depression and anxiety. In a stratified analysis, an association between regular smoking and psychiatric morbidity was found in girls of all ages but for boys only in the youngest group. CONCLUSIONS. The cross-sectional association is consistent with the use of smoking by teenage girls as sel...
311 citations
TL;DR: Not only is the prevalence of mental disorder, in particular severe mental illness, high in this population of men, but the numbers identified at reception are low and subsequent management in prison is poor.
Abstract: Objective: To define the prevalence of mental disorder and need for psychiatric treatment in new remand prisoners and to determine to what extent these are recognised and addressed in prison. Design: Study of consecutive male remand prisoners at reception using a semistructured psychiatric interview. Setting: Large remand prison for men (HMP Durham). Subjects: 569 men aged 21 years and over on remand, awaiting trial. Main outcome measures—Prevalence of mental disorder at reception, prisoners need for psychiatric treatment, identification of mental disorder by prison reception screening, and numbers placed appropriately in the prison hospital. Results: 148 (26%) men had one or more current mental disorders (excluding substance misuse) including 24 who were acutely psychotic. The prison reception screening identified 34 of the men with mental disorder and six of those with acute psychosis. 168 men required psychiatric treatment, 50 of whom required urgent intervention; 16 required immediate transfer to psychiatric hospital. Of these 50, 17 were placed on the hospital wing because of mental disorder recognised at prison screening. Conclusion: Not only is the prevalence of mental disorder, in particular severe mental illness, high in this population, but the numbers identified at reception are low and subsequent management in prison is poor. Key messages In this study in Durham prison 26% had a serious mental disorder Only about a quarter of the mentally disordered patients were recognised by the prison doctor and hospital officer Only two fifths of patients who required urgent psychiatric treatment were put into the prison hospital Improved diagnosis of psychiatric illness in prison will greatly increase the pressure on psychiatric beds
273 citations
TL;DR: The SF-36 is useful in assessing functional status in patients with fatiguing illnesses and distinguishes patients with CFS and CF from those with MD and AIM, and from HC, but does not discriminate between CF and CFS.
240 citations
TL;DR: The results showed that 85 patients (27.2%) received a DSM-IV diagnosis, with several patients having comorbid diagnoses, including major depressive disorder, and nurses were more proficient than medical staff at identifying patients who had received a psychiatric diagnosis.
Abstract: The aim of the present study was to determine the prevalence of psychiatric disorders in acutely ill medical inpatients. A total of 313 consecutively admitted patients were interviewed using a semistructured psychiatric interview. Diagnoses were made according to DSM-IV diagnostic criteria during two time periods, the 7 days following admission and the month prior to admission. The results showed that 85 patients (27.2%) received a DSM-IV diagnosis, with several patients having comorbid diagnoses. Major depressive disorder was present in 16 patients (5.1%), most of whom also had major depressive disorder in the month prior to admission. This prevalence rate is above that of the general population (1.2% to 2.8%), but less than that reported in most previous studies (20% to 40%). Forty-three patients (13.7%) had an adjustment disorder, 18 patients (5.8%) had an anxiety disorder, and 17 patients (5.4%) had either alcohol dependence or abuse. Nurses were more proficient than medical staff at identifying patients who had received a DSM-IV diagnosis, recognizing 61% of cases compared with 41% for medical staff.
201 citations
TL;DR: The results suggest that the presence of PTSD in children confers a substantial likelihood of other formal diagnosis, and more extensive evaluation and specialized, multi-modal treatment should be considered in children presenting with PTSD.
195 citations
TL;DR: Patients with IVD showed a relatively more severe dysfunction of the frontal lobes as demonstrated by single-photon emission CT and expressed in specific psychiatric and neuropsychological changes than AD patients matched for age, sex, and severity of dementia.
Abstract: Background and Purpose Psychiatric, neuropsychological, and cerebral blood flow differences between patients with ischemic vascular dementia (IVD) or Alzheimer’s disease (AD) were examined. Methods A consecutive series of patients who met either the criteria of the National Institute of Neurological Disorders and Stroke and the Alzheimer’s Disease and Related Disorders Association for probable AD or the State of California AD Diagnostic and Treatment Centers criteria for probable IVD were included in the study. Twenty consecutive patients with IVD were matched for age, sex, and Mini-Mental State Examination scores with 40 consecutive patients with probable AD. Patients underwent a psychiatric interview, a neuropsychological assessment, and single-photon emission CT imaging with 99m Tc-hexamethylpropyleneamine oxime. Results Patients with IVD showed significantly more severe anosognosia ( P P P P P P Conclusions Patients with IVD showed a relatively more severe dysfunction of the frontal lobes as demonstrated by single-photon emission CT and expressed in specific psychiatric and neuropsychological changes than AD patients matched for age, sex, and severity of dementia.
151 citations
TL;DR: Survival analysis showed that dimensional psychometric measures of coping and social support based on patient self-assessment were the best significant predictors of survival.
Abstract: Objective : This study prospectively investigated the relation between pretransplant assessment of psychiatric diagnosis, coping skills, and social support and outcome measures of survival and health care utilization. Method : Ninety-four heart transplant patients underwent structured interviews and completed a battery of self-report psychometric tests assessing coping style, health status, and psychosocial supports. Follow-up that ranged from 9 to 56 months after transplant produced a group of 63 survivors and 31 nonsurvivors, who were found to be comparable in terms of pretransplant cardiac status and severity of illness. Results : Survival analysis showed that dimensional psychometric measures of coping and social support based on patient self-assessment were the best significant predictors of survival. Considered separately, interview-determined ratings of social support and pretransplant compliance with treatment regimens were also potential predictors. Formal DSM-III-R diagnoses were related specifically to posttransplant hospital utilization (axis I diagnoses) and posttransplant health behavior (axis II diagnoses). Conclusions : The data demonstrate the value of multifaceted assessment, since psychiatric diagnosis, coping style, and psychosocial support may contribute differently to prediction of such aspects of outcome as mortality and health care utilization.
116 citations
TL;DR: It is revealed that changing the attribution of SD symptoms from psychiatric to physical dramatically affected the rates of diagnosing SD in the CFS group, illustrating that the terminology used to interpret the symptoms will determine which category CFS falls into.
Abstract: This study was conducted to examine the rates of somatization disorder (SD) in the chronic fatigue syndrome (CFS) relative to other fatiguing illness groups. It further addressed the arbitrary nature of the judgments made in assigning psychiatric vs. physical etiology to symptoms in controversial illnesses such as CFS. Patients with CFS (N = 42), multiple sclerosis (MS) (N = 18), and depression (N = 21) were compared with healthy individuals (N = 32) on a structured psychiatric interview. The SD section of the Diagnostic Interview Schedule (DIS) III-R was reanalyzed using different criteria sets to diagnose SD. All subjects received a thorough medical history, physical examination, and DIS interview. CFS patients received diagnostic laboratory testing to rule out other causes of fatigue. This study revealed that changing the attribution of SD symptoms from psychiatric to physical dramatically affected the rates of diagnosing SD in the CFS group. Both the CFS and depressed subjects endorsed a higher percentage of SD symptoms than either the MS or healthy groups, but very few met the strict DSM-III-R criteria for SD. The present study illustrates that the terminology used to interpret the symptoms (ie, psychiatric or physical) will determine which category CFS falls into. The diagnosis of SD is of limited use in populations in which the etiology of the illness has not been established.
106 citations
TL;DR: The CFS group with concurrent depressive disorder was found to account for most of the personality pathology in the CFS sample, and the results are discussed in the context of the relationship between personality variables and fatiguing illness.
104 citations
TL;DR: The authors examined mental health and marital quality in an index group of spouses of women with postpartum psychiatric disorders and a control group of men whose wives had recently given birth but had no such disorders.
Abstract: The authors examined mental health and marital quality in an index group of spouses of women with postpartum psychiatric disorders and a control group of men whose wives had recently given birth but had no such disorders. At 6 to 9 weeks postpartum, couples underwent a psychiatric interview and completed self-report measures of psychological symptoms, marital satisfaction, and changes in couple and family functioning since the birth. Index spouses reported more symptoms and had lower Global Assessment of Functioning (R. L. Spitzer, J. B. W. Williams, M. Gibbon, & M. B. First, 1990) scores than controls. Index men reported greater marital dissatisfaction and more change in household routines, recreation, and intimacy with their partners than controls.
95 citations
TL;DR: A psychometric approach to psychiatric nosology that emphasizes the diagnostic accuracy and confusability of diagnostic categories is described, and sensitivity and specificity were excellent for both DSM-III-R and RDC diagnoses of major depression, bipolar disorder, and schizophrenia.
Abstract: The dominant, contemporary paradigm for developing and refining diagnoses relies heavily on assessing reliability with kappa coefficients and virtually ignores a core component of psychometric practice: the theory of latent structures. This article describes a psychometric approach to psychiatric nosology that emphasizes the diagnostic accuracy and confusability of diagnostic categories. We apply these methods to the Diagnostic Interview for Genetic Studies (DIGS), a structured psychiatric interview designed by the NIMH Genetics Initiative for genetic studies of schizophrenia and bipolar disorder. Our results show that sensitivity and specificity were excellent for both DSM-III-R and RDC diagnoses of major depression, bipolar disorder, and schizophrenia. In contrast, diagnostic accuracy was substantially lower for subtypes of schizoaffective disorder-especially for the DSM-III-R definitions. Both the bipolar and depressed subtypes of DSM-III-R schizoaffective disorder had excellent specificity but poor sensitivity. The RDC definitions also had excellent specificity but were more sensitive than the DSM-III-R schizoaffective diagnoses. The source of low sensitivity for schizoaffective subtypes differed for the two diagnostic systems. For RDC criteria, the schizoaffective subtypes were frequently confused with one another; they were less frequently confused with other diagnoses. In contrast, the DSM-III-R subtypes were often confused with schizophrenia, but not with each other.
TL;DR: Differences in the nature and frequency of psychiatric symptoms reported by patients with learning disability and key informants using the PAS-ADD are investigated, indicating that it is crucial for sensitive case detection to complete both interviews where possible.
Abstract: This paper investigates differences in the nature and frequency of psychiatric symptoms reported by patients with learning disability and key informants. The study involved psychiatric assessment of 100 patients with learning disabilities and key informants using the Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD), a semi-structured psychiatric interview developed specifically for people who have a learning disability. There was considerable disagreement between respondent and informant interviews: only 40.7% of cases were detected by both interviews. Respondents were more likely to report on autonomic symptoms and certain psychotic phenomena. Other anxiety and depression symptoms were more frequently reported by informants. The results indicate that it is crucial for sensitive case detection to complete both interviews where possible. If the respondent cannot be interviewed, panic disorder or phobias may be particularly difficult to detect.
TL;DR: ST in primary care is a much broader phenomenon than categories such as somatoform disorders reflect and may be less influenced by sociodemographic factors, but more chronic than previously reported.
Abstract: BACKGROUND This is the first attempt to study the prevalence and clinical characteristics of somatisation (ST) in a representative primary care sample in Spain. METHOD The sample consisted of 1559 consecutive patients attending eight randomly selected health centres in Zaragoza, Spain, examined by two-phase screening. First phase (lay interviewers): Spanish versions of GHQ-28, CAGE questionnaire, substance abuse, Mini-Mental State Examination. Second phase (research clinicians and psychiatrists): Standardised Polyvalent Psychiatric Interview, which permits the reliable coding of Bridges & Goldberg9s ST criteria. RESULTS The prevalence of somatisers was 9.4% (34.5% of the cases) and most patients (68.7%) were diagnosed in the depression or anxiety DSM-IV categories. The severity was moderate in 401% and 66.6% were chronic (six or more months). No significant demographic differences were found with non-cases. Backache was the most frequent somatic presentation (71.4+%). CONCLUSIONS ST in primary care is a much broader phenomenon than categories such as somatoform disorders reflect. It may be less influenced by sociodemographic factors, but more chronic than previously reported.
TL;DR: It is suggested that the patient's protoprofessionalization, which is typical for psychotherapy, already begins in the initial interview and that it is an effect of the interviewer's specific use of the formulation-decision device in the interview.
TL;DR: A strong relationship between active cancer and/or physical symptoms and level of psychological distress is demonstrated, suggesting a need for psychological distress to be evaluated alongside other domains, e.g. as in a multidimensional quality of life instrument such as the European Organization.
TL;DR: The traumatic stress response was related to age, marital status, occurrence of breast cancer in first‐degree relatives, previous physical and psychological health parameters, social support and life events during the last year.
Abstract: In this study, the concept of ‘acute traumatic stress response’ was applied to breast cancer diagnosis. A total of 106 patients were studied before surgery, by means of a psychiatric interview and questionnaires (Impact of Event Scale, General Health Questionnaire and Clinical Global Impression Scale). The traumatic stress response was related to age, marital status, occurrence of breast cancer in first-degree relatives, previous physical and psychological health parameters, social support and life events during the last year.
Of the patients, 44% reported a high level of intrusive symptoms (mean score 17.2) and 29% of avoidance symptoms (mean score 15.0). Younger age and being married were positively correlated with intrusive symptomology while patients with a first-degree relative with breast cancer had less intrusive distress. Previous physical and psychiatric health parameters showed no association to acute traumatic stress symptoms except for those who had experienced ‘a serious illness/accident/hospitalisation last year’ who had some more avoidant symptomology. Multiple regression showed a statistically significant effect for age only on intrusive symptoms when other factors were controlled for in this analysis.
TL;DR: The ethological data of this study support clinical observations, which suggest that alexithymic traits interfere with both processing of emotion and interpersonal behavior.
Abstract: The relationship between nonverbal behavior and emotional awareness, as measured by the Toronto Alexithymia Scale, was studied in 24 young volunteers free of medical and psychiatric disorders. Multiple regression analysis revealed that nonverbal behavior during psychiatric interview was a significant predictor of the Toronto Alexithymia Scale total score independent of situational depression and anxiety. Subjects who had difficulty identifying and describing their feelings showed a combination of poor nonverbal expressivity and frequent self-directed behavior patterns indicative of tension and anxiety. In addition, subjects with a tendency toward externally oriented thinking showed more avoidance behavior during the interview. The ethological data of this study support clinical observations, which suggest that alexithymic traits interfere with both processing of emotion and interpersonal behavior.
TL;DR: Census-derived indices of neighbourhood income and urban residence are utilized to identify departures from population representation arising at the time of family enrollment in the twin registry and family participation in a psychiatric interview and whether demographic sample biases influenced prevalence rates of adult psychopathology in the VTSABD sample.
Abstract: The Virginia Twin-Family Study of Adolescent Behavioral Development (VTSABD) is a current longitudinal study of psychopathology in 1412 pairs of 8-16-year-old Caucasian twins and their parents. The primary aim of the study is to evaluate family-genetic and environmental risk factors for major domains of psychopathology in families representative of the Virginia Caucasian population. In this report, we utilize census-derived indices of neighbourhood income and urban residence to identify departures from population representation arising at the time of family enrollment in the twin registry and family participation in a psychiatric interview. Furthermore, we consider whether demographic sample biases influenced prevalence rates of adult psychopathology (including major depression, generalized anxiety disorder, alcohol dependence, phobias, and panic disorder) in the VTSABD. Results indicated that families that enrolled in the twin registry (83% of those identified by Virginia schools) and that participated in the home interview (75% of those targeted) resided in urban and rural communities with a range of per capita income levels representative of the Virginia population. However, participation biases operated throughout the study and were primarily characterized by losses of families living in low income, urban communities. There was also a smaller number of families living in high income neighbourhoods that did not enroll in the twin registry or that indefinitely postponed the psychiatric interview. These biases had small effects on prevalence rates of adult psychopathology in the VTSABD sample, even though neighbourhood income was significantly related to a subset of adult diagnoses. We emphasize the usefulness of the census methodology in evaluating sample biases in population-based psychiatric genetic studies.
TL;DR: Estimates of the incidence of different mental disorders from a Finnish prospective epidemiological follow-up study, the UKKI Study, were rather close to those of the Swedish Lundby Study, but nowhere near the results of the American ECA Study.
Abstract: BACKGROUND The aim was to give estimates of the incidence of different mental disorders from a Finnish prospective epidemiological follow-up study, the UKKI Study.
METHOD The original probability sample consisted of 1000 persons, aged 15-64 years. The baseline survey took place in 1969-71, and follow-up surveys were conducted 5 and 16 years after the baseline survey. The research methods included a personal psychiatric interview and data collection from different registers. The diagnostic system was based on the ICD-8 classification.
RESULTS The estimated annual incidence of all mental disorders was close to 15 per 1000 both between baseline and the 5-year follow-up as well as between the 5-year and the 16-year follow-up. During the entire 16-year follow-up period the annual incidence of all disorders was 14 per 1000 in men and 17 per 1000 in women. The annual income of neurotic disorders was 10 per 1000 in men and 14 per 1000 in women, and that of psychotic disorders 2 per 1000.
CONCLUSIONS In the literature, there are huge differences in the results concerning incidence of mental disorders. The results of the present study were rather close to those of the Swedish Lundby Study, but nowhere near the results of the American ECA Study.
TL;DR: GHQ‐28 as an aid to detect mental disorders in neurological inpatients and its application in clinical practice is described.
Abstract: The prevalence of mental disorders (DSM-IIIR criteria) among 107 neurological inpatients was estimated, as well as the extent to which disorders were detected by neurologists. The validity of the scaled version of the General Health Questionnaire (GHQ-28) was evaluated using Receiver Operating Characteristic (ROC) analysis and DSM-IIIR as external criteria. Of the 107 patients who submitted to a structured psychiatric interview (SCID-R), 56 (52.3%) showed evidence of a mental disorder. Major depressive episode (n = 16), generalized anxiety disorders (n = 13) and dysthymia (n = 12) were the most frequent diagnoses. The neurologists recognized only 13/107 cases (12.1%). Significantly more women than men exhibited some form of mental disorder. The validation of GHQ-28 in the series of 107 neurological inpatients indicated that the best trade-off between sensitivity and specificity was the cut-off score of 5/6. The high occurrence of mental disorder, in association with the low rate of detection by the neurologists, points to the need for special attention to be paid to this problem by staff and experts.
Journal Article•
TL;DR: Some dermatology inpatients have psychiatric morbidity, which affects the course of the dermatological condition as well as the duration of hospitalization, and regular liaison between psychiatrists and dermatologists are essential for appropriate management.
Abstract: Background. Research on psychiatric morbidity among patients with dermatological diseases generally fo~uses ~n outpatients and questionnaire-based surveys. The aim of thl~ study was to determine the preva!en~e an? natur~ of psy~hlatric morbidity among dermatological Inpatients with the dla~nosis being made by psychiatric interview, and asce~am whether demographic and clinical details in dermatol09l.cal inpatients with psychiatric morbidity differed from those without it. Methods. Charts of all inpatients admitted by the dermatology department between 1 January 1991 and 31 July 1995 were analysed for socio-demographic data, clinical features, treatment and course in hospital. For those patients who were referred to a psychiatrist, all records of the psychiatric consultation were obtained and analysed. Results. A total of 1073 patients were admitted during the study period. Ninety-eight patients (9%) were diagnosed to have a psychiatric illness. Patients with psychiatric illnes~were likely to have had more admissions and longer duration of hospital stay. The most common psychiatric diagnoses were depressive episodes (34%) and adjustment disorders (29%). The highest rates of psychiatric morbidity were found among patients with chronic urticaria, exfoliative dermatitis and sexually transmitted diseases, including human immunodeficiency virus infection. The prevalence of psychia!ric disorders was significantly higher in those who had received long term (more than six weeks) treatment with high-dose steroids (more than 1 mglkg body weight o! pre~nisolone): .. Conclusion. Some dermatology Inpatients have psychiatric morbidity, which affects the course of the dermatologic~1 condition as well as the duration of hospitalization. The availability of psychiatric consultation at dermatology clin~csand regular liaison between psychiatrists and dermatologists are essential for appropriate management.
TL;DR: If differences exist between Caucasian and minority patients presenting with CF, particularly in the frequency meeting criteria for CFS, are determined, with the exception of less social support from friends, no significant race/et...
Abstract: Purpose: Chronic fatigue (CF) is a common complaint in ambulatory settings. Chronic fatigue syndrome (CFS) is characterized by profound fatigue associated with other symptoms that is rarely reported in racial/ethnic minorities. Our objectives were to determine if differences exist between Caucasian and minority patients presenting with CF, particularly in the frequency meeting criteria for CFS. Patients: 690 patients with CF seen in a university-based referral clinic. Design/Methods: Demographic, historical, physical examination, laboratory, and psychosocial information was prospectively collected and compared. Psychosocial assessment consisted of a structured psychiatric interview, the Medical Outcomes Study Short-Form Health Survey to assess functional status, the General Health Questionnaire to ascertain psychological distress, and measures of health locus of control, illness attribution, social support, and coping. Results: With the exception of less social support from friends, no significant race/et...
TL;DR: A computerized version of the Present State Examination was developed and administered to 29 patients sitting at a terminal as discussed by the authors, each subject was also interviewed by a doctor, and patient acceptability of the computer interview was assessed.
01 Jan 1996
TL;DR: Stage of illness, serum β2-microglobulin, psychiatric indices of depressed mood or anxiety, and NP "motor" performance were the most significant independent variables associated with the presence of neurological symptoms, which confirmed the value of CSF β2m and neopterin as important markers of advancing disease stage.
Abstract: Objective. To examine the cross-sectional prevalence of neurological symptoms and signs in a large cohort of human immunodeficiency virus (HIV)-seropositive men, and determine the relationship of the symptoms to disease stage, immunologic markers, and independent variables from neuropsychological (NP) testing and psychiatric interview. Methods: One hundred-nine controls and 386 HIV-infected volunteers enrolled in the HIV Neurobehavioral Research Center (HNRC) longitudinal study. The majority, without acquired immune deficiency syndrome (AIDS), were screened for alcohol/substance abuse; previous diagnosis of HIV-associated dementia; and HIV-unrelated developmental, neurological, medical, and neurobehavioral conditions which potentially impair cognition; and underwent a structured neurological interview and examination, standardized NP testing, and psychiatric interview as part of a more extensive battery. A large subset (N = 377) underwent lumbar puncture for cerebrospinal fluid (CFS) examination. We exami...
Journal Article•
TL;DR: In this paper, the presence of psychiatric disorders (according to DSM-III-R), the discriminating power of a psychiatric structured interview, and sleep monitoring were investigated in psychophysiological insomnia.
Abstract: Background : The presence of psychiatric disorders (according to DSM-III-R), the discriminating power of a psychiatric structured interview, and sleep monitoring were investigated in psychophysiological insomnia. Method : Forty young (20-40 years old) patients, selected for putative psychophysiological insomnia, underwent a psychiatric structured interview and home ambulatory sleep monitoring for 2 nights. The results were compared with those of a group of nine young normal sleepers. Results : 48% of the insomniacs showed some psychiatric disorders, while 52% did not meet DSM-III-R criteria for a psychiatric diagnosis. Both groups, but not the controls, showed a slight first-night effect in the sleep analysis. The sleep structure of all insomniacs was found to be disturbed, mainly in sleep continuity, but essentially the two groups showed no significant differences. When we used a stepwise logistic regression analysis, the number of sleep stage shifts (indicating sleep instability) was the best variable in discriminating the insomniacs from controls, but not the patients with psychiatric disturbances from those without psychopathologies. Conclusion : The evaluation of young insomniacs with a structured psychiatric interview rather than with ambulatory sleep monitoring seems to be most useful in discriminating between patients with only psychophysiological insomnia and patients with both insomnia and an associated diagnosis of another mental disorder.
TL;DR: The results indicated that psychiatric interviewing can be taught effectively in a short period with regard to mood disorders, but on the other hand, performance decreased after the 6 months during which students received no training.
Abstract: This study [1] evaluated the immediate and long-term effects of systematic training in psychiatric interviewing Students of Mental Health Sciences (n = 14) were trained First in psychiatric interviewing with regard to mood disorders Six months later, they received training focusing on psychotic disorders Effects of instruction were examined by means of a quasi-experimental design Four &pendent variables were measured using patient encounters: process interviewing skills, content-related interviewing skills, recall of relevant patient information and diagnostic accuracy After the first training, students' performance improved substantially with regard to content-related interview skills and recall of relevant patient information Performance, however, decreased after the 6 months during which students received no training The second training did not improve performance The results indicated that psychiatric interviewing can be taught effectively in a short period with regard to mood disorders, but s
TL;DR: The Questionnaire Design Tool (QDT) as discussed by the authors is based on the structure of a psychiatric interview and separates interview text and branching rules from the mechanism that reads replies and skips to subsequent questions.
Journal Article•
TL;DR: The proposed criteria, used as a single rating instrument, are cost-effective in terms of time and staff, avoid unnecessary hospitalisation and ensure that mentally ill accused will have a fair trial.
Abstract: OBJECTIVE: To identify criteria whereby triability can be determined. DESIGN: Questionnaire survey. The final rating was decided on the basis of a structured psychiatric interview. SETTING: Oranje Hospital, Bloemfonteln. PARTICIPANTS: A total of 736 questionnaires was sent to 176 judges of the Supreme Court, 480 magistrates and 32 attorneys-general and state advocates in South Africa and Namibia, and 33 psychiatrists and 15 clinical psychologists working in forensic psychiatric units in South Africa. With the information from the completed questionnaires, rating criteria were compiled. The rating criteria were applied by means of a structured interview to 100 persons referred in terms of section 77(1) of the Criminal Procedure Act 51 of 1977. A multiprofessional psychiatric team was requested to evaluate the same 100 observandi independently. RESULTS: A total of 298 (40.5%) of the questionnaires were returned. From the data of the completed questionnaires, 19 legal items, 17 psychiatric items, 2 special laboratory tests and 2 psychosocial items were identified as the most important and clear diagnostic indications for the evaluation of triability. The similarity between the findings of the researchers and those of the multiprofessional psychiatric team was meaningful to 1% of significance. For the proper application of the criteria a cut-off point of 31 was determined. A score of 31 or higher therefore indicates that a patient is unfit to stand trial, while a score of less than 31 indicates triability. CONCLUSIONS: The application of the proposed final rating criteria as a single method of rating is at the very least just as reliable as the multiprofessional team in evaluating fitness to stand trial. The proposed criteria, used as a single rating instrument, are cost-effective in terms of time and staff, avoid unnecessary hospitalisation and ensure that mentally ill accused will have a fair trial.
Journal Article•
TL;DR: Treatment of OCD can be successful with serotonergic antidepressants, behavior and cognitive therapy, but the combination of antidepressants with behavior therapy treatment does not enlarge the efficacy of behavior therapy alone.
Abstract: In this review diagnosis, epidemiology, etiology, assessment and treatments of obsessive compulsive disorder (OCD) are discussed. OCD is diagnosed on the basis of a psychiatric interview. OCD can be reliably diagnosed with ADIS, a structured interview for anxiety disorders. The life-time prevalence rate of this chronic disorder is 2.4%. Research on etiological factors has yielded conflicting findings, but treatment of OCD can be successful with serotonergic antidepressants, behavior and cognitive therapy. The treatment effect of cognitive-behavioral therapy is larger than of antidepressants. The combination of antidepressants with behavior therapy treatment does not enlarge the efficacy of behavior therapy alone.
TL;DR: This article addresses the literature on this subject, as well as providing new research data on the use of these instruments from a psychiatric clinic population, and presenting relevant case examples of the Rorschach and Thematic Apperception Test.
Abstract: The need to access the internal mental life of a patient during the diagnostic process is essential and is ordinarily accomplished through self-report data during the psychiatric diagnostic interview. Because of cognititve and verbal limitations, persons with mental retardation, however, are ill-equipped to fully participate in the psychiatric interview. The ability of projective tests to access the patient's inner mental life provides a very helpful diagnostic aid, especially for persons with mental retardation. Psychologists may erroneously assume that such patients may not be able to comply with the testing format. This article addresses the literature on this subject, as well as providing new research data on the use of these instruments from a psychiatric clinic population, and presenting relevant case examples. The Rorschach is especially useful in identifying psychotic processes and thought disorder in persons with mental retardation. The Rorschach and Thematic Apperception Test are also useful in providing generalized treatment planning, but also in identifying problems in aggression and sexually aberrant behavior. Guidelines for using projective tests will be given, as well as recommendations for the psychological evaluation of persons with mental retardation presenting with psychiatric disorder.