ABSTRACT
Creation of a comprehensive mental health telecommunications system to serve isolated persons in Georgia, resulting in a more equitable distribution of mental health resources, is the goal of the telepsychiatry program at the Medical College of Georgia. Although telepsychiatric consultation is not a new idea, the "distribution" of telepsychiatry through additional integrated telecommunications channels such as the World Wide Web is a distinctive approach. This report describes the history of the development of the MCG Telepsychiatry Program. Through the use of a multichanneled telecommunications system, a more equitable distribution of mental health resources is underway in Georgia.
Subject(s)
Psychiatry/organization & administration , Telemedicine/organization & administration , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Georgia , Health Services Accessibility , Humans , Male , Middle Aged , Program Development , Psychiatry/trends , Telecommunications , Telemedicine/trendsABSTRACT
BACKGROUND: Personality disorders in medical patients have received less attention than depression, anxiety, or somatization. METHOD: We conducted a selective literature search to assess the role of personality disorders in medical patients. RESULTS: Review of recent studies suggests a high prevalence and morbidity of personality disorders in medical populations. Important correlates in selected groups are depression, somatization, noncompliance, sexual risk taking, and substance abuse. Difficulties in physician-patient relationships are also frequently reported. Psychiatric interventions are considered beneficial, though no single treatment of choice is available. CONCLUSIONS: We recommend that physicians consider the possibility of personality disorders in medical patients to choose appropriate treatments for selected symptoms. Training in interviewing skills may enhance recognition of personality disorders and management of associated psychiatric conditions.
Subject(s)
Personality Disorders/diagnosis , Humans , Personality Disorders/classification , Personality Disorders/therapy , Physician-Patient Relations , Primary Health CareABSTRACT
A patient with recurrent, life-threatening water intoxication secondary to compulsive water drinking is described. This patient responded well to nearly 1 g of propranolol daily with a decrease in her drinking behavior, reduced sensation of thirst, and a reduction in her delusional thinking. The rationale for the choice of propranolol with this patient is reviewed.
Subject(s)
Compulsive Behavior/drug therapy , Drinking/drug effects , Propranolol/therapeutic use , Adult , Compulsive Behavior/psychology , Female , Humans , Recurrence , Schizophrenia, Paranoid/complications , Schizophrenic Psychology , Sodium/blood , Water Intoxication/drug therapy , Water Intoxication/psychologyABSTRACT
1,000 medical and surgical inpatients referred for psychiatric conSULTATION SHOWED CONCURRENT PHYSICAL AND PSYCHIATRIC DISORDER IN 68.2% of cases. This is in accordance with epidemiological findings that these two types of morbidity have a positive association and coexist in 20-50% of patients. Depression was the commonest psychiatric disorder in all classes of organic disease and accounted for 53% of all psychiatric diagnoses. Organic brain syndromes, acute and chronic constituted 18% of referrals. Almost twice as many women as men were referred despite their nearly equal distribution in hospital population. One-third of the females had no positive medical diagnosis compared to one-fifth of the men. Alcoholism was a major problem in 8.9% of referrals. 7.8% of patients were referred following suicidal attempt. Of the 50 patients with cancer. 66% had depression. Too few medical patients with psychiatric complications are referred and adequately treated. Greater emphasis on teaching psychiatric syndromes is called for. Psychiatric consultation-liaison services offer the most direct form of collaboration between psychiatry and medicine in the interests of comprehensive patient care.
Subject(s)
Hospitals, General , Psychiatric Department, Hospital , Referral and Consultation , Adult , Age Factors , Aged , Alcoholism/epidemiology , Depression/epidemiology , Female , Hospitals, Teaching , Humans , Male , Mental Disorders/diagnosis , Middle Aged , Neurocognitive Disorders/epidemiology , New Hampshire , Sex FactorsABSTRACT
The term "psychosurgery" encompasses a wide variety of different neurosurgical procedures applied in the treatment of behavioral and psychiatric disorders. Arguments about the effectiveness and ethicality of psychosurgery are often based on studies using outdated procedures or inappropriate patient populations. The debate over psychosurgery is also obscured by the frequent confusion between its use in classical psychiatric syndromes and in such controversial areas as aggression or violent behavior associated with temporal lobe epilepsy. The author believes that such factors need to be clarified so that practitioners can choose a personal position based on sound medical fact.
