Subject(s)
Anxiety/chemically induced , Lactic Acid , Panic Disorder/chemically induced , Panic Disorder/diagnosis , Stress Disorders, Post-Traumatic/diagnosis , Adult , Analysis of Variance , Anxiety/diagnosis , Diagnosis, Differential , Female , Humans , Infusions, Intravenous , Male , Middle Aged , Panic/drug effects , Panic/physiology , Psychiatric Status Rating Scales/standards , Stress Disorders, Post-Traumatic/complicationsABSTRACT
OBJECTIVE: Sodium lactate infusion has induced flashbacks accompanied by panic attacks in male combat veterans with posttraumatic stress disorder (PTSD) and concurrent panic disorder. This study addressed whether sodium lactate induces flashbacks or other intrusive PTSD symptoms in PTSD patients free of concurrent panic disorder. METHOD: Behavioral, cardiovascular, catecholamine, and cortisol responses to infusion of 0.5 M sodium lactate were compared among seven subjects with PTSD without panic disorder, seven subjects with panic disorder only, and seven healthy subjects. RESULTS: Six of the seven PTSD subjects but no panic disorder or healthy subjects reported flashbacks or other intrusive PTSD symptoms during lactate infusion. Flashbacks were accompanied by substantial anxiety symptoms. Cortisol levels were low in the PTSD subjects. CONCLUSIONS: Sodium lactate induces flashbacks in persons with PTSD without comorbid panic disorder. The relationship between anxiety responses accompanying a PTSD flashback and those in a panic attack remains unclear.
Subject(s)
Blood Pressure/drug effects , Epinephrine/blood , Hydrocortisone/blood , Norepinephrine/blood , Sodium Lactate/pharmacology , Stress Disorders, Post-Traumatic/chemically induced , Adult , Comorbidity , Female , Heart Rate/drug effects , Humans , Infusions, Intravenous , Male , Memory/drug effects , Middle Aged , Panic Disorder/blood , Panic Disorder/chemically induced , Panic Disorder/psychology , Sodium Lactate/administration & dosage , Stress Disorders, Post-Traumatic/blood , Stress Disorders, Post-Traumatic/psychologyABSTRACT
The number of beds identified among 308 community mental health centers in operation in 1972 bore little relation to inpatient case load or to the proportion of center patients likely to require hospitalization. Analysis of occupancy data indicated that there was a surplus of beds in many centers. These findings suggest a lack of effective planning for community mental health center impact on the nature of psychiatric treatment provided. This is suggested by the close relationship between inpatient capacity and average duration of stay.
Subject(s)
Community Mental Health Services , Health Facility Planning , Health Planning , Health Services Needs and Demand , Hospitalization , Adolescent , Adult , Aged , Bed Occupancy , Community Mental Health Services/statistics & numerical data , Humans , Length of Stay , Middle Aged , Socioeconomic FactorsABSTRACT
Program evaluation is a new field vested with high and often unrealistic and conflicting expectations from many quarters. Instead of being clear and realistic, evaluators have tended to react blindly to the various demands, compounding the confusion by engaging in unproved, even potentially counterproductive, efforts. A more constructive type of evaluation is needed--a cooperative enterprise in which information is obtained as a service for a client, with his full and meaningful participation in designing the evaluation and in the interpretation and implementation of the results.
