ABSTRACT
Results from a Consumer Reports (CR) survey indicated that psychotherapy has proven to be quite effective and that longer-term therapy has been more effective than shorter-term therapy. Critiques of the methodology of this study have included the claim that (a) the self-selected sample was biased in favor of people who felt that they had benefited from psychotherapy, (b) the use of retrospective accounts led to a further positive bias, and (c) the validity of the outcome assessment was questionable. Supplemental data from other sources, including prospective data from a large sample of psychotherapy patients, are presented to augment the interpretation of the results of the CR study and to illustrate how some critiques of research results can be evaluated systematically.
Subject(s)
Consumer Behavior , Mental Disorders/therapy , Psychotherapy/statistics & numerical data , Adult , Female , Humans , Male , Middle Aged , Prospective Studies , Retrospective Studies , Surveys and Questionnaires , Treatment OutcomeABSTRACT
This study addressed whether the fact that the initial screening interview was with the treating therapist or with another clinician differentially affected engagement in treatment for those patients who actually entered psychotherapy. Patients (N = 418) accepted for individual psychotherapy were separated into two groups: (1) those who entered therapy with the same clinician who did the intake screening (same); and, (2) those who saw one clinician for intake screening and were subsequently assigned to another clinician for therapy (different). Chi-square was used to test the hypothesis that a greater proportion of patients who saw the same clinician from the beginning would complete at least 8 sessions of psychotherapy than would those who saw a different clinician. The results indicated that a greater proportion of patients who were assigned to therapy with the same clinician who conducted the initial screening evaluation returned for their next appointment. However, a greater proportion of patients who saw one clinician for intake screening and were assigned another clinician for therapy continued beyond eight sessions.
Subject(s)
Patient Dropouts/psychology , Physician-Patient Relations , Psychotherapy/methods , Adolescent , Adult , Aged , Female , Humans , Interview, Psychological , Male , Middle Aged , Psychiatric Department, HospitalABSTRACT
Pseudomonas aeruginosa auricular perichondritis can be a serious and expensive postoperative infection requiring prolonged hospitalization and intravenous administration of antibiotics. Oral antimicrobial agents have not been effective in the treatment of serious P. aeruginosa infections. Recently completed clinical trials have shown that oral ciprofloxacin, one of the new fluoroquinolone antimicrobials, is effective in the treatment of certain P. aeruginosa infections. We report two cases of P. aeruginosa auricular perichondritis successfully treated as outpatients with oral ciprofloxacin. This article also reviews the salient features of the new fluoroquinolones and their impact on antimicrobial therapy of serious skin and skin-structure infections.
Subject(s)
Ciprofloxacin/administration & dosage , Otitis Externa/drug therapy , Pseudomonas Infections/drug therapy , Administration, Oral , Aged , Female , Humans , Male , Middle Aged , Otitis Externa/etiologyABSTRACT
The atypical or environmental mycobacterial organisms constitute a large group of potential agents in the pathogenesis of cutaneous infection. The most commonly encountered mycobacterial infection after contact with water is Mycobacterium marinum. We report an unusual case of cutaneous mycobacterial infection caused by a newly described opportunistic mycobacteria, M. avium-intracellulare scrofulaceum intermediate. This case emphasizes the difficulty in distinguishing among the species M. avium-intracellulare, M. scrofulaceum, and M. gordonae.
Subject(s)
Leg Dermatoses/microbiology , Mycobacterium avium-intracellulare Infection , Adult , Humans , Leg Dermatoses/drug therapy , Male , Mycobacterium avium-intracellulare Infection/drug therapy , Recreation , Tetracycline/therapeutic use , Water MicrobiologyABSTRACT
Dematiaceous fungi have a diverse clinical spectrum that presents a difficult problem in diagnosis and treatment. These opportunistic pathogens are of concern in healthy, debilitated, or immunocompromised individuals. We describe three patients with localized cutaneous infections produced by dematiaceous filamentous fungal organisms with varying clinical presentations. Two patients were immunocompromised, and a third was otherwise healthy. The unusual clinical and unique histologic features of these difficult infections are reported in detail, as is their successful medical management with ketoconazole (Nizoral) and an experimental antifungal agent, fluconazole.
