ABSTRACT
While seeking research subjects to test the effect of hemodialysis on schizophrenia, the authors noted that the relatives of schizophrenic patients tried to involve themselves excessively in the selection process. Of 27 patients referrals meeting diagnostic criteria for schizophrenia, only one contact was initiated by the patient; the rest were initiated by family members. In more than half of the family-initiated contacts relatives attempted to become excessively involved in the patient's decision making. The authors discuss these observations in light of family theories of schizophrenia. They urge caution in selecting subjects for research that attempts to test other researchers' earlier claims which may have stimulated premature hope of improvement.
Subject(s)
Decision Making , Family , Research , Schizophrenia/therapy , Adult , Coercion , Female , Humans , Male , Professional-Family Relations , Renal Dialysis , Research Personnel , Scapegoating , Schizophrenia/genetics , Schizophrenic PsychologyABSTRACT
The authors present 3 cases of childbirth-related psychosis in young women to illustrate an interpersonal psychodynamic pattern that may contribute to such reactions. In each instance, the woman is the submissive partner in a symbiotic relationship with her husband and/or mother. The baby's presence threatens the symbiotic equilibrium of these relationships and leads to the dominant partner's overt or covert aggression against the woman, which precipitates the psychosis. A personal or family history of psychosis may increase the woman's vulnerability to becoming psychotic in this situation.
Subject(s)
Family , Object Attachment , Psychotic Disorders/psychology , Puerperal Disorders/psychology , Adult , Aggression/psychology , Bipolar Disorder/psychology , Female , Humans , Pregnancy , Suicide, Attempted/psychologyABSTRACT
The need for continuing care of chronic psychiatric patients within the community is a pressing problem that calls for development and testing of new treatment methods. This paper describes one such method, the Continuing Care Clinic, an outpatient program for chronic patients who have not responded well to other outpatient treatment approaches. The clinic's structure, treatment rationale and procedures, and clinical results over a 31/2-year period are described. Among specific treatment features discussed are the use of multiple therapists, focus on available personality strengths and on reality issues, and patient-staff group interaction as an adjunct to individual psychotherapy.
Subject(s)
Aftercare , Mental Disorders/rehabilitation , Outpatient Clinics, Hospital , Adaptation, Psychological , Chronic Disease , Continuity of Patient Care , Evaluation Studies as Topic , Humans , Michigan , Patient Readmission , Professional-Patient Relations , Psychiatry/education , Psychotherapy, Multiple , SocializationABSTRACT
The incidence and patterns of drug overdose admissions to the University of Michigan Medical Center Emergency Suite were studied for the first 3 months of each year from 1956 to 1970. Among variables investigated with regard to age, sex, and time comparisons were types of drugs used, purpose of ingestions, medical condition on arrival, disposition after emergency care, and history of treatment for emotional problems. The continuing escalation in drug overdose emergencies, primarily related to intentional self-poisoning, reflects the growing social health problems of drug use proliferation and rise in suicide attempts over the past two decades. Emergency room resources are being increasingly taxed by the psychological and medical care needs of these cases. Renewed effort toward primary prevention is essential.
